Online doctor consultation has numerous uses and I have already covered 5 common use cases in an article. In this article, I’ll be covering a few more situations where online doctor consultation can be used, especially in the case of palliative patients.
#1 Mr. Rajeev is a 68 year old retired Government servant who was diagnosed with lung cancer 4 months ago. His cancer has spread to the spine and that has made him paralyzed for the last one month. He is currently bedridden with cough, restlessness, severe chest pain that is not getting adequately controlled with the painkiller medicines which he received from nearby hospital. His nearest palliative care center is 30 kms from his home and he has not been visited by a palliative care specialist doctor ever since his diagnosis. His oncologist has been frequently asking Mr.Rajeev’s family to get a palliative care specialist doctor’s opinion and care, but they were never able to consult such a doctor.
A palliative care doctor is specialised to provide symptomatic relief for the patient as well as give support to the family and the patient by studying his psycho-social issues. Management of pain when done by a palliative care specialist doctor is completely different from that given by an untrained doctor. The license to prescribe and distribute Morphine, one of the most powerful painkiller medicine in the world is available only for the palliative care specialist doctors. It doesn’t mean that all patients need Morphine to control their pain.
In India, palliative care services are provided to the patient only at the terminal stage if the same service can be started along with other treatment options or even at the time of diagnosis, the patient can have a better quality of life in his remaining days.
In Mr. Rajeev’s case as the family is finding it difficult to consult a palliative care doctor, an online doctor consultation service can be of great help. Doctors specialised in providing pain and palliative care all over the country can consult and prescribe medicines to millions of patients similar to Mr.Rajeev. The patients condition can be frequently followed up using online doctor consultation, any difficulty the patient or the family experiences can be immediately addressed by the doctor and other care providers virtually. Time, money and resources can be saved by making use of online doctor consultation services.
#2 Mr. Moideen has been getting palliative care from one of the major palliative care centers in Kerala for the last 2 years. At the time of diagnosis the doctors had predicted only 6 months life expectancy for Mr. Moideen and was advised palliative care alone. 2 years later Mr. Moideen is still happy mainly because of the reason that he is still in his home along with his family and all of his symptoms are well controlled with the medicines from the palliative care center. The palliative care team visits him once in every 2 months and spends at least 30 mins chatting with him, discussing his problems, changing his urine collecting bag, and giving instructions to his family member. The only complaint from Mr. Moideen is that the palliative care team needs to visit him more often. But unfortunately, as more than 2000 such patients are being visited by the same palliative care team, they cannot visit every patient even on a monthly basis. Moreover emergencies like blood in urine, leaking catheter are managed by nurses from the nearby hospital and not by the palliative care team.
By using online doctor consultation services, Mr. Moideen’s wish can be easily fulfilled. Mr. Moideen can talk to a palliative care specialist doctor whenever he wants to and that conversation will not be limited by the number of minutes they talk. The doctor can see Mr.Moideen through video calls give instructions to the family members, examine the colour of his urine collected in the bag and can even instruct the local hospital nurse when they are providing the care.
#3 Mrs. Shakuntala has been eagerly waiting her death, ever since she was diagnosed with the advanced cancer of cervix. She has not received any radiotherapy, chemotherapy or surgery and was on oral medicines that she received from the palliative care center. Her pain is now well controlled with Morphine. Her family who looks after her very passionately wants to say farewell in such a way that the memories stay forever. They have also accepted the imminent death of Mrs. Shakuntala. For the last 2 weeks her condition has been deteriorating rapidly as she is not taking any oral feeds in spite of pressure from her family. She doesn’t want to be hospitalised in her last few hours and her family respects her decision, but they are worried because dealing with a terminally ill patient was their first ever experience. They have already received instructions from the palliative care center on what to expect and how to manage her during the last few days. But it was getting more and more difficult for them as her condition worsened.
Doctors specialised in providing palliative care services who can be reached 24 x 7 can be of immense help in this case. They can instruct the family members on how to care for such a person at home overriding the need to take her to the nearest hospital. Doctors can advise that force feeding is not required in the last few days as her body is in a shutting down process and that it can result in more damage than achieving actual benefit. Noisy breathing, often termed as “Death Rattle” can also be managed at home with a simple prescription medicine that can be applied underneath the patient’s tongue. Terminal care is an important part of palliative medicine and in order to satisfy the patient and family’s wishes, online doctor consultation should be used during those times.
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These were some of the situations were online doctor consultation service like Dofody can be made use of in providing palliative care. I hope that this article was an informative one. Share this article with your friends and family whom you think are in need for palliative care services.
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