Doa pelindung & penawar angin ahmar
Posted by nurjeehan in Doa & Zikir, Petua & Amalan. 52 Comments
PENYAKIT Angin Ahmar ialah penyakit mati sebahagian badan, yang biasanya datang dengan tiba-tiba dan sukar pula untuk diubati. Walau bagaimanapun, dengan rahmat dan belas kasihan Allah swt kepada hamba-hambaNya maka melalui Nabi Muhammad s.a.w., umat Islam dikurniakan doa yang sangat mustajab dan besar faedahnya bagi menjauhi penyakit tersebut disamping lain-lain penyakit berbahaya dan bala bencana.
Amalkanlah membaca doa ini selalu, paling kurang sekali seumur hidup. Dengan mematuhi kaedah dan adab-adab berdoa disamping berikhtiar, Insya Allah, mudah-mudahan doa kita dikabulkan dan kita terhindar dari penyakit yang berbahaya ini.
Maksudnya:
Dengan nama Allah Yang Maha Pemurah lagi Maha Penyayang; dan dengan-Nya kami memohon pertolongan; dan dengan Allah; dan dari Allah; dan kepada Allah; dan segala pujian tertentu bagi Allah; dan tiada Tuhan melainkan Allah; dan Allah Maha Besar, yang Maha Mulia dan Maha Agung; yang aku takut dan bimbang terhadap-Nya. Allah Maha Besar dengan segala kebesaran-Nya; segala pujian tertentu bagi Allah, sebanyak-banyak pujian. Dan Maha Suci Allah pagi-pagi dan petang-petang. Dengan nama Allah yang menyembuhkan, dengan nama Allah yang mencukupkan; dan dengan nama Allah yang menyihatkan; dengan nama Allah yang dengan nama-Nya tiada memberi mudharat sesuatu apa jua di bumi dan di atas langit, dan Dia Maha Mendengar lagi Maha Mengetahui. Dan Kami turunkan sesetengah dari Al-Quran yang menjadi penawar dan rahmat untuk orang-orang yang beriman.
Ya Allah, aku yang menjampi dan Engkau yang menyembuhkan. Aku berlindung dengan-Mu daripada kejahatan yang telah Engkau takdirkan. Allah Maha Besar, Allah Maha Besar, Allah Maha Besar. Aku berlindung dengan Allah, Tuhanku dan Penciptaku, Pembentukku dan Pencipta Rupabentukku dan Pemberi Rezeki sekalian manusia. Aku berlindung dengan Allah daripada sekalian kebinasaan, dan segala maksiat, bala bencana, penyakit dan segala kesakitan, kemalasan, kemunduran dan kebinasaan.
Ya Allah, lindungilah penanggung (pengguna) suratku ini dengan nama-Mu yang Maha Mulia dan Maha Agung; dan sifat-sifat-Mu yang sempurna, wahai Yang Mempunyai Kebesaran dan Kekayaan. Wahai Tuhan yang memiliki kerajaan dan alam malakut; wahai Tuhan yang memiliki keagungan dan kegagahan. Maha Suci Engkau, alangkah besarnya Engkau wahai pencipta segala langit dan bumi. Wahai Tuhan tempat berlindung mereka yang menyesal (akan dosa-dosa mereka); wahai Tuhan yang Maha Pengasih terhadap orang-orang miskin; wahai Tuhan pemilik kebesaran dan kekuasaan, wahai Tuhan yang mempunyai belas kasihan dan memberi kebajikan dan Ihsan; wahai Tuhan yang banyak kasih sayang, wahai Tuhan yang banyak memberi; wahai Tuhan yang Maha Gagah dan tiada sesiapapun yang mampu mengalahkan-Nya; wahai Yang Melindungi dan Dia tidak memerlukan perlindungan, aku berlindung dengan-Mu dari azab ke atas badan dan kesempitan; dan aku berlindung dengan-Mu dari penyakit Angin Ahmar dan penyakit yang besar yang menimpa ke atas diri dan roh, darah dan daging, tulang dan kulit, urat dan urat saraf.
Maha Suci Engkau; yang apabila Engkau menghendaki sesuatu maka Engkau hanya mengatakan “Jadilah! Maka jadilah ia”. Allah Maha Besar, Allah Maha Besar, Allah Maha Besar. Wahai Tuhan yang menjadikan; wahai Tuhan yang membuat kebajikan, wahai Tuhan yang memberi pertolongan, wahai Tuhan yang Maha Gagah, wahai Tuhan yang Maha Adil, wahai Tuhan yang Berdiri dengan Keadilan, wahai Tuhan yang mendengar tangisan orang-orang yang meminta pertolongan. Wahai Tuhan yang memulakan (dari tiada kepada ada), wahai Tuhan yang mengembalikan, wahai Tuhan yang menolak, wahai Tuhan yang Mencukupkan. Wahai Tuhan yang menyembuhkan, wahai Tuhan yang meng’afiatkan, wahai Tuhan yang memberi pertolongan terhadap orang yang memohon pertolongan.
Wahai Tuhan yang menerima kesyukuran, wahai Tuhan yang banyak memberi balasan atas kesyukuran. Wahai Tuhan yang Maha Kasih Sayang, wahai Tuhan yang Maha Belas Kasihan, wahai Tuhan yang memberi pertolongan, wahai Tuhan yang Maha Berkuasa, wahai Tuhan yang Maha Gagah, wahai yang Maha Berkuasa, wahai Tuhan yang Maha Agung, wahai Tuhan yang mendahulukan, wahai Tuhan yang mengkemudiankan. Wahai Tuhan yang hidup, wahai Tuhan yang berdiri dengan sendiri-Nya, yang membalas mereka yang jujur dengan balasan ke atas tiap-tiap diri dengan apa yang mereka usahakan. Wahai Tuhan yang memerintahku, wahai Tuhanku yang memiliki aku, wahai Tuhan yang memberi perlindungan.
Wahai yang Maha Mengetahui sesuatu yang kami sembunyikan dan kami dedahkan; wahai Hakim yang menjatuhkan hukuman, wahai Tuhan yang memerintah sekalian orang-orang yang beriman; wahai Tuhan pembantu orang-orang yang dhaif dan miskin; wahai Tuhan yang Mencukupi keperluan orang-orang yang bertawakkal.
Wahai Tuhan yang mendatangkan malam ke atas siang dan siang ke atas malam; wahai Tuhan yang Gagah (mengalahkan) setiap syaitan yang sangat durhaka, wahai Tuhan yang mengalahkan setiap orang yang sombong lagi degil; wahai Tuhan sebaik-baik Pemerintah; wahai Tuhan yang sebaik-baik memberi pertolongan, wahai Tuhan yang memberi rezeki kanak-kanak yang kecil, wahai Tuhan yang Maha Pengasih terhadap orang tuan (yang sangat tua), wahai Tuhan yang memerintah orang-orang yang beriman; wahai Tuhan bagi orang-orang yang dahulu dan orang-orang yang kemudian; wahai Tuhan yang pengasih kepada orang-orang yang bertaubat, wahai Tuhan yang Maha Pengasih dari kalangan yang mengasihi. Wahai Tuhan sebaik-baik pengampun dari yang mengampuni; wahai Tuhan sebaik-baik pewaris; wahai Tuhan sebaik-baik Pemberi Keputusan; wahai Tuhan yang memerintah pada Hari Pembalasan.
Ya Allah, hanya Engkaulah yang aku sembah dan hanya kepada Engkaulah aku memohon pertolongan. Dan kepada-Mu aku bertawakkal. Dan kepada-Mu aku gemar dengan apa yang ada di sisi-Mu. Kepada-Mu aku berharap dan hanya Engkau yang aku takuti. Ya Allah, peliharalah aku dari segala kepayahan hidup dan penyakit-penyakit dan segala kesakitaan dan kesusahan dan darah hitam.
Ya Allah, peliharalah aku dari penyakit yang merbahaya dan dari penyakit Angin Ahmar dan penyakit darah kuning, dan segala kebinasaan dan segala maksiat dan pengsan, dan kerungsingan dan kesedihan dan dukacita dan dari di penjara. Ya Allah, peliharalah aku dari kejahatan binatang buas, dan binatang yang melata, serta permusuhan (benci membenci) orang awam, dan dari kekalahan dan kejahatan syaitan; dan raja, kemarau, kemahalan barang keperluan, dan gempabumi, dan bala bencana, dan keruntuhan bangunan, dan serangan musuh. Ya Allah, peliharalah aku dari kejahatan orang-orang yang jahat dan tipudaya orang-orang yang melampau, dan dari sesuatu yang silih berganti atasnya oleh malam dan siang melainkan yang datang itu adalah dengan baik, wahai Tuhan yang Maha Pengasih lagi Maha Penyayang.
Aku berlindung dengan Engkau dari kejahatan setiap kejadian yang Engkaulah pemegang ubun-ubunnya; sesungguhnya Tuhanku di atas jalan yang tegak dan lurus. Engkau ialah Tuhanku dan di atas Engkau jua aku bertawakkal, dan Engkaulah yang Mencukupkan aku, dan sebaik-baik yang Mewakili, sebaik-baik Pemerintah dan sebaik-baik yang Memberi Pertolongan. Dan tiada daya upaya bagiku melainkan dengan Allah yang Maha Tinggi lagi Maha Agung.
Dan cukuplah kami oleh Allah, dan sebaik-baik yang mewakili sebagai Pemerintah dan Engkau sebaik-baik pemberi pertolongan. Allah yang mencukupkan, Allah yang menyembuhkan, Allah yang memberi a’fiat. Dan ucap selawat oleh Allah ke atas penghulu kami Nabi Muhammad dan ke atas keluarga dan sahabat-sahabatnya; selamat sejahtera; dan segala pujian bagi Allah Tuhan Pemerintah Seluruh Alam. Amin…
http://nurjeehan.wordpress.com
Sunday, 28 March 2010
Saturday, 27 March 2010
STROKE
How Is A Stroke Treated?
A stroke is a medical emergency, regardless of whether it is a major stroke or a short-lasting TIA. A person suffering a stroke should be taken immediately to a hospital emergency department.
The ability to pinpoint quickly the precise location of a stroke and determine the extent of damage is critically important in treatment decisions. A stroke caused by a blocked artery is treated in an entirely different way than a stroke caused by bleeding within the brain.
The key to survival and recovery is prompt medical treatment.
How-To Information:
If a stroke is caused by a blocked artery, medications are now available to reverse damage to the brain and significantly increase the odds of survival. However, these medications are effective only if they are given within a few hours of the time when the first stroke symptoms begin.
Tests That May Be Performed At The Hospital
Scans of the brain are performed to confirm a diagnosis of stroke and to determine the type of stroke. This is important since the treatment of different types of stroke differs.
These tests include:
* Computed tomography scan (CT scan) is generally the first diagnostic test done after a person suspected of having a stroke arrives in the emergency department. The test uses low-dose x-rays to take pictures of the inside of the brain.
For more information about CT Scan, go to Computed tomography scan (CT scan).
* Magnetic resonance imaging (MRI) is an advanced diagnostic tool that uses the principals of magnetism to view the inner body. An MRI of the brain can show small blood vessels that may be blocked or bleeding.
For more information about MRI, go to Magnetic resonance imaging (MRI).
* Transcranial doppler (TCD) is a new, noninvasive ultrasound procedure that uses a small probe placed against the skull to track the blood flow through the vessels in the brain.
* SPECT imaging uses low doses of a harmless radioactive substance injected into a vein in the arm, then uses a specialized camera to view the blood flow in the brain.
Medicines To Treat Stroke
If the stroke A type of cerebrovascular disease that is caused by a sudden interruption of blood flow to a part of the brain, which can kill or damage brain cells. A brain attack. is caused by a blockage:
* Drug therapy is a relatively recent approach to the treatment of stroke. If the stroke is caused by a blockage in an artery, medications called thrombolytic drugs can be used. The only drugs approved by the FDA for treatment of stroke are tissue plasminogen activators (TPA drugs). Popularly referred to as "clot-busting" drugs, these medications have been used for years to treat heart attacks.
Some studies have indicated that if TPA drugs are given to stroke patients within three hours of the onset of symptoms, more than half of them will make a full recovery in a matter of months.
Not all hospitals, however, have the ability to give TPA drugs to people having a stroke. Before these drugs can be given, doctors must be certain that the stroke is the result of a blockage in the artery and not due to bleeding from an artery. This is determined through imaging procedures such as computed tomography (CT) scans and magnetic resonance imaging (MRI). But not all hospitals have around-the-clock imaging services.
If a stroke is caused by bleeding:
* Medication can be given to reduce swelling of brain tissue.
Surgical Procedures
If the stroke is caused by a blockage:
A procedure called carotid endarterectomy The surgical removal of plaque that is blocking or reducing blood flow in a carotid artery. can be used to remove a buildup of plaque Fatty deposits that stick to the inside walls of blood vessels, causing the vessel to become narrow and, in some cases, blocked altogether. from inside the carotid artery The arteries on each side of the neck that carry blood from the heart to the brain., one of the major sources of blood to the head and neck. Carotid endarterectomy can be used to treat people who have had a stroke and also as a preventive measure for people at risk for stroke.
If the stroke is caused by bleeding:
* An artery within the brain sometimes can be "clipped" to prevent further bleeding.
* If the bleeding has occurred in the subarachnoid space, pooled blood (hematoma) can dangerously increase pressure on the brain and damage delicate tissue. If it is feasible, surgery may be necessary to drain blood from within the area of damaged brain tissue.
Other Procedures
Several types of interventional radiology also are available to treat stroke. These procedures have been in existence for some time, but they have been improved and refined in recent years. However, not all hospitals are equipped to offer interventional radiology.
Interventional radiology is performed by inserting a long, thin, flexible tube called a catheter into blood vessels. The insertion point is usually in the groin, and the incision is about the size of the tip of a pencil. The catheter is guided to various parts of the body while a computer tracks it and records images of the blood vessels. This procedure creates a precise road map of even the tiniest vessel in the body.
* The catheters can be guided to areas of bleeding and used to effectively close off the leaking vessels.
* The catheters can be used to widen areas of blood vessels that have become narrowed because of a buildup of plaque.
* The catheters can be used to place stents made of a fine, tubular wire mesh to hold a blood vessel open.
What To Expect During A Hospital Stay
After the initial tests to determine the type of stroke and the best treatment, other procedures may be necessary to find the cause of the stroke. These procedures may include tests of the heart or the arteries to the brain.
The length of the stay in the hospital and the type of treatment will depend on the severity of the stroke. Many people need some form of therapy to help their brain relearn skills lost because of the stroke.
Nice To Know:
Q: My father had all the signs of a stroke, but he waited more than six hours before getting to the hospital. Even though his stroke was caused by a blocked artery, doctors did not give him "clot-busting" medicines. Why not?
A: TPA drugs are powerful blood thinners that can help dissolve a clot and restore blood flow, but the FDA requires that they be given within three hours after stroke symptoms first begin. When TPA is given more than three hours after stroke A type of cerebrovascular disease that is caused by a sudden interruption of blood flow to a part of the brain, which can kill or damage brain cells. A brain attack. onset, there is a greater risk that it will cause uncontrollable bleeding. It is very important that this guideline is followed and that everyone is made aware of the critical importance of seeking help immediately if experiencing stroke symptoms.
A stroke is a medical emergency, regardless of whether it is a major stroke or a short-lasting TIA. A person suffering a stroke should be taken immediately to a hospital emergency department.
The ability to pinpoint quickly the precise location of a stroke and determine the extent of damage is critically important in treatment decisions. A stroke caused by a blocked artery is treated in an entirely different way than a stroke caused by bleeding within the brain.
The key to survival and recovery is prompt medical treatment.
How-To Information:
If a stroke is caused by a blocked artery, medications are now available to reverse damage to the brain and significantly increase the odds of survival. However, these medications are effective only if they are given within a few hours of the time when the first stroke symptoms begin.
Tests That May Be Performed At The Hospital
Scans of the brain are performed to confirm a diagnosis of stroke and to determine the type of stroke. This is important since the treatment of different types of stroke differs.
These tests include:
* Computed tomography scan (CT scan) is generally the first diagnostic test done after a person suspected of having a stroke arrives in the emergency department. The test uses low-dose x-rays to take pictures of the inside of the brain.
For more information about CT Scan, go to Computed tomography scan (CT scan).
* Magnetic resonance imaging (MRI) is an advanced diagnostic tool that uses the principals of magnetism to view the inner body. An MRI of the brain can show small blood vessels that may be blocked or bleeding.
For more information about MRI, go to Magnetic resonance imaging (MRI).
* Transcranial doppler (TCD) is a new, noninvasive ultrasound procedure that uses a small probe placed against the skull to track the blood flow through the vessels in the brain.
* SPECT imaging uses low doses of a harmless radioactive substance injected into a vein in the arm, then uses a specialized camera to view the blood flow in the brain.
Medicines To Treat Stroke
If the stroke A type of cerebrovascular disease that is caused by a sudden interruption of blood flow to a part of the brain, which can kill or damage brain cells. A brain attack. is caused by a blockage:
* Drug therapy is a relatively recent approach to the treatment of stroke. If the stroke is caused by a blockage in an artery, medications called thrombolytic drugs can be used. The only drugs approved by the FDA for treatment of stroke are tissue plasminogen activators (TPA drugs). Popularly referred to as "clot-busting" drugs, these medications have been used for years to treat heart attacks.
Some studies have indicated that if TPA drugs are given to stroke patients within three hours of the onset of symptoms, more than half of them will make a full recovery in a matter of months.
Not all hospitals, however, have the ability to give TPA drugs to people having a stroke. Before these drugs can be given, doctors must be certain that the stroke is the result of a blockage in the artery and not due to bleeding from an artery. This is determined through imaging procedures such as computed tomography (CT) scans and magnetic resonance imaging (MRI). But not all hospitals have around-the-clock imaging services.
If a stroke is caused by bleeding:
* Medication can be given to reduce swelling of brain tissue.
Surgical Procedures
If the stroke is caused by a blockage:
A procedure called carotid endarterectomy The surgical removal of plaque that is blocking or reducing blood flow in a carotid artery. can be used to remove a buildup of plaque Fatty deposits that stick to the inside walls of blood vessels, causing the vessel to become narrow and, in some cases, blocked altogether. from inside the carotid artery The arteries on each side of the neck that carry blood from the heart to the brain., one of the major sources of blood to the head and neck. Carotid endarterectomy can be used to treat people who have had a stroke and also as a preventive measure for people at risk for stroke.
If the stroke is caused by bleeding:
* An artery within the brain sometimes can be "clipped" to prevent further bleeding.
* If the bleeding has occurred in the subarachnoid space, pooled blood (hematoma) can dangerously increase pressure on the brain and damage delicate tissue. If it is feasible, surgery may be necessary to drain blood from within the area of damaged brain tissue.
Other Procedures
Several types of interventional radiology also are available to treat stroke. These procedures have been in existence for some time, but they have been improved and refined in recent years. However, not all hospitals are equipped to offer interventional radiology.
Interventional radiology is performed by inserting a long, thin, flexible tube called a catheter into blood vessels. The insertion point is usually in the groin, and the incision is about the size of the tip of a pencil. The catheter is guided to various parts of the body while a computer tracks it and records images of the blood vessels. This procedure creates a precise road map of even the tiniest vessel in the body.
* The catheters can be guided to areas of bleeding and used to effectively close off the leaking vessels.
* The catheters can be used to widen areas of blood vessels that have become narrowed because of a buildup of plaque.
* The catheters can be used to place stents made of a fine, tubular wire mesh to hold a blood vessel open.
What To Expect During A Hospital Stay
After the initial tests to determine the type of stroke and the best treatment, other procedures may be necessary to find the cause of the stroke. These procedures may include tests of the heart or the arteries to the brain.
The length of the stay in the hospital and the type of treatment will depend on the severity of the stroke. Many people need some form of therapy to help their brain relearn skills lost because of the stroke.
Nice To Know:
Q: My father had all the signs of a stroke, but he waited more than six hours before getting to the hospital. Even though his stroke was caused by a blocked artery, doctors did not give him "clot-busting" medicines. Why not?
A: TPA drugs are powerful blood thinners that can help dissolve a clot and restore blood flow, but the FDA requires that they be given within three hours after stroke symptoms first begin. When TPA is given more than three hours after stroke A type of cerebrovascular disease that is caused by a sudden interruption of blood flow to a part of the brain, which can kill or damage brain cells. A brain attack. onset, there is a greater risk that it will cause uncontrollable bleeding. It is very important that this guideline is followed and that everyone is made aware of the critical importance of seeking help immediately if experiencing stroke symptoms.
can stroke be treated
For the best, most effective treatment of stroke, a person with a suspected stroke must be given immediate medical attention. It is during the critical first 3 to 6 hours following stroke that today's growing stroke therapy options have the highest curative potential. Doctors can now administer an injection of tissue plasminogen activator (TPA) to dissolve the clots that block blood flow to the brain. If the blockage can be removed with administration of TPA and sufficient blood flow is recovered within a three hour period following the stroke, the severity of permanent brain damage (neurological disability) is minimized or eliminated. However, medical imaging is a critical component in determining the course of stroke treatment.
Medical imaging is vital in the detection and treatment of stroke.
Important Note: Some of the methods of acute stroke diagnosis and treatment described herein are new and are still not widely available in the U.S. People who are at high risk of stroke should investigate which medical centers in their area have active stroke diagnosis and treatment capabilities. Those medical centers and hospitals with dedicated stroke treatment programs should have experience in the administration of tissue plasminogen activator (TPA) or other thrombolitic and neuro-protective agents, as well as dedicated specialists and imaging protocols for diagnosing stroke and mapping the best course of therapy. Particularly in rural areas, which may not have large medical centers with the needed neurology specialists and emergency room staffing, access to these new methods of stroke diagnosis and therapy may be limited for some time (some predict it may be five years before TPA treatment of stroke becomes routine).
Updated: January 14, 2008
http://www.imaginis.com/stroke/treatment.asp
hmmm..another one of my auntie got stroke..praying for the best of her
Medical imaging is vital in the detection and treatment of stroke.
Important Note: Some of the methods of acute stroke diagnosis and treatment described herein are new and are still not widely available in the U.S. People who are at high risk of stroke should investigate which medical centers in their area have active stroke diagnosis and treatment capabilities. Those medical centers and hospitals with dedicated stroke treatment programs should have experience in the administration of tissue plasminogen activator (TPA) or other thrombolitic and neuro-protective agents, as well as dedicated specialists and imaging protocols for diagnosing stroke and mapping the best course of therapy. Particularly in rural areas, which may not have large medical centers with the needed neurology specialists and emergency room staffing, access to these new methods of stroke diagnosis and therapy may be limited for some time (some predict it may be five years before TPA treatment of stroke becomes routine).
Updated: January 14, 2008
http://www.imaginis.com/stroke/treatment.asp
hmmm..another one of my auntie got stroke..praying for the best of her
Thursday, 25 March 2010
Tuesday, 23 March 2010
Hirscsprung disease
Normally, nerves tell the colon, rectum, and anus to work together to push waste out of the body
With Hirschsprung’s disease, a section of colon is missing nerves. Waste backs up behind this section
http://www.mountnittany.org/wellness-library/healthsheets/documents?ID=7341
A gastrointestinal stromal tumor (GIST) is one of the most common mesenchymal tumors of the gastrointestinal tract
GISTs are tumors of connective tissue, i.e. sarcomas; unlike most gastrointestinal tumors, they are non-epithelial. 70% occur in the stomach, 20% in the small intestine and less than 10% in the esophagus.
MALToma
Lymphoid tissue located beneath the mucosal epithelia, mucosa-associated lymphoid tissue (MALT), protects the body against pathogens that may enter the body via the mucosa
Often MALT consists of small accumulations of lymphoid cells or one to a few lymph follicles beneath the epithelium and possibly extending into the submucosa. The tonsils and Peyer's patches are large accumulations of lymphoid tissue with associated specialisations of the epithelium.
Saturday, 20 March 2010
Friday, 12 March 2010
The ANATOMY of HOPE
The Actors in this Story
1. Patient: 52-year-old Frances Walker, an African-American with a teenage daughter, Sharon.
2. Main doctor: 50-plus-year-old, Dr. Richard Keyes at Russell Clinic, a town north of Los Angeles, California, USA.
3. Second doctor: Dr. Jerome Groopman, 27-year-old, up and coming doctor doing a fellowship in blood disease at the University of California, Los Angeles.
Frances had traces of blood in her stools during her yearly physical examination. A colonoscopy indicated a tumor in the lower bowel. She underwent a surgery to remove the tumor but the surgeon found that the cancer had spread to the lymph nodes and invaded the left lobe of her liver. Medically this was considered a Stage 4 metastatic colon cancer.
Frances and her daughter, Sharon, came to Dr. Richard Keyes's clinic. They were greeted warmly by the doctor who proceeded to examine Frances's operation wound. Everything seemed okay. They sat down to discuss follow-up treatment.
Richard: Frances, all traces of cancer were removed from your bowel and the surrounding lymph nodes. A few small spots of tumor were found on the left side of the liver. But we have chemotherapy to help take care of them.
Frances's face showed great relief.
Richard: The chemotherapy I will give you is very active against those spots in the liver. I expect some side effects, like mouth sores, diarrhea and anemia, but you'll be monitored closely. All of the side effects can be managed and will ultimately reverse. Any questions?
Frances thought for a moment and understood what needed to be done. Richard wrote into this patient's file: "Patient and family understand the risks and benefits of the proposed therapy."
Frances left the clinic.
Groopman to Richard: When I'm with the (patient), if direct questions come up, I should emphasize remission, correct?
Richard: Yes, I certainly wouldn't look at Frances and say: "Madam, the cancer in your liver will kill you." What's the point of that? All it does is make the remaining time even more miserable. Or cause her to panic and refuse palliation. Richard continued further: Each doctor has his own style, his own way of doing things. Believe me, for patients in situations like this, too much information is overwhelming.
After the first shot of chemotherapy Frances had some nausea and dry heaves. But she seemed to be in good spirit despite the side effects. She said: "I'm a fighter." Later, she suffered painful mouth ulcers and had to be hospitalized and put on drips. After that she had to be hospitalized again due to fevers and abdominal cramps and diarrhea.
Three months into chemotherapy
Richard to Frances: Look at that CAT scan. This is the liver ... those are the deposits we are treating. They're about half the size of what we started with.
Frances: Does that mean I am partly cured?
Richard: You are well on the way to a remission. Thank God. It's going away.
Frances's daughter, Sharon, closed her eyes and bowed her head in a silent prayer.
Time passed and it was January 1979
Dr. Groopman shook Frances's hand and felt it trembled. France's liver function tests showed elevated values as they had not been before. Dr. Richard Keyes examined her abdomen.
Richard: Your liver edge is tender and your blood tests are slightly abnormal. Sometimes the chemotherapy can inflame the liver as a side effect. You are due for a follow-up CAT scan in a week. Until then, I'll give you a prescription for some pain medication. Don't be reluctant to use it if you need to.
Frances left the clinic.
Richard to Groopman: You know, it really doesn't make a difference clinically if it is the cancer and not the chemo. There's little we can do about it. By telling Frances and Sharon now, we just add another few weeks of worry. This way they have something to cling to for a little longer. Richard looked at Groopman kindly and continued: You're at the beginning of your career, Jerry ... SUSTAINED IGNORANCE IS A FORM OF BLISS. May be she'll be lucky and it will turn out to be a side effect from the drugs.
Two weeks later Groopman saw the report of Frances's scan and wrote: "The liver metastasis had more than doubled in size, and new deposits had appeared in the spleen. The organs looked as though they had been riddled by large-caliber bullets, leaving gaping holes. The scan also showed the fluid was building up in the abdomen. I knew that patients like Frances rarely survived over a few months. I noticed a faint tinge of yellow in her eyes. It was jaundice, an indication that the cancer was blocking the liver's excretion of bile. Her abdomen was so distended from the ascites that it pressed her navel outward like a bubble."
Frances came into the clinic.
Groopman: How are you?
Frances: Very tired. I have no appetite. I have to force myself to eat, since the food doesn't go down easily.
Groopman: We need to drain the ascites to relieve the pressure. You should feel better afterward.
Sharon: Then that means it's spreading quickly, doesn't it?
Frances: I have no energy. I felt for a while that something was wrong ... But Dr. Keyes said it was from the chemotherapy treatments.
Sharon: I thought you and Dr. Keyes said that the chemotherapy could cure her.
Groopman: He didn't -- we didn't -- quiet say that. We said that there was a good chance of going into remission, which happened. Groopman then explained what remission meant and how it differed from cure.
Sharon: Why didn't you tell us before?
Groopman: Colon cancer behaves this way. Shrinking for a while from the treatment then becoming resistant to it and growing again. I am sorry.
Groopman wrote: "The last time I saw the (patient) was in early March. Frances was unable to eat more than a few bites of solid food. If drinks were too cold or too hot, she regurgitated them. Each drainage of the ascites provided only a few days of relief before the fluid re-accumulated. Frances declined further chemotherapy after hearing my frank recitation of data on its chance of working.
Sharon: I guess he (Dr. Richard Keyes) didn't think people like us are smart enough or strong enough to handle the truth.
Groopman: It wasn't a question of smart enough. Dr. Keyes and I were trying to spare you the worry. Well, we were both wrong.
Frances died soon afterwards. Groopman wrote: "A sense of shame and guilt gripped me. Richard and I had failed the (patient). It has been a delusion to tell myself that what Richard had done and what I have embraced as his apprentice was for the best for them. Ignorance was not bliss, not when it mattered. By abandoning the truth, Richard and I had abandoned Frances, and through our deception we left Sharon alienated and bitter."
Comments: It amazed me that the same story is been played over and over again by different doctors everywhere. It does not seem to matter if it is in Malaysia, Indonesia, Singapore or the United States.
Groopman felt ashamed and guilty. I wonder how many others felt the same way after having failed. How could they ever face their patients knowing that in "trying to do their best" they actually deceived or misled their patients?
Groopman was right when he wrote that the episode had left Sharon alienated and bitter. Who would not feel disappointed, cheated or deceived? In a decade of my own experiences, I have met patients and their family members who felt bitter and enraged at those doctors who had taken them for a ride. Many have lost their loved ones besides having to face a hefty medical debt to settle. For some who are poor, they resorted to selling their property -- land or house. That was the bet that they took to "buy" the "misrepresented cure" which doctors told them was promising indeed. Patients fail to understand that there is "that much any oncologist" can do when faced with cancer.
http://ezinearticles.com/?Chemotherapy-for-Colon-Liver-Cancer---A-Medical-Smoke-Screen?&id=548516
1. Patient: 52-year-old Frances Walker, an African-American with a teenage daughter, Sharon.
2. Main doctor: 50-plus-year-old, Dr. Richard Keyes at Russell Clinic, a town north of Los Angeles, California, USA.
3. Second doctor: Dr. Jerome Groopman, 27-year-old, up and coming doctor doing a fellowship in blood disease at the University of California, Los Angeles.
Frances had traces of blood in her stools during her yearly physical examination. A colonoscopy indicated a tumor in the lower bowel. She underwent a surgery to remove the tumor but the surgeon found that the cancer had spread to the lymph nodes and invaded the left lobe of her liver. Medically this was considered a Stage 4 metastatic colon cancer.
Frances and her daughter, Sharon, came to Dr. Richard Keyes's clinic. They were greeted warmly by the doctor who proceeded to examine Frances's operation wound. Everything seemed okay. They sat down to discuss follow-up treatment.
Richard: Frances, all traces of cancer were removed from your bowel and the surrounding lymph nodes. A few small spots of tumor were found on the left side of the liver. But we have chemotherapy to help take care of them.
Frances's face showed great relief.
Richard: The chemotherapy I will give you is very active against those spots in the liver. I expect some side effects, like mouth sores, diarrhea and anemia, but you'll be monitored closely. All of the side effects can be managed and will ultimately reverse. Any questions?
Frances thought for a moment and understood what needed to be done. Richard wrote into this patient's file: "Patient and family understand the risks and benefits of the proposed therapy."
Frances left the clinic.
Groopman to Richard: When I'm with the (patient), if direct questions come up, I should emphasize remission, correct?
Richard: Yes, I certainly wouldn't look at Frances and say: "Madam, the cancer in your liver will kill you." What's the point of that? All it does is make the remaining time even more miserable. Or cause her to panic and refuse palliation. Richard continued further: Each doctor has his own style, his own way of doing things. Believe me, for patients in situations like this, too much information is overwhelming.
After the first shot of chemotherapy Frances had some nausea and dry heaves. But she seemed to be in good spirit despite the side effects. She said: "I'm a fighter." Later, she suffered painful mouth ulcers and had to be hospitalized and put on drips. After that she had to be hospitalized again due to fevers and abdominal cramps and diarrhea.
Three months into chemotherapy
Richard to Frances: Look at that CAT scan. This is the liver ... those are the deposits we are treating. They're about half the size of what we started with.
Frances: Does that mean I am partly cured?
Richard: You are well on the way to a remission. Thank God. It's going away.
Frances's daughter, Sharon, closed her eyes and bowed her head in a silent prayer.
Time passed and it was January 1979
Dr. Groopman shook Frances's hand and felt it trembled. France's liver function tests showed elevated values as they had not been before. Dr. Richard Keyes examined her abdomen.
Richard: Your liver edge is tender and your blood tests are slightly abnormal. Sometimes the chemotherapy can inflame the liver as a side effect. You are due for a follow-up CAT scan in a week. Until then, I'll give you a prescription for some pain medication. Don't be reluctant to use it if you need to.
Frances left the clinic.
Richard to Groopman: You know, it really doesn't make a difference clinically if it is the cancer and not the chemo. There's little we can do about it. By telling Frances and Sharon now, we just add another few weeks of worry. This way they have something to cling to for a little longer. Richard looked at Groopman kindly and continued: You're at the beginning of your career, Jerry ... SUSTAINED IGNORANCE IS A FORM OF BLISS. May be she'll be lucky and it will turn out to be a side effect from the drugs.
Two weeks later Groopman saw the report of Frances's scan and wrote: "The liver metastasis had more than doubled in size, and new deposits had appeared in the spleen. The organs looked as though they had been riddled by large-caliber bullets, leaving gaping holes. The scan also showed the fluid was building up in the abdomen. I knew that patients like Frances rarely survived over a few months. I noticed a faint tinge of yellow in her eyes. It was jaundice, an indication that the cancer was blocking the liver's excretion of bile. Her abdomen was so distended from the ascites that it pressed her navel outward like a bubble."
Frances came into the clinic.
Groopman: How are you?
Frances: Very tired. I have no appetite. I have to force myself to eat, since the food doesn't go down easily.
Groopman: We need to drain the ascites to relieve the pressure. You should feel better afterward.
Sharon: Then that means it's spreading quickly, doesn't it?
Frances: I have no energy. I felt for a while that something was wrong ... But Dr. Keyes said it was from the chemotherapy treatments.
Sharon: I thought you and Dr. Keyes said that the chemotherapy could cure her.
Groopman: He didn't -- we didn't -- quiet say that. We said that there was a good chance of going into remission, which happened. Groopman then explained what remission meant and how it differed from cure.
Sharon: Why didn't you tell us before?
Groopman: Colon cancer behaves this way. Shrinking for a while from the treatment then becoming resistant to it and growing again. I am sorry.
Groopman wrote: "The last time I saw the (patient) was in early March. Frances was unable to eat more than a few bites of solid food. If drinks were too cold or too hot, she regurgitated them. Each drainage of the ascites provided only a few days of relief before the fluid re-accumulated. Frances declined further chemotherapy after hearing my frank recitation of data on its chance of working.
Sharon: I guess he (Dr. Richard Keyes) didn't think people like us are smart enough or strong enough to handle the truth.
Groopman: It wasn't a question of smart enough. Dr. Keyes and I were trying to spare you the worry. Well, we were both wrong.
Frances died soon afterwards. Groopman wrote: "A sense of shame and guilt gripped me. Richard and I had failed the (patient). It has been a delusion to tell myself that what Richard had done and what I have embraced as his apprentice was for the best for them. Ignorance was not bliss, not when it mattered. By abandoning the truth, Richard and I had abandoned Frances, and through our deception we left Sharon alienated and bitter."
Comments: It amazed me that the same story is been played over and over again by different doctors everywhere. It does not seem to matter if it is in Malaysia, Indonesia, Singapore or the United States.
Groopman felt ashamed and guilty. I wonder how many others felt the same way after having failed. How could they ever face their patients knowing that in "trying to do their best" they actually deceived or misled their patients?
Groopman was right when he wrote that the episode had left Sharon alienated and bitter. Who would not feel disappointed, cheated or deceived? In a decade of my own experiences, I have met patients and their family members who felt bitter and enraged at those doctors who had taken them for a ride. Many have lost their loved ones besides having to face a hefty medical debt to settle. For some who are poor, they resorted to selling their property -- land or house. That was the bet that they took to "buy" the "misrepresented cure" which doctors told them was promising indeed. Patients fail to understand that there is "that much any oncologist" can do when faced with cancer.
http://ezinearticles.com/?Chemotherapy-for-Colon-Liver-Cancer---A-Medical-Smoke-Screen?&id=548516
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