User talk:Syleth

Welcome

Hello, Syleth! Welcome to Wikipedia! Thank you for your contributions. You may benefit from following some of the links below, which will help you get the most out of Wikipedia. If you have any questions you can ask me on my talk page, or place {{helpme}} on your talk page and ask your question there. Please remember to sign your name on talk pages by clicking

or by typing four tildes "~~~~"; this will automatically produce your name and the date. If you are already excited about Wikipedia, you might want to consider being "adopted" by a more experienced editor or joining a WikiProject to collaborate with others in creating and improving articles of your interest. Click here for a directory of all the WikiProjects. Finally, please do your best to always fill in the edit summary field when making edits to pages. Happy editing! Ser Amantio di Nicolao^{Che dicono a Signa?}_{Lo dicono a Signa.} 02:56, 25 March 2011 (UTC)[reply]

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References

Medical articles on Wikipedia must be cited by the best available evidence and written in a consistent format. A list of resources to help edit such articles can be found here. Additionally, the diberri tool will aid in the formatting of references; all one needs to do is cut and paste the results. The welcome page is another good place to learn about editing the encyclopedia. If you have any questions, please feel free to drop me a note. Cheers. Doc James (talk · contribs · email) 00:30, 9 May 2011 (UTC)[reply]

Also we typically use person rather than patient and the info you are adding should be in a section regarding treatment.Doc James (talk · contribs · email) 00:33, 9 May 2011 (UTC)[reply]

Your recent edits

Hello. In case you didn't know, when you add content to talk pages and Wikipedia pages that have open discussion, you should sign your posts by typing four tildes ( ~~~~ ) at the end of your comment. You could also click on the signature button located above the edit window. This will automatically insert a signature with your username or IP address and the time you posted the comment. This information is useful because other editors will be able to tell who said what, and when. Thank you. --SineBot (talk) 01:10, 9 May 2011 (UTC)[reply]

Welcome to Wikipedia

It is good having you here editing. A couple things though 1) adding the exact same text to every cancer article is not going to go over well. Maybe work on the palliative care article to start with until you get the hang of editing. 2) Review articles must be used. The study you are referencing is a primary research study that pertains to only lung cancer. I will leave what you wrote on that page but will move it from the others. 3) There is specific referencing formatting that should be followed. There are automatic tool to do this. Anyway email me if you have further questions. Doc James (talk · contribs · email) 02:17, 9 May 2011 (UTC)[reply]

Editor got good faith for awhile. But edit warring across several articles? Sorry, no good faith here. I requested a block for vandalism. Maybe some cooling off time to actually read Wikipedia policy, understanding WP:MEDMOS and WP:MEDRS would be time well spent. OrangeMarlin ^{Talk• Contributions} 02:24, 9 May 2011 (UTC)[reply]

Ah give him some time. He is new to Wikipedia and you must admit that editing here is complicated sometimes. I am sure he can make some really great contributions. Just give him a bit more time. :-) Palliative care could definitely use better coverage. Doc James (talk · contribs · email) 02:27, 9 May 2011 (UTC)[reply]

I'm not one of those nice editors. If it was something important like the NIH was publishing data on the root cause of all cancers, and the editor kind of messed it up, I'd give him a hug. Palliative care? Not so much. OrangeMarlin ^{Talk• Contributions} 02:41, 9 May 2011 (UTC)[reply]

Working on your text

Palliative care consists of a multidisciplinary team including a physician, nurse practitioner, RN, social worker, and chaplain. This team is ideally suited to address the issues that patients face when dealing with severe diseases such as cancer.

Palliative care practitioners, unlike most physicians, have extensive, specialized training in symptom management. Specifically, they are experts in treating pain, shortness of breath, nausea, constipation, and fatigue. In addition, palliative care practitioners have extensive training in communication and are therefore adept at addressing the emotional needs of patients dealing with cancer, from normal grief and emotions to pathologic anxiety or depression. Oncologists and primary care doctors generally do a fine job with symptom management in most cases, but in more complex or severe cases palliative care physicians can provide a great service to the person with their added expertise. Palliative care can also help address advanced care planning, spiritual concerns that often arise with life-threatening illnesses, and the transition to hospice care if necessary.

One study out of Harvard found that individuals with lung cancer who received palliative care survived almost 3 months longer than patients who received standard care only[Link to study]. Palliative care can provide better symptom management, improved rates of depression, better family support, and assistance with end of life decision making. Current research finds improved survival rates among those who have received palliative care services. Therefore, there is a strong argument to include these services in the care plan of many patients with cancer. In fact, many experts would argue that palliative care should be involved in every patient with stage 3 or 4 cancer of any type or in any patient with severe or difficult to control symptoms.

WRT this text the first to paragraphs need referecing and would only really belong on the page about palliative care. The third paragraph deals only with lung ca and therefore does not belong on a page about stomach cancer. The second issue is that the ref is primary research. WP:MEDRS discusses referencing further. Cheers. Doc James (talk · contribs · email) 02:34, 9 May 2011 (UTC)[reply]

Also if you take the PMID which is 20818875 you can set if up so it formats automatically ^[1]

^ Temel, JS (2010 Aug 19). "Early palliative care for patients with metastatic non-small-cell lung cancer". The New England journal of medicine. 363 (8): 733–42. PMID 20818875. {{cite journal}}: Check date values in: |date= (help); Unknown parameter |coauthors= ignored (|author= suggested) (help)

Doc James (talk · contribs · email) 02:36, 9 May 2011 (UTC)[reply]

I would delete that from almost any cancer article. Giving undue weight to new age medicine (again IMHO) just bothers me. Since medical articles aren't to give advice, and we're here to discuss the disease, palliative care doesn't do squat for the disease, it's there to make sure everyone is happy at the end. One sentence is all that I'd like to see, if that. It's not that important. OrangeMarlin ^{Talk• Contributions} 02:39, 9 May 2011 (UTC)[reply]

It's a bit like an advertisement for physicians who market themselves as palliative care specialists, rather than saying what palliative care is. (Also, most trained palliative care professionals seem to be nurses, not physicians.)

I think the subject ought to be mentioned at both Cancer and Management of cancer, since it is an important form of patient care, but I wouldn't write it this way. I'd ignore the "specialist" physicians and life extension claims, and focus on the more common things, like in-home nurse evaluations, comfort packs, and a phone number to call for help. I'm not sure whether it should be mentioned in any more specific articles; it might depend on those editors' vision for the article. WhatamIdoing (talk) 03:12, 9 May 2011 (UTC)[reply]

That's sort of what pissed me off. After watching these articles for years, I'm sort of used to what newbies do. This felt like spam. From my POV, palliative care is the point where the oncologist has given up and moved on. That's kind of why I'm convinced it doesn't belong. But I like the idea of putting in the more general cancer articles. OrangeMarlin ^{Talk• Contributions} 03:22, 9 May 2011 (UTC)[reply]

Technically, giving a patient an anti-emetic for vomiting due to chemotherapy is palliative care, even if you expect a total and permanent cure: the point of that prescription is to make the patient feel better now, not to kill cancer cells. I think that one of the problems that patients encounter is exactly your intuitive take on the situation: They often can't access a lot of feel-better-now services until the oncologist is emotionally ready to "give up" on a permanent cure. The patients whom we reasonable expect to be cured would probably experience both less emotional trauma and fewer hospitalizations if they had better access to palliative care—like a phone number to call about the pain in the middle of the night, rather than needing to make a trip to the emergency room to talk about the same problem. WhatamIdoing (talk) 03:50, 9 May 2011 (UTC)[reply]

Your editing

Hello, Syleth, and welcome to editing Wikipedia. I see you have been putting quite a lot of work into editing, and I hope you will continue to make useful contributions. I have been looking at your contributions because of a report about you at Administrator intervention against vandalism. It is clear to me that your edits have been made in perfectly good faith, and describing them as "vandalism" is a mistake. However, there are various things you need to learn about how Wikipedia works, and I hope the following remarks may be of some help to you.

First of all, Wikipedia works by collaboration and consensus. As you are aware, other editors have questioned some of your edits, and it is a mistake to just repeat those edits, rather than discuss them, with a view to trying to reach agreement on how to take the relevant articles forward. I see that you have posted messages to other users' talk pages asking why they have reverted your work, which is a step in the right direction, but you have not followed this up by significant engagement in discussion, even though others have tried to initiate such discussion. If every one of us pushed ahead with what we individually believe is the best way to edit articles, without regard to what others think, we would never get anywhere, as articles would be endlessly fought over and never settle down. Repeatedly reverting other people's edits back to your own preferred version, known as edit warring, can even lead to being blocked from editing if it continues.

You need to make sure that any information you add to articles which has any reasonable chance of being disputed is supported by references to verifiable sources. "You can take my word for it, as I know about this subject" is not a sufficient justification, as anyone can edit Wikipedia and claim to have personal knowledge, and unfortunately it is far from unknown for people to make false claims of this sort. (I am not suggesting that you are making such false claims, just explaining why we can't accept anonymous people's words for it.) Certainly saying "There is strong evidence that..." but giving no indication what the evidence is or where it can be found is not helpful.

Wikipedia articles must be written from a neutral point of view. Posting your own commentary or judgements in an article is not acceptable. To give just one example, putting the heading "Lie of the Year" above a section of an article is a comment rather than a statement of verifiable fact.

It is not appropriate to add copies of the same substantial text to every article where you think it has some sort of connection. If the text is useful then it should go in the one article where it is most relevant, and if appropriate there can be links to it from other articles.

These are just a few pointers. You should also take note of comments in other messages to you. Also, do have a look, if you haven't already, at some of the pages linked from the welcome message above. Unfortunately Wikipedia has too many guidelines and policies for it to be realistic to expect you to read and absorb everything before you start editing, but you should at least have a glance at some of them. As I have already indicated, the reason I am here is that a report was made at Administrator intervention against vandalism, with a view to having you blocked from editing. However, I do not believe that you have edited with any malicious intentions, but have simply made mistakes through lack of experience of how Wikipedia works. If you can take on board what has been said, and learn how to edit collaboratively, blocking will not be necessary. JamesBWatson (talk) 10:20, 9 May 2011 (UTC)[reply]

Best place to start

Probably the best place to start learning to edit is on a single page. Palliative care could use work and is your area of expertise. The two guidelines that are the most important are WP:MEDRS and WP:MEDMOS. If you have specific question drop me a note or start a discussion at WP:MED on the discussion page. Referencing can be a little hard to get the hang off. Doc James (talk · contribs · email) 20:57, 9 May 2011 (UTC)[reply]

I wanted to say something friendly in the way of welcome, because it looks like you've had a bit of a rough introduction to Wikipedia. And your initial edits actually remind me of mine, before I became acculturated (for better or worse) to this place.
First of all, I think there is definitely a need to improve Wikipedia's coverage of subjects related to palliative care. Since you have an obvious interest in and knowledge of the area, I hope you'll stick around and help make our coverage better. I hope that this introduction doesn't put you off.
I think it's probably worth focusing first on our articles on palliative care, cancer, and management of cancer. The degree of detail on palliative care should probably differ depending on the article focus, although some mention is obviously appropriate in all three. Then, for specific malignancies, it may be worth focusing on making sure that palliative care is properly included and described as a treatment option where appropriate (for instance, for patients with Stage IIIB or IV non-small-cell lung cancer, palliative care should probably be presented upfront as an alternative to chemotherapy for many patients).
It will help to have references; you mentioned the fairly recent NEJM article, which is excellent, and there is (as I'm sure you know) a growing body of literature on palliative care, much of it in oncologic journals (e.g. Journal of Clinical Oncology) and some in journals dedicated specifically to palliation and symptom management.
Anyhow, I can tell that your heart's in the right place, and we're always on the lookout for motivated people to help improve our coverage of medical articles. It would be a shame to lose someone who's interested in contributing, so please let me know if you'd like any help, suggestions, advice, or whatever, and I hope you stick around. Cheers. :) MastCell ^Talk 20:59, 9 May 2011 (UTC)[reply]

Appreciate the welcome, and I'm planning to stick around for a bit at least, lots of work I'm happy to help with. So far it's really only been a single issue, and I'll take that as a learning experience. I appreciate the tips, and I'm happy to get a little cite-happy to back basically anything I say at first, other people can help tone it down if need be. Thanks for the offer to help if I have questions, I likely will have many. First, am I replying to you in the correct way? I'm trying the talkback thingy, so we'll see if it works ;) Syleth (talk) 00:06, 10 May 2011 (UTC)[reply]

Sure. It's probably easiest to reply here, to keep the conversation in one place. Personally, I usually watchlist users' talk pages after I leave a note, so the talkback message on my page isn't strictly necessary in my case, but it doesn't hurt either. Cheers. MastCell ^Talk 17:31, 10 May 2011 (UTC)[reply]

I'm glad you're going to stick around. Have we invited you to WP:WikiProject Medicine yet? It's a group of volunteers who are interested in improving Wikipedia's medicine-related articles. We've got sourcing advice and style advice—and (not to boast) some of the best and most helpful folks on Wikipedia. There's a page to officially sign up, but in practice, joining means that you keep an eye out for messages on the group's talk page (click on WT:MED to see what I mean).

Speaking of helpfulness, I'd be happy to have both you and MastCell take a look at the note Cliff ("Uploadvirus") left on my user talk page about what to do with some new information at Carcinoma—some of which is good, and some of which is perhaps not so good, but we'd like to keep the baby when we toss out the bathwater. WhatamIdoing (talk) 20:55, 10 May 2011 (UTC)[reply]

Palliative care

Hey, I see you took some umbrage to my palliative care edits, though I take a bit of insult to your comments, I figure we should talk a bit more. I'm in the field of palliative care, so for you to say it's just not important- that's an opinion, and many would disagree, so I'm not sure that's reason enough to exclude it from articles. I understand I have quite a bit to learn here as I edit, and I frankly had no clue there were so many rules, but I'm trying. Most people feel like you do- palliative care is ONLY for "after an oncologist has given up", and that is 100% not true. Many world leaders in oncology and palliative care agree that palliative care needs to be moved way, way upstream from the often end of life only that it is right now. That's why I feel it's important to have at least a blurb about it as a treatment option for any cancer. Palliative care can help symptoms with any cancer, and people should know the option is out there. I'm not drumming up work, I've said nothing about myself or my practice but if it were my mother or sister that was ill I'd want her to be able to research and at least know it's an option. I think going so far as to call it vandalism is a bit much, I added information I could back up with studies (happy to site more if need be for each claim- depression, symptoms, family outcomes, etc.) If

If putting the same short blurb under each major type of cancer isn't acceptible I'm happy to change it up a bit for each of them, but what else can I do to make sure I don't step on any toes while adding palliative care to each section. I very strongly believe palliative care should be listed, but I'm more than happy to do it in "the right way" if you'll help me with that. —Preceding unsigned comment added by Syleth (talk • contribs) 19:41, 9 May 2011 (UTC)[reply]

Apparently, you failed to read the message at the top of my talk page. I do not EVER respond to comments, arguments, rants, or anything about articles there. I also watch your page, and I will respond on your page, if I feel like it. And honestly, I really don't. Moreover, I don't care that you're insulted, grow a pair. I'm only being nice to you (yup, this is my nice), because you're new. I don't care what you think, what you believe, what you dream or what you want. The only thing that matters is does palliative care have anything to do with a specific cancer, and can it be verified with reliable sources. Palliative care is end stage touchy feely stuff. It has nothing to do with treating/curing a real disease. Honestly, there is much more important stuff to be done on these articles than wasting time writing the same thing over and over and over and over (I'll repeat that the 10-12 times you spammed a bunch of articles). I'm done here. OrangeMarlin ^{Talk• Contributions} 21:10, 9 May 2011 (UTC)[reply]

I guess I feel you don't really understand what palliative care is. I'm a fellowship trained palliative care physician. I do a lot more than "touchy/feely stuff". Frankly, palliative care trained physicians are the best group at symptom management, and if you asked pretty much any physician they'd agree. Anyone with bad pain, nausea, shortness of breath, fatigue, or a myriad of other symptoms that patients go through palliative care can help with. Patients that get palliative care concurrent with aggressive treatment do better from several standpoints. There are only smaller studies and not nearly as many well controlled randomized as the field needs, but based on the best literature available I do feel palliative care is a reasonable thing to include in "treatment" of darn near any cancer. Now, does it need to be a whole section, or can it be a sentence and a link? I'm happy to discuss, coordinate, get a consensus opinion, whatever is appropriate. If you want to get a little better understanding of what palliative care is and then explain why it doesn't fit, fine, but as of now your comments show without a doubt you have no idea what palliative care actually is, at least in the USA. If it's a country issue I'm happy to admit I don't know what palliative care is like in every country, and can make the section USA specific.

If you're interested, a few research links to support each claim I made. Again, not all review articles, but in this young field we don't always have that. Chest guidelines supporting palliative care in patients at all stages of illness Increased patient and family satisfaction Another article supporting improved survival Evidence based guideline on how palliative care helps How palliative care teams help

I could link more if you have a particular question, but I doubt you'll read these.

You mention there are other things more important to edit. I'm obviously learning how to correctly edit wikipedia, but I'm a board certified internist. I'm happy to take a look at a subject if there's something you'd like help with.Syleth (talk) 00:03, 10 May 2011 (UTC)[reply]

I would just like to mention that, in my opinion, Orangemarlin has been distinctly less civil and welcoming to you than he/she should have been. For some reason he/she seems to take pleasure in seeing how far he/she can defy Wikipedia's civility standards and get away with it. I suggest you ignore it and move on. JamesBWatson (talk) 08:36, 10 May 2011 (UTC)[reply]

I looked at this also. I am not sure what happened with that user. They were on wiki peacefully enough for years, then left sometime after this interaction and have not returned in over two years. They should have been nicer. Sorry you had this experience. Blue Rasberry (talk) 19:53, 10 September 2014 (UTC)[reply]

Headings

WRT headings the first letter is capped and then the next letter are not. Doc James (talk · contribs · email) 22:00, 10 June 2011 (UTC)[reply]

Also can you please use PMIDs and one does not write words like NOT in all caps. Doc James (talk · contribs · email) 22:03, 10 June 2011 (UTC)[reply]

PMID is a WP:Magic word on Wikipedia: you type PMID (all caps) followed by one space and then the id number, and it automagically generates a link to the PubMed entry, e.g., PMID 12345678 (I wonder if something actually has that id number).

Adding proper citations is a hassle with Diberri's tool down for so many weeks now. You might try http://toolserver.org/~holek/cite-gen/index.php (paste the PMID into the field, and it will get everything else for you). Two other options are currently being discussed at WT:MED. WhatamIdoing (talk) 22:33, 10 June 2011 (UTC)[reply]

A cup of coffee for you!

I came here to thank you for the work you did on feeding tubes back in 2011. I am building from that now. Blue Rasberry (talk) 19:50, 30 October 2013 (UTC)[reply]

Turning off ICD's

I saw that you removed information which I added about ICDs being turned off at the end of life. You said you worked in palliative care, and I got this info from a palliative care organization. To what do you object in these statements? Please ping me by saying my name {{u|bluerasberry}} when you reply. Also, I see you are new and learning the rules of medicine. I do not practice medicine but I know Wikipedia, and if you ever want a tour of the health content here, just ask and we can meet in a virtual space and I will show you around. Blue Rasberry (talk) 19:51, 10 September 2014 (UTC)[reply]

Blue Raspberry

Hey, it's been a long time since I logged on. Once I'd finished my project life has kept me busy, but I'm going to be doing some editing again and just saw your comment. I've actually been writing quite a bit of content for Wikipedia, and there's someone else in the group that has been uploading it though I don't know his name on here.

I can't remember even adjusting or changing the ICD page as it's been so long. Out of curiosity I went and looked and what it says looks good to me. I'll be on here a bit for the next couple of months, message me if you're still around.

[1] Temel, JS (2010 Aug 19). "Early palliative care for patients with metastatic non-small-cell lung cancer". The New England journal of medicine. 363 (8): 733–42. PMID 20818875. {{cite journal}}: Check date values in: |date= (help); Unknown parameter |coauthors= ignored (|author= suggested) (help)

[1]