Coping with the death of an infant

A discussion of caring for a severely deformed child who has died.

podcast link

earlier podcasts about TinyPrincess discussed the problem of caregiving and burnout in the family due to her fragile nature and frequent seizures. They finally got help from some local sisters who do home care for the dying.

Much of this is overtly religious, but as a doc who worked with the poor, I might just say that it reminds one of how parents think and feel about their children: but few are articulate enough to put it into words.

This is the story told by a pious Catholic father, but the idea that a young child who dies, especially one who is "special needs", will await one in haven and even intercede for their parents is found in other religions, such as Islam.

Dale Evans (wife of Roy Rogers) had a child with Down's syndrome who died as a toddler of measles and wrote a book about her. Download it from this MN site, or borrow it  (free registration) from internet archive.

compare and contrast to many "opinions" of so called "bioethicists" who see them as useless eaters, better to be aborted or killed at birth.

Sigh.

often these families are helped by local churches (as in the podcast) and/or government programs.

and caring for a loved one, even in the USA, where the meme is that everyone is selfish, is astonishingly common: this site estimates 45 million caregivers who gave up time and work in the past year: often giving up their own outside job to properly care for the child or elder in their care.

Hospice care is often seen as sort of like a nursing home, but actually most hosice cases are also cared for in the home, with the hospice nurse helping advise in getting things to help the person (caregiver to do bathing, a hospital bed, adjusting pain medicine to keep the person free of pain but not oversedated).

but a lot of cases are from chronic disease. And the hardest cases are those with behavior problems: Severe ADHD in children with developmental disabilities, or Alzheimer's disease in the elderly.

Often the behaviors are hard to treat, so these people end up in nursing home or need frequent respite care to stop caregiver burnout.

Here in the Philippines, the extended family is the one who usually cares for the sick: often with outside help. For example, I hired someone to help me with Lolo at night, his cousin with a broken hip and osteoporosis and COPD that made surgical repair inadvisable was cared for by a cousin and her teenaged children, and Joy's pastor's son has family to care for him with a part time caregiver.

In the US, modern trends (to save money) insists people to be cared for at home (also because it is better for the patient) ignores an economy that insists women work full time to support themselves.

One result: A lot of caregivers quit their jobs or work part time to do this care. Adult day care and other activities help.

another junk science opiod article

this one claims that giving opiods post partum is a risk for continued opiod use.

So they suggest not to give the moms pain pills post partum

(usually we give them for Caesarian section or if they have a large episiotomy, not to everyone.) but here the article claims the risk was the same in both groups.

but how big is the risk?

The incidence of persistent opioid use during the year following delivery was low overall -- at less than 1 percent -- and was higher among women with cesarean versus vaginal delivery.

so let the women suffer.

Actually, what might be happening is that women who are depressed find their depression is helped by these pills. the wife of Senator McCain would be a big example.

However the study only included those who hadn't taken narcotics in the past 180 days. Did they check the percentage of women who took other drugs such as marijuana or tranquillizers?

Ebola update

Science magazine says that the new Ebola vaccine seems to be helping fight the outbreak in Central Africa.

40 thousand people have received the vaccine.

So far the outbreak has tallied some 500 cases, about half of whom have died, according to the DRC’s Ministry of Public Health. It spans a region of the DRC’s northeast that abuts four other countries, and Salama and many others worry about the deadly virus jumping a border, which would require separate response teams and boost the potential for wider spread by infecting people with increased transportation options.

Without more financial and personnel support from wealthy countries, the situation could explode into a long-running calamity similar to the Ebola epidemic that devastated three West African countries from 2014 to 2016, warns an editorial published last month in The New England Journal of Medicine (NEJM).

A consensus statement from 25 public health and policy experts published the same week in The Journal of the American Medical Association calls the outbreak “exceptionally” dangerous. The editorials urge the U.S. government to change a policy that prevents its Centers for Disease Control and Prevention (CDC) from sending staff to the region because of security concerns.

well, unless they send in the Marines (Or hire a bunch of mercs from Blackwater), the CDC personnel would be risking their lives, not from Ebola but from local violence including kidnappers and thieves who attack hospitals and clinics and those driving down roads without guards.

I worked during a war, and several of my friends were killed, so maybe I take this more seriously than those sitting in offices in Chicago (JAMA).

a lot of the work can be done by locals, as I noted in an earlier post.

And yes, they are under threat too...

one only has to look at the health care workers, many local folks, in Afghanistan and Pakistan who have been kidnapped or killed trying to help people. At least they were volunteers.

Speed in wartime

Stimulants are frequently abused (one big problem here in the Philippines is use of Shabu, i.e. meth, by drivers and farmers to stay awake, but also leading to abuse and violence in some users, especially when used to get high).

StrategyPage has a long article on the use of drugs in the War, including new treatments for post traumatic stress, but also how soldiers cope in stressful combat situations using stimulents so people don't fall asleep in times of battle (and sometimes sleeping pills to counteract these pills to fall asleep).

This is not just by Americans: The ISIS type crazies like it too.

While Islamic terrorists found heroin, cocaine and prescription drugs useful, the most widely used Islamic terrorist chemical enhancer was that old World War II era standby amphetamines ("speed") pills. When shipments of Islamic terrorist weapons and ammo were seized there were often quantities of amphetamines as well guns, ammo and sometimes medical supplies.

this is nothing new: A recent book showed how the Nazis pushed this on not just soldiers in combat (which was also how the Yanks used it) but in civilians.

from the UKGuardian:

The book in question is The Total Rush – or, to use its superior English title, Blitzed – which reveals the astonishing and hitherto largely untold story of the Third Reich’s relationship with drugs, including cocaine, heroin, morphine and, above all, methamphetamines (aka crystal meth), and of their effect not only on Hitler’s final days – the Führer, by Ohler’s account, was an absolute junkie with ruined veins by the time he retreated to the last of his bunkers – but on the Wehrmacht’s successful invasion of France in 1940. Published in Germany last year, where it became a bestseller, it has since been translated into 18 language

of course, the traditional drug has always been alcohol.

my take? I agree with StrategyPage: It's the lesser of two evils,

Prolonged use of these drugs is not healthy. But neither is being drowsy during combat. It's better to get some sleep when you can, even if you have to take more medications to help make that happen. Troops exposed to prolonged combat find the stimulants lifesavers and consider them as essential as ammunition. Thus Islamic terrorists consider a weapons and ammo shipment incomplete if some Captagon was not included.

but I do wonder if the drug use in combat contributes to the high rate of suicide.

long discussion here (and note how traumatic brain injury also might be one reason for the high rate of psychiatric problems)