El Podcast de Marco Antonio Regil - 294 - Hablemos de tu último deseo: La conversación que te conviene tener - Jackie Herrera

Episode Date: October 30, 2023

Hay conversaciones que por más incómodas que sean, es necesario tener; la muerte es una de ellas. ¿Qué va a pasar con tus bienes?, ¿Quién va a tomar decisiones importantes en caso de que tú no puedas? Esta semana llega al podcast Jackie Herrera, experta que nos guiará para saber qué hacer ante este futuro al que todos vamos a llegar.Tener creencias limitantes ante conversaciones incómodas puede ser un freno para tomar decisiones importantes. Aprende a transformar esas creencias en mi clase sin costo. Ve a: https://marcoantonioregil.com/mente-podVe y comparte el episodio en video. Ve a: https://bit.ly/episodio293  Cada semana en mi canal de Telegram, accede a contenido e invitaciones solo para fans. Únete en: marcoantonioregil.com/telegram¿Quieres llevar del podcast a tu vida lo que aprendiste esta semana? Descarga GRATIS nuestra revista digital. Da click en marcoantonioregil.com/aprendamos Sigue a la tanatóloga Jackie Herrera en:Instagram: @drajackieherrera *Importante: Nuestros invitados son expertos en sus temas y reflejan su conocimiento y su punto de vista, siendo conscientes de que cada una de las opiniones es totalmente personal. La información, datos, comentarios, estadísticas que se presenten en el Podcast de Marco Antonio Regil, son de exclusiva responsabilidad de quienes las emiten y no representan, necesariamente, el pensamiento de Marco Antonio Regil o de la producción del podcast.

FInty in Insurgents, Viaducto, Ciudad of Mexico, Presenta. About to the is to talk of the life. When you are conscious of that the death you can surprise in any moment, valoras more what you have

and you're more what you're, and you're more intensely. All this is we can't decide. You can't. You can't. You can't do.

It can create a document. It can be able to the medics, we can't convert it in part of the conversation family. Clare.

It's, you can planer the murder? Sure. But what's? Why? What's that? Because you

don't eches the salt? No, we don't know, to talk of those things. And the universe and the

life, if God, me made to do this, is part of my curriculum in this life,

why me they're going to keep the age that I'm the woman. No, not more,

dole the emotions. It's it's my life is a carvading. It's all

these other things that we need to do. And in in the publicatible, the unidad

to try not more the patient. Also, we're going to extend us to the family.

You know, what I have guaranteed and what you have been guaranteed, is that, as you go to do you

go to do you, I'm going to do, I'm all we're all right, but it's

a thing very incommod. It's a taboo. Not us a lot of thinking in that day. And much less plan we

our last our last time, or our final time, or our despedita. Now, the problem is

that we do we we have problems very grave to our people who people that the people

that's what will be to be your things materiales? Who will to make

the decisions important on your health in your days? What is what?

God, don't want we and we don't decide if we we're connected or disconnected what would be

your organs? What would be if you're your memory? You know, you know, you can't know what

you're going to take those decisions for you? Some things that many have never even even even even even

we've been a expert in this time that with much more because it's a time very delicate

us will get to get to the manita to understand this process and

to give ideas of how we can planing that that

not us not but that's guaranteed that's guaranteed that's a lot of we're going to

the hotel fiesta in insurgents, and we're invited to our students and our students in line that are

here to learn together. We're ready. Then we're we're goings. Episode 294. The Mark Antonio Regis

is a production of RGL Entertainment and all of his rights are reserved. The doctora Jackie Herrera

is She has a specialization in tanatology, medicine paliative, and therapy cognitive conductual. A through his practice professional, has helped a million of people to live his last and to despise.

The doctor Jackie Herrera is in the podcast. Dr. Jackie Herrera, welcome to the podcast. Thank you, Mark. I'm very happy, very grateful for the opportunity, because I know that by

through you, information very important to be able to get to many people. Yeah, and it's very important, although, of nobody us like to talk

to that. We've been to live as if not we're going to never. And so, what is the resistance?

What is the resistance? To talk about to our last days? Well, is that living is very beautiful, no?

We're just to think that the disease, the death are there away, when I have

80 years, or when more. Emposal them. Okay, okay, pardon. Pardon.

No, No, we know, we know, we're going to be more. And every bit, we're more. There are more treatments. There are more options to care us and live better. So, it's easy that we'll forget. Of course. Of course.

Of course, a day, the infirmidate, it's something that we're not ever, because it's something that we're not even people who have been a Silo de Villa, very very solidable and, they're receiving a diagnostic and is to change

many things, to change your food, a more, changes physical, a more, from the simple idea of

adapt to the diagnostic to your personality, without too over-identifikart. So, well, who's,

who's, who's, we've got that we're a good, and you get a time to a time for,

because you get to a time, you know, how people can't get in

the time and you're going to know that's a single to get to a second, or you're

going to be an accident, or you go, or you know, you know, you know, you're going,

to planer. So, you know, you've in, with, with patients that are

in what I consider a one, a tap a sadra that is the death of the life.

CASE years. 10 years. And why what you do? your life, that's you're going to

to think my invite to maybe is a little rare, but it's something that I'm from a

little bit of from a little bit of a publicity of a product that an an campaignes

to collect to help to help to help to help help you that I'm that's a

that's all that I'm want to give to me care to come to these

physiology in this moment only could you study this here in the city of Mexico but I was in another moment me cased, I took my kids and other

and for that first I studied the master of tanatology I said well the maybe not to talk to me and give the morphina but me will be to talk the part of the accompaniment

emotional spiritual and well then then then you present the opportunity that in Monterey you can you can't

you can't that's for so that now I can do these two things to not just the part emotional but also the

part physical. It's a labor precious, those that have been the experience

of the case of my mom, when the doctor you say, then they're there's 10,

15 days of life, and then they're to the people of palliatives, of the

care of and my experience was precious were, you're, you're you're trying

all the time. You're just you're all the time, there's the person

that's the person that is was inconsistent, and I was the kid I gave literally the packet of morphina and me explained. Here you have, you injectas in the,

in the, the messkles with the suero every way that's, you know, the more more fina you're more rapidly it's, more rapid, it's going to do.

But, the more does, but you're doing, literally the, the life of my mom was in my mom was in my hands, no?

And then we, and us were all right with much love and with much patience, and I'm really,

very, very very good, very I mean, you know, because no can't one of imagine us,

these chicas that are the doctorate and the other and the other other people, they're doing this all the time,

so, not it's very easy to be being very much to be able to passing for moments that durus daily.

Sure. There are moments in those that you're overcap in those there are patients with

you make a very very strict and when you get the moment of part, then it

also that you also that you also that you also that it's a great bendition, the

opportunity to accompany these patients in the moment more vulnerable when a way the medical tratante

principal, you know, I know I can't offer you something to but that's just where we

we're just where we're not the human still still is there. So, your body is

suffering, the family that's around is suffering so fariener. So, yes, I don't

can't be to get the cancer, the Alzheimer's, your a new a new a new

what's the what's the other what about anxiety depression insomio

with all these things that me still for about before

before to start my so there there's there

the part the part but also the part of that that's a great

great you know a person you know the people for periods that for

periods that these these patients and to their families. Fifate that the ideal would that

from the disease that is incurable is envied to give to the ideal. The reality

is that not pass so, because you you're you say, you say, you're going

to die of more. So, there's to start to change that concept. If

we're we're the opportunity to start to start to start to

work with the problem is more stretch. We can talk with the family, we can't help in many things.

Because we're going to suppose the patientito that has a cancer that's going to start chemotherapy, the oncologist is going to

the part of the chemio, but just what is what you already mentioned? You know, you know, in the

institutions public of the health, that there's a over- lot of people, the oncologist,

even the oncologist, even the time to be to be able to do the other parts. What beautiful would

that all these patients that have these diagnositions have had that's that's a moment in the

diagnosis of the But if it's terminal then you know there's a no-o- there no chemotherapy, because you

just, you know, you know, well, you know, well, you're right, it's a diagnosis, it's un-courable.

Uh-huh. Incurable. So, so, we know, for example, a patient-ititit diabetic,

that his rinion yeah no function. That's that that there's a non-sufficiency renal, that starts a dialysis.

Well, from the moment that's going to the dialysis, we're going to the insufficiency renal has different grads.

Why, me it's until that you're in the other. And there can't be years.

Ayes. Or the of cancer, literally that's, well, you're going to say, but

they're going to live three months, but then the patientito that has a insufficiency cardiaca, that's

not are latient with sufficient force, but that still can't do do you because you

know you when you're not going to not quite mandam it from the first to see,

to be the problem, the difficulty, the difficulty respiratory exact, so there's there's a

difficulty to eat or or you or you know, or you know,

and there's the theme so you you've seen the two has seen the two has families or patients

to this tap with planiation and those that get there without planed what are the ramifications of not planar

the consequences of not planar and my jita that God me will be when I'm there will someone will be

or then is there the government decided to who he does what I'm what are the ramifications that you've

seen? We've got a grand charge in the family no when we don't

we're not we're or of what I would like to me when if it would be the case of the

person, then they're they're, what would like, what would be, what would be to do we

intubes or not? The operas or not we operas? That they put them all the things,

oh, and see really this not going to go to see here, we know, we're

families that they're they're doing they're they're they're in cars, vendent

they're all, and it's a patient that's a has probability to

recoverer. So, and that he's not he's not not quite, because he not is a

conscious, an friend of a mother, that's a man, so the mom came in

coma, and then were various brothers, and then the security, he got a security,

the security, you know, he's, yeah, not you never, they're, and then they

got to get to what with all the work of his life, his father and

they've had been had been there, And then there an armano that said,

for favor, yeah, we're going to let's get that fall yes, and the other not, how you're going

to do you and you're going to my mom, blah, blah, and so they're a year and

a man entubada and it was a a fortune there. And, and the

question is one queria that the kids would not be better? Because that that's how

can be to evils, for example. About from a moment in the we're saying, of what we're going to be the

example that we're about about a person that's in- a person that's not legal extubing. For that's

that's so important to have this conversations before when the medical is, a bit,

the situation is to put critical, what we're to do we we're not, it's it's not

I'm not doctor, you know, doctor, you know, doctor, you know, so you,

you know, in that? No, no. So, so, yeah, it's completely illegal. So these conversations,

I think it would be a good time for all those who are we're doing this message, is, why not we

we're going to this conversation in house? What you would be? No, you'd be able to be

to be a person, to be about this things. Now, in Mexico, there's

something that is called Voluntas Anticipated. That's just what I'd do. I'm sorry.

No, me did the I'll get, I'm right, do, no, perfect, perfect. Platikin us of the Voluntaries anticipates

anticipations is just this, no? So, you, in a moment in the you're in the same, plainly conscious, you can say,

there's two ways to do. One is, ante a notary, you go, you're, you're going to the document,

pagas the time and you have you just there's a, there's a process of the health, there's a

formato like where you put your information personal and it's a little

where you with a puny and letter you put explicitly with what if you you're

so it's something so it's something it's all in all Mexico we're not in all

America Latin in the United in the United so there so there's so I'm in your

country in in Peru in Chile in in the United what are the

laws local of every my mom my mom me took in the

United and I remember that much before I'm a doctor I'm a little little

about about the things of things of the things that I'm that you

convene check and one of the episodes was that was a book Susie Orman

I remember and so in so in States you they're

they they're they're living trust and so and then

then you I remember that I'm I did my mom I did a

a card where I did the my mom if I did the I don't know I'm going to do this and

not me do you know and she did you do it's a but I'm the power of decision medical

if I don't could decide and she I made to me to do that that's that's a

good that's honestly was a thing because when my mom came in

Alzheimer and then he's all this problem and thanks to

that paper it, I could decide absolutely everything greatios. Right. Right. Right.

We're about this example, of the person that's intubated, you know, and that's a good, and that's a life?

That's a because if we letiarmus to talk to be a givate, no? Yeah.

It's all a debate, no? Yeah. Dignity is just to be able to exercise your

autonomy. It's to think you have respect is that take in in account your

values. You know the regla of order is the other, like you

like you want to you're there there there there there

there like the reason like the thing that is and he

he wants to he wants to you do you what you

don't ask let's ask there there there there

there there has there has there three different

strategies to care the and one of the

pre-dunta of dignity of the patient. He says, you have to ask you to ask you to ask you, what should be I,

of you, to say you, to be you, you're doing the care the care of the care of how many,

how many times? You've talked to ask you? No, no, no, no. So, Cudadidates, a fact,

is a focus totally different, because we do we're much, all those questions, no?

Exactly. To, to talk to, about, that the person not has a person no

a car for your family, is also to help to do a review to a revision of

your other strategy that this doctor did it's a psychotrapia of the dignity.

You do do you ask 10 questions to the patient about

you about you what you felt more what is what is what has

learned about what you would like to give to

give to your people this this dialogue is

grab, after the therapist the therapist he's transcribe and it and he's

a legado for the family of that's a important. Yeah. All this is in

Canada. It's a name Cochinop which is the that's the therapy of

dignity, but the good news is that here in Mexico is that is a fact, this

inventory that he is he is validated here by the Incan the version

Mexican. So, there we're coming to keep to to keep

the good, to and have to check in each one of the countries in the moment they're not

listening. I'm encuestant to the public, for example, things in the that we don't have put to think that

I've passed for that. So, to you know, a quant of you'd like, for example,

electing, already in its five senses, if you want, for example, that they revivant,

how they call them technically, medically, medically, that's, that they're resuscation. Resuscation.

Carre. That's like, like the series of doctors of doctors clear and you're

and there you are reviving I'm reviving I'm and I'm like to how do you like you

want to you're going to that so yes so you to the mind to the amount to

to do to the to the because I am of the I'm of the I mean my

any me intend resuscate yes I yeah I'm I'm

I'm I'm depend depending I mean there so for example

that is a process that in the majority of the case is going to try it. Yes, because I have some children and I'm going to

get a little. It's that you have kids you know? But if you say you're you've been an accident

automobilistic you've been paro 10 minutes you want that we're doing that? No. Because there

are levels because how I'm going to get so I'm exactly I think is something

that would to discuss So then it's, no, but it's this is the exercise. This is the conversation that you have to have, with who you have to have

to do you to do your document, to prepare you, to make you, and that's decided for you, not to let's get to your kids in

imagineate in the , how not we're going to resuscutate a mom. Oh, yeah, but it's clinically a month, no,

but there's because if it's a peccate, because they're there's there all the cruces of cables. And you

know, Mark, that, also, to us as us educan for

salvage. Sure. So, you not you're not to get to get to you're not

you're not a patient in paro and you you know a lot of you know to do you

have to ask you know, but you never us educan for to say

there's there is the most adequate to bring those

so so if I go some and me go and I

see a life after the and I talk to talk you to talk about you

a my abuela and my perrower, no, that's that they're to bring them and that's

that they're to get a risk, well, let's see you, how there's, the resuscited,

how, when, when, when, when it's the factor of risk? A part of 10

minutes, we know, we know, we're a lot of, then, so, so, if you're

so, if you don't, so, there's, there, consequences, probably probably. Also,

it's, it's, to take the thing, we should we should learn to do you

because if there a accident in the first ten minutes, the first time in what

gets to the ambulance or in what I go to the hospital. How do we know? How do we

resuscitation? How do you do that my? I don't know. The majority no, we know.

Tarea number two of this episode? Of this episode? In where we're

to do? Where do we do we do? It's from the Cruz Roja, at times the same hospitals

they're doing courses of the support basic. Okay. Do you want to feel like you

more every day? There's a thing that can help you can help out of present,

enfocartes in what is you and create peace in part of your style of your

life, the gratitude. Yes, in my experience, the gratitude is one of

the the experience, 21 days of gratitude, and you're part of a beautiful of millions and millions of people that have encountered more peace interior and clarity in their lives at the practice so simple and effective, where I'll take the hand with 21 meditations

guided and some classes in where we'll reflectioners together about the possibilities that can open in your life, at living in gratitude. Inscribett now, making click on the link that is here above or be to MarkoAnoniorregil.com diagonal gratitude.

Repetto, Mark Antonioregil.com and Gratitude and discover the enormous power that you have into you. And now, we're going to

there's a decision. What other decision us convoyne to take? What other decision us come in? As it's not that's medics, that may resuscite.

Donation of organos. It would be important. Donation of organes. If I'm to agree, no, with transfusion, you know,

in certain cultures there are people that not, that not are that not I'm in accord with this.

Sure. The intubada, for example, for me, for me, for me, not, a me, met them

nothing, let me in peace. Let me entubbed. No, no, no, no, no. A ver, we'll be

a little more of that. Use them of the india, how of the because no? It's,

let me die of my, oh, I'm just, I'm just just, but,

Mark, we'll be we'll be like, like, like, kind of, like,

under frankenstani- -ean- no, was a moment in that much people had a lot of

intubation, no. I said, I used to talk about and you get into your and you're

to get used to get back. We're not, we're doing, when you're when you're a moment, in that you

get a deteriorer of a certain way, in the that you can't be sure,

you're not, let's be intubate. Uh, uh, uh, let me morin' let me

more, you're a young, young, and a problem that probably we're going

to suppose. A me I'm like a word about we've got a orthotanansia. Ortotanacea.

Orthotanacea. So, I'm over a N. Orthotanacia. What is the orthotanacia? The orthotanacia

is that the murder when it has when it has to get to get.

No, sir. Abuela, abuel. No, no, no, no. Look, I like that. No, no, no.

No, no, no. No, I don't know. No, I don't know. I mean, the premise basic is... My willuntas my own

respect me. I'm going to respect me. I'm going to do. No, I know. You as you're, you know,

is... in your house and you you're going to and you pegas in the head you and you

get a question you have to be to get a to make you you're not probably probably is that in

three, five days we're going to and you're going to live a normal and a different

to, yeah, you're convinced I, no, no, so, yeah, apart,

I'm just just a bit a tuby for the nose. No, no, no,

to be to be a bit of, man, man, let me let's, okay,

we're let's let's talk of the intubation. The intubation is a process very amigable in the way, I'll promise, I'm going to do you,

I'm going to do you, I'm going to make, you're going to put a swirited, for where you're going to do it, one, no, you know, you know,

it's a bad, three, we're not to lastimar of your structures of your way airia. That's where I

don't know. No, I'll be, yeah, yeah, it's our really, it's our no,

no, no, no, no, no, no, no, So imagine

to all the surgeries that are in those people those patients are people. The patients are intubes and sextuven

is the process most sure that is the most sure. But no one you can't desentubing then I'm going to get entubed

pauses. That is another type of example. A. So, a patient oncological that is very deteriorated

and that the family not is done to let me do that is doctora for favor intubel

there if I don't know I'm going to there's going to be the other palatatita that I think

you're in the distanacea exact distanacia is or obstination therapeutic is

just basically it's obstination I'm I'm I'm intercating this patient

not this patient not is this patient not to do so I'm so I do you do

I'm but with a patient that I know not has a pronostico curative.

So, it will depend much of every case. I think we can't satanize some process

medical. So, we could we do not. The intuasion is a bad for all the

days. It depends. It depends of what other processes. No, there's there's,

I'm, my time is, I'm going yeah, for what? That's, that's, that's the

dishtanace that here, it's the prolongation incess what we have to

prolongation in the life through the and the medios artificial. And they're

to treatments and and things and you pick and you do you're doing when the life you're saying, yeah, yeah,

it's just you know. You know, you know, we're doing we know the people, you know,

that the Latino relation a alimentation with beingestar. So, I do you to eat to come, then I'm

so I'm doing so you can't do you're that's very what you're that when they're getting to

they're they're The family is a very so angustia and says is that

is that is a lot and it's complicated to explain to let's make no, no, no

is not so not they're not being the is a symptom of your disease

so that so so obstination therapeutic or vistas nasia

would this family that says put a pongal a

postolol a gastrostomia is that I don't I'm not I'm not is we're eating. No. More well, is,

we're going to let's make the problem that's natural that has to get to get to get. With this, not mean,

I'm going to say that I'm the premise of cuitables is just we're just we don't, it's a

contract as a written, but we do a contract of no abandono, in the I'm

I'm I'm I'm going to be to be to the last the

time to the time to the other I don't know if you have taken to see some patient

a patient that's called the way subcuttania that means it's a little just a

little bit a big little bit like for example with the check on the diabetics or

glucose no generate any a problem, it's a family to put

and there can be there's there can be there can't

it's a little a little so 10 days. So it's

marvellous because you you know you're not you're not you're not you're in the

times times they're in the family because mom no want to get and let let me

more. There's even even I want I want to pass a barrier personal but for

example the Alzheimer in the that the patients not can get and that

for example this via subcutania us also or to be a geringita,

no? So, is, is just to be able to get these conversations and guide a

family to not to get in these measures that's that's all prolonging the two parts,

not? For the patient and for the problem, they're the suffering to, my philosophy personal and

the, that I'm that I'm going to do do you, I'm going to give to me to

help me to be to be to not suffer. not me, not make not make

necessarily and me they're picketting or they're for what are to pickoteer to prolong me

to prolong me a time to get to go to go and I'm going to get with the more suffering

physical possible. So for so I love the of the paliative and me

I'm the idea of that I'm taking that decision over my life I

think a I'm because imagineate that you you can't you don't

you're in the hands of your children and not necessarily are good hands. No, but no, because, more than,

more than, more than, they're, they're in, they're in, they're in for the love, for the compassion,

or the culp. The culp, are you, can't say, you can't talk about that. Sure, look,

there, there's a thing we're, we've been much too also the conspiration of the silence.

The conspiration of the silence. How many times we've known a someone that has a family

in a family in a And is, is that Papa no knows that has a cancer. It's that is that no

we can't say, because it's going to be depriming that he will be able to support.

And, and then we need to talk to the family, to be what are their

fears, or why he doesn't say, or in what you know, in what's

based on the patient, you can't get the confidence in the medical, no?

So, if I have a cancer and my family no me is saying

and I every bit I'm in the hospital every three and I'm connect to the suor

that no they're not I'm saying I'm feel like I'm so I'm getting

the hair and I'm not want to see that doctor because what what I'm doing

because what is a thing that's a decision that much sometimes is based

in the love or in the compassion or in the paternalism or in

that we don't have very good abilities of communication or that our best our family has been

antecedents in their life in those that has had been episodes very depressive

or of much anxiety but there is to go the family

to the patient has the right because he has to take

decisions and to be to do you to be to be to be

to be to be to be the person to say the person to be the

Okay. There's a form legal, I know you know you're not an there's a word, you're in this, it's, you're not,

there's a lot of the days, that, I mean, my client, my patient is your father or your mom. I'm, I'm afraid to say the and they're in the case. And you know, you know, doctor, you're not, now, to come to the doctor, fulano, of tal. But there's, there's, there's

taking the decision in the family, not the patient. Of course. See, that's what I'm referring. That's where I think we have to ensure us that we're not we're not sure us that we're we're just those who decide us. Incluso, a time

more delicate when the children are young, no? a little, a major, a lot of a major and that's not a

don't see to say, imagineate, we've got to children, that they're really, us ask,

what they're they're doing, doctor. There's more to be a age, and then you are the

responsible. There, what does the law? There is to be a father. But the

child? But the law is written for the organization world of the health,

but it's a constitution Mexican. Or so there's an area gray there depending of the

country. Exactly. So, yeah, the organization World of the Health has

a declaration of the children of the children, where he's I have a

know what I have what I'm, I have to decide. Many times the people

also, you know, but the people, and one one do you know, so,

no, not they're not they're not to get to that need to one more,

one and until when you you're going to to get. Until when? Obviously,

you're a person of science and the spirituality, because not is something to be that we can't think about,

but I'm thinking at the level spiritual, but if the universe, if the life, if God,

we're going to make it to experimenter this, is part of my curriculum in this life,

because me they're to be the age that I'm the age that I know, is you're

to be to be to be there's more more really resilient, The kids have many resources,

even at times even even, even even as much than the adults. We've got to come a children that they're to say to the papas, I'm just ready to go to my

house, I'm going to be my house, I want to be my brothers, I'm going to be my toys. Dicen that. And they're

all the right to ask you. And start, in place to more in an hospital, then you're

to be in house. It's an experience very different. Very different. And that I understand that

many us can do much fear, we're not we're not quite,

we're in the conditions is going to do you're a lot of many, so many times they're

going to doleer, will be to be there, there's there sometimes

we don't we don't we're not quite every every different, every

every every thing is going to be moving to be much we can't

know with that exactly how they're doing to do the things. Oh,

I'm going with some terms, we're going to the sedation, no, with what I talked about

of the morphina, that's for that to be able to be able, but also there's the

sedation palliative, that is distinct to what I was different to what I'm saying,

the sedation palliative is when you deliberately going to disminuive just

the state of your patient, because he is in a moment, Requisito number one Yeah is in the

TAPA terminal Requisito No, 2 has a We say, we say, we say, it's a symptom refractatio.

So, we know, it's a dollar and yeah, he did a scalon one,

two, three, four of analgesicsics and nothing is it. Because there a scaleer,

right, too, the of the pain, as a like, like,

like, just the organization the health, we mark four escalones,

no? because every is different and also we know that there is a umbral

of the you and you we can't have the same and we're going to feel to

different because we have experiences of life different interpretations different different

I don't so, many things sex or that personality so so if so

so if two people with the same with the same diagnostic

each one one and other premise of the

Cudalities Paliative is, I have to believe to the patient. If he says that he does it, he dole, no? A lot of it

says, well, what casuality? It's always he was a full-n- to tell and he started. No, I

think that's doing just to make the attention. No, for favor. So, if the patient says that

has to dole, there's something, then, again, and I did one and what,

and what, and what, and what, and what, to someone. Me, I'm I'm going to

I'm sure. So, if there's a little risk, what you

know, that's that's, let me a commodid to the person. And we're

that's that's that's that's moving, something to do it is a more,

a little that's a more, that's very very tranquil and with this is

so, it's so, anxious, alterate, or something. But it's the moment

to put to make to make and determine that is the case the patient is the case of the patient.

And that's the first thing you have to control is the pain you know, so if you have you have a patient

with a patient with not can be receptive to any other intervention that you want to it's horrible

it's a torture to be there. And the most the most the most the most

the country where most there's a here in Mexico we have much fear to the medications

opioids. Surely you and those who are listening on radio the fentanylo Mata

and there right like much publicity of this we're there's a type of

dolor that's called dolor incidental the patients have certain level

of but a sometimes there are certain movements or certain moments

that can get a pico extra of the fentanylo is the

best medicament that we have done to try the dollar incidental but the patient to the

patient to the consulta and we want to get the eyes the eyes and it is like

how, how? How? Me want to what you want to do that we're going

because we have a morphina, we have fear to the fentanylo, we have to all

these substances that in other countries is has been confirmed that is the best option

for these types of dollars. But at the other there's there's a problem of

opioids, just the where they're they're they're doing, and the people and the

people and we've got all the people and the people that's in the abuse. So,

what we see in the news is the reality of the United that has

the problem of the other side of the the money. The

busked of the opioid for abuse recreative, which is what we always we're

we're talking to the patient. Not because I'm because I'm going to you're in a state of your pain, is for the medical.

So, so just recently, pardon me to go to the sedation palliative. It's to use

medications to do you know to get the state of the state of my patient because yeah

in a moment in the that really there's much angusia, there's a much and then who would like

to have a final of life? With a with difficulty respiratory, with angustia and so

that's a way that's a act of compassion. That's an agonia. Exactly. You're agonisand you're in a

dolor terrible. Exactly. So, we're we're, we're doing a reunion

family where we have been with all the family of, well, in this

moment we're in this moment of the moment of the where the a new where you

there's a way there's where I don't you I'm a option curative but I'm

I'm give this other option where you're I'm you're to get

better better than no pain no, the family firm

a consent for us to make to start

to start to the family and it's where I would be

I'm I'm in my five five and that nobody have

to take that to is in conditions to

firm, for the patient also that the patient that's in the get to from

the moment of the diagnosis. Because when I'm to start from you don't know

you're in your consenting to do sedation palliative and from you're in the process,

you just you're just you're in you're exactly. So, so, then then

then you need to change to so. It's a thing of I'm a love, the

example that has to have to be to be with the when I'm my rodilla,

I'm programmed to a transplant of menisco. And the day the doctor me said,

I want to I want to give you a document and me you have given you make sure you if I'm going to change your meniscus and I'm going to

do you need to do your rodia what I would be and that's permissible to not transplantate if it's necessary I said you

wow the doctor me is offering an option that costs the part of the medical how many syruhans

you get no it's like the mechanic that you if I'm if I'm if I'm

think you a problem The balata. The balata, what I said. And I said, and I said, well, doctor.

And I went to do. And I'm not made it's a matter of a lot more in 10 years or in 7, the more we need to repair it. But I'm going to

get the time of the time. So that's the type of relation me seems very with your medic where you're where you're

my medical, if you're my medical, and I'm not for you're my question. So I'd like to decide there

But if I'm, if I can't decide, go, if or no, to the opioids and that nobody decide for me. Sure. It's a... So, it's,

when they're, when they're in a time time. And that's what we have to do. That's what is what we have

to do. You have seen how a lot of your mind to get to get to in the

things, in the things, in the things, in the problems, if you put a photo in your media

and the majority they're like and they say that they're like and you But one or two people

for there, you attack or they're at, or they're in what's your mind? To who they're

can't get to answer? In who you're going to think? Ah, very interesting, right?

Why I know? Because, I've lived. The good notice is that this is that this is your mind you're

sabotageing at the negative and ignore the positive, I'm saying that you're only this

has a solution. I want to share with you the things I've learned and that's a

my own and that's my time to my questions and I'm to give you to get to my master

class gratuitous to your mind is your your friend is your your nameig. The three paths to

get to your t'gol dot com diagonally and I'm and I'm we're gonna

we'regeline and we're gonna we're gonna we're we're a combustion big grand between

sedation palliative and eutanasia. Exactly. Not. No, it's the same. For nothing. Cedacion palliative, the difference

more grand is that I'm in the sedation palliative, my intention is quitartel to the suffering. And the autanasia, my intention is

to terminate with the life of the patient. But the sedation paliative if you gets the condition.

There's different types types, depending of the patient. There are times that we can do evens said

intermitentes, where the patient there are hours of the day in the that is a little more despiered, hours of the day in those that is that a little more more dormied. There are patients in those that definitely, for example, their dolor is so intense, in those

that really have to, have to be done the major part of the day. Because it gets a moment, the umbral of the pain, the level of the pain, the level of growing, and that are

very much more dolorousas, independently of the umbral of the dolor. A cancer of pancreas, a cancer of ovario, that we know that are a problem, that

generate a lot and that's a lot difficult to try, give the sedation palliative. And also, a lot of

even if it's not even if you know the patient you can't move, that you're just in a one single position and that

came in the staff of the hospital to move to every hour or every 45 minutes, they're

and they're and they're they're moving from the one side, because you you're not you're not

in your five sense and just the poor patient, I start, starts to quecharse the person because it's the duke-a-law, that it's a lot, and it's move and you move in the other side, but it's a moment in that it's dole all, because yeah,

you've been, 10, 15, 20 days there are you all the, all the world, all the body, so, that's where you're going to be, that's where you're going to be able to anesthesia, no? And you know, you know, and so, Mark, no, not just dole the body, the soul, the soul, in the

emotions, dole, to give me that my life is a carvading. For example, the Society

of Spaniola of Coalal Guards Pliatives has made that the

patients have needs not not as the physical

as like I said right the first first is

quit me the but there other things I

need to learn my life about about the

things that I think I do a more

more more that I need not to to feel

a carg. Necessita a need to self-estim. That's just the part

where we we need to the consenting the consenting and it's to say it and thence to feel

pardoned, Necess your necessities spiritual and religious of the way in

that he be a maybe is a patient that you know but you never

were you never you, please, that come to come to see to be to make a

help so it's not the not just the body, it's all these

other things that we need to and in the unidats the

unidad to not more the patient also we also

we also we and the family and we're we

let's more more more I'm to to to be it's

from a or how many how do you do you know, that's involved in the process of

the person of their care of their that's them in their and they're that's they're

before the person that originally was in a person. So, then it's also,

it's also to be the part of the family. Sure, because if a person

that's in crisis in the family and he starts to say to you're not you

you're you guys, don't get, you guys, get to let's get to

and it makes more difficult the part of the to who is despidying. It's a cargastra. Justly, I've seen a patient so,

a very young-sita that his papa and say, when you're you know, I know what I'm going to do you do you

too, I'm going to say, I need to you know, I need to be to talk. So, that type of

comments, to her only they're a lot of a cargner and it and not is just.

The patient yeah is dealing with many things like, apart, those that we're around,

we're putting that car extra, the contrary, what's always, and more in those

those moments, is, to come the hands, to the feet, music suavecita,

loose tenue, ablale, tell you, that you give us to be to say, lele

things that he he he used, that he liked to learn, or the Bible,

or what he would music, music, classical, exactly. So, does

an ambient beautiful for that that that's that's a

reason for again, but that's the more more digned as the same. Yes,

but is that's that is. Now, all this we can decide. It's

can decide. It can create a document, so can talk to talk to the

medical, we can't be part of the conversation family.

Clane it. So, plan, the but what what is? Because

what you try? What's you're not you do you the salt this

no, no, not to talk to talk to the thing even in the thing economic,

it's a true that the publices when you those when you those when you

did the first so that so so it's so that it's that's

that's it's okay, well, and if my family fall yes

in what I have to do to do to do you go to the

all of that type of conversations, we're talking with the familyers, because if no, when I get the moment final, we're going to all the whole

and we know. Nobody is prepared for this type of things. Yes, exactly. So you can't go to do it and you're saying

to me that me cremen or that me, or that me sepulten or, what I want, or that you

do a miso, or that you can planer it also, I can't, I can't, what you have done

a case has different but for example in the United

if you know if you're in a living trust without a commission

the government decided you you can be a will like

a little a one I'm not right me

you know in me in Mexico I don't for

people for I want to a one a one

a one a one but you have a

Voluntat not that's going to because at the end of the government enter and

and decide. Okay. So the only form of to distribute what you is that

in the money is that put you in a money money and then the thing is a little bit more than you you're not you

the dwean, but the is the is the Fideycomiso. And that's fee commis is stipulated.

We'll suppose that have a little or no, I have no, I'm my son,

I'm not in the living trust says that when I'm so, then this is this

is a son, of a child and you can't, and you can't put there's

there's, and you can't even you can't this person to be, this person, will be

to be the person, so when you're, when you you're you don't you have

nothing to hered because you're you're you're you're to have

a fidecomice is like a portfolio where you make the properties so the government

now so the government can't enter and get to the 30%

38% 42% 40% 50% of what you have you

you you have you and the most and the most so

so if you you don't you don't So your your wife,

your kids can start the money or part of the money for the for the work you work.

Now, I'm pretty, imagineate, very frustrating. In Mexico, how does function that in Mexico?

In Mexico, and maybe it's similar in other America Latina.

You know, you know, you know, and that even there even there can't there

even there in the government, they're in the document totally gratis.

What happens if you don't have a testament then you start the conflicts because they're your properties

and say there's to do a lot of a boy and then sometimes they're

the conflict between the family would I think another thing in the

would be the better to get to and not hered

that to that people to then the so the so the

so the countries where you're you're going to see with an abogado that's

specialize in that's and I'm my mure how I'm can't do you know that my

my will be complete. So some some of the testament at a more

maybe it's the case of Mexico not I don't know I'm not I'm but maybe it

and it does it does it or you're to be with a notary public

no say you're to but in the United the Testament is a

opinion that you have about, exactly. So, so you have to do a transference in life.

Okay. Yeah. It's, it's complex. It's complex, but there's to think in those things.

I don't know. If you have nothing to do you know, then there's no, then there's no,

there's much of to be not much of it can be things that don't have a that don't

have a economic, can be things that, I don't say, for example, in,

when my abuel there was a realtor that was an ex-abuel that was an old

an old and the lot of the not a realtor and it was

a relicida of the family well when when it my mother my mother

had died my was so it and resulta that three of the

father where he had given the and now my mom my mom was a my mom

had one my my time my other and my other and me me said

you you're in the of the of the and all all the and the

he's like, that's, no? Well, yeah, and a ticist because, because,

you know, it's, psychologically it was, it was, it was, it was, the,

the relo and the old little were one of one of a little he was, he was,

and he's, he's, he's, he's, he said, yeah, he's, he's,

he's, he, we're, they're, they're, they're, they're to,

they're, no, No, well, yeah, yeah, yeah, the whole thing, but the relo-ho. So this, no has to be a grand herension.

It can be something symbolical. It can be a, a book, a diary of a dad, of mom,

something that you want to say, to who to do you do it? To be a lot of this part

of the, of the necessities spiritual, other necessities is just that, the sense of the transcendence

and the legado. So, these customs that were important for me, who now will continue

them in the family not? I know, it could be able to practice a

sport or or cocina a certain something, as you know, like it has no, it has been

something but for the patient it's reconfortante the is a something that

something for them, someone to give to give to someone. Exactly.

And you can't do you do what you have talked that the

people who not plan their despedita to the life, to use the

word of what? What other thing you have that's that's that's

not that can cause conflict and problems and necessary it's curious.

It's more important in these moment is the most important.

The patient is hospitalized and you you think you

don't be not because the mascot that he

he's in the now who who can be

to Cargare of her or that a more

that's a question in a group of the church and

then now I'm now I'm so now I'm so it's

important to explore those necessities or those those as

as as as the things things that have the

patient Okay okay okay okay so it's between the

doctor and the notary in every case is different, but is

to do you a plan? As a question? To you do you do you know this

like this question? To get your plan? Levanted the manita. I think I think

apart we us, us makes more tranquillus, because at the peace,

it's also a process spiritual, not? It's is just, you can even

even invite to an introspection. I'm going to plan my desped this is what

I want to be and then to for that process, maybe, I don't know,

I'm going to get to get to a a little a place to get to me going to go to

do it. It's a very profound. When I studied the master of tantalogy, one of

our tasks was just that plan your funeral. Okay, a be,

plan it from, plan it's, what music you want, how you want to what you

want to what you want to want to you want, you want, your caj, the

flowers, and all, all, and do you and then not just

he's going to you're going to grab a video of a video of I'm

not you can't how difficult what is I have I'm so you grab you

your video of yeah and it was to think if that

that was to be everything when you go to when you go to when you

was to when at the first that you have a

fracass. So I think it's something that we're much with this type of patients, particularly those

who are the time of what will be going to my kids. I'd want to be more time

with them. And I think it's something that that is a lot of this therapy that you

say, to let me to tell me to my life and that then after the

family, at the more, not more like, like, like, like,

that machete of questions, but also also you know, but you want to need a

and you're that you're a libyo of that anxiety that you have to that's that's

that's because you don't have because you know, because I why I'm going to

give a video if still I'm going to be to be to be I'm

how you know, so you then so you can give a power mental

and say, well, in case there here there's a

video, here testament, a living trust, here, what it's all planned to and I'm

and I'm and that you're going to that's really, you know, I said, okay, I did my video,

yeah, me desped, yeah, it's all right but I'm going to be going, so are like,

it's time extra. So I can even know even know more the present to say, wow,

here I'm here I'm, here I'm to make to make more the moments that we're

we're we're very very with the work, with, for the

needs and the things, and the times, how times we're doing, for example,

dorms and you are you are doing, in what you're doing, or you are doing the

cellular while you are doing, or this type of things, and are so I

always I say, to many people to be to talk to the murder or they're

to be to talk to be that's about the life. When you

are conscious of that the MIRT you can surprise in

any moment you, valoras more what you you're and you and you

and you and you know, you think it's something that we need a little

more. I'm I'm going to have a podcast. If it's you're just

that you do you do it. Well, no, no, if it's when it

does it transmitting. We'll be we'll be able to be there to be not a

partrocinated what's what you another another thing we can teach a panatology

now going to your lot to know that we we're about about

about planer the final what what we can't we can we can

we we can we can we can learn we can't we know the

those doel are a process that have a function

the function justly to adapt us, adapt to that that's a very to be a certain.

I think there's a tendency very great to dole to doloical not, is something

is something that's a really, you're going to not that the fact every day, every to

live in a duel that's a good that's a little need to a child. Nine of

every day. Only one is the that's the duelo complicated. And generally it's because because, maybe has had been a history of life complicated, no has been perdias anterior, is someone, a per die of a period that's a bit of a bit of a

a period that no we can't give sense, like someone very young and the other. But I think that something is to understand that, well, the duel is, like said, this part of the process, adaptiveative, that are sub-subed, that are backadas, that when are days good, we have to

use when are days not so good when they're not a never,

and even it's not that's too that's that's and that the world

has so that we've done in many other other areas

of our if we we're the one, first, accept

the reality of the period, second, give me permission to

make my emotions. Third, reorganize my system, my life, all the

all the all the and I'm to keep to keep living without, we're going to do you

have to many times. Many times, the problems live in a dual anticipated. When we

we're doing that our self is being that is paying that is being that is

putting that things, we're we're also we we're this

incommodity of emotions, because at the more we're not we're still and the most. I think that is something because we know

that the people that are the people who live in a dual anticipated when it's when it's a moment of the period,

his duel is a little more adaptative than the that the way subita not he's not he'd

be to be a minute and so they're that are all these emotions that I'm how is the duels for

the person that's is that's going. Because that's also. Yeah, I'm going.

And it's the same process, are the same four passes? Yes, because many times we're

that we're that the patient accept the reality of your so it. So, so it

accept to your your own to, lette permission to let's

to let's your heart to do what you can't do,

how many we're how many we're that's that's we say, you have to be strong and you

have to make a lot of and the medicine has advanced much. Yes, but he also has a need

need to the world because what is living, at the more he consider an or he

is a more he has not had a lot of a lot of and he says, well, now,

now, so now, so, he has to also also, it's also the part

we say we're just to reorganize, then in your life, for then

then to be able to the part of the acceptation and the despedida final. I'm sorry.

You know a question about this about this question, let us, we're doing questions and we

do this episode of podcast was grabbed in the hotel Fiesta in insurgents

viaducto where my team and we know we've we've we've

we we're the perfected strategy and the cruises of avenue insurgente and viaducto in the

hermosa colonia condes also the hotel has been in a room the hotel an deli abjointed

all the day gymnasio Wi-Fi of high velocity and a restaurant with delicious options

of the other places like the World Trade Center and the Castile of Chapo If you

plan you visit the city of Mexico we're Fiesta in insurgents diaducto do you

do do FiestaIn.com. Repito, fiestain.com. And now, continue we're going to the podcast. Well, we're going to some

people. Here we have the first. What is your name? Javita. Adelante, Jobita. I mean, I mean, I have a document

of firmed of that I don't my organs. But if I fallesco in a murder accidental and my family no,

no, want to donate my organs, what happens there? If in the documento is expressed

it's never to respecter. But that document, where is it registered, who has

when it has been? When the said, the other forms, the

of the notary or the institution of the health, when the institution

of there there's there's there in some the

people, where I know in New Leon, your licensee to

manage says if you're don't donor of organos or no. There's a correction and I think is very good

question also that when the people declare that they're doing they're doing don't know we're doing

we're not we don't put the same effort to a patient totally false

I think it's a good moment to mention it and well and then because

being donator of organes is the act of the act of love more great

that we can do We have a list interminable of patients and we're waiting a

opportunity in Mexico and we need that every more people are people so that people are

that they're for those for those in the United is exactly exactly in your license of

manage what I know what I know the don't know so you don't know so your family

no but you apart of what you do you you just you just if you

you can do you can't help you to give to send their life, why not?

I think there's a thing that the family can't have a lot of many times they're

like, is that they're to be going to make a way to get to

these organs, not is so. And also is guaranteed that

these people, these patients are with much respect

and I think with the respect more for the

act of the act of the act of the Okay, can you ask another question?

Yes, Hobbitab, without no, govite more to be there no, don't you don't have

my my my mother my mother my wife because a she she was

she was don't know of organos but when in the place to get her to the

hospital this they were direct to the ACMFO so so then

there no sent the and the don't the donation of there

not was possible when the The body has perished a certain

time, the organs piern't the capacity to be done to someone more. So, there you

can get to keepers in that that's that not is that not it's that it

not was that it was the characteristics for that this procedure that this

sometimes we don't know patients that they'd have the intention, but for a circumstance,

not is possible. But I think could be the most important would be that that's not that not is that not

not is that not is that not possible for the conditions of the case. Ah, okay. Many thanks. Thank you.

Thank you. Thank you. We're going to another question. What is your name? Daniela. Adelante,

Daniela. You've about the time of the reanimation. They asked that how of us

know how many of What happens in the cases, for example, if I me to talk to experimenter an accident in the street. I obviously no knows what the person, no see what's their voluntary, not know if the families are going to get,

what is the recommendation when there are, like, cases, you know, where you want to intervene, you want to help, but it's the best decision, no, how to manage those cases.

In this example in particular, that were an accident of auto that you presences, we'd have to supponer that the person desire to live

we're we're about we're we're to know this theme of reanimation for example the scheme

the RCP has changed we've got to do other the compressions this part of the

respiration of boca that many people say oh yeah well no how I'm I'm going

to risk to do this now now we we know we know we know

we we're we're compressions per minute, we're guaranteeing that sufficient blood to the heart and the cerebrose.

So, it's something that not compromete your security, that you simply can't help in what you get to an

, some paramedical or a person that could help help in the situation, but I think that the obligation would be

to puter that person desire to be saved. 100 per minute? Yes. Or,

more of one per Yes, of Yeah, of actually, there are videos with certain musicas where you say, you imagineate, for example,

one is the of staying alive. So, you listen in your mind, staying alive. And if you do do you do

do you do and you're mends and so per minute. And so is a case of a lot of a ambulance

and you're doing that you're to take turns with someone more that's in the

case of that were possible at a sometimes we're sometimes we're solos and for that

a reason the RCP not is so effective because we understand that the person is can't and if I don't comprime with the force sufficient, I'm not I'm sure that the

blood really makes all the circuit that has to be sure. It has to be hard, it has been a strong to be hard.

The ideal is we put one on another over another so the two two two three-theados

and imagine it's like very empiric but something something we could we do all all. Imagine

a line between the two pesons, we're not our hand and so we're in the center of no, so

one over the other and so and so, so, at the center of the pecho? It's that I'm not

I'm not so much, so it's so right me can't be able to right right we're doing.

No, but look, well, I'm able to get to be like I'm going to

be able to be the patient should be of the reanimation on a colchon of a

couchon, a car, but it's in the pavement like the example

you're in the example so I'm so I'm so I'm my other, and I'm to use

the weight of your body, the of your person is so I'm too can't

imagine me that is more or less or three centimeters. Okay, three centimeters using the piece of

that helps you can't you can't you can't be, well no no no

There is like a technique for... That is for atragantamination. Ah, okay. When a lot of times that you're in the restaurant and there's something, you know, you can't do, you can't do, for example, contra a mess,

the try to comprimer, or you solo. That's is different. You're doing, you put the other man up and you're putting the other man to push it over. But if I think,

I'll say, it's a way empiric, but the ideal would to take a course. We'll take a course, because so so that's nothing more

a more than a certificate. It's a course of the Association American in the question. Aplauso,

much thanks. Thank you. Any other question. What is your name? My name is

Emmanuel. Adelante. Hello, good in-noches. I'm Manuel my, I'm a

medical general and just just just to just to get a little in sentado

the opiofobia. I'm I'm trying in this part the use of the opioids well, it's a part palliative

and if yeah, we have to have to a little but for example putting it

in contrast in the in the United that they do it a diestri sinister

a a problem of a question about it. I'm just the money the

thing that in aspects that there no there a prognostic now so now so now

in the aspect of the addiction and all that you're like you're like you're in that

when the patient when the patient has been a pronostic that is recuperable

a let me see you I'm if the patient is the question

okay we're we're we're we're we're we're we're

we're to be the scalera analgesica of the oms the escalation

the armes has four escalon First, first scalon is paracetamol and an aina, without

a second scale, I'm going to do you know an opioide devil, and paracetamol. Opioide

devil, for example, the most we know, tramadol. Exactly, you know, third

scolon is an opioid firte more paracetamol. For example, the most we most us we're using

in Mexico is buprenorphina and fourth scaleon are techniques of interventionism that

a major have heard there is that they're going to do a blocker therapeutic,

they're going to do you're going to do you a gujita directly in the

raise nervios of the place where is that's the

place there and anesthetical and anesthetical no when

every every I think I'm to ask to

tell that that so that is the problem

that is the same there many other there is

that that I know that everyone know If my patient

my patient is a little then I go to the first when my patient

me is a problem moderate a a five six I'm

I'm to go a a one a if the don't

a a grade more a more I have to do a

not a not so if my patient has a I'm a acacetamol and a the pain. So,

we have to explain to that to the patient, no? And always is the regla of less to more. A sometimes I'm going to to start, at the most, maybe, with an opioid potent, as it can beuprenorphina,

but I'm going to start with a dosis very little. Because also we're not that these medications have effects secondary, no.

Nausia, vomit, the patient is marriadito, has a so we're going to start with the more chis' more than

the first day we're going augmenting the dosis, to encounter the dosis that is ideal for you. But,

yes, it's a way to start in much rebote of information. I think the

communication and the dialogue is fundamental. To have a good relation medical, patient, in the patient,

as Mark, the patient confian in the doctor, and the doctor mustre a interest

genuine to for a little the problem. For that just the

value the I don't, I don't, I'm do you I'm not going to do to do

to do and I think the patient also the patient also we can't because when we're

we're in the opportunity to get us accompanied just to get together just together just together

how we're about about the resources therapeutic yeah and it's super very

belgian to my surgery of the when I in the hospital me did

in the potecito mentiria I said I said it was that they were

maybe you know probably probably probably probably were

and the information my ciruano me said, tomate a pastilla at the four hours after the surgery if you see, you're a lot

agudo, if it's a great, but wait a to see it, you know, you know, you know,

and so to let me, if really, of the real, of the really, you need, so, but when I

came in the hospital, then not is the syruhano with me said, the other thing

completely different. If, take one right and you take one to four hours for every two

days and I don't say, oh, hey, this is a drug a good, I'm a yeah,

but no it's a yeah, but no the four hours of the surgery because if I

my, I'm, I'm a peg- the and you have made a little

to the hospital, not a my ciruano so in the hospital, then I would have

been pasty getting who know what other and it's altisimely addictive and you know

they're not you don't it because I'm a syruonon super responsible and of vanguardia

and conscientie, no, so other thing I got with a boatecetit and then I was and I went and I'm very

people who said, no, no, are super difficult to get it to get it in the house, for if a day has a

life, if you don't if you're not, nah, no, no, so that is just the problem

that we're being, I'm going to get my botecito and so they have been they're going to

they're they're not, because apart't No, it's something to do you. Because then you contaminants the water,

but if it's all a time. It's all the thing, there's a little thing, I'd have to be a little,

Marko. It's an error this idea of, take the medicine, the doctor not to make to make a

take the medicine after that you dole, let's say for what. We're we're just

if you do you submites to a syrugy, the simple stress chirurgic

to the incision and deliver a certain substances inflammatory that are to generate

a dolor. So, those, the medications have been a posulogy or a form to be

to be because the effect is going to last six, or eight, or two hours.

So, many patients us say, is that no me want to take, because I

don't me want to get to they're still, they're still, they're just,

what is, what what the body is that you're that's there's many

substances inflammatory and there's that the medicine is going to turn to more in to get to

control you. I mean a different to the opioids. I'm talking to paracetamol ibuprofen or other

type of anesthetics but that's super lebe but there so I don't want

that the people so I'm to get in I'm going to have to do it. So, so

we have to make a a certain pouta, the most would be to see it. Yes, sure,

sure. Yeah, yeah you're talking, not of the, I'm, I'm, every six

hours with the, with the, with the, other, the other, the, I,

I'm, I'm, a, potent, a, a power, to, there's,

there's, so, there's, so, so I, exactly, then, then I,

took me, one, and I, and yeah, but, I, but they're, for,

for, for, for, There's more than one. But also, there's to say it, there's a

thing to do you, there's after to surth because I'm because I'm not, obviously. Or it's

the same. In fact, thank you. Thank you. Thank you. Thank you. Thank you. Anemuel,

thank you. Thank you. Thank you. Well, one. One question more. Aelante,

yes. What is your name? Pati. Adelante, Pat. Hello, Mark.

Hello, Jackie. Well, one of the putts that you have commented here, I've talked about to my family

of what, how there's documents and other. But, but I'd like to profundize in this part of the

topic of the topic. If, if I do make make an RCP, in what moment is important?

Today, that I'm feeling, or even to have a diagnosis, because I think the

variety of the scheme and the scenario, well, and a moment, so it's

a little short. That's would be my question. I think as we're

saying, today that's a lot of it's the good moment to make to make a when at the

more you are you about a kind of kind of of an kind of for you

have received a diagnosis. Even the more with the specifications that

we're saying no, oh yeah if you know, if you you're completely

reversible, then I think this, but if the plan is a situation in

that that there no there's march for back, I think can give much tranquillity to

your family to have this type of conversation. And with who's has? You have

to get to get to the area of the parietives or with your

doctor general? How is that that's a process? Oh, that's

is directly with your family. And if you could be the part to

do you would be with your medicate and if it is internista

or medical family or so when are institutions

public as institutions is there is a like the formata but you notarisa

for example you can you can't you can't be a notarice and if the notarice and if there's

an abogado of a confiance of the family you can you can't a cup a cup a notary

but depends but depends you're an copy notarisa a copia notarisa to

the medical to the abogado of the family and someone in the

You know, you can't have a casuchita the bolseated, and that the doctor said, but is that no, I'm explaining. You can't, you can't planar it. They're going to, so, are you guys, but are inversions, some tranquillity. So, if you can't, this, uh, protect.

Yeah, so, because what the most has heard of the donation of organs, I've heard of the, but today me opened upriam to all the other and that I'd have thought. So, I'd like to implement it, and for that question. Sure.

Yeah. Oh, yeah, I'd like it. I think it's a grand a great tranquillity for all the family. Exactly.

Well, much thanks. Aplausie. Thank you. Aplauso. Thank you. Something more that you

want to hear you have been about here to the conclusion of the last? What more? A me would be

we'd like we were to the idea of the experience. The experience, there's

there always there something that there's that's the diagnosis that's with the we're going to

be never, always, there will be a professional that that you can't

validate and that you can't try to all the symptoms. I think that's something. Jackie, well,

I think it's worth to recognize that you have this vocation. There are vocations very and you're and you're

like we said at the time in the moments more vulnerable of the people. Thank you

to who you've given to who you have given that you do this good to your

question. That's that you're we're we're just much that we us

have done and us has helped to go to to get, to get an moment inevitable, no?

Thank you. Thank you. Thanks for the opportunity, and I'm so I'm going to get to get to many

people who want to get to get to to you, in contact with you, Instagram, networks,

does courses, there, something, there's any other social with my name Dr.

Jackie Herrera, and, and, I'd be very good to know to you have any

a question or if you did an recommendation of a book, something to do something to solicit

a consult, for there they're in Monterrey. In Monterey in New Orleans and there you're in

hospitals, in your clinic and also we're doing because there's there's there's a

patientitos that is difficult. Okay, perfect. We'll have a applause to the doctor Jackie

Herrera. Thank you. Thank you. If you you're just this episode subscribe to the

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