Tag Archives: foreshortened future

Pain vs. suffering: why they’re not the same for patients

19 Feb

by Carolyn Thomas      @HeartSisters

I’ve written a lot (here, here, and here, for example) about cardiac pain, because I live with a lot of cardiac pain called refractory angina due to a pesky post-heart attack diagnosis of coronary microvascular disease. This pain varies, but it hits almost every day, sometimes several episodes per day, and it can feel very much like the symptoms I experienced while busy surviving what doctors call the widow maker heart attack in 2008.

But there’s pain, and then there’s suffering. The two are not the same.

I spent many years working in the field of hospice palliative care, where we all learned the legendary Dame Cicely Saunders‘ definition of what she called total pain”.(1)  This is the suffering that encompasses ALL of a person’s physical, psychological, social, spiritual, and practical struggles. Although addressing total pain is an accepted component of providing good end-of-life care for the dying, the concept seems to be often ignored in cardiac care for the living. Continue reading

“Live a healthy life, then die quickly at 90”

19 Jan

by Carolyn Thomas     @HeartSisters

woman funny oldYou’d hardly expect a physician who spends his life trying to cure cancer to suddenly shift gears and suggest that maybe, just maybe, we should “stop trying”. But it turns out that New Jersey oncologist Dr. James Salwitz agrees with a review of data published in the September 2012 issue of Lancet Oncology, entitled “First Do No Harm: Counting the Cost of Chasing Drug Efficacy.” *

An accompanying Lancet editorial suggests that during the 10 years between 2000 and 2010, “many new cancer drugs produced marginal extensions in survival and simultaneously increased risk of treatment-associated death and side effects.”  This compelled Dr. Salwitz to write:    Continue reading

A foreshortened future

27 Sep

by Carolyn Thomas   @HeartSisters

Cardiac psychologist and heart attack survivor Dr. Stephen Parker recently described a symptom of Post Traumatic Stress Disorder that rang a bell for him after his own cardiac event. The PTSD symptom is called “a sense of a foreshortened future“. In other words, after a traumatic event – in this case, a heart attack – the patient “does not expect to have a career, marriage, children, or a normal life span.”  As Dr. Steve tells his own story of this symptom:

“Three months after the heart attack, I went to Home Depot to buy something for the house. I walked inside, saw the plethora of nice things to make a nice house, and started feeling extremely depressed.

“What was the point? I knew I was going to die within a short time.   Continue reading