I am sure those of you who are reading this blog , must be thinking about various problems,like STD or prostitution or problem related to money or greed.But I am talking about the problem that we in medicine and the general public is facing more and more.THE AGING POPULATION . This came to my mind when I saw 'few' patients in their nineties. The problem is complex and it has many facets from health issues , to mental problem and the memory loss to loss of companionship.So let me tell you about the patients that triggered the thought or may be got more intense.
I was seeing this patient who was 99 years old and his wife , who is also my patient 96 years old and her sister who was 98years old I just causally mentioned to them that you all have 'good genes' The wife just smiled and did not say much..He had COPD and was on oxygen too. He got bad pneumonia and then got worse and so I had to admit him . Within 2 days of his hospitalisation, his wife got sick and though had only acute bronchitis , due to her age I had to admit her too. During the hospitalisation , I did check his heart as he was not getting better.I did echo cardiogram, an ultrasound of the heart. It showed that his heart was weak. He was followed by a cardiologist in the past , but no recent echo cardiogram was available.Again with his advanced age the cardiologist and the wife and I decided that not much work could be done. I made him DNR and he celebrated his 100th birthday . He continued to get worse and then died. The wife did OK and was discharged.
In next 3 months , her sister got sick. She needed to be admitted and got really worse.She also had some dementia.So after discussion with her I made her DNR and called Hospice.She was discharged and died in next 2 days after the discharge
I saw her in next 2 or 3 weeks..She was doing OK ,but looked depressed.When I asked her as to how she was doing, she said,"Do you remember what I was saying few months ago,"I was not sure as to which part of our conversation she was referring to . So she answered , that it was related to the GOOD GENES that I had commented about.She said, " Having good genes is not a blessing.I lost my life long partner, my only sister died and I am loosing my memory and can't see well .So how I am going to enjoy these good genes?" I had no answer.
It is one thing to get old and accept the reality of the aging process. But it becomes very difficult , when either the patient or the family does not want to accept it.But I will talk about it in the next blog.
I was seeing this patient who was 99 years old and his wife , who is also my patient 96 years old and her sister who was 98years old I just causally mentioned to them that you all have 'good genes' The wife just smiled and did not say much..He had COPD and was on oxygen too. He got bad pneumonia and then got worse and so I had to admit him . Within 2 days of his hospitalisation, his wife got sick and though had only acute bronchitis , due to her age I had to admit her too. During the hospitalisation , I did check his heart as he was not getting better.I did echo cardiogram, an ultrasound of the heart. It showed that his heart was weak. He was followed by a cardiologist in the past , but no recent echo cardiogram was available.Again with his advanced age the cardiologist and the wife and I decided that not much work could be done. I made him DNR and he celebrated his 100th birthday . He continued to get worse and then died. The wife did OK and was discharged.
In next 3 months , her sister got sick. She needed to be admitted and got really worse.She also had some dementia.So after discussion with her I made her DNR and called Hospice.She was discharged and died in next 2 days after the discharge
I saw her in next 2 or 3 weeks..She was doing OK ,but looked depressed.When I asked her as to how she was doing, she said,"Do you remember what I was saying few months ago,"I was not sure as to which part of our conversation she was referring to . So she answered , that it was related to the GOOD GENES that I had commented about.She said, " Having good genes is not a blessing.I lost my life long partner, my only sister died and I am loosing my memory and can't see well .So how I am going to enjoy these good genes?" I had no answer.
It is one thing to get old and accept the reality of the aging process. But it becomes very difficult , when either the patient or the family does not want to accept it.But I will talk about it in the next blog.
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