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Dr. med. Jörg Cuno
Haben Patienten bisher häufig den Satz „Wir können nichts mehr für sie tun“ gehört, hat heute an einigen Stellen ein Umdenken stattgefunden. Palliativmedizin wird frühzeitiger zu den bestehenden konservativen Therapiemaßnahmen hinzugezogen und damit ein zweiter Blick eines Palliativmediziners. Gemeinsam wird danach geschaut, was könnte für den Patienten mehr Lebensqualität erreichen? Das heißt nicht, dass man noch mehr Therapie machen muss, sondern auch manchmal ein „Wir machen weniger Therapie" - reduziert auf das Wesentliche. Nicht der 35. Zyklus Chemotherapie erhöht das Lebensglück, sondern unter Umständen der Verzicht auf den 35. Zyklus erhöht die Lebensqualität. Was können wir wirklich erreichen und wovon profitiert der Patient JETZT. Es geht nicht um Therapieabbruch, sondern um Therapiezieländerung.

Dr. Jörg Cuno ist Chefarzt für Palliativmedizin am DONAUISAR Klinikum und zuständig für die Palliativstation in Deggendorf und für die palliativmedizinischen Dienste an den Krankenhäusern in Landau und Dingolfing. Eine wichtige Aufgabe ist die Verknüpfung mit der ambulanten Palliativversorgung, die er bereits in Form der Spezialisierten Ambulanten Palliativversorgung PalliDONIS für die Landkreise Deggendorf, Regen, Freyung-Grafenau und Dingolfing-Landau leitet.
“Schwerkranke und sterbende Menschen am Ende ihres Lebens begleiten zu können, erfüllt mich mit tiefer Dankbarkeit. Wenn Palliative Care in der Behandlung schwerkranker und sterbender Menschen frühzeitiger angedacht und umgesetzt wäre, würden die Patienten nicht schneller sterben, aber vermutlich symptomfreier und friedlicher leben. Für mich ist Palliative Care vor allem auch eine, dem Leben und dem Sterben positiv zugewandte Haltung.”
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6 Kommentare
Hallo Corinna,
das Interview mit Dr. Cuno hat mich sehr bewegt. Mein Vater ist 2013 innerhalb von 6 Wochen an Lungenkrebs verstorben. Der behandelnde Arzt sagte uns, dass nur noch palliativ behandelt werden könnte, da der Krebs schon metastasiert hatte. Leider hat mein Vater von einer palliativen Behandlung, so wie es Dr. Cuno beschreibt nichts erleben dürfen. Die Chemotherapie und angedachte Bestrahlung kam durch die vielen Voruntersuchung nicht zu Stande.
Dafür bin ich im Nachhinein eigentlich dankbar, damit ist meinem Vater zusätzliches Leiden durch Nebenwirkungen erspart geblieben.
Ich hätte mir damals so einen Arzt wie Dr. Cuno für die letzte Lebenszeit meines Vaters gewünscht. Mein Vater hätte sicher mit einer palliativen Versorgung noch eine gute letzte Zeit erleben können.
Es ist gut zu hören, dass es auch anders sein kann.
Macht weiter so. Danke.
L.G Annett
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The reason being is that this train has a really similar setup to the
bent-over barbell row; nevertheless, your arms are in a
impartial position versus pronated. Inverted rows are a compound horizontal
pulling motion where the exerciser suspends themselves
chest-up from a bar or comparable object. This permits for them to
quite literally row their very own physique – acting as an efficient replacement in situations the place no barbell or other types of gear are present.
In comparability to bent over rows, the T-bar row places a higher emphasis on the latissimus
dorsi and targets the again stabilizer muscles to a
slightly greater extent. Pendlay rows are very similar to bent-over rows, but they’re
a little easier in your decrease back. With Pendlay rows, you set the bar down on the floor between reps,
giving your again and grip a brief rest.
The t-bar row is supposed to primarily work the muscle tissue of
your middle again and lats and to take action effectively, your torso
must be bending ahead till it’s just above parallel to
the ground. However, it’s an superior alternative to
the t-bar row as it’s going to work the muscles of your back, in addition to your triceps
long head and rear delts. Nonetheless, if you don’t have entry to those, we’re going to advocate some alternate options for t bar row
exercise that are just as effective for developing a bigger bac.
It can be performed using a barbell loaded into a landmine attachment or on a devoted
t-bar row machine. The inverted row is a good bodyweight exercise for working your again muscle
tissue particularly the upper back. Total alternating the barbell row out of the
workout routine may help prevent accidents and promote higher muscle stability and development as properly as being efficient at breaking
by way of plateaus. In truth, Pendlay began doing barbell rows when he was
competing in powerlifting.
Even so, it’s likely safer to get an inexpensive resistance
band anchor to avoid any problems. Resistance bands are versatile pieces of fitness gear that are mainly elastic cords.
One potential downside is that you just want an elliptical machine to do this exercise.
That means both investing in your personal elliptical machine or becoming a
member of a gym. Each hammer Power machines and free weights have their professionals and cons.
The trapezius, typically generally identified as the traps,
is a kite-shaped muscle that covers the top half of your mid again.
Having your physique more horizontal (parallel to the ground) will make the train harder.
Being more upright (raising the bar higher off the ground) will make it
easier. Experiment with different tempos or add a
pause mid-rep to handle areas of weak spot or
sticking factors.
Nonetheless, this is going to place lots of rigidity on the neck and
higher back muscular tissues. You may additionally use this movement as a again finisher for when the muscle tissue have been fatigued with different, more difficult again workout routines.
By altering hand positions and adopting both a wide
grip or slender grip this may also work the
again muscular tissues slightly in a special way. So,
if you would like to tackle any strength imbalances or
enhance muscle mass to sure parts of your again, altering your beginning place
might help you do that as it’s such a versatile train. Muscle and restoration is a net site dedicated to
helping you exercise and reach your exercise targets pain free and
as effectively as possible.
This muscle originates on the lower two thirds of the spine, as well as the lower third and fourth
ribs and the underside of the scapula. As a former gym owner and
certified private coach I’ve been programming
every of these strikes with everyone from novice weightlifters to aggressive bodybuilders, with
nice results. The bent over row has been a mainstay of bodybuilding workouts to develop again thickness for many years.
Make sure you keep pressure by closing your
armpits and squeezing your lats. This can promote optimum activation and range of movement when executing the carry.
When done successfully, secondary muscle tissue which are focused
by this train are the erectors and core stabilizers. This can promote muscle density and thickness within the trunk which instantly strengthens compound
exercises. Contrary to the traditional row, this exercise is carried out with the palms
facing up.
Performing a rep this fashion places you at greater threat of making decrease again pain and different again points.
A common mistake is to load up an extreme quantity of weight and require using other muscle tissue to complete a rep.
Here’s the weight of the Smith machine bar, so you probably can calculate the weight of
your lifts. Examine out different back exercises utilizing a Smith machine
to construct a whole workout.
The decrease two-thirds of the backbone, the decrease ribs, and
the iliac crest of the pelvis are the place the lat muscle fibers originate.
They then journey diagonally to the head of the humerus
within the armpit area. The obvious drawback with this
machine is that not every health club has the Hammer Energy high-row machine.
Except you’re at a high-end fitness center, your coaching facility might not have
Hammer Power gear. If you load large plates onto the finish of the barbell,
it’s going to reach your torso a bit faster than a smaller plate.
For correct activation of your back muscle tissue, you need to be squeezing
your shoulder blades together at the prime of each repetition.
Apart From that, it is certainly one of the handiest corrective
workout routines that help compensate for poor posture and shoulder
dysfunction. The inverted row is a particularly
versatile exercise that can vary in issue as you would possibly
be extra upright or perpendicular to the bottom. Additionally, You
can use momentum on this exercise to get extra weight on the bar
as nicely. By letting the load pull you ahead barely you must use your complete physique to tug
the load towards your naval. Sadly, the trade off
is more focusing on of the erectors and
stabilizers than the t-bar row which is normally a deal breaker if you’re affected by low back ache.
An Inverted Row is a great bodyweight various for a Chest Supported Row.
It’s also a great option for newbies as it’s simply modifiable depending upon the angle
at which you set up the row. As such, the next substitute
exercises to the barbell row are those who possess the closest possible
similarity in all but name and tools used. If you can’t do pull-ups,
progress by using a pull-up machine, lat pulldown machine, or lengthy loop resistance bands for assistance.
This exercise is performed on a machine that allows you to row the weight
towards your stomach. This train is carried out on a Smith machine, which
is a guided barbell. This train is also just like the bent-over
barbell row, however you only use one dumbbell at a time.
The inverted row may be carried out with a barbell and squat
rack, smith machine, and even rings. You can carry out this train anytime during a back
or higher body workout. As the name implies this exercise primarily
focuses on your latissimus dorsi also referred to as your lats.
Select a resistance band with enough tension to load the muscle tissue in your back.
Quite than sticking to a strict rep scheme, go for larger units and
stop when you’re 1-2 repetitions from technical failure to compensate for
the lighter loading. For a visual assist, take a glance at this handy video
from RPI power demonstrating the right approach for a supinated barbell row.
This variation of the bent-over barbell row uses a supinated grip, which signifies that
your palms are facing up.
Training one side at a time is also nice for bettering core stabilization too.
Bilateral (two-sided) workouts can disguise this downside
and even make it worse. This move is unilateral (one-sided), which can make
it simpler to determine after which fix left-to-right energy
imbalances. That’s because it’s concerned in every pressing train you do
– each horizontal and overhead.
I like Chin-Ups here slightly over Pull-Ups just because the underhand grip gets the biceps more involved.
Lean again barely more than you usually would for a Lat Pulldown and row.
Focus on controlling the weight back to the highest of
the rep so you don’t end up rocking all over. You can use both palms on the bar, one arm at a time, stand barely off
to the aspect for Pendlay Rows or use a Lat Pulldown attachment.
To carry out a repetition of Yates row, the lifter will pull a
loaded barbell off the floor with the palms set shoulder-width aside
using either an underhand or overhand grip. The
T-bar row is most often employed as a bent over row different in cases where a
pronated grip, insufficient lat ROM or insufficient loading capability are a problem.
Nonetheless, when you do discover that the standard
barbell bent over row causes problems for you, any of the seven bent
over row options will provide a good substitute.
Posterior deltoids – whereas barbell bent-over rows are most definitely a again train,
your shoulders are also concerned. Of the three deltoids, the
posterior or rear head is most active throughout this train.
If you’ve entry to a Hammer Strength high-row machine, we strongly encourage you
to program it into your exercises. To keep constant tension in your muscle tissue, make certain you don’t
rack the weights at the bottom. The high-row machine is a popular piece of equipment manufactured by Hammer
Energy. You can find videos of top pro bodybuilders utilizing this machine everywhere in the web.
Lat pulldowns place very little pressure on your decrease again and might even assist stretch and decompress your backbone.
Dumbbell pullovers don’t look anything like lat pulldowns, but they’re still a
useful lat pulldown alternative. While there are pullover machines you ought to use, not each gym has one, and the dumbbell model is pretty effective
anyway. You’re performing almost the precise same movement because the rowing machine, minus the leg work.
The bent-over barbell row might look like a staple train for building
a robust back however alternating it out every so often can truly
be useful. Specifically it focuses on the latissimus dorsi or „lats“ which are
the biggest muscular tissues within the again responsible for pulling movements.
This train is commonly included in strength coaching routines because it helps to develop a robust and muscular back.
Maintain a neutral spine and solely select a weight that you could
raise with excellent form to avoid straining your back.
At All Times management the eccentric (lowering) section of
the carry, rather than merely dropping the barbell as soon as they
lock it out. Decrease the barbell slowly onto its pins or blocks
to get probably the most out of this train and keep away from any accidents.
Verify out this video from Scott Herman Fitness for a visible information to performing the inverted body
weight row.
That’s why we take the time to select our alternative exercises fastidiously to verify they do the same thing as the original
transfer. Related to the inverted row, you can do a TRX row and make the
train as easy or as exhausting as you want. As An Alternative of performing a full rep, on the finest way down you’ll pause at the half method
mark, deliver the burden again up, and then convey the weight
all the means in which down. So, in addition to working your higher
again, scapular wall slides also provide your chest with a helpful stretch.
As its name implies, this muscle is positioned on the again of your shoulder.
The rear delt is often underdeveloped and wishes loads of direct coaching to ensure that
it doesn’t lag behind the opposite two deltoids. This additionally is decided by your
fitness targets however, as a basic rule, yes you
could.
You may need another simply to add selection to your upper body day,
or if all of the free weights are taken. The advantages of suspension coach
rows prolong past just focusing on the back muscular tissues.
This exercise additionally engages the core muscular tissues, selling
higher total stability and balance. The instability of the suspension trainers requires greater activation of the stabilizing muscle tissue,
resulting in improved useful energy. Additionally, suspension coach rows allow
for a full vary of motion, enabling you to totally stretch and contract the again muscles for optimum
growth.
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