Palliative medicine

 This has been posted with Consent of patient and family only .

Though I do not like posting pictures of my patients much I did this to dispel the notion that Palliative medicine is all depressing and end of life 

Even some physicians feel so .

The end of life care is called Terminal care which is also under Palliative medicine .

This patient is 84 year old lady  having multiple myeloma which has progressed with treatment but she can continue for some more years 

She does have pain which is treated in her case with Morphine .

As you can see she is cheerful and normal 

The  myth that  Morphine is only to make patients sleep to reduce pain and has so many side effects is widely spread .

Morphine is an opioid narcotic if used judiciously by physicians trained for it ( Palliative specialists ) gives complete relief of pain  and good quality of life 

Most patients are active and lead a normal life some are more tied down to wheel chair or bed while this patient can walk comfortably 

Many patients even without advanced cancer but curable types may have severe pain initially when being treated 

Most children with bone tumours soft tissue tumours adults with extensive breast cancer all have pain initially  but with oncology treatment they become completely cured .

So pain management is needed only  in initial period but later can be stopped .

I have several patients whose Morphine or fentanyl are stopped and are now living cured of thier disease too .

So it's a myth to feel that once narcotics is started its for life 

over dosing rarely occurs as its a team work between family of patient and Palliative physician in knowing his or her condition adjusting dose etc .

All my patients have my mobile number and none misuse it to call me at odd hours .

Palliative medicine is not only for cancer but in several chronic long standing incurable conditions 

 life style diseases like Diabetes mellitus with target damages ,renal failure patients on dialysis ,Motor neuron disease , neuralgia like trigeminal neuralgias ,Alzheimers disease, Parkinsonism ,HIV AIDS ,Spinal injury induced paraplegias ,post Amputation pain or phantom pain etc .

Pain beyond 6 months is called chronic pain and needs different medications from acute pain and is classified into neuropathic and Nociceptive pain .

Pain management is both science and art which needs empathy ,care of social spiritual dimensions of patients too and good communication skills .

Relief from pain is the best reward for both physician and his patient .

It's possible with Palliative medicine with use of interventional pain management as needed to get total relief of pain .

In cancer radiotherapy in small doses too helps .

Pain relief makes a big difference in quality of life of patient and family .