The death rattle of a dying empire. Deathrattle mechanics in Wild mode

Translated into ordinary Russian, US sanctions mean that Russia must die. Fully. Having surrendered all the positions they occupied and resignedly conceded everything that the United States wants to take for itself.

The United States has published a new sanctions list on Russia. 210 names: 114 Russian politicians and 96 businessmen. Including: Dmitry Medvedev, Igor Shuvalov, Vitaly Mutko, Alisher Usmanov, Roman Abramovich, Suleiman Kerimov, Anton Vaino, Alexey Gromov, Dmitry Peskov, Vladislav Surkov. In addition, the list includes Valentina Matvienko, Vyacheslav Volodin, Igor Sechin, Alexey Miller, Sergey Naryshkin, Gennady Timchenko, Alexander Bortnikov, Petr Aven, Vladimir Potanin, German Gref, Andrey Kostin.

There are exactly three decisive points in this:

First, the authors do not hide its complete groundlessness and obvious bias. Along with the publication of the list of names of individuals against whom the United States intends to impose sanctions, the document directly states that the American authorities intend to further clarify whether these individuals are really connected with the government, influence something, and are generally guilty of anything reprehensible? That is, they were included only because “I don’t like your face.”

Secondly, they promised to immediately introduce sanctions, but instead of a shot, so far only a whistle was heard. IN the decision taken it is said that sanctions can be introduced against the declared defendants, but they have not yet been announced and whether they will be announced in the future - the authors themselves do not know. Apparently even very hotheads in the American establishment understand the possible scale of the consequences. America, of course, is a great, powerful country and dominant over the whole world, but getting kicked by Faberge is painful. And over the past few years, the Russians have successfully demonstrated their ability to weigh “from their feet” more than once. But the geopolitical situation is such that the Americans must at least make threats. Despite the risks. In other words, it is not they who control the process, it is the process that drags them down, forcing them only to react to changes.

1. Stop major defense deals under threat of sanctions.
2. Stop flying near American planes.
3. Stop attempts to interfere in free and democratic elections.
4. End the conflict in Donbass
5. Stop chemical attacks in Syria.
6. Stop perceiving Washington’s policies as a threat to Russian sovereignty.

Translated into ordinary Russian, the Russian state should simply die. Fully. Having surrendered all the positions they occupied and resignedly conceded everything that the United States wants to take for itself. Now or in the future. The most ideal option there would be a collapse of the Russian Federation into separate small “independent” states. The more there are and the smaller they are, the better.

I believe there is no longer any need to specifically explain that this is in fact a declaration of war. For now - cold. Achieving any kind of friendship with the United States is no longer possible in principle. And since the lion’s share of the world in which we exist has been Western for about half a century, then in the near future we can expect increased pressure on Russia in all “universal, cultural and humanitarian” areas, in the manner of the story with the Olympic Games in South Korea. We need to mentally prepare for this and work out countermeasures now.

Western, primarily American, psychology is mostly figurative and strictly black and white. Simplified, it looks like this. They are good because God is with them, who by definition is good and right everywhere and in everything. That means everyone who is against America is automatically against God. And, as you know, only the devil, who is the embodiment of absolute evil, is against Him. Consequently, the war against Evil is absolutely right and obligatory. Even a feat. It’s just a matter of little things, in order to justify aggression against anyone, it is necessary to demonize the enemy in the eyes of society. “They” are “bad” because they do evil and do not live according to truth, conscience and honor. When such beliefs take root in the population and the public mass position of society, it remains to dehumanize the enemy a little with an emphasis on pity for the unfortunate victims, the blame for which naturally lies with the “bad ones.” The fourth and fifth points on the list are just about this.

Everywhere and always at the end of this chain of actions there is open war. Factors don't allow us to start it now nuclear weapons and the inability of the West as a whole (especially the United States alone) to conduct successful global offensive military operations. In front of everyone the latest developments in weapons, superiority in aircraft carriers and advanced technology, not to mention the size of the pile of controlled money, America nevertheless leads Great war unable to. Moreover, the European members of NATO do not want to go back into the trenches and under total bombing.

The beating of military drums among the Poles and Baltic states does not count. None of them are going to fight on their own or at least carry this burden as equals as part of a coalition. According to their ideas, their job is only to beat the drum and call for war, and others must fight and die: the Germans, the French, the British, the Americans, at worst, the Italians, the Belgians and the Greeks. The Turks are also suitable. The Poles must only receive the sweet fruits of victory and solemnly march through the capital of the defeated Evil.

Everyone in Washington understands this quite well. But understanding and accepting are far from the same thing. Inertia of thinking and worldview. Since 1914, they have considered themselves the center of the World and the navel of the Earth, the first after God, who granted them the right to rule this world. Their desire is law. Their view is a moral and ethical norm. They lived like this for a whole century, and it must be admitted that during this time they achieved enormous success, from a patchwork quilt of migrants to becoming the leading nation of the world. They are too accustomed to perceive themselves only this way and no other way. Because of this, even realizing their inability to win the war, they, nevertheless, simply cannot act otherwise. It's like a kind of psychological complex. In order to consider yourself the embodiment of good, you inevitably need to find someone to appoint as the embodiment of absolutely evil in order to write off all the costs on him. Including negative consequences own actions.

And we have finally been publicly appointed as such extreme ones. The example of the Winter Olympics shows that we are not talking only about the evil Putin, as the Dark Lord who enslaved the unfortunate people. And not about Russian state, power in which was seized by a small group of outright evildoers. It's about about the complete destruction of us as a people, as a bearer of a different culture, different values, a different worldview. We have no right to life. Even just next door. Because we interfere with them. In much the same way as the first settlers were hindered by the American Indians. The same thing can happen against us.

The only difference is that, unlike the Indians, we are able to kick back. This means that we should expand and build up this deterrent ability. And in mandatory conduct an audit of the media space.

Someone may try to say that it doesn’t matter to us what “these idiots” think about us. But dehumanization is not required for us; it is aimed exclusively at internal consumption. So that THEIR society “agrees to war” and expresses its readiness to bear its burden. Nuclear war? So after all, missile defense can prevent it, right? And missile defense is just additional costs that the nation must bear, right? Well, that means you can lower the level of social standards so that “everything is for the front, everything is for victory.” Losses? Yes, there will be some losses, but there are no wars without losses. The main thing is that the sacrifices are considered to be made for a good cause, and what could be more good than victory over the Great Evil?

That is why in the next 3 - 5 years they will actively try to dehumanize us. In films, in computer games, in sports, in culture, in business, in politics, everywhere. Not because they are good and we are bad. It’s just that the personal well-being of the United States, as a nation, as a state, is based on the consumption of wealth, taken by any means from conquered countries and peoples. The world that could be discovered and colonized is over. And any book on marketing says that in this case, competition moves into the phase of capturing resources from existing players, after their destruction.

Otherwise they will not survive. Because these are the laws of war.

Alexander Zapolskis

Translated into ordinary Russian, US sanctions mean that Russia must die. Fully. Having surrendered all positions occupied and resignedly conceded everything that the United States wants to take for itself

Alexander Zapolskis

US new sanctions list for Russia. 210 names: 114 Russian politicians and 96 businessmen. Including: Dmitry Medvedev, Igor Shuvalov, Vitaly Mutko, Alisher Usmanov, Roman Abramovich, Suleiman Kerimov, Anton Vaino, Alexey Gromov, Dmitry Peskov, Vladislav Surkov. In addition, the list includes Valentina Matvienko, Vyacheslav Volodin, Igor Sechin, Alexey Miller, Sergey Naryshkin, Gennady Timchenko, Alexander Bortnikov, Petr Aven, Vladimir Potanin, German Gref, Andrey Kostin.

There are exactly three decisive points in this:

Secondly, they promised to immediately introduce sanctions, but instead of a shot, so far only a whistle was heard. The adopted decision states that sanctions can be imposed against the declared defendants, but they have not yet been announced and whether they will be announced in the future, the authors themselves do not know. Apparently even very hotheads in the American establishment understand the possible scale of the consequences. America, of course, is a great, powerful country and dominant over the whole world, but getting kicked by Faberge is painful. And over the past few years, the Russians have successfully demonstrated their ability to weigh “from their feet” more than once. But the geopolitical situation is such that the Americans must at least make threats. Despite the risks. In other words, it is not they who control the process, it is the process that drags them down, forcing them only to react to changes.

Translated into ordinary Russian, the Russian state should simply die. Fully. Having surrendered all the positions they occupied and resignedly conceded everything that the United States wants to take for itself. Now or in the future. The most ideal option would be the disintegration of the Russian Federation into separate small “independent” states. The more there are and the smaller they are, the better.

I believe there is no longer any need to specifically explain that this is in fact a declaration of war. For now - cold. Achieving any kind of friendship with the United States is no longer possible in principle. And since the lion’s share of the world in which we exist has been Western for about half a century, then in the near future we can expect increased pressure on Russia in all “universal, cultural and humanitarian” areas, similar to the story of the Olympic Games in South Korea. We need to mentally prepare for this and work out countermeasures now.

Everywhere and always at the end of this chain of actions there is open war. The factor of nuclear weapons and the inability of the West as a whole (especially the United States alone) to conduct successful global offensive military operations do not allow it to begin now. With all the latest developments in weapons, superiority in aircraft carriers and advanced technologies, not to mention the size of the pile of money under its control, America, however, is not able to fight a Great War. Moreover, the European members of NATO do not want to go back into the trenches and under total bombing.

And we have finally been publicly appointed as such extreme ones. The example of the Winter Olympics shows that we are not talking only about evil Putin, as the Dark Lord who enslaved the unfortunate people. And not about the Russian state, where power was seized by a small group of outright evildoers. We are talking about the complete destruction of us as a people, as a bearer of a different culture, different values, a different worldview. We have no right to life. Even just next door. Because we interfere with them. In much the same way as the first settlers were hindered by the American Indians. The same thing can happen against us.

The only difference is that, unlike the Indians, we are able to kick back. This means that we should expand and build up this deterrent ability. And it is mandatory to conduct an audit of the media space.

Otherwise they will not survive. Because these are the laws of war.

So, last time I promised you that I would tell you what happened with the death rattles during the Great Tournament and after it. Let's go!

The Great Tournament and the League of Experiments

Big tournament finally strengthened Metelitsa's position regarding Death rattle: make slow but useful creatures (just like in the original), and at the same time, none of them had a decisive impact on the board upon death - all the profit was associated with the deck.

Most of the expansion cards were similarly measured (especially those using the Inspiration), and that is why they did not bring anything fundamentally new to the meta, except for the Paladin on secrets.

Everyone's favorite League of Explorers was not rich in new powerful creatures with Death rattle- for the most part there were slightly modified creatures from Naxxramas. And since cards like Fossil lizard, Anubisath Sentinel, or Explorer Hat were unable to show themselves adequately on the battlefield, finally proving the inconsistency of the aggressive Death rattle: either he is completely unplayable, or everything else is unplayable because of him.

New beginning

Although the awakened ancient gods had a “special relationship” with Death rattle(apparently old N'Zoth loved him very much), the cards themselves with this mechanic confirm previous conclusions: they either have basic stats ( Infected Wolf, Twilight Summoner etc.), or interact with the deck ( Shifting Shadow And Dirty flea hawker). At the same time, most of the cards remained useless to anyone, except for one, which secured its place in the zoo deck for a long time - Possessed Peasant- a card worthy of presence in Naxxramas. But, thank Brod, she was an exceptional card of Gul'Dan.

Party in Karazhan was really bad in some ways Death rattles: 4 cards total. Rune Egg And Ditch Lurker were, of course, interesting, but weak, sharp fork was sharp enough only for the Arena, and Grandmother, which was very reminiscent of another Crawler, and which was a class card of the Hunter, did not play precisely because of the weaknesses of the Hunter himself.

IN The hot city of Gadgetzan Death rattle gave way at the helm to a new division into 3 clans - only Aya Blackpaw, Master of potions And Milky-Eyed were good enough to exist in the era Little Eye. Well, besides, they show an already formed balance of interaction with the deck.

Subject to this balance Expedition to Un'Goro: Crystal Oracle,Little raptor, Piros... Those few cards that still remind us of the glory days of Naxxramas ( Unstable Elemental, Egg Thief, Dinomancer etc.), were verified to a very high quality, and most likely that is why few people play them.

If you look at the already opened cards of the new addition, it becomes clear that most of the new cards still interact with the deck ( Frozen Champion, Grave Digger). The rest received sufficient restrictions, for example - Corpse wagon, which needs to be buffed for a very long time in order for it to get anything good.

Apparently, Blizzard has finally realized the mistakes of Naxxramas, so expect new ones Gravediggers And Nerubian eggs not worth it. What we can expect is even more interesting interactions with this mechanic, as well as a slowdown in the overall meta as Death rattle doesn't like haste.

And on this cheerful note, I propose to end. We'll probably return to this topic once more maps from the new expansion are revealed. That's all for now. Have a nice game.

A person's life journey ends with his death. You need to be prepared for this, especially if there is a bedridden patient in the family. The signs before death will be different for each person. However, observational practice shows that it is still possible to distinguish a number common symptoms, which foreshadow the approach of death. What are these signs and what should you prepare for?

How does a dying person feel?

A bedridden patient usually experiences mental anguish before death. In a sane mind there is an understanding of what is to be experienced. The body undergoes certain physical changes, this cannot be ignored. On the other hand, the emotional background also changes: mood, mental and psychological balance.

Some people lose interest in life, others completely withdraw into themselves, and others may fall into a state of psychosis. Sooner or later, the condition worsens, the person feels that he is losing his own dignity, more often thinks about a quick and easy death, and asks for euthanasia. These changes are difficult to observe and remain indifferent. But you will have to come to terms with this or try to alleviate the situation with medications.

As death approaches, the patient sleeps more and more, showing apathy towards the world around him. In the last moments there may be a sharp improvement in the condition, reaching the point that the recumbent for a long time the patient is eager to get out of bed. This phase is replaced by subsequent relaxation of the body with an irreversible decrease in the activity of all body systems and the attenuation of its vital functions.

Bedridden patient: ten signs that death is near

In conclusion life cycle old man or a bedridden patient increasingly feels weak and tired due to lack of energy. As a result, he is increasingly in a state of sleep. It can be deep or a slumber through which voices are heard and the surrounding reality is perceived.

A dying person can see, hear, feel and perceive things and sounds that do not actually exist. In order not to upset the patient, you should not deny this. Loss of orientation is also possible and the Patient becomes more and more immersed in himself and loses interest in the reality around him.

Due to kidney failure, urine darkens to almost brown with a reddish tint. As a result, swelling appears. The patient's breathing quickens, it becomes intermittent and unstable.

Under pale skin, as a result of impaired blood circulation, dark “walking” venous spots appear that change location. They usually appear first on the feet. In the last moments, the limbs of a dying person become cold due to the fact that the blood, flowing from them, is redirected to more important parts of the body.

Failure of life support systems

Distinguish primary signs, appearing on initial stage in the body of a dying person, and secondary, indicating the development of irreversible processes. Symptoms may be external manifestation or be hidden.

Gastrointestinal tract disorders

How does a bedridden patient react to this? Signs before death associated with loss of appetite and changes in the nature and amount of food consumed, manifested by problems with stool. Most often, constipation develops against this background. It becomes increasingly difficult for a patient to empty his bowels without a laxative or an enema.

Patients spend the last days of their lives completely refusing food and water. Don't worry too much about this. It is believed that when dehydrated, the body increases the synthesis of endorphins and anesthetics, which to some extent improve overall well-being.

Functional disorders

How does the condition of patients change and how does a bedridden patient react to this? Signs before death associated with weakening of the sphincters in the last few hours of a person's life include fecal and urinary incontinence. In such cases, you must be prepared to provide him with hygienic conditions using absorbent underwear, diapers or nappies.

Even with an appetite, there are situations when the patient loses the ability to swallow food, and soon water and saliva. This may lead to aspiration.

In case of severe exhaustion, when eyeballs severely sunken, the patient is unable to completely close his eyelids. This has a depressing effect on those around you. If the eyes are constantly open, the conjunctiva must be moistened with special ointments or saline.

and thermoregulation

What are the symptoms of these changes if the patient is bedridden? Signs before death in a weakened person in an unconscious state are manifested by terminal tachypnea - against the background of frequent breathing movements Death rattles are heard. This is due to the movement of mucous secretion in the large bronchi, trachea and pharynx. This condition is quite normal for a dying person and does not cause him suffering. If it is possible to place the patient on his side, wheezing will be less pronounced.

The beginning of the death of the part of the brain responsible for thermoregulation is manifested by jumps in the patient’s body temperature in the critical range. He may feel hot flashes and sudden cold. The limbs are cold, the sweating skin changes color.

Road to death

Most patients die quietly: gradually losing consciousness, in their sleep, or falling into a coma. Sometimes in such situations they say that the patient passed away along the “usual path.” It is generally accepted that in this case, irreversible neurological processes occur without significant deviations.

A different picture is observed with agonal delirium. In this case, the patient’s movement towards death will take place along a “difficult road”. Signs before death in a bedridden patient who has taken this path: psychosis with excessive excitement, anxiety, disorientation in space and time against a background of confusion. If there is a clear inversion of the cycles of wakefulness and sleep, then for the patient’s family and relatives this condition can be extremely difficult.

Delirium with agitation is complicated by a feeling of anxiety, fear, often turning into a need to go somewhere or run. Sometimes this is speech anxiety, manifested by an unconscious stream of words. A patient in this condition can only perform simple steps, not fully understanding what he is doing, how and why. The ability to reason logically is impossible for him. These phenomena are reversible if the cause of such changes is identified in time and treated with medication.

Painful sensations

Before death, what symptoms and signs in a bedridden patient indicate physical suffering?

In general, uncontrollable pain rarely worsens in the last hours of a dying person's life. However, it is still possible. An unconscious patient will not be able to let you know about this. Nevertheless, it is believed that pain in such cases causes excruciating suffering. A sign of this is usually a tense forehead and deep wrinkles appearing on it.

If, during examination of an unconscious patient, there are suggestions of the presence of a developing pain syndrome, the doctor usually prescribes opiates. You should be careful, as they can accumulate and over time aggravate the already existing problem. serious condition due to the development of excessive overexcitation and seizures.

Providing assistance

A bedridden patient may experience significant suffering before death. Symptom relief of physiological pain can be achieved drug therapy. Mental suffering and psychological discomfort of the patient, as a rule, become a problem for relatives and close family members of the dying person.

Experienced doctor at assessment stage general condition the patient can be recognized by him initial symptoms irreversible pathological changes cognitive processes. This is primarily: absent-mindedness, perception and understanding of reality, adequacy of thinking when making decisions. You can also notice disturbances in the affective function of consciousness: emotional and sensory perception, attitude to life, the relationship of the individual with society.

The choice of methods to relieve suffering, the process of assessing chances and possible outcomes in the presence of the patient, in some cases it can itself serve as a therapeutic agent. This approach gives the patient a chance to really realize that he is sympathized with, but is perceived as a capable person with the right to vote and choice. possible ways solutions to the situation.

In some cases, a day or two before the expected death, it makes sense to stop taking certain medications: diuretics, antibiotics, vitamins, laxatives, hormonal and hypertensive drugs. They will only aggravate the suffering and cause inconvenience to the patient. Painkillers, anticonvulsants, antiemetics, and tranquilizers should be left.

Communication with a dying person

How should relatives who have a bedridden patient behave?

Signs of approaching death can be obvious or conditional. If there is the slightest prerequisite for a negative forecast, you should prepare in advance for the worst. By listening, asking, trying to understand the patient’s non-verbal language, you can determine the moment when changes in his emotional and physiological state indicate the imminent approach of death.

Whether the dying person knows about it is not so important. If he realizes and perceives, it makes the situation easier. You should not give false promises and vain hopes about his recovery. It is necessary to make it clear that his last will will be fulfilled.

The patient should not remain isolated from active cases. It’s bad if there is a feeling that something is being hidden from him. If a person wants to talk about the last moments of his life, then it is better to do it calmly than to hush up the topic or accuse him of stupid thoughts. A dying person wants to understand that he will not be alone, that they will take care of him, that suffering will not affect him.

At the same time, relatives and friends need to be prepared to show patience and provide all possible assistance. It is also important to listen, let them talk, and offer words of comfort.

Doctor's assessment

Is it necessary to tell the whole truth to relatives whose family has a bedridden patient before death? What are the signs of this condition?

There are situations when the family of a terminally ill patient, being unaware of his condition, literally spends their last savings in the hope of changing the situation. But even the best and most optimistic treatment plan may not produce results. It will happen that the patient will never get back on his feet, will not return to active life. All efforts will be in vain, expenses will be useless.

Relatives and friends of the patient to provide care in the hope of get well soon, quit their jobs and lose their source of income. Trying to ease the suffering, they put the family in a difficult situation. financial situation. Relationship problems arise, unresolved conflicts due to lack of funds, legal issues - all this only aggravates the situation.

Knowing the symptoms of inevitably approaching death, seeing irreversible signs physiological changes, an experienced doctor is obliged to inform the patient’s family about this. Aware, understanding the inevitability of the outcome, they will be able to focus on providing him with psychological and spiritual support.

Palliative care

Do relatives whose family has a bedridden patient need help before death? What patient symptoms and signs indicate that she should be seen?

Palliative care for a patient is not aimed at prolonging or shortening his life. In its principles, the affirmation of the concept of death as natural and natural process life cycle of any person. However, for patients with an incurable disease, especially in its progressive stage, when all treatment options have been exhausted, the question of medical and social assistance is raised.

First of all, you need to apply for it when the patient no longer has the ability to manage active image there are no conditions in life or in the family to ensure this. In this case, attention is paid to alleviating the suffering of the patient. At this stage, not only the medical component is important, but also social adaptation, psychological balance, peace of mind of the patient and his family.

A dying patient needs not only attention, care and normal living conditions. Psychological relief is also important for him, the relief of experiences associated, on the one hand, with the inability to independently care, and on the other, with the awareness of the fact of his inevitably approaching imminent death. Prepared nurses and master the subtleties of the art of alleviating such suffering and can provide significant assistance to terminally ill people.

Predictors of death according to scientists

What should relatives who have a bedridden patient expect?

Symptoms of approaching death of a person being “eaten” cancerous tumor, documented by clinic staff palliative care. According to observations, not all patients showed obvious changes in their physiological state. A third of them did not show symptoms or their recognition was conditional.

But in most terminally ill patients, three days before death, a noticeable decrease in response to verbal stimulation could be noted. They did not respond to simple gestures and did not recognize the facial expressions of the personnel communicating with them. The “smile line” in such patients was lowered, and an unusual sound of the voice was observed (groaning of the ligaments).

In addition, some patients had hyperextension neck muscles(increased relaxation and mobility of the vertebrae), non-reactive pupils were observed, patients could not close their eyelids tightly. From the obvious functional disorders bleeding was diagnosed gastrointestinal tract(in the upper sections).

According to scientists, the presence of half or more of these characteristics may high probability testify about poor prognosis for the patient and his sudden death.

Signs and folk beliefs

In the old days, our ancestors paid attention to the behavior of a dying person before death. The symptoms (signs) of a bedridden patient could predict not only his death, but also the future wealth of his family. So, if in the last moments a dying person asked for food (milk, honey, butter) and relatives gave it, then this could affect the future of the family. There was a belief that the deceased could take wealth and good luck with him.

It was necessary to prepare for near death, if the patient is without obvious reasons shuddered violently. It was believed that she looked into his eyes. Also a sign of imminent death was a cold and pointed nose. There was a belief that it was for him that death kept the candidate in last days before his death.

The ancestors were convinced that if a person turns away from the light and most of the time lies facing the wall, he is on the threshold of another world. If he suddenly felt relief and asked to be shifted to his left side, then this is a sure sign of imminent death. Such a person will die without pain if the windows and doors in the room are opened.

Bedridden patient: how to recognize the signs of impending death?

Relatives of a dying patient at home should be aware of what they may encounter in the last days, hours, moments of his life. It is impossible to accurately predict the moment of death and how everything will happen. Not all of the symptoms and signs described above may be present before the death of a bedridden patient.

The stages of dying, like the processes of the birth of life, are individual. No matter how hard it is for relatives, you need to remember that it’s even harder for a dying person. Close people need to be patient and provide the dying person with the maximum possible possible conditions, moral support and attention and care. Death is an inevitable outcome of the life cycle, and this cannot be changed.

We will all die one day. We will call death different names: cancer, diabetes, heart failure, stroke.

First one organ will fail, then another. Or maybe all at once. We will all become similar to each other.

A dying person exhibits symptoms of death. They do not depend on the diagnosis. The manifestations of the disease in the weeks and days before death vary in each individual case, but in the hours before the end of life, the symptoms of death are overwhelmingly similar.

Death rattle

There were suspicions that the patient would not survive. The blood clot was moving through the blood vessels to the back of the brain, blocking the flow of blood to the area that controls susceptibility.

The death rattle began when the breathing tube was removed and continued until the patient died. It was a bubbling, crackling sound, similar to air blowing through a straw into the bottom of a mug of water. The average time between the onset of death rattles and death is 16 hours. For this patient it was 6 hours.

The death rattle is a symptom of swallowing dysfunction. Typically, the tongue rises to the top of the mouth and pushes saliva, liquid or food into the esophagus. The epiglottis moves forward to protect the airways from ingested substances.

For a dying person, the swallowing process becomes a cacophony of weak and erroneous movements. Sometimes the tongue pushes saliva back before the epiglottis can close the airway. In other cases, the tongue does not push through at all, and saliva flows down the respiratory tract into the lungs. The death rattle is the lungs' attempt to breathe through a layer of saliva.

Although the sound is alarming, it is unlikely that the death rattle is painful. The presence of wheezing does not correlate with signs of respiratory distress.

As often happens in medicine, the process treatment is underway based on the doctor's intuition. To reduce the intensity of wheezing, the dying person is given medications that reduce saliva production. Sometimes it is possible to drown out the dying sounds. Moreover, the instinctive preoccupation with noise, which probably sounds worse than the dying person feels, goes away.

Oxygen starvation

The patient was a spunky 80-year-old woman who had been smoking for seven decades. The cigarettes turned the spongy structure of her lungs into plastic bags. The lung collapsed as she exhaled. The air is trapped.

Oxygen starvation - a feeling of difficulty breathing - is one of the most common symptoms of approaching the end of life.

Treatment? Opiates, usually morphine.

People sometimes ask why oxygen deprivation treatment is a drug that can suppress breathing.

The answer depends on determining why oxygen starvation causes discomfort.

Some scientists believe this is due to a mismatch between the breathing the brain needs and the lungs' ability to provide it. Opiates adjust the brain's need for oxygen to a level that the body can provide.

Others believe that morphine affects the ability to breathe. Because oxygen deprivation activates the parts of the brain that control pain, opioids may simply dampen the brain's pain signals.

At some point, the patient quit smoking and planned to return home and live again. But a few days later she died in a hospice.

Terminal stage

My grandfather screamed two days before he died. “Open this door and let me go! Right now! Open this door! It was the cry of a lost child.

We were preparing for his absence. But not to excited delirium. Not to rage.

The famous poet wrote that “dying is an art, like everything else.” For hospice doctors, the end stage is the patient's rebellion. It's hard to watch.

Instead of peaceful near-death state the dying man screams and tries to get out of bed. His muscles tremble and spasms may occur. The body looks emaciated.

There are physical reasons for similar agitation, such as shortness of breath, pain and metabolic disorders. There are medications that suppress this.

People who watched terminal stage, believe that this is the reaction of a dying person to the proximity of death. We scream when we come into the world, and sometimes we do the same when we leave it.