You've been entrusted with making difficult health care decisions for older loved ones. It's a great honor and a grave responsibility. So here's the first tough question: Do you actually know what the patient would want?
Chances are, the answer is no.
In a newly published study, researchers at Yale University interviewed 350 patients aged 55 and older in the VA Connecticut Healthcare System, and the people entrusted to make health care decisions for them (health care surrogates).
While 75 percent of surrogates expressed high confidence in their knowledge of patients' preferences, only 21 percent knew what the patient would want in the event of severe physical problems causing them to be bedbound; severe mental decline that left them unable to recognize family members; and severe daily pain.
The problem, said the researchers, is that surrogates are often not part of actual advance care planning. Older people often find themselves filling out forms alone. "Advance care planning cannot focus on the patient alone. The health care agent has to be brought into the conversation," said study leader Terri Fried, a professor of medicine at Yale University.
Body of Knowledge
A baby cannot taste salt until roughly four months old, writes Georgina O'Hara in her book "The World of the Baby." The delay may be related to the development of kidneys, which start to process sodium around that age.
Get Me That, Stat!
In 2017, 70,237 people died from drug overdoses in the United States, the most ever in a single year and more than any peak year for deaths from HIV, car crashes or gun violence. According to the Centers for Disease Control, the abundance of overdose deaths has actually reduced the overall life expectancy in the United States by four months over the past three years. Drug overdoses are now the leading cause of death for adults under 55.
Doc Talk
Bolus: A large dose of a drug that is given (usually intravenously) at the beginning of treatment to raise blood-level concentrations to a therapeutic level
Phobia of the Week
Alektorophobia: Fear of chickens (not to be confused with being chicken)
Number Cruncher
A double-double burger with onion from In-N-Out (330 grams) contains 670 calories, 369 from fat. It has 41 grams of total fat or 63 percent of the recommended total fat intake for a 2,000-calorie daily diet, according to the Calorie Count database.
It also contains 120 milligrams of cholesterol (40 percent); 1,440 milligrams of sodium (60 percent); 39 grams of total carbohydrates (13 percent); 3 grams of dietary fiber (12 percent); 10 grams of sugar; 37 grams of protein.
Never Say "Diet"
The Major League Eating record for bacon is 182 pieces in five minutes, held by Matt Stonie, outstripping his competition.
Best Medicine
A man went to see his doctor because he was suffering from a terrible cold. The physician prescribed some pills, but they didn't help, and the man returned the next day. The doctor gave him an injection, but that didn't improve the man's cold either.
On his third visit, the doctor told the man to go home and take a hot bath, immediately followed by standing outside in the cold. "But doc," protested the patient, "If I do that, I'll get pneumonia."
"I know," replied the physician. "I can cure pneumonia."
Observation
"Isn't it a bit unnerving that doctors call what they do 'practice'?" — Comedian George Carlin (1937-2008)
Hypochondriac's Guide
Hemiasomatognosia: A neurological condition in which a person, typically after suffering a stroke or other brain injury, loses sense of about half of their body, leading to neglect of it. In this subset of anosognosia, people with certain disabilities seem unaware of their disability's existence.
Medical History
This week in 1985, Mary Lund of Minnesota became the first woman to receive a Jarvik 7 artificial heart in Minneapolis. Lund received a human heart transplant 45 days later. She survived until October 1986. The Jarvik 7 has two pumps, much like the heart's ventricles. Each sphere-shaped polyurethane "ventricle" has a disk-shaped mechanism that pushes the blood from the inlet valve to the outlet valve. The ventricles are powered by air pulses at rates of 40 to 120 beats per minute. The artificial heart is attached to the heart's natural atria by cuffs made of Dacron felt. The drivelines exit the left side of the body to an external air power supply.
Self-Exam
Q: How many human senses are there?
A: The simplest answer is five: sight, sound, taste, smell and touch. However, researchers generally say there are more, though a precise number remains much in debate. Among the additional "senses" are pressure, itch, temperature, pain, thirst, hunger, direction, time, muscle tension, proprioception (the ability to tell where your body parts are, relative to other body parts), equilibrioception (the ability to keep your balance and sense body movement in terms of acceleration and directional changes), stretch receptors (these are found in such places as the lungs, bladder, stomach, blood vessels and the gastrointestinal tract) and chemoreceptors (which trigger an area in the brain involved in detecting blood-borne hormones and drugs — also involved in the vomiting reflex).
Epitaphs
"Don't try." — Gravestone of German-born American poet Henry Charles Bukowski (1920-1994)
The phrase, used in one of his poems, alludes to his advice to aspiring writers. Asked to explain, he once said, "Somebody asked me, 'What do you do? How do you write, create?' You don't try, I told them. You don't try. That's very important: not to try, either for Cadillacs, creation or immortality. You wait, and if nothing happens, you wait some more. It's like a bug high on the wall. You wait for it to come to you. When it gets close enough you reach out, slap out and kill it. Or if you like its looks, you make a pet out of it."
To find out more about Scott LaFee and read features by other Creators Syndicate writers and cartoonists, visit the Creators Syndicate website at www.creators.com.
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