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Old 02-27-2012, 08:42 PM   #21
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That is exactly what one would expect. How much of the class advantage is due to wealth (meaning ability to afford advanced treatment), and how much is due to education and lifestyle would be more difficult to assess.
There is research on this, it appears to be be just some X factor that correlates with social class. Likely a surprisingly small amount of lifespan has anything at all to do with medical treatment beyond the basics.

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Then, the next question is how much longevity doctors have over laymen of the same wealth. I would think this question could be answered more easily with mere statistics.
Right, this would be easier to establish, but why? No one is going to make the decision about whether or not to become a doctor by examining doctors lifespans relative to other upper middle class professionals/ businesspersons.

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Old 02-27-2012, 09:27 PM   #22
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True.

But what I am curious about is the relative advantage of the "doctor heal thyself" effect!

I suspect it may not be that much, because I believe that beyond the basic healthcare issues, much of the longevity of an individual is due to genetics, hence not under his control.
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Old 02-27-2012, 10:27 PM   #23
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The New Yorker article is also interesting but too depressing.
Agreed. However I appreciate how good it is for starting a dialogue among the family members, and I'm sending a printout in my next letter to my brother... who may already be hinting that he's thinking the same way.

We just need to give each other permission to say what's on our minds.
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Old 02-28-2012, 05:19 AM   #24
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I just read the New Yorker article. It brought back clear memories of my father and the way he died, but also of hospice. DW worked in one as a volunteer for a number of years and got me to go along to help on occasion as well.

These conversations are critical when there is not the stress of terminal illness upon us. Once that happens a series of forces come into play that affect everyone's emotions, including the medical professionals, but also ask family members to make choices they are not prepared to make.
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Old 02-28-2012, 07:32 PM   #25
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But who does one have such conversations with?
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Old 02-28-2012, 08:38 PM   #26
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But who does one have such conversations with?

You do not have to have the discussions with anyone .You just put them in your living will . Living wills are usually included with regular wills at minimum cost or you can download them free on the Internet . It is nice but very difficult to have that conversation . I have had it with my loved ones because I do not want the burden of making a choice on them .
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Old 02-28-2012, 08:41 PM   #27
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You do not have to have the discussions with anyone .You just put them in your living will . Living wills are usually included with regular wills at minimum cost or you can download them free on the Internet . It is nice but very difficult to have that conversation . I have had it with my loved ones because I do not want the burden of making a choice on them .

Perhaps I'm confused...but aren't 'regular wills' usually not read until the individual is dead? Wouldn't that be a bit late for the living will?

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Old 02-28-2012, 09:43 PM   #28
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You do not have to have the discussions with anyone .You just put them in your living will . Living wills are usually included with regular wills at minimum cost or you can download them free on the Internet . It is nice but very difficult to have that conversation . I have had it with my loved ones because I do not want the burden of making a choice on them .
You are right but if you do not talk to someone about it ahead of time the people making decisions at a critical time may not know that you have a living will. If you think that having a copy on file with your primary physician will make it readily available when you are injured or seriously ill in an emergency room you are wrong. Working as a nurse I saw many cases where people did not know anything about their relative's living will. I also saw several cases where the patient apparently did not know or remember what was in their own living will.
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Old 02-28-2012, 10:33 PM   #29
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Perhaps I'm confused...but aren't 'regular wills' usually not read until the individual is dead? Wouldn't that be a bit late for the living will?

omni
Living wills and Power of Attorney are used before death but usually made when a regular will is drafted.I hope this explains it .
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Old 02-28-2012, 10:39 PM   #30
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You are right but if you do not talk to someone about it ahead of time the people making decisions at a critical time may not know that you have a living will. If you think that having a copy on file with your primary physician will make it readily available when you are injured or seriously ill in an emergency room you are wrong. Working as a nurse I saw many cases where people did not know anything about their relative's living will. I also saw several cases where the patient apparently did not know or remember what was in their own living will.
Thanks ,I did talk with my loved ones about it because having been an RN in the OR for forty years I know the importance of that . I also have had personal experience with living wills .
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Old 02-28-2012, 11:14 PM   #31
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Option 1 do nothing, 95% chance you are going to die in months not year
Well depending on the cancer & chemo drug you may not git an extra year. My uncle's prostate cancer had metastasized to his bones. His chemo option generally provided two months of more life. After hearing about the potential side effects he eschewed chemo for palliative care.

Methinks that qualitative measures should factor in as well a quantitative measures. If one is likely to feel crappy that extra period of time gained; it may not be worth the hassle.
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Old 02-29-2012, 09:04 AM   #32
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Perhaps I'm confused...but aren't 'regular wills' usually not read until the individual is dead? Wouldn't that be a bit late for the living will?
Could happen that way. I'm fortunate that my parents have shared their wills, advanced directives and trust info for many years. And they meet with sis and I when they make changes/additions. On the other hand, my MIL hasn't shared anything, though she probably has no estate to speak of.

I guess if your family has not had the intergenerational discussions about such things, we should at least attempt to convene the discussion, though I realize that may not happen (and some feathers may be ruffled).

We have briefed our executor (BIL) about our will and advanced directives.

And I know when DW was hospitalized for something pretty serious a few years ago, the hospital asked for a copy of her advanced directive before surgery. I don't know if they would have demanded it or not (hope so), but we willingly provided hers. Hopefully that's a common practice, as jclarksnakes mentioned.
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Old 02-29-2012, 09:30 AM   #33
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Could happen that way. I'm fortunate that my parents have shared their wills, advanced directives and trust info for many years. And they meet with sis and I when they make changes/additions. On the other hand, my MIL hasn't shared anything, though she probably has no estate to speak of.

I guess if your family has not had the intergenerational discussions about such things, we should at least attempt to convene the discussion, though I realize that may not happen (and some feathers may be ruffled).

We have briefed our executor (BIL) about our will and advanced directives.

And I know when DW was hospitalized for something pretty serious a few years ago, the hospital asked for a copy of her advanced directive before surgery. I don't know if they would have demanded it or not (hope so), but we willingly provided hers. Hopefully that's a common practice, as jclarksnakes mentioned.

The only problem with advanced directive is that sometimes the hospital or doctor will not accept one that is 'old'... they want you to sign a new one that fits their preprinted form...

They do not demand it as some patients just do not want to fill one out...
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Old 03-07-2012, 09:28 AM   #34
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Perhaps physicians generally have a better acceptance of the fact that life is ultimately a 'round-trip ticket' (or however you wish to phrase it). Far too much "care" is foisted on folks at/near end-of-life at huge cost not only in dollars but perhaps more importantly in pain/suffering & declines in functional status. Clearly otherwise healthy person having coronary bypass for ave (say) 10+yrs of quality life is good call. OTOH- If diagnosed with cancer, would you ALWAYS sign-on for complex treatment on promise of 50% longer life?? Most docs who have seen it before would rather live well for their last 6mo of life & die quietly at home vs suffer through surgery/chemo in hopes of 9mo survival. Life is about LIVING rather than mindless & ultimately futile avoidance of death.


To paraphrase Hunter Thompson- Life is not a journey to the grave with the intention of arriving safely in a well-preserved body, but to skid across the line broadside, thoroughly used up, shouting WOW what a ride!!!!
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Old 03-07-2012, 03:50 PM   #35
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To paraphrase Hunter Thompson- Life is not a journey to the grave with the intention of arriving safely in a well-preserved body, but to skid across the line broadside, thoroughly used up, shouting WOW what a ride!!!!
I question the credibility of this philosophy if its originator couldn't even hang around for the end of the ride.

Although I must admit he chose to "die differently".
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Old 03-07-2012, 05:00 PM   #36
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To paraphrase Hunter Thompson- Life is not a journey to the grave with the intention of arriving safely in a well-preserved body, but to skid across the line broadside, thoroughly used up, shouting WOW what a ride!!!!
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I question the credibility of this philosophy if its originator couldn't even hang around for the end of the ride.

Although I must admit he chose to "die differently".
We do know how he went, but not his state of mind when he pulled the trigger.

This thread and the comments about Hunter T. remind me of a Lou Reed CD - Magic and Loss. A couple of the songs were about friends who apparently had attitudes (and lifestyles) similar to Thompson yet when they were diagnosed with terminal illness they became very conventional in their approach to treatment, not letting go and pursuing every medical option.

A very dark CD than can bring a dark cloud into the clearest sunny sky.
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Old 03-07-2012, 06:18 PM   #37
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I question the credibility of this philosophy if its originator couldn't even hang around for the end of the ride.

Although I must admit he chose to "die differently".
If you prefer a sl different version from another author, let's try '80's motorcycle racer Bill McKenna-

Life is not a race to the grave trying to arrive safely in a pretty, well-preserved body, but to skid across that line broadside in a cloud of smoke screaming "Holy Sh#t, what a ride"!

AFAIK, Bill is still alive & well - albeit with some racing scars.

BTW- Sometimes people can still pursue great goals while doing chemo-
Creve Coeur woman completes Ironman while battling cancer | Newsmagazine Network

Clay Treska: The Most Courageous, Inspirational Person I’ve Ever Met | Home Post
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Old 03-08-2012, 02:19 AM   #38
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My thoughts exactly. I have seen death many times, and I have also had to inform many patients that they have terminal cancer. Avoidance of death is futile, and this is one of the reasons why I intend to FIRE and LIVE this year, age 47.
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Most docs who have seen it before would rather live well for their last 6mo of life & die quietly at home vs suffer through surgery/chemo in hopes of 9mo survival. Life is about LIVING rather than mindless & ultimately futile avoidance of death.
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Old 03-08-2012, 01:26 PM   #39
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I have a feeling this is only going to get worse with time... there is talk now than longevity research by mid century will mean that people born prior to 2000 will be the last generations not to have a choice to live forever...

there is substantial evidence that through gene therapy aging can be stopped and even reversed (many think this will be a reality by 2050)...they are already extending the lives of some insects and small animals to be magnitudes longer than average. What you don't read about are the implications this will have on society and our bodies. What happens to our brains if we try to live 200+ years... what happens to our bones... our heart?

Medicine is a double edged sword... it does amazing things to prolong life and allow people to survive who years ago would never had stood a chance (my 4 month old daughter is one of them... she just underwent open heart surgery to correct a continental heart defect that was 100% fatal just a few years ago - she has a 95% chance of living a perfectly healthy normal life now with no complications)... but it also seems to make each generation more and more afraid of death.

Also introduces social stresses when ultimately we are faced with decisions... at what point is extending life worth it, when quality is reduced, and at what cost. How do you draw that line...
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Old 03-08-2012, 09:35 PM   #40
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I have a feeling this is only going to get worse with time... there is talk now than longevity research by mid century will mean that people born prior to 2000 will be the last generations not to have a choice to live forever...

there is substantial evidence that through gene therapy aging can be stopped and even reversed (many think this will be a reality by 2050)...they are already extending the lives of some insects and small animals to be magnitudes longer than average. What you don't read about are the implications this will have on society and our bodies. What happens to our brains if we try to live 200+ years... what happens to our bones... our heart?

Medicine is a double edged sword... it does amazing things to prolong life and allow people to survive who years ago would never had stood a chance (my 4 month old daughter is one of them... she just underwent open heart surgery to correct a continental heart defect that was 100% fatal just a few years ago - she has a 95% chance of living a perfectly healthy normal life now with no complications)... but it also seems to make each generation more and more afraid of death.

Also introduces social stresses when ultimately we are faced with decisions... at what point is extending life worth it, when quality is reduced, and at what cost. How do you draw that line...
Insightful. These metaphysical questions are clearly not answered by medical science.
BTW- Glad things turned out well for your daughter.
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