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DavidE
Ultra Nomad
Posts: 3814
Registered: 12-1-2003
Location: Baja California México
Member Is Offline
Mood: 'At home we demand facts and get them. In Mexico one subsists on rumor and never demands anything.' Charles Flandrau,
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Hey Whatchit With The Cracks About The Ladies Bars Willya?
Whatza a little pee'ing without a little screaming, eh?
You guys don't remember the three-tier houses of repute verde in Cd. Constitucion do you?
First one, new pickups, and cars, gravel, well lit
Second one: Older beaters, sand, a light bulb here and there
Third one, swear-to-god, a burro and horses parked outside. No lights and mud.
A Lot To See And A Lot To Do
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vgabndo
Ultra Nomad
Posts: 3461
Registered: 12-8-2003
Location: Mt. Shasta, CA
Member Is Offline
Mood: Checking-off my bucket list.
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| Quote: | Originally posted by DavidE
Hey Whatchit With The Cracks About The Ladies Bars Willya?
Whatza a little pee'ing without a little screaming, eh?
You guys don't remember the three-tier houses of repute verde in Cd. Constitucion do you?
First one, new pickups, and cars, gravel, well lit
Second one: Older beaters, sand, a light bulb here and there
Third one, swear-to-god, a burro and horses parked outside. No lights and mud. |
This time, I'm buying every word of this for absolute truth!
Undoubtedly, there are people who cannot afford to give the anchor of sanity even the slightest tug. Sam Harris
"The situation is far too dire for pessimism."
Bill Kauth
Carl Sagan said, "We are a way for the cosmos to know itself."
PEACE, LOVE AND FISH TACOS
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Mulegena
Super Nomad
Posts: 2412
Registered: 11-7-2006
Member Is Offline
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Ok, I'm coming out here.
It's my family we're talking about here. It's my mother-in-law who is very, very ill. Three weeks ago she was diagnosed with leukemia. She's now in
the IMSS Hospital in La Paz.
To clarify: The doctor did not forbid the family from discussing the illness with the patient.
The daughter, not the doctor, has directed the doctor as well as all family members not to discuss the illness with the patient, specifically with
respect to prognosis.
The mother does know the name of her illness and knows the treatment. That can't be hidden.
She doesn't know the deeper aspects of the illness or the prognosis. It was the withholding of this information from her by the doctor at the
daughter's request that I question and so wrote to Dr. Ensenada to clarify.
Today the whole of the patient's family has gathered together here in La Paz. I'm very focused now on caring for my mother-in-law and cannot spend
much time participating in this thread.
I'm about to go in to pull the night-shift in care of her.
Thank you, Dr. Janene, for starting this thread. It's proven to be an interesting topic already. I hope it provides some insight and good discussion
here.
Thanks, Nomads, for your prayers and good thoughts for my mother-in-law. I take them with me now.
Mulegena
| Quote: | Originally posted by EnsenadaDr
Yes Bob that is the case. | Quote: | Originally posted by durrelllrobert
| Quote: | Originally posted by elizabeth
Assuming an adult conscious competent patient, what right does the doctor have to give medical information to anyone other than the patient (unless,
of course, the patient has given consent). |
Janean wrote:
"..the Mexican Doctor has forbid all family members to tell the patient.."
Sounds like the family members already know but the patient doesn't |
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"Raise your words, not your voice. It's rain that grows flowers, not thunder." ~Rumi
"It's the mark of an educated mind to be able to entertain a thought without accepting it." ~ Aristotle
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DENNIS
Platinum Nomad
Posts: 29510
Registered: 9-2-2006
Location: Punta Banda
Member Is Offline
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| Quote: | Originally posted by vgabndo
This time, I'm buying every word of this for absolute truth! |
True, for sure, that Constitucion was the ho-house district in the seventies.
The workers in Loreto in those days would make bus trips there for weekends.
It was love.
.
[Edited on 9-28-2013 by DENNIS]
"YOU CAN'T LITTER ALUMINUM"
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Ateo
Elite Nomad
Posts: 5900
Registered: 7-18-2011
Member Is Offline
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I wish you and your family the very best.
| Quote: | Originally posted by Mulegena
Ok, I'm coming out here.
It's my family we're talking about here. It's my mother-in-law who is very, very ill. Three weeks ago she was diagnosed with leukemia. She's now in
the IMSS Hospital in La Paz.
To clarify: The doctor did not forbid the family from discussing the illness with the patient.
The daughter, not the doctor, has directed the doctor as well as all family members not to discuss the illness with the patient, specifically with
respect to prognosis.
The mother does know the name of her illness and knows the treatment. That can't be hidden.
She doesn't know the deeper aspects of the illness or the prognosis. It was the withholding of this information from her by the doctor at the
daughter's request that I question and so wrote to Dr. Ensenada to clarify.
Today the whole of the patient's family has gathered together here in La Paz. I'm very focused now on caring for my mother-in-law and cannot spend
much time participating in this thread.
I'm about to go in to pull the night-shift in care of her.
Thank you, Dr. Janene, for starting this thread. It's proven to be an interesting topic already. I hope it provides some insight and good discussion
here.
Thanks, Nomads, for your prayers and good thoughts for my mother-in-law. I take them with me now.
Mulegena
| Quote: | Originally posted by EnsenadaDr
Yes Bob that is the case. | Quote: | Originally posted by durrelllrobert
| Quote: | Originally posted by elizabeth
Assuming an adult conscious competent patient, what right does the doctor have to give medical information to anyone other than the patient (unless,
of course, the patient has given consent). |
Janean wrote:
"..the Mexican Doctor has forbid all family members to tell the patient.."
Sounds like the family members already know but the patient doesn't |
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EnsenadaDr
Banned
Posts: 5027
Registered: 9-12-2011
Location: Baja California
Member Is Offline
Mood: Move on. It is just a chapter in the past, but don't close the book- just turn the page
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Well the daughter can't direct the Doctor not to discuss the illness with the patient, or anyone else for that matter. That is one of his inherent
duties as a physician to let the patient be the first to know, and they will decide who to tell and who not to inform. Leukemia is a very grave
illness, and the resources for treatment are scarce in Mexico. In some cases, bone marrow transplants are warranted, but I don't know if they have
the facilities for that where your suegra is. The doctor should tell the daughter that your mom-in-law has every right to participate in her
treatment decision. The herbal remedies are probably harmless, depending on what they are. But I am hoping the Doctor has identified the herb and
has allowed it to be given because it is harmless. I did post the patient rights specifically from IMSS to let you know that it is a patient right to
be informed of their condition and to know the prognosis, and treatment options, and the patient be able to participate in the decisions regarding
those treatment options. To explain possibly the daughter's reasoning at this time I would say she is just overprotective of her mom and doesn't want
her to suffer unnecessarily, but she is not being rational and is allowing her emotions to cloud what is the right thing to do, which would be to
allow her mother to fully, unequivocally participate in her own care and decision making 100%. | Quote: | Originally posted by Mulegena
Ok, I'm coming out here.
It's my family we're talking about here. It's my mother-in-law who is very, very ill. Three weeks ago she was diagnosed with leukemia. She's now in
the IMSS Hospital in La Paz.
To clarify: The doctor did not forbid the family from discussing the illness with the patient.
The daughter, not the doctor, has directed the doctor as well as all family members not to discuss the illness with the patient, specifically with
respect to prognosis.
The mother does know the name of her illness and knows the treatment. That can't be hidden.
She doesn't know the deeper aspects of the illness or the prognosis. It was the withholding of this information from her by the doctor at the
daughter's request that I question and so wrote to Dr. Ensenada to clarify.
Today the whole of the patient's family has gathered together here in La Paz. I'm very focused now on caring for my mother-in-law and cannot spend
much time participating in this thread.
I'm about to go in to pull the night-shift in care of her.
Thank you, Dr. Janene, for starting this thread. It's proven to be an interesting topic already. I hope it provides some insight and good discussion
here.
Thanks, Nomads, for your prayers and good thoughts for my mother-in-law. I take them with me now.
Mulegena
| Quote: | Originally posted by EnsenadaDr
Yes Bob that is the case. | Quote: | Originally posted by durrelllrobert
| Quote: | Originally posted by elizabeth
Assuming an adult conscious competent patient, what right does the doctor have to give medical information to anyone other than the patient (unless,
of course, the patient has given consent). |
Janean wrote:
"..the Mexican Doctor has forbid all family members to tell the patient.."
Sounds like the family members already know but the patient doesn't |
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DENNIS
Platinum Nomad
Posts: 29510
Registered: 9-2-2006
Location: Punta Banda
Member Is Offline
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Can we all just hold our breath, die, and get this thread over with?
OK...I---2---deep inhale now------3
"YOU CAN'T LITTER ALUMINUM"
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DENNIS
Platinum Nomad
Posts: 29510
Registered: 9-2-2006
Location: Punta Banda
Member Is Offline
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You are now in Andrew's hands. He'll take you to heaven.
"YOU CAN'T LITTER ALUMINUM"
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toneart
Ultra Nomad
Posts: 4901
Registered: 7-23-2006
Member Is Offline
Mood: Skeptical
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| Quote: | Originally posted by DENNIS
Can we all just hold our breath, die, and get this thread over with?
OK...I---2---deep inhale now------3 |
Nope! I'm still breathing and this thread is most serious, especially to the principals involved. These are current, urgent questions that must be
resolved.
Mulegenia can be influential in the resolution. I know her. She has her head on straight. I commend her for reaching out with this real dilemma.
I too have Cancer; Lymphoma and Leukemia. So I have gleaned every bit of information, both traditional and alternative. It is not easy to wade
through. And then, every well meaning person hits you with their remedy that a friend of a friend, etc....
The onus is on the patient him/herself to do the research and choose the path that resonates best (and responsibly). That is why it is imperative that
the patient in this case is completely informed as to what she is up against. She alone has to choose her course of action, or inaction if that is her
desire. But she must have all the facts in her arsenal.
Dra. is contributing well to this string, too!
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bajabuddha
Banned
Posts: 4024
Registered: 4-12-2013
Location: Baja New Mexico
Member Is Offline
Mood: Always cranky unless medicated
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I have been watching didigently throughout this thresd and there's one other avenue that hasn't been addressed. I also have diabetes mellitus type
II, hypertension, high choleserol (hereditary), hereditary cardiac and aortal atherosclerosis(w/3 stents), broken back (T-1 compression fracture with
failed kyphoplasty), degenerative disc disease, chronic depression, PTSD, bad attitude and a few lesser but annoying inconveniences, including
temporary and fleeting sobriety (AA is for quitters).
All seriousness aside, we forget the patient's choice more than just hospice or full chemo-radiation longevital misery. There's a difference between
flat quitter's suicide (mostly a f--- U to somebody somewhere) and a terminal patient's right to choose their own time and place of passing in a calm,
controlled and dignified exit.
PBS had a wonderful special on FinalExitNework.com, and as far as my future is concerned when the time comes and i'm still able to choose, it's helium
for me.
Simple suicide may be the coward's way out, but if you self-delve into the true choices and decisions, it's a brave person to take the reigns of their
own life, and death... and ease it all into a doable, finished and prepared parting. For those with terminal situations, beats being a rutabega and
cleaned up after for weeks and months until 'Who's God' decides to pull the plug. I'd rather have that choice myself, i DO have that choice anyway,
and don't care about society's morals. I'm not F---U'ing to anyone, i'm choosing my DIGNITY to pick my own time, with all legaleses in place.
This so far (i think) hasn't been a part of this thread, but to me, should be. I hope i haven't offended anyone. If so, i deeply appologize. To me
birth is the second-greatest miracle (i've been an EMT).... death is the greatest. The first is still 'iffable'... the second is mandatory and set
in the Stone of Life. Once again, i'm sorry if this is too sore of a subject, but i feel deeply for it.
Happy trails,
bb
I don't have a BUCKET LIST, but I do have a F***- IT LIST a mile long!
86 - 45*
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EnsenadaDr
Banned
Posts: 5027
Registered: 9-12-2011
Location: Baja California
Member Is Offline
Mood: Move on. It is just a chapter in the past, but don't close the book- just turn the page
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Patient assisted suicide is not legal in Mexico at this time. In fact, many of the narcotic medications given to patients in the US such as morphine
or valium are not readily available in Mexico to relieve intractable pain and/or anxiety for patients suffering with terminal cancer, or post
operative patients dealing with severe post operative pain. There is a special license in Mexico that can be obtained to administer these
medications, and I firmly believe that in cases such as these, not administering these medications to relieve the pain adequately of the patient would
be cruel and inhumane. Many times in the course of treatment with potent painkillers, in the US, the patient may pass away peacefully. My uncle in
New Jersey had intractable pain and was placed on a morphine drip because of terminal cancer. He could never be fully awake because he would be
screaming in pain. Thankfully he passed away without suffering because the doctors kept him medicated enough so he didn't suffer. If the pain or
anxiety is controlled adequately I don't see a need for suicide. | Quote: | Originally posted by bajabuddha
I have been watching didigently throughout this thresd and there's one other avenue that hasn't been addressed. I also have diabetes mellitus type
II, hypertension, high choleserol (hereditary), hereditary cardiac and aortal atherosclerosis(w/3 stents), broken back (T-1 compression fracture with
failed kyphoplasty), degenerative disc disease, chronic depression, PTSD, bad attitude and a few lesser but annoying inconveniences, including
temporary and fleeting sobriety (AA is for quitters).
All seriousness aside, we forget the patient's choice more than just hospice or full chemo-radiation longevital misery. There's a difference between
flat quitter's suicide (mostly a f--- U to somebody somewhere) and a terminal patient's right to choose their own time and place of passing in a calm,
controlled and dignified exit.
PBS had a wonderful special on FinalExitNework.com, and as far as my future is concerned when the time comes and i'm still able to choose, it's helium
for me.
Simple suicide may be the coward's way out, but if you self-delve into the true choices and decisions, it's a brave person to take the reigns of their
own life, and death... and ease it all into a doable, finished and prepared parting. For those with terminal situations, beats being a rutabega and
cleaned up after for weeks and months until 'Who's God' decides to pull the plug. I'd rather have that choice myself, i DO have that choice anyway,
and don't care about society's morals. I'm not F---U'ing to anyone, i'm choosing my DIGNITY to pick my own time, with all legaleses in place.
This so far (i think) hasn't been a part of this thread, but to me, should be. I hope i haven't offended anyone. If so, i deeply appologize. To me
birth is the second-greatest miracle (i've been an EMT).... death is the greatest. The first is still 'iffable'... the second is mandatory and set
in the Stone of Life. Once again, i'm sorry if this is too sore of a subject, but i feel deeply for it.
Happy trails,
bb |
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Mulegena
Super Nomad
Posts: 2412
Registered: 11-7-2006
Member Is Offline
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Hi, Everybody,
It's Mulegena. I'm back at my aunt's house after a night guarding over mom-in-law. She rested on and off most of the night. Had some minor
complications which she and I and the nurses handled.
What's on my mind this morning is patient advocacy, advanced directives, power of attorney for healthcare. These are things which everyone needs, I
feel, and especially having someone who will step up and "go to bat" for the patient. When you're sick, you need someone to stick up for you, speak
for you if need be.
The Mexican culture is one in which there is a matrix of broad family ties. Someone will almost always be there for you. As far as having legal
documents in place, well that concept probably isn't existent for many. Additionally, the psychological makeup of people tends to be one of quiet
stoicism in times of stress. There doesn't appear to be any deep angst or philosophizing on one's circumstance.
Within my family there is little understanding of the science of medicine. There's acceptance of circumstance and trust that doctors will do their
best to cure. The influence of the Church runs deep, deeper than the trust in medicine. The belief in God and miracles is forefront in the hearts of
the people. To quote a family member, "We feel that medicine helps, but we believe in miracles." I was gobsmacked when I heard this and I think my
head spun around 3 times. I've spent most of my adult life in the practice of medicine and study of science; I believe in science and medicine--
miracles are nice when they seem to occur but I'm not holding my breath.
We'll see what these next couple of days bring. I'm going to nap now then go back to the hospital in the afternoon. Thanks for your continued strong
thoughts and goodwill.
"Raise your words, not your voice. It's rain that grows flowers, not thunder." ~Rumi
"It's the mark of an educated mind to be able to entertain a thought without accepting it." ~ Aristotle
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bajaguy
Elite Nomad
Posts: 9247
Registered: 9-16-2003
Location: Carson City, NV/Ensenada - Baja Country Club
Member Is Offline
Mood: must be 5 O'clock somewhere in Baja
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Directives and POA
We have been working with a local attorney to complete our (Mexican) wills, advanced directives, power of attorney for healthcare and a general POA
for decisions that need to be made.
All of this goes through a Notary and is recorded at the Municipal offices and in the Notary file at the state capitol in Mexicali.
September (and October) Wills in mexico are 50% off. Will be costing us 900 pesos each.
These are important documents to have if you are full or part timers in Baja.
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EnsenadaDr
Banned
Posts: 5027
Registered: 9-12-2011
Location: Baja California
Member Is Offline
Mood: Move on. It is just a chapter in the past, but don't close the book- just turn the page
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Excellent contribution here, Bajaguy. I have seen cases where none of this is in place and things going totally haywire. | Quote: | Originally posted by bajaguy
We have been working with a local attorney to complete our (Mexican) wills, advanced directives, power of attorney for healthcare and a general POA
for decisions that need to be made.
All of this goes through a Notary and is recorded at the Municipal offices and in the Notary file at the state capitol in Mexicali.
September (and October) Wills in mexico are 50% off. Will be costing us 900 pesos each.
These are important documents to have if you are full or part timers in Baja. |
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EnsenadaDr
Banned
Posts: 5027
Registered: 9-12-2011
Location: Baja California
Member Is Offline
Mood: Move on. It is just a chapter in the past, but don't close the book- just turn the page
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It's wonderful your mother-in-law has such a caring advocate for her. Unfortunately, the Mexican culture is steeped in the Catholic religion to the
point of sometimes ignoring medical fact and advice. All you can do is give your emotional support to your suegra and try to convince the family
members to do the right thing by her. Have a good day and get plenty of rest and I hope you don't get too exhausted. Attending to gravely ill family
members can sometimes cause the caregivers to get sick themselves. | Quote: | Originally posted by Mulegena
Hi, Everybody,
It's Mulegena. I'm back at my aunt's house after a night guarding over mom-in-law. She rested on and off most of the night. Had some minor
complications which she and I and the nurses handled.
What's on my mind this morning is patient advocacy, advanced directives, power of attorney for healthcare. These are things which everyone needs, I
feel, and especially having someone who will step up and "go to bat" for the patient. When you're sick, you need someone to stick up for you, speak
for you if need be.
The Mexican culture is one in which there is a matrix of broad family ties. Someone will almost always be there for you. As far as having legal
documents in place, well that concept probably isn't existent for many. Additionally, the psychological makeup of people tends to be one of quiet
stoicism in times of stress. There doesn't appear to be any deep angst or philosophizing on one's circumstance.
Within my family there is little understanding of the science of medicine. There's acceptance of circumstance and trust that doctors will do their
best to cure. The influence of the Church runs deep, deeper than the trust in medicine. The belief in God and miracles is forefront in the hearts of
the people. To quote a family member, "We feel that medicine helps, but we believe in miracles." I was gobsmacked when I heard this and I think my
head spun around 3 times. I've spent most of my adult life in the practice of medicine and study of science; I believe in science and medicine--
miracles are nice when they seem to occur but I'm not holding my breath.
We'll see what these next couple of days bring. I'm going to nap now then go back to the hospital in the afternoon. Thanks for your continued strong
thoughts and goodwill. |
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bajabuddha
Banned
Posts: 4024
Registered: 4-12-2013
Location: Baja New Mexico
Member Is Offline
Mood: Always cranky unless medicated
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It's not just the Church they turn to in times of medical need; my old and dear friend that ran the little beach camp i stayed at for many years had
an obvious tumor on his neck, and rather than see a doctor he went to the local 'Bruja' or Herbalista for aid. Unfortunately by the time it
progressed and he ferried across to Hermosillo, he was obviously in stage 4. Never made it back home. I miss him dearly to this day.
I don't have a BUCKET LIST, but I do have a F***- IT LIST a mile long!
86 - 45*
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EnsenadaDr
Banned
Posts: 5027
Registered: 9-12-2011
Location: Baja California
Member Is Offline
Mood: Move on. It is just a chapter in the past, but don't close the book- just turn the page
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You are right about that. When you think about it, the Catholic Church forbids the worship of false Gods or loosely translated, the consultation with
any voodoo types or self-proclaimed healers. I know Mulegena was concerned about the herbs the family brought in. I have seen some of the herbs they
bring in and most of the time they are harmless, but some can act as a stimulant like Gingko Biloba, and affect the heart. I will never forget an
elderly legally blind lady that lived in San Antonio del Mar, and she signed over her home to a local church in Rosarito upon her death. Three weeks
later she was dead. | Quote: | Originally posted by bajabuddha
It's not just the Church they turn to in times of medical need; my old and dear friend that ran the little beach camp i stayed at for many years had
an obvious tumor on his neck, and rather than see a doctor he went to the local 'Bruja' or Herbalista for aid. Unfortunately by the time it
progressed and he ferried across to Hermosillo, he was obviously in stage 4. Never made it back home. I miss him dearly to this day.
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DENNIS
Platinum Nomad
Posts: 29510
Registered: 9-2-2006
Location: Punta Banda
Member Is Offline
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| Quote: | Originally posted by EnsenadaDr
You are right about that. When you think about it, the Catholic Church forbids the worship of false Gods or loosely translated, the consultation with
any voodoo types or self-proclaimed healers. |
Not entirely so. There are cases in the annals of conversion that note a compromise in beliefs so as to keep the interest of the converts. I
believe the Spanish were aware of this judicious tolerance.
"YOU CAN'T LITTER ALUMINUM"
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bajalinda
Senior Nomad
Posts: 551
Registered: 6-7-2008
Location: Pacific Coast, BCS
Member Is Offline
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Very timely topic here - Bajaguy, recently we have also been trying to get info about the Mexican equivalent of what I think is called a Living Will
in the States - document which gives POA to someone who can make medical decisions for you if you are not able to do so yourself. Do you (or
EnsenadaDr) know if there is a Mexican equivalent for this? and what is the name for it in Spanish? We have been told that medical decisions will be
made by the relatives as long as they prove their relationship with vital records. Well, what if there are no relatives nearby (which I imagine is
probably a fairly common state of affairs among the ex-pat community) and a time-sensitive decision has to be made?
Mulegena - hoping for the best for your mother-in-law and all your family.
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toneart
Ultra Nomad
Posts: 4901
Registered: 7-23-2006
Member Is Offline
Mood: Skeptical
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The story is different than when first presented. It is not the doctor, but rather the daughter who has directed all to withhold the complete picture
to her mother.
Family dynamics under stress often gets pretty crazy and unpleasant. That is not somewhere that any of us here on the BajaNomad can go, nor should we.
All I can say is Bless You, L.M.! Try not to take the whole burden upon yourself. You can offer input and support. It appears that the daughter is
the primary caregiver. It is not easy to stand by and watch. This illness is insidious. It can kill the Caregiver too.
BajaGuy has given good information on Health Directives in Mexico. The patient may have already abdicated her personal responsibility to the daughter.
But, if she is still competent, she should have that option to give a legal directive. Time is not on her side. Pain management, and often dementia,
can quickly remove that option in the end stages.
And again, the main point of this thread is that she really should have full knowledge of her diagnosis and prognosis. But perhaps that is
beyond your sphere of influence, Mulegenia. (?)
To Nomads In The United States, there is a wonderful software program from Nolo Press. It costs $60.00. It is a four part legal document; Will,
Healthcare Directive, Durable Power of Attorney your final wishes. It is updated annually and is State Specific. It asks you questions so thoroughly
(some that you may not have even thought of), that when you make your decisions you are left with a peaceful, confident feeling. You can update
periodically as your circumstance and assets change.
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