17 Aug THE ART OF BEING A CARETAKER PART 3
The mental health of the patient is also strengthened by obtaining for them blessings from a Gadol, and informing them that people are praying for them by the Kosel and by kivrei Tzadikim, the graves of our Sages. Hearing that friends are regularly saying Tehillim for them is also encouraging. So too is knowing that people are giving tzedakah for their speedy recovery.
In general, it is a great balm for the patient to know that they have friends who are thinking of them. I have always wondered why the Hebrew word for friend, rai-echa shares the same shoresh / root word as ra, evil! After all, one of life’s greatest treasures is a good friend. Good times are doubled when you have a friend to share them with and troubles are halved when you have a friend to commiserate with you. I think the answer is that you can tell who your friends really are in ‘bad’ times, and hence the connection to the word ra. Fair-weather friends disappear when times are tough but true friends really come to the surface when things get choppy.
It is obvious that to maintain the patient’s mental health, the caretaker has to help their charge be as pain-free as possible. This can be a daunting task when dealing with something as thorny as cancer breakout pain. However, you must know that with today’s sophisticated medicine, there should be no excuse for the choleh to be suffering in constant pain. Boruch Hashem, today we have a vast arsenal of pain killers to deal with pain. From Percocet to slow release Morphine to Fentanyl patches and sprays, there should be a way to keep the pain under control. Of course, dealing with the side effects of these powerful drugs is a delicate tightrope. Constipation can be a big problem. Even more serious is the balancing act between chasing away pain and enhancing the patient’s quality of life as opposed to their being in a sleepy, drug-hazed existence induced by too many pain meds. Even more serious is the real possibility of stopping a person’s breathing by over-medicating.
For non-terminal conditions, there is also the serious specter of addiction which needs to be considered. In hospitals such as Sloane Kettering, the patient is assigned a pain management specialist. In other cases, the oncologist is an expert in this branch of medicine. Yet other times the family has to bring in a specialist on their own. Either way, this is a quality of life issue of paramount importance that needs constant attention and may require frequent alterations. There are times that the choleh gets used to a specific medicine and it needs to be changed. Other times there is a remission and the meds can be significantly reduced. Also, be aware that the correct approach is often not achieved on the first attempt but is reached by trial and error and delicate calibration.
This is a good place to speak about proper medical insurance. Many pain meds are very, very expensive. Having a good insurance plan can make a difference in obtaining the most effective meds. Organizations such as R.C.C.S. might be able to help guide you on how to upgrade your insurance. A compassionate oncologist might be able to get the patient on a program to receive sophisticated pain killers or he/she might have samples to help out. Good insurance is critical in many other ways such as getting approval for immunotherapies and helpful testing.
It is also important to have an oncologist with ethical integrity. Unfortunately, if a physician is greedy, economics can dictate medical decisions. Changing a patient’s chemo regimen when the cancer markers are skyrocketing can mean losing data for a profitable study. Moving a patient off chemo-therapy to some immunotherapy drugs might be beneficial to the patient but can significantly reduce the physician’s profits.
It is not only pain meds that demand the caretaker’s attention. Sleep is imperative for healing and for the strength to fight diseases and tolerate treatment. But worries about one’s future, fear of treatments, surgery and pain, and of course the pain itself can make sleep very difficult. Sleeping pills can make a big difference in the patient’s quality of life. Sometimes the use of pain meds which also can make a person drowsy negates the need of sleeping aids. The interaction between the sleeping pills and pain meds also needs to be monitored. Then, there is the sagacious usage of anti-depressants and anti-anxiety medicines. When someone is suffering from a dangerous or a debilitating disease, they can get quite depressed or anxious. It is wise to have a proper psychiatric advisor to assist in buoying the spirits of a suffering choleh.