tag:blogger.com,1999:blog-5883634615775822475.post4146788350044784588..comments2024-03-18T09:00:31.992-04:00Comments on Doctor Grumpy in the House: Checkout timeGrumpy, M.D.http://www.blogger.com/profile/09858110332436246760noreply@blogger.comBlogger147125tag:blogger.com,1999:blog-5883634615775822475.post-17701435094385879982010-07-30T22:26:29.170-04:002010-07-30T22:26:29.170-04:00So sad to see and hear what others have been throu...So sad to see and hear what others have been through.I'm going to tell you about my experience,from the other side of the bed.Six years ago I was admitted to the local hospital with PCP,sepsis and a staph infection.No I didn't know I had HIV let alone AIDS.My Dr at the time kept telling me I had the flu.Until the night I started hallucinating and called my Dad to take me to the hospital.He came,took one look at me and called an ambulance.I passed out in the ambulance and the next time I knew anything three months had passed by.The Dr at the hospital told my Dad it would be a miracle if I live til morning,but he had them do everything they could.My family was called to the hospital a few times because they thought I was going to die.But they,like the family's you all mention insisted that the Dr's do everything to save me.I had been put on a vent,given a feeding tube,two chest tubes and a greenfield filter.During that 3 month coma and despite the morphine and ativan drip they kept me on I remember feeling PAIN lots of PAIN and horrible dreams/nightmares I don't know what you would call them but they were so vivid that six years later I can still remember them,and "screaming" in pain.I know you can't really scream on a vent but it seemed so real.I would be begging for pain meds in my head.<br />When I finally started to come out of it I was transferred to a bigger hospital that had a vent rehab unit.the first thing they did was to stop all my morphine and ativan.I the time I didn't know what I had been on so didn't understand what was wrong with me.Yeah I got to go through withdraw cold turkey.I was completely paralyzed at this time unable to move any part of my body.So then I had the "fun" of learning to walk,talk,breathe on my own and even had to learn how to eat again.Another three months of hell before I could get out of the hospital but still not be able to go to my home.<br />Now I'm not saying that I'm not glad my family had the hospital do everything they could to save me because despite the fact that I'm on disability I still manage to work part time and enjoy every second of my life.What I am trying to say is,when your loved one is laying in that bed s/he IS being tortured,there is pain and fear and a real wish that it would all end,many times I prayed to just die and be out of the pain I was in.Looking back I would never want to go through that again and I do have a living will and my family all know what my wishes are.Call hospice and let me go when my time comes.theresadaughertyhttps://www.blogger.com/profile/14129825770767691899noreply@blogger.comtag:blogger.com,1999:blog-5883634615775822475.post-19347204411158458872010-07-09T07:12:07.737-04:002010-07-09T07:12:07.737-04:00Rather late coming to the party but: I'm amaze...Rather late coming to the party but: I'm amazed that you got 140+ comments with no-one calling for your blood (and the dissenting ones were all from one person who is not fully informed). I would suspect, too, that s/he had a conscience about something, it was too near to home.<br /><br />It is always a thing of wonder to me that people who profess such a belief in a wonderful heaven won't let their loved ones go to it but prefer to imprison them ina living hell.<br /><br />Let's face it: if you didn't break a rib or two in a code you didn't do the compressions correctly. Broken ribs HURT, especially every time you have to be moved by someone else. But that aside, death is incurable and inevitable at some point - except too much TV drama shows the arrested patient sitting up and smiling 20 mins after the code. A result like that is like hen's teeth.<br /><br />Too many doctors come out of med school believing they are god and that they will be able to do it all. They are not taught how to accept and advocate the death process where it is necessary and so they believe they have failed when a patient dies - the nurses who walk alongside that patient have a far more realistic and compassionate outlook. <br /><br />Nothing will deal with the patient in denial though - my brother-in-law would not accept that he had entered into the death process. He wouldn't talk about things in which he knew he would have no part - he knew he was dying in that sense - but insisted his children should not be told. They were in their late 20s! They believed he still had months to live until I spoke to the son. After his death, at the funeral, the son and daughter asked my daughters when they had known he was dying - and were so angry at the response of "9 months ago". It was a huge untreatable (slow-growing) lung tumour that was mixed up with the lungs so surgery was also not an option. From the outset it could only be palliative care but he seemed to have a desire to torture himself and eveyone else. He refused the care of the hospice staff because he didn't understand that hospice in Britain is not only for death but also to aid with living with a terminal diagnosis. For everyone. It was a salutory lesson to all the onlookers as how NOT to die.<br /><br />It's so complex - yet also so simple. But more power to you Dr G for a fantastic post - and for the comprehension and compassion of your readers. I'm still amazed.Eileenhttps://www.blogger.com/profile/02684985554953836607noreply@blogger.comtag:blogger.com,1999:blog-5883634615775822475.post-62568977363334184822010-05-03T11:43:42.237-04:002010-05-03T11:43:42.237-04:00I watched them do this to my grandmother. Despite ...I watched them do this to my grandmother. Despite our pleas, my grandfather and the doctors kept sending her for chemo even though she was dying. On her "good days" they'd send her for more poison. She finally had peace 2 years ago. We were sad to see her go, and miss her terribly, but relieved that she is no longer in pain.Anna Qhttps://www.blogger.com/profile/10814772149001699886noreply@blogger.comtag:blogger.com,1999:blog-5883634615775822475.post-77333270447805564152010-04-22T04:49:05.804-04:002010-04-22T04:49:05.804-04:00Thank you for writing this.
It is unfortunate tha...Thank you for writing this.<br /><br />It is unfortunate that some have made this a political issue, rather than a patient care issue.Rogue Medichttps://www.blogger.com/profile/07598646309630074992noreply@blogger.comtag:blogger.com,1999:blog-5883634615775822475.post-89266439057274958602010-04-19T12:23:55.310-04:002010-04-19T12:23:55.310-04:00I am just happy that someone is finally saying thi...I am just happy that someone is finally saying this. My mother has a DNR in place and has a friend with durable medical power of attorney to ensure she isn't left in a vegetative state. My husband and I are clear on what we want: let us die when our bodies say it's time.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-5883634615775822475.post-1593446730635773392010-03-23T13:26:00.252-04:002010-03-23T13:26:00.252-04:00Thanks for posting this. It's something I'...Thanks for posting this. It's something I've seen friends of mine do to family members and it horrifies me. I'm single, have a directive specifying exactly what I want done/not done if I end up in a hospital at the end of my life. As for the so called death panels I think that ALL people need to be talked to frankly by their doctors and to talk frankly with their own families. My daughter knows exactly what few measures I want taken for me if I'm unconscious/incompetent and my own personal answer is not very much. To much money is involved in maintaining people who realistically have no hope of a viable recovery. There is no benefit to the patient in such cases and also no benefit to anyone except possible the family who delude themselves.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-5883634615775822475.post-38023850902210713042010-03-20T03:49:22.078-04:002010-03-20T03:49:22.078-04:00More people need to read!
Submitted to Digg!
http...More people need to read!<br />Submitted to Digg!<br /><br />http://digg.com/d31M7E9aeriehttps://www.blogger.com/profile/16458938287603035869noreply@blogger.comtag:blogger.com,1999:blog-5883634615775822475.post-81281084142854189082010-03-14T22:10:44.068-04:002010-03-14T22:10:44.068-04:00Thank you Dr Grumpy.
Death of a loved one is hard...Thank you Dr Grumpy.<br /><br />Death of a loved one is hard and sucks (my dad passed away a year and a half ago), but it's the way nature is. You just take one day at a time, and eventually the pain lessens, but the memories never die. <br /><br />And wouldn't good memories be better to have than ones of them suffering?Wagon Leaderhttps://www.blogger.com/profile/02830105902196767793noreply@blogger.comtag:blogger.com,1999:blog-5883634615775822475.post-2485255103428047612010-03-13T06:38:33.489-05:002010-03-13T06:38:33.489-05:00It's true that this family (and others like th...It's true that this family (and others like them) shouldn't put their loved one through all of this suffering and torture. <br />But that doesn't mean that panels of medical, ethical, and legal experts should convene to take the decision about continuing treatment away from the family.<br />It is also true that resources are limited while suffering is infinite. If no one (the family, insurance companies, or a wealthy benefactor) can/ will pay for all of the futile treatments provided to patients like this, then the treatments should not be provided.<br />We're all going to die. It's simply a matter of how and when. Feed, hydrate, bathe, and comfort this suffering woman. And let nature take its course.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-5883634615775822475.post-37840615276634063742010-03-10T10:03:52.509-05:002010-03-10T10:03:52.509-05:00I hope, wherever you are, that you're on the v...I hope, wherever you are, that you're on the volunteer faculty at the local medical school and offer to give the lecture on medical ethics. Future medical professionals, in particular, need to hear your words of wisdom.<br /><br />And, I must say, I agree 100%.<br /><br />How do I recommend you for surgeon general?student dr. blazehttps://www.blogger.com/profile/17307156914515136574noreply@blogger.comtag:blogger.com,1999:blog-5883634615775822475.post-49017436783217291132010-03-08T04:13:14.716-05:002010-03-08T04:13:14.716-05:00You guys make your points well and offer something...You guys make your points well and offer something to think about. I respect what you do, and it must be so frustrating to see situations like this.<br /><br />That said:<br /><br />1. I do not believe in disinterested doctors. They'd be appointed by someone political, and besides, everyone has personal beliefs and biases. (Just look at the Supreme Court.)<br /><br />2. Two extremes are presented here: dragging practically dead people from hospital to hospital, and handing life-and-death decisions to the government (disinterested panel or not). It's as if there are no options between. But here is one idea: Respectfully, the medical establishment needs to learn to speak up, much like you are here except out in the real world. Minimedic says, "they don't see what we see and they don't know what we know." But is that "their" fault? We see miracles in the media; we rarely see cases like the one Dr. Grumpy describes. Instead of deciding the only solution is to take decisions out of our hands, consider giving us a little respect. We can learn.<br /><br />3. Some of you are attacking people for being "ignorant" and disagreeing with you. Yet you display the same disgust for them -- a lack of interest in learning about their point of view and instead an interest in lumping all naysayers into groups you can disparage. You say things like:<br /><br />"Yeah, I'm sure you Sarah Palin fans will accuse me of putting a price on human life."<br /><br />"... religious wackos who seem to think that a persistent vegetative state is part of 'Gawd's plan.'"<br /><br />You guys have voiced your own opinions about what you'd want done for yourselves. Since you mostly agree, a couple of comments suggest, you guys must be in the vast majority. But, as you say, anecdotal experience does not equal proof. There are people outside your bubble who also have intelligence, rational thoughts and strongly held beliefs.<br /><br />4. As Dr. Grumpy says, this is a slippery slope. There are many things to consider. I won't get into them here, but if the debate crops up elsewhere, where there are more varied opinions, I'd suggest considering the idea that not everyone who disagrees with you is a nut job. Some may be irrational and uninformed, as are some people on your side. But not all.<br /><br />Thanks for starting the discussion, Dr. Grumpy.Lnoreply@blogger.comtag:blogger.com,1999:blog-5883634615775822475.post-22183677333577973942010-03-07T23:44:04.341-05:002010-03-07T23:44:04.341-05:00I just started reading your blog, & have never...I just started reading your blog, & have never posted, but as an ER RN & former ICU RN I have to say THANK-YOU for posting this!!!! I believe anyone going into a major surgery should have to watch a video showing how you put in all those lines, RN's wiping your privates at 3 in the morning, showing a ventilated-trached-tube feeding patient who's family only visits on Sunday afternoon while they are stuck there 24-7. How many people would change code status or get a living will? I bet most would! Have seen this DAILY in the ED & ICU. It happens, & it sucks for the poor patient involved! Thank-you Dr. Grumpy!!!!Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-5883634615775822475.post-65058414135439581762010-03-07T12:33:59.502-05:002010-03-07T12:33:59.502-05:00I think you're preaching to the choir, Dr. Gru...I think you're preaching to the choir, Dr. Grumpy. You need to expand your circle a little bit.<br /><br />--Flaming LisaAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-5883634615775822475.post-3400908895533601582010-03-07T12:32:41.704-05:002010-03-07T12:32:41.704-05:00@Dr. Mongo Lloyd
So you think Terri Schiavo shoul...@Dr. Mongo Lloyd<br /><br />So you think Terri Schiavo should have been murdered as she was? Well, she wasn't on any machine as you say, she had a feeding tube because her asshole murdering husband wouldn't get her the rehab she needed to learn to swallow again (and he had the money to put toward her rehab from a lawsuit--that was supposed to go directly for her) he had her illegally in a hospice when she was not dying and was not going to die in the 6months time allotted BY LAW to be in hospice (she was there YEARS). You don't know anything about this case except that you wouldn't want to be bothered caring for someone in her state. But that's because you're a pathetically selfish human being who should NOT have access to patients. So much for your poorly interpreted Hippocratic Oath. You should be ashamed and take the Dr. title away. You are unworthy.<br /><br />--Flaming LisaAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-5883634615775822475.post-85029141690909865502010-03-07T03:05:46.449-05:002010-03-07T03:05:46.449-05:00I'm a bit late commenting on this. But this wa...I'm a bit late commenting on this. But this was unbelievably enlightening. It gives me so many more issues (and an interesting perspective) to think about when I start med school in a few months. Thanks Dr. Grumpy.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-5883634615775822475.post-77469337226733673452010-03-06T21:15:52.825-05:002010-03-06T21:15:52.825-05:00I am living with this right now. My husband has p...I am living with this right now. My husband has pancreatic cancer. We both have living wills, which I instigated, but when we got the news that the cancer was too advanced I sat him down and asked "What do you want?". Contrary to our living wills he wants to be given every chance/treatment UNLESS there's no realistic chance of him being released from hospital to live at home for a reasonable length of time. <br /><br />That's what he wants and that's what I will insist upon for him. <br />I demand that the doctors are honest with us, that they give us all the information so that we can make an informed and rational decision about treatments offered. We have already turned down one clinical trial because it wasn't right for my husband. In short, it's about quality, not quantity.Nickinoreply@blogger.comtag:blogger.com,1999:blog-5883634615775822475.post-85270725418861166842010-03-06T18:46:24.416-05:002010-03-06T18:46:24.416-05:00I totally agree with you. I've seen way too ma...I totally agree with you. I've seen way too many people believe that a miracle will happen. I've also seen almost every person in this situation on Medicare/Medicaid and therefore the family never will pay a cent for this-we the taxpayers do. I am a Catholic and am well aware of miracles and keeping people hydrated and fed while dying.We don't need to attach people to vents, hemo, every possible med out there to keep them alive. A miracle will happen if God wills it, not by torturing the body. My fellow nurses and I believe that if you must be kept alive with dialysis, drugs and vents, that's not living and after 1 week, the burden should be placed on families physically and financially-the same families that leave the room when their loved one needs suctioned, has had a loose stool that now requires a drsg change to their coccyx wound-demand they do it all including pulling up the pt every 10 minutes. <br />Doubt they would do anything. Oh and don't allow them to readmitted to the hospital after they are in that position-make them care for them at home, by themselves. It was done 100 years ago and it can be done now.knittinnursehttps://www.blogger.com/profile/10621893682010155004noreply@blogger.comtag:blogger.com,1999:blog-5883634615775822475.post-64254252727922501342010-03-06T16:32:06.273-05:002010-03-06T16:32:06.273-05:00I agree whole-heartedly.I agree whole-heartedly.myoclonicjerkhttps://www.blogger.com/profile/07144725426127851940noreply@blogger.comtag:blogger.com,1999:blog-5883634615775822475.post-41295126594595211152010-03-06T13:56:42.533-05:002010-03-06T13:56:42.533-05:00Dr. Grumpy,
I am in total agreement with your ass...Dr. Grumpy,<br /><br />I am in total agreement with your assessment, and if I beleived most doctors were like the one you play on the internet, I would be more than willing to designate my life to a so-called panel.<br /><br />Unfortunately, my experience, and the news often reminds me that this is not always the case. In a way, I see this end-of-life debate as an outside issue, only for those people with enough income, family and insurance to reach this point.<br /><br />As someone who lives near the designated povery-level, <i>(I refuse to say impoverished, when my essentail needs are met)</i> I am currently blessed to have found caring, capable medical staff, but before this, my experience with 'medicine' was medeocre- at best - and outright damaging -at worst, mixed with a helplessness in knowing I had no other options.<br /><br />The more I work with my current team, the more horrifying my past experiences become, and I know I'm not alone in this.<br /><br />As long as I hear stories of the disproportiante number of low-income elderly and children being medicaited for being 'difficult', and as long as treatments aren't being tried due to opinions on a persons ability based on socio-economic status or perceived ability to contribute in life...<br /><br />As long as I hear these stories & experience some myself, there is no way I could carte blanche sign the decision of my life & suffering to another human being, let alone,'panel'.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-5883634615775822475.post-10510986199740117732010-03-06T11:25:23.412-05:002010-03-06T11:25:23.412-05:00Flaming Lisa, there is a difference between living...Flaming Lisa, there is a difference between living and being alive. Terry Schiavo hadn't been alive for a long time; she was simply living with the assistance of machines. The only part of Terry Schiavo that was "murdered" was her dignity...by religious wackos who seem to think that a persistent vegetative state is part of "Gawd's plan."Dr. Mongo Lloydhttps://www.blogger.com/profile/09351344829632811877noreply@blogger.comtag:blogger.com,1999:blog-5883634615775822475.post-29576954924355030122010-03-06T10:35:30.451-05:002010-03-06T10:35:30.451-05:00Wow! I missed a few days of your blog this week. ...Wow! I missed a few days of your blog this week. <br /><br />Thanks for saying what you said. I, too, have seen this sort of scenario play out in my practice. One of the questions I always like to bring up, can we do this? The answer is almost always yes. The more important question often is, should we do this?<br /><br />I get the concept of "let's give this a few days/weeks and see if a corner is turned." If/when it doesn't, things can get pretty sticky.<br /><br />I also appreciated the chaplain's comments that often the miracle may be a few pain free days for the patient and whole heartedly agree that stopping aggressive care may be the most courageous decisions a family can make.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-5883634615775822475.post-74121905591359435062010-03-06T09:52:28.128-05:002010-03-06T09:52:28.128-05:00This is why people should write out specifically w...This is why people should write out specifically what they do/don't want done to them - an advance directive I think it's called. I can see food and water tubes, but when it comes to all this, and it's futile,just let me off ventilator, keep in food/water,and let me breathe my last (if I can) and if I can't, then it's too darn late. I'd rather stay at home and die than be stuffed in a hospital hooked up to many machines. Took care of my father-in-law at his house when he was dying of cancer until the last.Dianehttps://www.blogger.com/profile/17765443131151220391noreply@blogger.comtag:blogger.com,1999:blog-5883634615775822475.post-41273942593636343652010-03-06T01:26:18.665-05:002010-03-06T01:26:18.665-05:00You rock, Dr G!You rock, Dr G!Michelle.noreply@blogger.comtag:blogger.com,1999:blog-5883634615775822475.post-8205949522640003162010-03-05T23:56:10.193-05:002010-03-05T23:56:10.193-05:00agree with you Dr. Grumpy, I'm a health care p...agree with you Dr. Grumpy, I'm a health care provider in long term care & I see clearly, daily, that family members make decisions to protect themselves from loss and pain, even going so far as secreting and hiding DNR's and Advanced Directives from caregivers...so 95 year old mom is subjected to invasive, sometimes painful interventions she never wanted. It is a travesty.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-5883634615775822475.post-58922385064376080012010-03-05T23:12:26.155-05:002010-03-05T23:12:26.155-05:00Dr. Grumpy:
Great article...and thanks for your c...Dr. Grumpy:<br /><br />Great article...and thanks for your comment on my blog.<br /><br />I have to agree with danielle. No, we had a family that didn't agree that their 90something year old parent would suffer if we did intubate him and not do CPR (he'd be suffering with that, too, as we cracked all his ribs.) Thankfully, we never got the chance to code him. He d/c'd elsewhere.<br /><br />People get so attached to people for the wrong reasons, and they view their personal needs above the dying person.<br /><br />You almost want to throttle them and say, "This isn't about you. It's about him or her. What did they tell you to do?"<br /><br />Many know, they just don't want to have to make the choice and be the bad guy/gal.RehabNursehttps://www.blogger.com/profile/02695247141022093754noreply@blogger.com