Can a hospice patient go to the doctor
Hospice care is a specialized form of care provided to individuals who are terminally ill and have a life expectancy of six months or less. The primary goal of hospice care is to manage the patient's symptoms and provide comfort and support during the end-of-life process. As such, hospice care is typically provided in the patient's home or a hospice facility. However, it is not uncommon for hospice patients to require medical attention outside of their usual care setting, such as a visit to the doctor's office.
So, can a hospice patient go to the doctor? The answer is yes, but with some important considerations. First and foremost, it is essential to ensure that any medical treatment or intervention is in line with the patient's hospice care plan and goals. This means that any visit to the doctor should be coordinated with the hospice care team, who can provide guidance on what type of care is appropriate and necessary for the patient's condition.
Additionally, it is important to keep in mind that hospice care is intended to provide comfort and support during the end-of-life process. Therefore, any medical interventions should be focused on managing the patient's symptoms and improving their quality of life, rather than attempting to cure their underlying condition. This may mean that certain types of medical treatments or procedures may not be appropriate for hospice patients.
In some cases, hospice care providers may have their own team of medical professionals who can provide care for the patient, such as a hospice physician or nurse practitioner. These providers can offer medical attention in the patient's home or hospice facility, reducing the need for visits to the doctor's office.
In summary, hospice patients can go to the doctor, but any medical intervention should be coordinated with the hospice care team and focused on managing the patient's symptoms and improving their quality of life. Ultimately, the goal of hospice care is to provide comfort and support during the end-of-life process, and any medical interventions should be in line with that goal.
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Three Oaks Hospice provides compassionate hospice care in the St. Louis, MO area. We currently serve the Counties of St. Louis, St. Charles, Jefferson, Franklin, Lincoln, and Warren.
Hospice care is designed for terminally ill individuals, providing comfort and peace to patients and families during the remaining weeks or months of life. We understand the importance of comfort and familiarity, so our team is prepared to visit patients wherever they reside-be it their own home, a family member’s home, or a senior living community or hospital.
Trained volunteers play an important role in the interdisciplinary hospice team that also includes physicians, nurses, social workers, clergy, administrators and various therapists that provide physical, emotional and spiritual comfort to persons with life-limiting illnesses.
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Endometriosis, Fat Doctors, And Bellybuttons: What They Don't Teach You In Health Class
Woo another rambling TED talk, but I just got home from a meeting with a doctor specializing in wound care that I really feel a lot of you should hear:
Firstly, I've been having mysterious pains in my bellybutton area since... probably last Autumn? But I've had menorrhagia (extremely heavy, painful, and even dangerous periods that can cause spontaneous hemorrhaging) since I was 13 years old. Since my menorrhagia became active, I've been begging for a hysterectomy. I'm moving into my 20 year anniversary of Living With A Uterus That Hates Me As Much As I Hate It.
Being trans (agender) also really incentivizes the whole "yeet the uterus" thing, too, but that doesn't really have anything to do with why I wanna talk to y'all about endometriosis and bellybuttons.
Anyway, as of this year, I've had a lot of issues with my bellybutton region. Random infections, inflammation, pain, trips in and out of the ER; the works. My doctor has been so confused by my bizarre constellation of symptoms that he hasn't been sure of what's going on or what the best course of action is, aside from referring me for more tests and prescribing comfort measures in the meantime.
Until today. My desperate track for a diagnosis began over a week ago when my symptoms became alarmingly sepsis-like, but my test results came back with nothing but signs of an elevated white blood cell count. My doctor has been rushing me from specialist to specialist, and today was a wound care doctor that specializes in treating bariatric, hospice, and disabled patients that can't necessarily follow conventional wound-care advice meant for young, abled, and thin people.
I didn't expect much. Maybe some magnifiers, swabs, and a biopsy at worst, followed by antibiotics and whatever else, but definitely nothing that would help me solve this latest scary health mystery. While the worst of the pain I had that landed me in the ER went away on its own enough that I can get by with mobility aids, I still haven't had a diagnosis.
Until Awesome Fat Doctor.
Awesome Fat Doctor I celebrate. I live for this man. He literally gave me a reason to keep on trying and not give up. I was so scared of the appointment I'd gone nonverbal (not weird for me these days), but I got my voice back after I spent a while with him and his nurse (who was also fantastic). Even though I only met him for a few minutes and he forgot to introduce himself so I can't remember his name right now, Awesome Fat Doctor was a rock star. He was in his later middle age, scruffy, unshaven, and fat - enough that I could imagine the reason he specializes as a wound care doctor is because he may have gotten fed up of other doctors blaming his own health problems on his weight and life choices.
AFD gave no fucks. Along with being a big guy, he carried himself with the gruff no-nonsense of a man that's probably beaten up his ableist colleagues overdiagnosing fibromyalgia in the back of a Wendy's parking lot. He had been informed of my autism and my own needs for a wheelchair due to my own long-term chronic pain and other health issues, as well as my troubles speaking, and treated me like a little cousin that was having a rough go of things like he'd had.
He was compassionate and a straight-shooter with me. He was respectful of my boundaries, talked to me as casually as if I could respond like anybody else with working vocal cords (which I was eventually able to), and generally had all the bedside manner of someone that has worked with patients with special needs of all kinds. He looked at the trouble area and my records and history, told me that he was gonna do his best to get things straightened out, and then went quiet as he studied the timeline of my issues.
"Do you have endometriosis?" he asked, while studying a photo my mom had taken of a... skin infection over my lower abdomen, which had spread from my bellybutton.
I was confused.
"Not that I know of," I answered. I'd found my voice already when he and his nurse both helped put me at ease and showed me I was respected, safe, and seen. I've been tested a few times in my life for endometriosis and had my fair share of ultrasounds (the most common way to diagnose endo), and nobody had found anything unusual. But I have menorrhagia, am always in pain from my reproductive organs, and am desperate to get them removed. I'm on a 24/7 regimen of 2x normal birth control pills just to keep me from menstruating for my own safety. It sucks.
"My wife once had to get emergency surgery for what we thought was appendicitis. Do you know what it turned out she had?" he asked me, very suddenly, and like he had an idea.
"Ectopic pregnancy?" was my first guess, because women have died in the past to ectopic pregnancies that were mistaken for appendicitis.
AFD shook his head. "It was her menstrual cycle, and she had endometrial tissue bleeding into the space beside her appendix. I think you may have endometrial tissue in your bellybutton, and every time your hormones try to cycle in spite of your birth control pills, it bleeds and infects."
I was gobsmacked. Endometriosis and PCOS run in my family as reliably as eye and hair color, but I'd never really thought of how pernicious endometrial tissue could actually be. When I picture endometrial tissue, I picture overgrowths inside of reproductive tissue, or clinging to the outside; not growing randomly within the abdominal cavity or emerging out of my fucking skin like a turkey pop-up timer of doom.
AFD slowly nodded. "And the only way we'd be able to see the endometrial tissue is if you had it tested while you were menstruating and the tissue itself was inflamed and bleeding. Otherwise, it won't show up as anything different to the normal, healthy tissues surrounding it. A biopsy isn't reliable, either, because we have to know exactly where the tissue is before we test it. You have to have your hormones triggering the tissue to inflame and behave differently so it can be diagnosed if there are no big deposits of tissue to see."
After a long time of my ears ringing, I asked him, "Do you think it's possible that the ultrasounds were showing false negatives? Like, I have endometriosis and had it all along, but the tissue is too small to see or were being looked at at the wrong time?"
As it turns out, that's exactly what may be going on.
I see my doctor tomorrow, and meet with my surgeon at the beginning of next month.
Listen to your bodies, y'all. I am so thankful to that doctor, who wound up diverting into a very colorfully-worded rant about how much he hates the American medical system immediately after that. He gave me hope that I was just having new issues with old problems and was right all along about what my body really needed, and that my symptoms now are just showing what happens when doctors neglect their patients' needs.
I did wind up asking if he specialized with wound care because of how other doctors responded to his weight, and he said that it was a mix of reasons beginning with Yes: Both so he could have a safe space from fatphobia and ableism for himself and his patients, but also so his wife - who, while I hadn't seen her, he explained was about as big as he was - would have her own pain taken more seriously, being both fat and female. As he'd already explained, she hadn't been successfully diagnosed with endometriosis until she was symptomatic of full-blown appendicitis-levels of pain as an adult and her doctors were forced to stop blaming her pain on her weight.
Now, as I sit here reflecting... It's hard to believe that, thanks to this doctor's theory, I may finally be free from pain and dysphoria sooner than I imagined. It just took a doctor who could empathize with me to see me, and choose to take the scarier hill to fight on with me.
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