Tuesday, November 16, 2010

THE PRINCESS INDEX

As I pay attention to developments in the world of cancer, I see a particular aspect gaining justified prominence: caregivers.

Just a couple of years ago, caregiver issues were considered almost ancillary, a sideline to the major phenomenon, the patient and his or her tumor. It’s increasingly apparent, though, that the quality of care patients receive is inevitably dependent on the condition of their caregivers.

In my experience, caregivers (usually spouses, but sometimes other relatives or friends) often suffer more than the patient does, beset by anxiety, depression, sleep deprivation, fatigue, and underappreciation.
And if you’ve ever been a patient, you know that at times you can be a real pain in the butt.

A scientist friend is currently caring for his wife. Normally easygoing and pleasant, she’s on a steroid, Decadron, that leaves her wired, sleepless, tired, and uncharacteristically irritable and demanding.

My friend says, “Her intensity around being sure I have done obvious things gets annoying, but I am trying to find words to convey my position without getting upset. It gives new meaning to the idea of your spouse acting like a ‘princess.’ Get me this, do that, do it THIS way, and do it NOW. Weird. But it is something I need to be tolerant of, especially because it is clearly not due to a previously un-manifest personality flaw, but is a pharmacologic side effect of euphoria. We have had to develop a sense of humor about it, so I came up with the idea of a a quantitative measurement, the ‘Princess Index.’” 

PRINCESS INDEX =  PRESENCE OF CRISIS (0 OR 1) TIMES DECADRON  DOSAGE TIMES DECADRON DURATION DIVIDED BY FUNCTIONAL LEVEL (0 TO 10)

So if you’re sick and it seems your caregivers regard you as Mr. Hyde, consider that there's nothing wrong with you. It's just that your Princess (or Prince) Index is temporarily elevated.

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