Notice a Change in Tone?

[GravitySucks]

Am I noticing a change in Tone or just coincidence.
NPR gave an hour to interviewing a palliative care physician who was saying basically maybe you should think if you want to be kept alive. Andrew Coumo saying only 20% of intubated patience get off the respiratory alive. The numbers I read a few weeks ago were saying 40 to 50% recovering.
At a 40% I told my health proxy I don't want to be tortured an extra week and would prefer massive morphine dose to a ventilator. At 20% she no longer argues with me.
I'm welcoming a change in the discussion. The system soft sold some actions that led to decisions when I was DWs proxy and she never did forgive me. None of us get out of here alive, we should give some thought to how we would rather go.

 

[DAYDREAMER]

Ug. I'd have a hard time making that decision for myself, being that just weeks before, life was happy go lucky, regardless what the odds were

 

[Rianne]

At a 40% I told my health proxy I don't want to be tortured an extra week and would prefer massive morphine dose to a ventilator. At 20% she no longer argues with me.

I agree with you. If you survive the ventilator it's highly likely you'll have long term effects. I don't even want to think about what those will be...lung, heart, organ issues that will drastically change lifestyle. I'm good to go if I'm in that position.

 

[stepford]

I don't want to be tortured an extra week and would prefer massive morphine dose to a ventilator.

I agree somewhat, but I thought most of the folks on ventilators are pretty heavily doped up or in medically induced comas. If I knew I was going to be unconscious I'd be willing to let doctors keep me on a vent for a limited time (maybe a week?) to see if I'm one of the "lucky" ones who recover. If I had to be awake and drowning with tubes down my throat, though, then yeah - I'll take the big sleep please.

 

[Aerides]

I've not heard 40-50% ventilator survival with Covid - that's more the norm for all uses/causes.

20% coming off a vent and walking out of hospital alive sounds very realistic, for a long time there weren't even anecdotal stories out there of those patients.

FWIW, if you put on a ventilator you're most likely kept under general anesthesia the whole time. You aren't awake to experience it. If awake, it's not torturous but it's pretty unpleasant. Ventilator use itself doesn't necessarily cause side effects; a bad case of covid may.

 

[MrsHaloFIRE]

I agree somewhat, but I thought most of the folks on ventilators are pretty heavily doped up or in medically induced comas.

WHat im reading is that corona folks "fight the ventilator" and are very difficult to get under and to keep under. They are running out of the traditional drugs bc they are havign to use such massive doses for so long and they keeping reaching to 2nd and 3rd tier of preference drugs. If you are in the elderly category with the such bad survivor rates, i would def think about this prior to getting ill.

 

[GravitySucks]

Not Covid, but DW was conscious after day 1 on the ventilator and even though survived the episode never forgave me for agreeing to it's use.

 

[W2R]

only 20% of intubated patience get off the respiratory alive. The numbers I read a few weeks ago were saying 40 to 50% recovering.
At a 40% I told my health proxy I don't want to be tortured an extra week and would prefer massive morphine dose to a ventilator. At 20% she no longer argues with me.
I'm welcoming a change in the discussion. The system soft sold some actions that led to decisions when I was DWs proxy and she never did forgive me. None of us get out of here alive, we should give some thought to how we would rather go.

(Bolded emphasis mine)
For me, suicide is out of the question. I'm tough and would rather try to handle it and maybe survive, than to just give up and off myself.

My family's coat of arms has a saying on it that translates to "Fight to the Death". That was the subject of SO many jokes about family interactions when I was a kid. But honestly, that is the way I am made, it is in my blood, and I would rather go out fighting.

 

[molly312]

They are finding that there is MUCH more about Covid that they didn't understand. Now some are using Oxygen and a C-Pap, instead of a ventilator, with pretty good results. The lungs are only one organ of concern. Much is left to learn about this. Medical Workers are trying their very best to save people without known medications or therapies. Some people are critical one day and then rally the next. You just can't predict what will happen.

 

[Boho]

IMO, end of life planning involves choosing the right location with the right laws and quality of health care, but I've found it hard to do the research. I want euthanasia to be legal, but I don't want a doctor to send me home with drugs. Lethal injection involves multiple drugs and the criminal is supposedly unconscious for the final dose so they have someone administering it and they STILL screw it up sometimes. I don't think there's agreement on whether two or three drugs are best. So, just morphine doesn't sound good. I imagine I'd experience feelings of suffocation even though morphine lowers air hunger. The lethal injection cocktail is more than just morphine for a reason. But if it's a lethal dose of morphine vs the OP's scenario, MAYBE morphine is the lesser of the two methods of being tortured to death. There should be a better option and I'd consider moving to another country if one exists there. I wish I could find more information on this topic.

Here's something discouraging:

http://www.mirror.co.uk/news/world-news/botched-execution-prisoner-who-took-9425798

Simon Chapman, director of policy at the National Council for Palliative Care, said: 'Sedation is recognised as being an appropriate part of end-of-life care for some patients.

'However it is concerning that some doctors are not using the appropriate drugs to provide it. We believe that training in palliative medicine should become mandatory for all doctors as a vital step towards improving end of life care in Britain.'

The survey also showed that most hospital doctors used the drug midazolam, which causes memory loss and loss of consciousness. But almost a quarter used opiate painkillers such as morphine - even though palliative care specialists would never use this drug alone.

Lead researcher Clive Seale, professor of medical sociology at Queen Mary, University of London, said: 'The widely accepted view is that midazolam is the first-time choice for providing sedation at the end of life, that use of opioids alone for this purpose is to discouraged, and that a decision to provide sedation should be accompanied by advice from palliative medicine specialists.'

The National Council for Palliative Care estimates that 300,000 people die every year without specialist care which can improve their death.

[mod edit]

 

[Gumby]

I have read about the problems with lethal injections by the states that still use capital punishment and have always wondered why they don't just simplify the process and use carfentanil. Based on what I have read about the opioid crisis, it appears to kill people almost instantly.

 

[Teacher Terry]

Gravity, I don’t under why they didn’t keep her asleep. My mil was on it for a month at 65 and survived but she was knocked out.

 

[Boho]

I heard they have to keep you awake at the end to ween you off of a ventilator, and I've read about a lot of people who woke up a few times, felt uncomfortable from the tube and like they couldn't take a good breath, then went back under. And the people most likely to have awareness during surgery are the elderly and those with heart problems, so those groups are probably the most likely to have problems staying under while intubated.

[mod edit]

 

[Clone]

There is a lot of money involved with keeping people alive for the longest possible amount of time.

 

[rodi]

This is an interesting topic to me. My DNR states no intubation. This decision was made after seeing 3 family members suffer on a vent before dying. They had to have their hands tied down so they wouldn't extubate themselves. My mother actually succeeded in extubating herself (with the vent inflated) and her first croaked out words were DNR!!!! (She'd agreed to be intubated for emergency surgery - but ended up on the vent for a week longer because the surgery was unsuccessful.)

A friend's son got botulism when he was in his early 20's. Ended up on a vent for 14 days - 10 years later he is still not the same. Damaged both physically and mentally. Another friends husband ended up on a vent for 25 days - went from healthy/robust to being on disability because physically he never fully recovered physically. Vents are not without consequences.

My husband and sister (main health care POA and backup POA) both have asked specifically if I still want to avoid intubation if I get COVID. With the 20% survival rate, the answer remains no.... They don't agree. My solution is I'll avoid going to the hospital if I get it.

From what I've witnessed with my mom, dad, and brother - I do NOT want to be intubated.

 

[Moemg]

My DNR states ventilation for two weeks max but I have already told my daughter and my SO if I get the coronavirus no ventilator .I already know what lung damage feels like and I'll pass.

 

[Aerides]

I was placed in a vent during emergency surgery following a surgical error that put me in the ICU (yay for simple outpatient procedures going wrong.)

One of my lungs partially collapsed during the 2nd surgery so I had to be intubated. Waking up on it was alarming as I was still under the drugged paralysis, I had no warning that might happen, and could not move or speak, but was not sedated otherwise (just post opp pain killers.) My heart rate must have leapt as a nurse quickly came and explained what was going on. It wasn't a fun 24 hours.

But maybe because I was conscious and otherwise not ill, and understood what was going on, I tolerated it. Every move you make you touch against the tube and you really have to manage your gag reflexes. Your body wants to convulse against it which is just going to make it worse. Also you can't talk of course, which makes asking for help or what's going on very challenging.

I was 28 at the time. I had to use a spirometer regularly over the coming months and monitor my lung improvement, but recovered fully. My one collapsed lung is 100% today and no current doctor has ever even hinted that there's a difference in the two. I run regularly, so maybe I just got super lucky?

 

[Scrapr]

Oregon & a few other states have the Death with Dignity procedure. It takes a bit over 2 weeks to go through the process. So that would likely be too long for a Covid 19 case. I'm not sure what the process would be for refusing the vent. I don't think a Dr could ethically prescribe morphine to a lethal dose. A pallative care Dr or hospice care could keep you comfortable. Hospice care has a number of rules to qualify & I'm not sure if a Covid 19 case would qualify.

 

[Oz investor]

well i am cynical ( and classed as HIGH risk )

but i looked at the Australian and state government reactions to the virus , can clearly see the economy comes first and ' let God take all the grannies he wants ' ( solve the drain on the stressed pension system on the way )

which will be unfortunate for him as those same grannies voted for him last election with the rival wanted to seriously meddle with the superannuation system

but he only won because he wasn't the other guy ( sadly he doesn't realize he was the cleanest shirt in the rubbish bin )

plenty of room for a minority party now , so there might be a gold lining , about time we broke the two-party system anyway

this will take a heavy toll on medical staff , but apparently they are expendable as well

 

[swakyaby]

I’m 59 and have obstructive sleep apnea as my only other co-morbid condition. If I were to get a severe case of Covid-19 and were faced with intubation and a survival rate of 20%, I think I would indicate for my physicians to proceed. I do know how miserable being on a ventilator can be. Yet, the intensive care physicians and nurses I have known were caring and compassionate people, and life right now is very precious to me.

The choice would be different, however, if I had stage 4 cancer and intubation/mechanical ventilation would at best buy me a few more months of dwindling health. In that case, I would request comfort care only, and that does not include dying slowly in the ICU on a ventilator.

 

[ivinsfan]

I heard they have to keep you awake at the end to ween you off of a ventilator, and I've read about a lot of people who woke up a few times, felt uncomfortable from the tube and like they couldn't take a good breath, then went back under. And the people most likely to have awareness during surgery are the elderly and those with heart problems, so those groups are probably the most likely to have problems staying under while intubated.

[mod edit]

This can happen and most likely when you go off the vent, you won't actually remember what was going on. Your entire body is so stressed and perhaps sedated that your memory won't work, which is a good thing. This doesn't mean it's not upsetting while you are going through it, just you probably won't have a memory of it. Everyone is different but generally this is what happens. My DH had 2 open heart procedures involving vent time and them told him he wouldn't remember any of his ICU time and they were right.

Can you remember the vent maybe but most likely you wouldn't.. your brain is your friend and doesn't want you to remember this stuff.

For myself, I vote no vent for Covid purposes...but I do not equate not taking a vent as any kind of assisted suicide or the like. The issue is would you be conscious enough to say no vent. Have your HC directive in order and hope they do as you wanted.

 

[Oz investor]

i don't know if i would be game to go to the hospital , my LVEF ( left ventricle ejector factor ) is 40% ( went below 20% in January 2017 ) and lung function of 40% and that is my current 'healthy status and heart rate at an artificially restricted to 60 bpm at rest

can you imagine the poor dears if i was arriving at the reception feeling 'sick '

 

[ER Eddie]

I was on a breathing tube/ventilator for two weeks in ICU, following a botched surgery. Total stay in ICU was a month. That was about 6 years ago. The whole ordeal was awful, but being on that breathing tube was the worst part.

There is a lizard-brain fear that gets activated, when your oxygen is not in your control. The fear was compounded by the sense that I was drowning. Water collects in the tube from condensation, and it gurgles as you're breathing. I've always had a fear of drowning, and it was constantly getting triggered.

You can't speak, which is frustrating and makes you feel helpless. I tried to write things down, but I was so weak, I had trouble doing that. Also, I couldn't sleep with that thing in, so I went for long stretches with no sleep. That made the emotions worse. Between lack of sleep, medications, and my physical condition, I couldn't think straight.

It was all I could do to just accept the pain and the fear, and ride it out. It was the worst (physical) experience of my life, by far.

 

[Scrapr]

IMO, end of life planning involves choosing the right location with the right laws and quality of health care, but I've found it hard to do the research. I want euthanasia to be legal, but I don't want a doctor to send me home with drugs. Lethal injection involves multiple drugs and the criminal is supposedly unconscious for the final dose so they have someone administering it and they STILL screw it up sometimes. I don't think there's agreement on whether two or three drugs are best. So, just morphine doesn't sound good. I imagine I'd experience feelings of suffocation even though morphine lowers air hunger. The lethal injection cocktail is more than just morphine for a reason. But if it's a lethal dose of morphine vs the OP's scenario, MAYBE morphine is the lesser of the two methods of being tortured to death. There should be a better option and I'd consider moving to another country if one exists there. I wish I could find more information on this topic.

Oregon has Death with Dignity (not euthanasia) I mixed the drugs for my wife last year. First drug is a anti nausea drug. Might have been a pill but more likely a powder as end of life patients sometimes can't swallow. I think the 2nd dose was Diazepam (Valium) and I don't remember the third drug..Morphine sulfate?

This is nothing like lethal injection. Not. At. All. It was very peaceful. But I don't think this would apply to Covid 19 patients as there is a waiting period established. I think the patient would pass before the 15 day waiting period is up w DwD

https://www.deathwithdignity.org/stories/

 

[Moemg]

(Bolded emphasis mine)
For me, suicide is out of the question. I'm tough and would rather try to handle it and maybe survive, than to just give up and off myself.

.

I do not think making an informed decision is suicide .Do you consider People who refuse chemotherapy when they are stage 4 as suicide ?