[Magdalen] Cold caps in chemotherapy

[Jay Weigel]

One of the finest doctors I ever dealt with on end-of-life issues was an
internal medicine doc who wasn't terribly well respected locally (partly
because he was rather free with pain meds), but he proved to be amazingly
sympathetic to his elderly and terminal patients. It wasn't until I'd had
several of them that I learned that he was dealing with his own mortality;
he had Hepatitis C and was on the list for a liver transplant. He never did
get the transplant, and he died a few years later. My memories of dealing
with him are all positive, even though he could be a bit abrasive at times.
He understood as few doctors could, I believe.

On Wed, Aug 19, 2015 at 3:32 PM, AT&T <jhandsfield at att.net> wrote:

> I fired my mother's oncologist after he treated her for CNS lymphoma and
> shrunk the tumor. He didn't acknowledge that she had descended into severe
> Alzheimer's type dementia. It might have added three or four months to he
> life.
>
> I went back to her PCP and gave instructions to keep her as comfortable as
> possible but otherwise let the disease take it's course.
>
> Jim Handsfield
> Sent from my iPhone
>
> > On Aug 19, 2015, at 3:22 PM, Jay Weigel <jay.weigel at gmail.com> wrote:
> >
> > One reason it's not my cuppa, Sally, is that I dislike most oncologists
> > intensely, and the reason is this--they are so focused on "fighting the
> > enemy" (cancer/death) that they frequently lose sight of the human
> element,
> > the patient. If the cancer does not respond to treatment, they often
> become
> > frustrated and abandon the patient, if not physically, at least
> > emotionally. Sometimes that takes the form of insisting on, and even
> > bullying the patient into, more extreme forms of treatment, even when it
> is
> > most likely futile. Been there and seen it. But I guess that's what you
> are
> > saying.
> > /rant mode off
> >
> > There was one I liked. His name, amazingly enough, or perhaps fittingly,
> > was Dr. Lazarus. He would tell his patients, "Death is a part of life and
> > we have to be realistic and accept that sometimes everything we can do is
> > not enough. We need to trust each other enough to know when to stop, if
> > there is a time to stop."
> >
> > On Wed, Aug 19, 2015 at 3:01 PM, Sally Davies <sally.davies at gmail.com>
> > wrote:
> >
> >> Well, I put the article together and will see if my sister likes it.
> >>
> >> It seems that doctors have often had a negative mindset because earlier
> >> attempts to achieve scalp cooling weren't very successful (and it's not
> an
> >> easy thing to do). But the systems have improved a great deal, whether
> >> those that pump coolant into the caps (located in treatment centres) or
> the
> >> DIY version which requires dry ice.
> >>
> >> People also still raise issues about possible metastasis, though it
> seems
> >> that the likelihood of metastasis to the scalp is very low, compared to
> the
> >> benefits of being able to keep hair. Especially if the cancer being
> treated
> >> is at an early stage...
> >>
> >> Those who are migraine sufferers, are on more extended chemo, are on
> >> particular chemo drugs that stick around longer, who have exceptionally
> >> thick hair (ironically) should not try the Cold Caps. Nor should anyone
> >> with a blood borne cancer because that would be a threat to treatment
> >> success.
> >>
> >> Our patient really had to work it all out herself, including how to
> prevent
> >> getting frostbite on her ears (she cut up panty liners and used them to
> >> protect exposed skin). And the oncology doctors here in Port Elizabeth
> were
> >> very negative and dismissive, though the staff at her local clinic in
> the
> >> small town of East London helped her and were thrilled with her success.
> >>
> >> Interesting stuff!
> >>
> >> And Jay, I agree - Oncology is not my cuppa either, though I have
> Hospice
> >> training and experience and have always done bereavement counselling...
> >>
> >> At the acute hospital, I have managed to work out a situation where I
> don't
> >> see their patients because nine out of ten times it's a psychological
> >> disaster!! They don't want the patients seen by someone who wants to
> talk
> >> about what's really going on, patients are desperately vulnerable as are
> >> the families, and I don't like the clinical risk that comes with
> patients
> >> who have such poor physician support. <rant mode off>
> >>
> >> Sally D
> >>
> >>
> >>
> >>> On Wednesday, August 19, 2015, Jay Weigel <jay.weigel at gmail.com>
> wrote:
> >>>
> >>> I've heard both pro and con about this. I didn't do oncology at all
> when
> >> I
> >>> was an active nurse (just not my cuppa, for various reasons which I
> won't
> >>> go into) but I get the feeling that such things are kind of scoffed at
> >>> here. I don't know whether it's because the FDA thinks it knows more
> than
> >>> doctors and agencies in Europe and elsewhere, or what.
> >>>
> >>> On Wed, Aug 19, 2015 at 8:56 AM, Roger Stokes <
> >>> roger.stokes65 at btinternet.com <javascript:;>
> >>>> wrote:
> >>>
> >>>> One of my nieces was, for a time, a representative for a firm
> supplying
> >>>> the refrigerators for this treatment.  From what I gather it was not a
> >>> good
> >>>> firm to work for as she was the one employee who was not part of the
> >>> family
> >>>> and her "beat" was the whole of the country, lugging the kit around in
> >>> her
> >>>> car.
> >>>>
> >>>> She now deals with and demonstrates edoscopy equipment in a much
> >> smaller
> >>>> area and with smaller bits of kit.
> >>>>
> >>>> Roger
> >>>>
> >>>>
> >>>>> On 19/08/2015 12:58, Sally Davies wrote:
> >>>>>
> >>>>> Dear Pub friends
> >>>>>
> >>>>> I have an interesting assignment from my sister, to write a piece on
> >> her
> >>>>> website about cold cap treatment which is a strategy for preventing
> >> hair
> >>>>> loss during chemotherapy.
> >>>>>
> >>>>> I just spoke to a former patient who did that and managed to save her
> >>> hair
> >>>>> - which was long and still is!
> >>>>>
> >>>>> It involved quite a rigmarole, they had to get Dry Ice in (from
> >>> elsewhere)
> >>>>> for the caps, change caps every twenty minutes on "chemo day" and
> >> ensure
> >>>>> that any skin not already protected by hair (such as the ears) was
> >>> covered
> >>>>> to prevent frostbite!
> >>>>>
> >>>>> But after six sessions of chemo - lovely natural hair. This patient
> >> had
> >>>>> been through chemo baldness before, as a teenager, and had been
> >>>>> traumatised
> >>>>> by it so she was highly motivated to manage the cold caps
> >>>>>
> >>>>> Not for everyone I'm sure and perhaps wouldn't even work for
> everyone,
> >>> but
> >>>>> she says that overseas (US/UK) chemo treatment facilities offer the
> >> caps
> >>>>> routinely and even have specialised apparatus for fast freezing them.
> >>>>>
> >>>>> Has anyone in the Pub come across these? And if so, did they work or
> >> was
> >>>>> the head-freezing just useful as a distraction during an awful time
> >> in a
> >>>>> person's life?
> >>>>>
> >>>>> Sally D
> >>
>