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cancer sgt berbahaya...kalau buat chemo nnt hair loss pulak kan |
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But doc...pesakit PCOS ni high risk untuk dapat ovarian cancer kan?if over stimulate i.e taken so much clomid, in trying to get pregnant...
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Innalillahi wa inna ilaihi raajiun.
LMS carries poor prognosis.
Jika dah stage 4, mmg lah lagi.
Semoga roh almarhum di kalangan roh yang diberkati Ilahi.
Kerana almarhum dah ambil morphine pill, maka maknanya beliau sudah mendapat some kind of Palliation dari Palliative Care doctors.
Harapnya, akhir akhir hiudp almarhum beliau tidak menderita.
Kepada you pula, harap you redha dan sabar selalu.
Dalam urusan Ilahi, tidak ada bahagian kita utk beri input.
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Hair loss tu bukanlah side effect yg doctors risaukan.
Byk chemo membunuh cells cancers yg cepat membiak ni.
Chemo akan target mechanism pembiakan cells itu.
Walaubagaimanapun, byk cells normal dalam badan kita yg juga membiak cepat.
Jadi, mechanism pembiakan cells ini pon akan ter-target jugak.
Contoh, cells darah putih, cells lining of intestine, cells kat kulit, cells kat mucocutaneous junctions.
Juga cells reproduction, cells kuku, cells yg tumbuhkan rambut etc
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Yes, sikit aje.
All in all, ianya tidaklah mencanak canak naik nya.
Kami recommend clomid jika pesakat ingin family; dan kami mention the very low risk of cancer tu pada mereka
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ipes2 replied at 20-8-2016 04:53 PM
Innalillahi wa inna ilaihi raajiun.
LMS carries poor prognosis.
Jika dah stage 4, mmg lah lagi.
...
Akhir2 hayat bapa saya, pernafasan beliau totally supported by ventilator. Doktor kata paru2 sebelah kiri dah totally disfunction.
Sedih sangat masa tu melihat keadaan bapa menahan sakit sedemikian.
Apa2 pun, terima kasih banyak2 dr.ipes2..  |
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Ventilator?
Kalau kami di sini tak bagi dah ventilator.
Kami bagi nebulizers, oxygen thru mask etc
also kami bagi infusion of midazolam into the skin supaya pesakit yg dah terminal ni tak berapa sedar sgt dan sakit sgt dan slowly ebb away
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ipes2 replied at 22-8-2016 12:20 AM
Ventilator?
Kalau kami di sini tak bagi dah ventilator.
Kami bagi nebulizers, oxygen thru mask e ...
Ye doc, doctor tu masukkan breathing tube melalui mulut yang terus masuk ke dalam badan tu ( I don't know the medical terms for these kinds of procedure because I'm not in medical line...). Intubation ...sempat guna ventilator tu 4 hari sahaja. |
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...doc...care to explain how does nebulizers and oxygen therapy bring back spontaneous breathing in patient who are not able to breathe on their own and thus require mechanical ventilation??
...appreciate your sharing of knowledge on cancer...
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For your information, nebulizers and oxygenation do not bring about spontaneous breathing or ventilation.
In cases bila pts have stage 4 cancers (not all types of cancers obviously), patients tak akan di ventilated lagi dah (ie he will not be intubated; ye lah, nnt u akan selamat kan dia hanya untuk dia melalui derita mati cancer); patients with stage 4 cancers are more or less excluded from intubation and ventilation. Biar saja lah patients yang stage 4 cancers mati in dignity and painless. Each week bila keje, i akan discuss dgn patients awal awal lagi that kita akan treat dia sebaik mungkin, beri antibiotics bila perlu etc, tetapi, jika dia dapat cardiorespiratory arrest, kita taka akan CPR dia, tak akan intubate or ventilate dia. In malaysia its very different, especially in private hospitals where multiple futile, unnecessary and even inappropriate procedures are done.
we should not bring back a patient who is dying, untuk to succumb to a terminal cancer.
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Exactly... sebab itulah bila cancers dah terminal, kita tidak lagi intubate or ventilate pesakit itu, kerana perbuatan itu hanya akan memanjangkan derita pesakit cancer tersebut, kerana cancers adalah penyakit yang amat sakit. Malah kami akan dapatkan Palliative Care Specialist utk jaga, eg beri midazolam, kurangkan sakit, beri fluids, dan pelbagai TLC (Tender-Loving-Care) measures. Harap u tak terlalu trauma. If kat Europe or USA ni, you boleh saman sesiapa yang prolonged your fathers punya derita tu, dan ini telah banyak kali terjadi.
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That is called intubation and ventilation (I & V); hanya in CCU, ICU, ITU and HDU sahaja. If isteri saya (dia Oncology Consultant) yang jaga almarhum dan dia dapat tahu some doctors buat I & V kat almarhum, tentu dia tension. Also, ITU Consultant dan Aneasthetist tentu dah komplen kat hospital manager pasal doctor yang buat I & V kat almarhum tu. Tapi di mesia lain; Mesia Boleh.
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ipes2 replied at 12-8-2016 03:22 AM
Askm Shirley. Chemotherapy dan radiotherapy ada problem sikit bila sudah berumur atau terlalu muda ...
Salam doc. Anak sy chemo masa umur 1 thn 7 bln. Radioteraphy masa umur 3 thn lebih. Retinoblastoma. Boleh doc terangkan lebih lanjut pasal kesan2 chemo n radio pada usia muda tu? |
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Edited by blackmore at 10-9-2016 04:24 PM
...precisely...i guess i got confuse with your reply to Shirley on that post cos she did mention that arwah ayahnya had to be supported by a ventilator as his left lung was totally dysfunction.... nebulizers and oxygenation wont do such patients good either cos its just not gonna make him breathe again...but after your further explanation to my post...now i understand better...and i do agree with u that initiating mechanical ventilator in a palliative patient is just prolonging their suffering...but...as healthcare provider...we do have to take into consideration patient's NOK expectations and preferences in managing patient's end of life care...
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waalaikumussalam; isteri saya is a consultant medical oncologist.. nanti pagi esok i tanya dia; dia dah masuk tido; pasal radiotherapy in a young child, ini adalah superspecialized area...tapi i ada kawan yg kejenya consultant radiation oncologist. i have whatsapp him for a short answer on this. i am sorry to hear of the diagnosis. i hope he is doing well
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ipes2 replied at 11-9-2016 05:53 AM
waalaikumussalam; isteri saya is a consultant medical oncologist.. nanti pagi esok i tanya dia; di ...
Tq doc. Skrg dah habis treatment. Cuma follow up ngan doc onco n doc mata. |
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Aku teringat arwah pakcik (Pengamal Homeopathy) katenye secara ringkasnya kanser ni adalah sel yang patutnya mati tak mati, patutnya dinyahkan tapi tak dinyahkan...stay dalam badan siap beranak pinak... |
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Aha, betul. Apoptosis (sebut 'apotosis') yakni scheduled death, tak menjadi kat depa sebab ada DNA rosak ke apa.
Semua cells ada tarikh luput dia..
Monocytes sehari dua, bila mati body kita ganti balik, neutrophils sehari seminggu gitu kot, erythrocytes (darah merah 120 hari, jika bayi 80-90hari), macrophage beberapa minggu kepada beberapa puluh tahun), cardiac muscle cells mati dengan kita ie dibuat hanya sekali aju, neurons pon mati dengan kita (tapi cardiac muscle cells ni jika some of them mati awal, jadilah heart attack, dan yg mati tu tak lagi diganti; neurons pula jika mati byk byk jadilah stroke, dan tak di ganti lagi)
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Hi hih depa dah jawab dah cuma i sebok beraya.
overall depa kata ok je.
tapi kena specialsits in the areas la yg jaga
ha alhamdulillah
semoga dia sembuh dan tak byk side effects
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Post time 15-8-2016 12:37 PM
Author
