Q&A

WHAT IS PALLIATIVE MEDICINE?

Palliative care physicians concentrate on preventing and alleviating suffering, improving your quality of life, and helping you and your loved ones cope with the stress and burden of your illness.

Palliative care relieves suffering and improves quality of life for people of any age and at any stage in a serious illness, whether that illness is curable, chronic, or life-threatening. Palliative care is whole-person care that relieves symptoms of a disease or disorder, whether or not it can be cured. You can also expect relief from symptoms such as pain, shortness of breath, fatigue, constipation, nausea, loss of appetite and difficulty sleeping.

Palliative care may be right for you if you are experiencing pain, stress and other symptoms due to a serious illness. Serious illnesses include but are not limited to: cancer, cardiac disease, respiratory disease, kidney failure, Alzheimer’s, AIDS, amyotrophic lateral sclerosis (ALS) and multiple sclerosis. Palliative care is appropriate at any stage of a serious illness and you can get it along with treatment meant to cure you.

WHAT IS HOSPICE CARE?

Hospice is a specific type of palliative care for people who likely have 6 months or less to live..

IF I RECEIVE PALLIATIVE OR HOSPICE CARE,WILL I STILL BE ABLE TO SEE MY PERSONAL DOCTOR?

Absolutely. Your palliative doctor coordinates care with your other doctors and helps you navigate the often-complex healthcare system.

IF I AGREE TO PALLIATIVE CARE,DOES THAT MEAN I'M "GIVING UP?"

Not at all. The goal of palliative care is to make you comfortable and help you achieve the best possible quality of life. You can have palliative care while you are undergoing treatments that may cure or reverse the effects of your illness. In fact, palliative care can help you cope with aggressive treatments by getting your pain and symptoms under control to help you fight the disease.

COULD I BECOME ADDICTED TO THE MEDICATION USED FOR MY PAIN AND SYMPTOMS?

Addiction to medication prescribed for pain relief is a common fear but does not frequently occur. Palliative doctors are experts in preventing problems and side effects of strong pain medications. They also can help patients with addictions get pain relief.

COULD TAKING PAIN MEDICINE HASTEN MY DEATH?

. Appropriately prescribed medicine will not hasten death. Your palliative doctor has the expertise to devise a medication plan that makes you comfortable and is safe.

WHAT IS MORPHINE?

Morphine is a strong painkilling drug. It works very well on many types of pain, although it is most commonly associated with cancer pain. It is also sometimes used to control feelings of breathlessness.

HOW DO I TAKE MORPHINE?

Morphine can be given in several ways. It’s available as a simple tablet or liquid which work for about four hours but as well as these, there are slow-release tablets or capsules that last for 12 or even 24 hours, so that you might only have to take one or two a day. Morphine can also be given as an injection too if needed although most patients take morphine in tablet form.

IF I TAKE MORPHINE, WILL I GET ADDICTED TO IT?

Taking morphine for pain will not make you an addict. It is quite normal for the dose to increase over time, although many people remain on a stable dose for long periods. As with other medicines, you should not stop taking morphine suddenly without discussing this with your doctor or nurse, as your body needs time to adjust.

WHAT HAPPENS WHEN I START TAKING MORPHINE?

We always start with the lowest possible dose to allow your body to get used to it. Your pain should improve very quickly, although it may take a little while to find the right dose and so it may have to be increased if it is not enough to stop the pain.

WHAT ARE THE MAIN SIDE EFFECTS TO LOOK OUT FOR?

Morphine tends to make you constipated and most people who take it need laxatives. Morphine can also make you feel sick when you first take it. Your doctor may give you something to stop this feeling, but it usually only lasts a few days.

Morphine can make you feel sleepy for the first few days while you are getting used to it or when the dose is increased but our bodies can usually adapt gradually. However, if you are already taking pain-killers they can often be equal in effect to a low dose of morphine, so changing to morphine should not feel especially different.

ARE THERE ALTERNATIVE PAINKILLERS?

Although morphine works well on many types of pain, some sorts of pain need different painkillers. You may need to take several different types of medicines to manage your pain. Morphine belongs to a group of painkillers called opioids. Morphine is the most commonly used opioid, but there are also several others, for example codeine, oxycodone or fentanyl. These can be as effective as morphine but occasionally one may suit a particular pain or patient more than another.

We can also give painkillers in a number of different ways. For example, some can be supplied as a patch that sticks to the skin or as a dissolvable tablet to use in the mouth.

WHAT IS THE DIFFERENCE BETWEEN ACUPUNTURE AND ACUPRESSURE?

Though the points are same for both the technique they are entirely different. Acupressure is probably Indian variant of acupuncture. There is no needle insertion in acupressure and how much pressure one should use is also controversial. We don’t practice acupressure we only do acupuncture.

HOW MANY TREATMENT SESSIONS ONE NEED AND HOW QUICKLY ONE GETS THE RELIEF?

There is no hard and past rules by and large most patients will need maximum of 20 sessions and minimum of ten. They feel the difference between 4 and 6 sessions. Each session is about 20 minutes. 

HOW DOES ACUPUNCTURE WORKS?

NOBODY KNOWS EXACTLY!
Various theories are put forward and following are some of them.
1. Chinese call positive and negative energy called yin and yang and imbalance of these results in disease. When we do acupuncture it regulates these forces hence disease is cured.
2. Some old Indian acupuncture text books say there is a fine connection between these acupuncture points and the six chakras of the body. Any disease is due to imbalance of any flow from the chakras to the peripheral points. If there is a block in one connection just before the block too much energy (spasms, fever etc.), distal to that lack of energy (weakness, numbness, flaccidity) when we put the needle the energy flow is regulated hence the disease is cured.
3. In the modern labs scientist have measured a chemical called endorphin levels going up after acupuncture. These endorphins are the naturally occurring morphine there by relives pain. In our experience it also releases other good healing chemicals which results in natural healing.

WHAT ARE THE TYPES OF ACUPUNTURE?

Two types one is western and second is traditional called TCM (traditional Chinese meridian).
The difference is western acupuncture is evidence based and lots of local points are used. The results are guaranteed whereas TCM (traditional Chinese meridian) is based on pulse and tongue diagnosis, they also use lots of Chinese herbs.

HOW LONG THE TREATMENT BENEFITS LAST?

.By and large the relief is permanent though ideally all of them will benefit a top up session once in ten days

WHAT ARE ALL THE SIDE EFFECTS OF ACUPUNTURE?

In experienced hands no side effects however in the inexperienced hands infection, trauma can happen

WHAT ARE ALL THE CONTRA INDICATION FOR THE ACUPUNTURE?

Local infection, bleeding disorders, patients who are all on warfarin, advanced liver disease needs to be very careful before having acupuncture.
Aspirin, clopidogrel and other blood thinning medications are not contra indicated and those patients can safely have acupuncture

CAN THIS BE TRIED WITH ALL OTHER MEDICINE?

Yes, since there is no internal administration of chemicals it can be tried in addition to any other system of medicine.

WHAT WILL HAPPEN TO MY ARTHRITIC KNEE OR SPONDYLITIC BACK?

Acupuncture either regenerates the knee or back structure or it eradicate the correct reason for the knee or back pain.