@DoctorbMD Agree this happens. Yet also many family members do not want to hear the truth, try to force further (incl) intensive treatment, get angry during code discussion, threaten personnell, disagree with medical decisions regarding no resuscitation, delay hospice decisions, etc.
@CoffeeBlackMD ..to better realize her body was failing, we were now able to step-wise discuss we would not provide invasive ventilation nor dialysis, and this led to good/better 'closure' I think. This was meaningful for the family, but preferably this would not have happened/been necessary.
@CoffeeBlackMD Or provide durable responses, or even cure. Sometimes these discussions are hard, e.g. if the message is not accepted (yet) or if we fail to make clear that ICU treatment will not change/improve the progressive underlying disease. Your description implies a different 'system',
@CoffeeBlackMD Of you would work at MD Anderson I could understand the nr of pts. I'm a Dutch oncologist and we try to avoid ICU admission at (clearly) end of life as much as possible (stage IV itself too unspecific as pts may have or have no option(s) left that can "bridge" them signific.)
HUMILIATING GOP MELTDOWN CAUGHT ON CAMERA: Rand Paul just pulled the chair out from under Marco Rubio in the Senate hearing — and the hypocrisy exploded in real time.
Rand drops the hammer:
“If another country bombed our air defenses, captured and removed our President on U.S. soil… would THAT be okay?”
Rubio freezes. He starts frantically erasing his notes, forgets how to breathe, and looks like a Trump sycophant who just realized he sold his soul for nothing.
Rand reminds him point-blank:
Congress declares war.
Congress controls the checkbook.
That Constitution you swore an oath to?
GOP loves executive power when Trump’s doing regime change abroad.
But flip the script? Suddenly it’s not so sexy.
Rubio couldn’t even choke out “NO.”
He couldn’t defend the endless foreign adventures he’s been selling for years.
Our tax dollars. Their cowardice.
This isn’t politics.
This is a bought-and-paid-for senator auctioning off the Constitution for donor dinners and Fox News applause.
GOP in power = rules for thee, but never for me.
@pvdbig@ballendraaister Mensen zijn massaal op zonvakanties gegaan Patrick. En bakken aan de kust. Maar doe je ding. Dermatoloog en oncoloog zijn er voor je als het nodig is.
@Banana_Oncology Maybe low-class topical steroids do the job as well (to reduce the inflammatory component that you see, even though it can be acneiform and in the face); have positive experiences, eg in pts with similar tox due to MEKi monotherapy.
@Banana_Oncology It's a nice experiment/early study, (yet) concerned 10 patients with gr 1-2 rash, with signs of efficacy (and/or improvement over time?) in the 2 lower cohorts and no effect or even worsening in 3rd/ highest dose level. Caused gr 1-2 skin AEs in 7 pts, too.