Sunday, April 25, 2010

Shell Shock

"Six weeks ago I felt fine". Today, I have two different kinds of cancer, one on my vocal cord making my voice hoarse and one in my lung pressing on my blood vessels, making me feel short of breath and causing my face and arms to swell. The lung cancer has already spread to my bones. My legs are weak. Now I need a brace and a walker to walk and my back hurts. If I try to walk, I get more short of breath. My pancreas is inflamed and they say I have diabetes. I can't sleep because I am worried. What happened??? 
I included the words "shell shock" on the Palliative Medicine consult today, amidst the obvious issues of pain, shortness of breath.... The term was first coined in WWI to describe the confused or nervous mental condition of people who had been under fire in a war. Today, "shell-shocked" is also used to describe someone in a state of stunned confusion or shock; someone who is dazed. The signs of shell shock are disorientation and inability to focus, with reactions like shaking, nightmares, twitching, headaches, fatigue, insomnia, dizziness, anxiety, and irritability. These are also signs experienced by patients with life-limiting illnesses who develop, for example, opioid neurotoxicity or delerium. In this case though, it was simply too much, too soon, too life-altering.

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