Stayin' Alive / DNR

[CarolinaKat]

www.slate.com/articles/health_and_science/medical_examiner/2015/04/the_bee_gees_stayin_alive_helped_me_perform_cpr_and_save_my_first_life_as.html?wpisrc=obinsite

I tugged the breathing tube away from the ventilator, but nothing happened. I tried again, but still nothing. A nurse half my size lunged in front of me and pulled the breathing tube off of the ventilator in one quick motion as Baio rattled off a series of questions while assigning each nurse a specific role in the resuscitation. Someone began squeez­ing a bag of oxygen into her throat as I rapidly glanced back and forth at the flurry of activity, looking for something to do. Baio briefly closed his eyes while again feeling under the gown. “No pulse. Matt, start chest compressions.”

I positioned myself on the left side of the bed and placed one hand over the other. I had performed CPR dozens of times on Janet, the Mass General crash test dummy, but never on a human before. A mo­ment of terror shot through me as I pondered the implications of my 190-pound body descending upon this 87-pound woman.

SPOILER: Click to show

This was it. After years of preparation, I had just helped bring someone back from the dead. My heart raced, and I could feel my own pulse pounding through my neck. This was the sensation I had been seeking, the one that was missing for me in surgery. Granted, I had done exactly what Baio told me to do, and it had involved damaging the patient in ways that seemed to create a new set of problems, but she had pulled through. She was stayin’ alive, and would live to see another day with her spouse, kids, whomever. Medicine was messy, but it was fucking incredible. As we stood together at the bedside, I looked over at Baio with a measure of pride. He seemed to sense this.

“You know,” he said, patting me on the back, “there is nothing more rewarding than bringing a 95-year-old demented woman with widely metastatic lung cancer back to life. Well done.”

This article makes me go want to write a DNR to invoke for when I get to be 95...

[NancysSummerSip]

And now I have that Bee Gees song stuck in my head for all the wrong reasons.

Actually, I have heard of that trick being used before.

[shanendoah]

Things to know about DNRs/living wills - paramedics HAVE to ignore them, and doctors will choose to ignore them if they don't agree.

One friend whose father was terminal wanted to die at home. They were advised to let him actually die (and be dead) before calling an ambulance, because paramedics are not allowed to honor DNRs or living wills. They must try to resuscitate/save the patient.

And when the MIL had her accident in 2000, she had a living will that said she was never to be hooked up to a ventilator. Obviously the hospital couldn't have known this when she was first brought in (from a car accident), but C, trying to honor his mother's wishes, brought it to the hospital with him. Doctors told him they were going to ignore it because the ventilator was not "breathing for her" just "assisting her in breathing" (there is apparently a difference, much like there is supposedly a difference between being in a coma and unconscious and unresponsive).

MIL did go on to live another 12 years, but I can't say quality of life was high. And C will tell you he lost his mom in 2000, not 2012 when her body finally died. The one time something actually really got him after she died was when we found a notebook from when she was training to be a CNA, and there was this neat handwriting and comprehensive notes, and a good drawing.... All things C remembered about his mom from before the accident.

[shanendoah]

And in our CPR classes, they totally teach us the Stayin' Alive trick.

[milee]

Even if you're not an advocate of assisted suicide, if you look objectively at some of the means we use to prolong the life of people it's easy to see that the methods are fairly barbaric.

It's not uncommon for CPR to cause rib fractures, especially in a case like listed in the OP - where CPR is done on a tiny, frail old woman. So now, that 87 pound dying woman will spend the next 6-8 weeks (if she lives that long) experiencing searing pain with every. single. breath. she takes.   Very cruel.

[jelloshots4all]

I disagree that hospitals won't honor DNR requests. I friend of mine was dying from cancer at age 38 and had been in the hospital for several months. On my second to last visit to see him, that had placed a DNR bracelet on his wrist the night before. They were acting as hospice for him since there was no way his wife could take care of him at home. And from speaking to his family, when the time came, the hospital allowed him to pass away peacefully without any intervention. Maybe it is a hospital/state law?

[NancysSummerSip]

Apr 9, 2015 16:16:33 GMT -5 jelloshots4all said:

I disagree that hospitals won't honor DNR requests. I friend of mine was dying from cancer at age 38 and had been in the hospital for several months. On my second to last visit to see him, that had placed a DNR bracelet on his wrist the night before. They were acting as hospice for him since there was no way his wife could take care of him at home. And from speaking to his family, when the time came, the hospital allowed him to pass away peacefully without any intervention. Maybe it is a hospital/state law?

I agree with jello on this. Both the hospital and the rehab my mother was in had a DNR bracelet on her, at her request (and I had the paperwork as well). When the time finally did come at the end of her life, the doctors were ready, needles in hand, to prolong her life. I still had the papers in hand, and told them no. They agreed, admitting that at best, what they could have done would have given her a few more bedridden weeks at most.

[Tennesseer]

Horrible what was done to that old woman.  Have some mercy for these poor old people.

Better to play 'This Is The End' by the Doors.

[kent]

I don't know what the "law" is but when I got the call at two in the morning that my Mom was not doing well, I charged over to the house. I did a very quick review of her situation and called 911 to tell them I had a non-responsive 86 year old with a very shallow breathing pattern.

The guys were there in minutes and did their best to stabilize her. A few minutes after I got to the hospital, the doctor approached me to say she was on support.  I told him that was NOT what she wanted. He excused himself, returned a few minutes later I told me I could see her now. She died holding my hand.

The doctor never asked for a DNR or a single signature on anything - I still love that guy for not screwing things up because of some "law" or "rule."

I've actually done this one other time when my friend was dying and his wife just "couldn't" respond when the doctor asked her what she wanted if things got worse. All I said to the doctor was don't keep him going using life support - he died the next morning, peacefully. 

[billisonboard]

The statement at a care facility was something like, "I can call an ambulance and they will take her to the hospital where they will put her in intensive care and you won't be able to be with her.  Would you like me to call?"

[zibazinski]

I can't begin to tell you how many medical directives I've witnessed in the last 6 weeks in critical care.

[TheOtherMe]

My mom chose to die in her home, in her chair.  Hospice and the facility where she lived had the DNR in their records.  We were advised by the facility not to call them as they had to call 911.  We called hospice at every crisis and they came.  Hospice pronounced mom dead and called the funeral home.

That is the way I want to go also and I have a DNR that is to go in to effect if I am no longer capable of making my own decisions.  That is when my nephew takes over and he is very aware of my wishes.  There is also another paper in the state where I live and I have that and my doctor has a copy of it.