Thursday, August 10, 2017

Estoy contemplando cual es peor.

August came, and with it I have transitioned to night float. Somehow, it seems much more difficult to balance work and life outside of work when one is awake all night.  I mean... it has taken me three days to even finish this post. Perhaps, it is just me, and the fact that I am not a fan of working the night shift. Whine aside, I am thankful the month seems to be moving quickly.

In America, the general population very commonly has multiple medical problems. As a whole, we don't take very good care of ourselves. One way to avoid this problem, is to never go to the doctor.  We see it once in awhile. 55+ year old individual who comes to the hospital reporting no past medical history, but at the same time hasn't been to see a doctor in over 30 years. Guess what... they're not as healthy as they believe themselves to be. Far from it usually. And in accordance with their stubbornness, the reason for finally bringing them to the hospital has typically already been festering and ignored for weeks.

We had an individual come to us the other night after finally being forced to present to the hospital by his sister. Complaint was three weeks of abdominal pain. Upon further investigation, as I'm sure you've guessed, the story was so much bigger.

We found an 8cm abdominal aortic aneurysm threatening to burst with each bounding pulsation. We also found a 10cm mass overtaking his lung. He confessed he'd quit smoking on his way to the hospital. Too little. Too late.

Options were presented to him.
1) Just a guesstimate, life expectancy of maximum 6months from what was almost certainly lung cancer.
2) Possible sudden death at any unpredictable time from a ruptured abdominal aortic aneurysm.
3) Repair of the AAA, preventing possible sudden death, but taking on the risk of surgery which includes bleeding, infection, respiratory failure requiring intubation unknown ability to extubate, paralysis of lower extremities, kidney failure, and of course death... just to name a few.  And should he even recover, then still with a 6month life expectancy.
4) Do nothing, and let nature take its course.

He couldn't give us an answer that night. We didn't blame him.

What would you do?

Much love.

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