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16 W edn e sd ay , O c tob e r 7 , 2015 Th e Nugg e t N ew spap e r , S i s t e r s , O r egon H o s p i c e p a t i e n t s , p r a c t i t i o n e r s f a c e q u a n d a r y a b o u t a n t i b i o t i c s B y D a v i d S t a u t h C o r r e s p o n d e n t PORTLAND — A su r- v ey o f ho sp i c e p rog r am s in O r egon found th a t on ly 31 p e r c en t h ad po l i c i e s fo r in i- t i a t ing th e u s e o f an t ib io t i c s , and on ly 17 p e r c en t a po l - i cy fo r wh en to d i s con t inu e th em — po in t ing to a con - t inu ed un c e r t a in ty abou t th e u s e o f su ch m ed i c a t ion s in th i s s e l e c t g roup o f t e rm in a l p a t i en t s . Th e f ind ing s , pub l i sh ed in the Ame r ican Jou rna l o f Ho sp i c e and Pa l l ia t i v e M ed i c in e, a r e among th e f i r s t t o q u a n t i f y p o l i c i e s f o r a n t i b i - o t i c u s e in ho sp i c e , wh e r e th e p r im a ry go a l i s to p romo t e p a t i en t com fo r t and qu a l i ty o f r em a in ing l i f e , bu t no t to p ro long i t . A con c e rn h igh l igh t ed in th e r e s e a r ch i s th a t an t ib io t - i c s m ay h av e unw an t ed s id e e f f e c t s th a t c an d e c r e a s e a p a t i en t ’ s com fo r t , su ch a s n au s e a , vom i t ing , d i a r - rh e a o r y e a s t in f e c t ion . I t found th a t su ch symp tom s w e r e ob s e rv ed “ som e t im e s o r o f t en ” by abou t h a l f o r mo r e o f r e spond ing ho sp i c e p rog r am s . R e spond en t s to th e su r- v ey d id s ay th a t th ey r a r e ly o r n ev e r u s e an t ib io t i c s to p ro long p a t i en t ’ s l iv e s — bu t 14 p e r c en t o f p rog r am s a l so r epo r t ed th a t th i s som e t im e s o c cu r s . “Th e l a ck o f sp e c i f i c po l i - c i e s and gu id e l in e s abou t an t ib io t i c u s e in ho sp i c e c a r e r e f l e c t s th e d i f f i cu l ty and un c e r t a in ty th a t s t i l l ex i s t s in how to m an ag e end -o f - l i f e c a r e , ev en among th i s g roup o f p eop l e who h av e cho s en no t to p ro long th e i r l i f e , ” s a id Jon Fu runo , an a s so c i a t e p ro f e s so r in th e O r egon S t a t e Un iv e r s i ty /O r egon H e a l th & S c i en c e Un iv e r s i ty Co l l eg e o f Ph a rm a cy , and l e ad au tho r on th e s tudy . “The re may be s i tua- t ion s wh e r e an t ib io t i c u s e do e s imp rov e symp tom s and p a t i e n t c om f o r t , ” F u r u n o s a i d . “On th e o th e r h and , an t ib i - o t i c u s e i s no t a lw ay s b en ign . T h e y c a n h a v e a d v e r s e e v e n t s a s so c i a t ed w i th th e i r u s e , su ch a s g a s t ro in t e s t in a l p rob - l em s . T h e s e a r e d i f f i c u l t d e c i - s ion s in a s i tu a t ion wh e r e w e ’ r e t ry ing to r edu c e th e numb e r o f m ed i c a t ion s t ak en a t th e end o f l i f e . ” The deve lopmen t o f F R E E CH IROPRAC T IC CONSU LTA T ION ! $50 VA LUE ! CA L L FO R DE TA I LS . C E R T I F I ED IN AC T IV E R E L EA S E Ann G r i ffi n DC E l izabe th Xen ia Qu in t D C Well ness Bigfoot 541 -699 -7457 LLC 703 N . La r ch S t . , S te . B • O f fe r good th ru 10 -31 -15 In s ide Th ree S i s te r s Hea l ing A r t s , Ne x t to She r i f f ’ s O ffi ce Ma s sage | | Sk in Ca re | | Na i l s | | W ax ing The G i ft o f G i v ing Ba ck An inv i ta t ion to acknow ledge tho se spec ia l peop le among u s w ho wou ld benefi t f rom the hea l ing touc h o f ma s sage . Ou r gene rou s the rap i s t s a re dona t ing the i r t ime . Sh ibu i i s o f fe r ing l im i ted t rea tmen t s FREE o f cha rge to tha t spec ia l pe r son . Nom ina te someone a t in fo@ sh ibu i spa .com S PA AT F I VE PI N E 541 -549 -6164 | www.Sh ibu iSpa .com 720 Bucka roo T r a i l , S i s te r s po l i c i e s i s a l so comp l i c a t ed by m ed i c a l un c e r t a in ty ov e r ex a c t ly how a p a t i en t m ay r e spond to an t ib io t i c u s e , Fu runo s a id , and by a p au c i ty o f s c i en t i f i c ev id en c e ov e r how w e l l th ey m ay wo rk to r edu c e symp tom s in p a t i en t s who a r e a l r e ad y t e rm in a l ly i l l and o f t en h av e comp rom i s ed immun e sy s t em s . “Th e go a l s o f ho sp i c e , in g en e r a l , a r e f a i r ly w e l l und e r - s tood by th e p a r t i e s invo lv ed , bu t th e app l i c a t ion in th e f i e ld i s mu ch mo r e v a r i ab l e , ” Fu runo s a id . “Th e r e w i l l a lw ay s b e , and shou ld b e , f l ex ib i l i ty in d e c i s ion s th a t v a ry f rom p a t i en t to p a t i en t , and ev en i f w e d id d ev e lop po l i c i e s th ey cou ld no t b e too r ig id . Bu t i t wou ld h e lp i f w e cou ld d ev e lop som e b e t- t e r gu id e l in e s to h e lp in fo rm th e s e d e c i s ion s . ” Acco rd ing to Ba rba ra H an s en , CEO o f th e O r egon Ho sp i c e A s so c i a t ion , th i s s t u d y i s a n im p o r t a n t f i r s t s t e p tow a rd qu an t i fy ing th e i s su e s r e l a t ed to an t ib io t i c u s e in ho sp i c e p a t i en t s , and und e r - s t and ing cu r r en t p r a c t i c e s . “Th i s i s su e i s ch a l l eng ing and p rob l em a t i c , bu t w e a l l f a c e i t , and th i s r e s e a r ch h a s now l a id th e g roundwo rk to know wh a t i s h app en ing in th e f i e ld , ” H an s en s a id . “W e do n e ed to b e mo r e sy s t em- a t i c in ou r app ro a ch e s , and g iv e ho sp i c e p r a c t i t ion e r s mo r e suppo r t in how to t a lk w i th p a t i en t s and th e i r f am i- l i e s abou t an t ib io t i c u s e . ” A s tep towa rd po l i- c i e s , H an s en s a id , m igh t b e gu id an c e abou t d e t e rm in- ing wh e th e r an in f e c t ion i s a c tu a l ly c au s ing a p a t i en t s ign i f i c an t d i s com fo r t — i f no t , som e m ay b e b e t t e r l e f t un t r e a t ed , r a th e r th an r i sk th e add i t ion a l comp l i c a t ion s th a t cou ld en su e f rom t r e a tm en t . And th e r e m ay b e commu- n i c a t ion th a t cou ld b e d ev e l- op ed e a r l i e r to h e lp f am i ly membe r s unde r s tand the w i sh e s o f th e p a t i en t b e ing c a r ed fo r , sh e s a id . C om p l i c a t i n g t h e p r o b l em , th e r e s e a r ch e r s s a id , i s th a t an t ib io t i c u s e i s so ing r a in ed in con t empo r a ry m ed i c in e . P r ev iou s s tud i e s a t OSU h av e shown th a t 27 p e r c en t o f ho s - p i c e p a t i en t s a r e s t i l l t ak ing an t ib io t i c s in th e f in a l w e ek o f th e i r l i f e . Th i s i s a sp e c i a l con c e rn fo r p eop l e who h av e s p e c i f i c a l l y c h o s e n a n e n d - o f - l i f e app ro a ch th a t i s fo cu s ed on p ro t e c t ing th e r em a in ing q u a l i t y o f l i f e w i t h o u t a g g r e s- s iv e ly con t inu ing m ed i c a l t r e a tm en t . T h e g o a l s o f h o s p i c e , i n g e n e r a l , a r e f a i r l y w e l l u n d e r s t o o d b y t h e p a r t i e s i n v o l v e d , b u t t h e a p p l i c a t i o n i n t h e f i e l d i s m u c h m o r e v a r i a b l e . — J o n F u r u n o Ho sp i c e i s cov e r ed by M ed i c a r e fo r p eop l e w i th a l i f e exp e c t an cy o f l e s s th an s ix mon th s . I t o f t en a l low s p eop l e to d i e in th e i r own hom e s , h e lp s to r edu c e m ed i - c a l co s t s and ho sp i t a l s t ay s , and i t s s e rv i c e s a r e now u s ed by mo r e th an on e th i rd o f dy ing Am e r i c an s . C o l l a b o r a t o r s o n t h i s s t u d y w e r e f rom th e OSU /OHSU Co l l eg e o f Ph a rm a cy and th e O r egon H e a l th & S c i en c e Un iv e r s i ty . I t w a s suppo r t ed by th e N a t ion a l In s t i tu t e s o f H e a l th . B i g foo t W e l ln e s s Ch i r o p r a c t o r s E l i z a b e th X en i a Qu in t and A nn G r i f f in o f B i g f oo t W e l ln e s s sp e c i a l i z e in A c t i v e R e l e a s e T e chn i qu e . T h e i r w o r k i s so mu ch m o r e th an th e sp in e ad ju s tm en t m o s t f o l k s a s s o c i a t e w i th ch i r op r a c t i c . A c t i v e R e l e a s e T e chn i qu e w o r k s th e s o f t t i s s u e s t o t r e a t p r o b l em s w i th mu s c l e s , t end on s , l i g am en t s , f a s c i a and n e r v e s . A w id e v a r i e t y o f c ond i t i on s c an b e r e l i e v ed and r e s o l v ed th r ou gh th e i r w o r k a t B i g f o o t W e l ln e s s . I t a f f e c t s th e wh o l e b od y , h e lp in g y ou r e c o v e r f r om t r a um a o r o v e r u s e in ju r i e s , r e s t o r in g fu l l fun c - t i on and r an g e o f m o t i on . G e t t in g p a s t p a in i s ju s t th e b e g inn in g ; th e i r t e chn i qu e c an h e lp a th l e t e s p e r f o rm b e t t e r , m om s g e t b a c k t o p i c k in g u p th e i r k id s an d th e i r k id s b a c k on th e s o c c e r f i e ld . F r om p e d i a t r i c c a r e t o h e l p in g s en i o r s , f r om e l i t e a th l e t e s t o w e e k end w a r r i o r s , f r om o f f i c e w o r k - e r s t o c on s t ru c t i on w o r k e r s , th e i r A c t i v e R e l e a s e T e chn i qu e c an r e l i e v e p a in , r e s t o r e fun c t i on — an d m a k e y o u d o wh a t y o u d o e v en b e t t e r . Sh ibu i Sp a Sh i bu i S p a o f f e r s A yu r v ed i c h e a l in g w i th th e i r “L o t u s D r e am . ” A c c o rd in g t o an c i en t t r ad i t ion , th i s h o t o i l , r h y thm i c m a s s a g e c l e a r s and b a l an c e s th e p r an a o r “ l i f e f o r c e ” in u s . B e f o r e y o u r t r e a tm en t y o u r d o sh a w i l l b e d e t e rm in ed w i th a 10 -m inu t e qu e s t i on- n a i r e , an d a s p e c i f i c o i l c om b in a t i on w i l l b e c a t e r ed t o y ou r ind i v idu a l d o sh a . W h en th e d o sh a s a r e in b a l an c e , o u r en e r g y i s in b a l an c e . T h e r e i s n o in t e r - f e r en c e an d c on fu s i on . T h e r e i s n o d i s e a s e ! A y u r v e d a i s a t r a d i t i o n a l h e a l in g s y s t em o f I n d i a . I t t r an s l a t e s t o m e an “S c i en c e o f L i f e . ” T h e th r e e d o sh a s — v a t a , p i t a and k a ph a a r e r e s p on s i b l e f o r a l l th e ph y s i o l o g i c a l and p s y ch o l o g i c a l p r o c e s s e s in th e b od y an d th e m in d . Sh ibu i e x t end s th e oppo r tun i t y to m ak e a p r o f o und d i f f e r en c e t o s om e on e in th e c omm un i t y th r o u gh th e “G i f t o f G i v in g B a c k ” p r o g r am , th r o u gh wh i ch s om e on e d e s e r v in g o f th e b en e f i t s o f m a s- s a g e wh o m a y n o t b e a b l e t o a f f o r d i t c an a c c e s s c a r e a t Sh i b u i .