What is the care given?
The care given is to make the patient as symptom free and comfortable as is possible. The needs of a terminally ill patient are many: medical, nursing, mental, social, spiritual and financial. The care given, therefore is with a team effort, each member of the team looking after the needs of the patient in his or her specialty. The team consists of doctors, nurses counselors, volunteers and spiritual advisors, to offer “total: care to the patient.
Is Cancer treatment given?
No specific treatment for the Cancer is given, as all this has already been exhausted before the patient is admitted. Besides, there are no infrastructure facilities for Cancer treatment, and hence it would be unfair to any patient who can still benefit from Cancer treatment, even for palliation, to be admitted in the Sadan.
Are extraordinary life maintaining measures used?
Our goal is to “Add life to days, and not days to life”. A terminally ill patient who has no hope for recovery, will not benefit from any extraordinary life maintaining measures, like a respirator, intravenous drips or alimentation, blood transfusions, etc. These measures make the patient more uncomfortable and miserable and uselessly prolong suffering. They are hence strictly avoided.
Is there need for an Intensive Care Unit?
It follows that if extra-ordinary life maintaining measures are not contemplated, then the ICU is the very last place a terminally ill patient should be placed in. Instead, they should be in their own bed, surrounded by the family and friends, and the discomfort of unnecessary supportive measures.
What is symptomatic care?
The relief of distressing symptoms is the primary goal of palliative care. Once the patient is free from symptos, especially severe pain and other distressing symptoms of Cancer like breathing difficulty, nausea and vomiting, cough, sleeplessness etc., he/she becomes a different person and can then attend to their other needs. Symptomatic care is therefore individualized to the needs of each patient with all the necessary medication needed, to make him or her as comfortable as possible.
How is pain controlled?
Pain is first evaluated to detect its cause, site and intensity. It is then graded as mild, moderate or severe, and accordingly treated. Mild pain is treated with mild analgesics like NSAIDS and others, moderate pain is treated with mild opiates like Codeine and severe pain is managed with strong opiates like Morphine. The pain medication is preferably given orally wherever possible, by the clock – every four hours for a cumulative effect, and constantly monitored as per needs of the patient so that he/she remains totally pain free.
What are opiates?
Opiates are obtained from the poppy plant and are the best drugs to control severe pain. The main drug used is Morphine, which is best used in the oral form, whenever possible. The dose is gradually increased till the patient becomes pain free. It is also continued with other supportive drug groups, which help to reduce the dosage and increase the response.
What are the side effects of Morphine?
What Morphine is initially given, there may be some nausea, drowsiness, and disorientation. These are transient side effects which are controlled with medication and pass away once the patient gets used to the Morphine. The main side effect of all opiates is constipation. This has to be anticipated by giving the necessary laxatives and mechanical bowel cleaning, when opiates are started so that it does not become a difficult problem.
What are the myths regarding opiates?
There are several myths regarding opiates:
1. It is addictive. Opiates are not addictive when used for pain relief.
2. It makes one a zombie. We have patients on large doses, who are alert and active as ever, doing everything.
3. Large doses are given. The dose is given per the need. Large doses, even up to several thousand milligrams can be tolerated because the patient develops an increasing tolerance to the drug which a normal individual does not have.
What is Complimentary medicine?
There are medications and compounds which have not shown a definite response in the treatment of Cancer. Some of them have shown some beneficial response in some cases. We intend to us some of these selected compounds for better palliation of the advanced Cancer patients.
What is Holistic medicine?
Every human being is a complex fusion of body, mind and soul. Holistic medicine means treating the patient in all these aspects to give complete care.
Is Alternate medicine permitted in the Sadan?
Alternate systems of medicine like Ayrvedic, Homepathic, Unani, Herbal etc, are often practiced in our country. We do not permit these systems to be used by outside doctors in the Sadan, simply because we do not know how they would react with our own medications. We therefore advise the patient who would like to try these methods, to do it at home or elsewhere, and come to us when they have finished with them.
What is the main goal of the treatment?
The first goal is to make the patient free of pain and distressing symptoms. Once this is achieved, we then help them to come to terms with their disease and impending death, so that they accept the same and are then at peace with themselves, their families and their God.