High-quality palliative care also requires special expertise in honest, compassionate communication. In addition to enhancing the patient's and family's experience, these skills help to establish trust and overcome barriers to adequate care and relief of symptoms. Several communication tasks are especially important: conveying accurate prognostic information while maintaining hope, eliciting information about symptoms, decision making about curative and palliative treatments, handling emotions, and dealing with requests from patients and families who have unrealistic goals [34, 35, 36] . The challenges of communicating effectively are discussed later in this course.
The Oxandrolone hormone does not carry any estrogenic related side effects. It does not aromatize and cannot lead to gynecomastia or water retention due to increases in estrogen levels. It further carries no progestin related activity, which again supports no estrogenic related side effects. Due to water retention being impossible with this steroid, this will decrease the risk of high blood pressure. Excess water retention can promote high blood pressure. Some steroids that do not aromatize can lead to high blood pressure, such as Trenbolone , but Anavar is rarely associated with this trait.
Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website ( http:///c4Rm4p ) for more information if you do not have access to a take-back program.