Dealing with life support as the health care proxy

[Psycho Doctor]

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Ok maybe this does not belong on this board, but i couldn't help it since it has dominated my life for the last week or more.

My grandmother suffered a massive cerebral hemorrhage a week ago Tuesday. She has not gained consciousness since I put her in an ambulance (and for this I feel guilty); she has barely opened her eyes and I'm not sure how much she recognizes us. This wonderful woman brought me up and babysat for me since I was born and I love her with all my heart. It is so difficult to watch her hooked up to machines that are breathing and eating for her and running every life support possible. My dad, as the health care proxy, is now left with the heart wrenching decisoin of whether to continue life support on her. I can not bare to watch my dad in such pain of making a life altering decison that perhaps he is too emotional to make. We know she would not want to live as an incognizant being and would rather be in the presence of the Lord, but who are we to decide when that time comes..we do not know what she feels, what she thinks or what she hears. Is there life going on inside her brain? Is she happy? Does she feel any pain? My life has been consumed with thoughts and concerns for her this past week; I've screwed up some interviews becayuse i can concentrate on nothing else and I can no longer sleep (how long does daily doses of sleeping pills lead to an addiction?). But I can not imagine what my dad is going through. I don't know where to turn, how to help him and I feel absolutely useless to my grandmother and my heart is breaking on the thought of losing her. Then I think am I even cut out to be a doctor if I can't handle this? Does anyone have any experience with this? Can anyone offer any advice?

 

[HrsNJ]

I am so, so sorry for your grandmother's condition. It's cliche, but words can't express how my heart hurts for you right now.

I've been in a similar situation with a family member. Although the issue of life support is never an easy one to deal with, I feel that my family was lucky when we were forced to deal with it--my relative had made it very, very clear what she wanted. I know it's awful, but keep the faith right now--everything happens for a reason...

The grief you're feeling now is natural and expected, but I can absolutely understand why you would question your abilities as a doctor. Please don't. Being a doctor and being a family member to someone who is ill are two entirely different things...I hope that isn't putting it too simply.

Hang in there, and feel free to PM me if you want to talk.

 

[MoosePilot]

Psycho,

There are too elements to your question: the practical question and the human one. As far as the practical question, I've heard of a standard that if two doctors agree that the patient has no realistic chance of waking up, then that might be a good time to consider removing life support. I don't think your dad needs to hurry the decision. Talk about it amongst family and get the technical advice from doctors and perhaps some advice from the hospital chaplain and/or your personal minister.

As to your issue - let schools know what's going on and reschedule the interviews. If you're worried about sleeping pills being habit forming, ask the doc who prescribed them for you. Ambien, for instance, is not habit forming IIRC.

God bless you and pull you through this tough time. It helped me to remember that my wife was going from a tougher place to a better place. The only thing to grieve is that you miss your family member while you're stuck here.

 

[melnyc]

Ok maybe this does not belong on this board, but i couldn't help it since it has dominated my life for the last week or more.

My grandmother suffered a massive cerebral hemorrhage a week ago Tuesday. She has not gained consciousness since I put her in an ambulance (and for this I feel guilty); she has barely opened her eyes and I'm not sure how much she recognizes us. This wonderful woman brought me up and babysat for me since I was born and I love her with all my heart. It is so difficult to watch her hooked up to machines that are breathing and eating for her and running every life support possible. My dad, as the health care proxy, is now left with the heart wrenching decisoin of whether to continue life support on her. I can not bare to watch my dad in such pain of making a life altering decison that perhaps he is too emotional to make. We know she would not want to live as an incognizant being and would rather be in the presence of the Lord, but who are we to decide when that time comes..we do not know what she feels, what she thinks or what she hears. Is there life going on inside her brain? Is she happy? Does she feel any pain? My life has been consumed with thoughts and concerns for her this past week; I've screwed up some interviews becayuse i can concentrate on nothing else and I can no longer sleep (how long does daily doses of sleeping pills lead to an addiction?). But I can not imagine what my dad is going through. I don't know where to turn, how to help him and I feel absolutely useless to my grandmother and my heart is breaking on the thought of losing her. Then I think am I even cut out to be a doctor if I can't handle this? Does anyone have any experience with this? Can anyone offer any advice?

I'm so sorry. I feel your pain. My Dad had to go through the same thing with my grandfather. He had lung ca, then chemo. We thought he would be ok, but he had a PE and had to be put on life support. It is a very difficult decision, but you have to think what your grandmother would want. I will keep you and your family in my prayers.

Don't question your ability to be a doctor. This experience will make you a stronger, better person and physician. You will be able to relate to others in the same predicament.

 

[Psycho Doctor]

Psycho,

There are too elements to your question: the practical question and the human one. As far as the practical question, I've heard of a standard that if two doctors agree that the patient has no realistic chance of waking up, then that might be a good time to consider removing life support. I don't think your dad needs to hurry the decision. Talk about it amongst family and get the technical advice from doctors and perhaps some advice from the hospital chaplain and/or your personal minister.

As to your issue - let schools know what's going on and reschedule the interviews. If you're worried about sleeping pills being habit forming, ask the doc who prescribed them for you. Ambien, for instance, is not habit forming IIRC.

God bless you and pull you through this tough time. It helped me to remember that my wife was going from a tougher place to a better place. The only thing to grieve is that you miss your family member while you're stuck here.

thanks Moosepilot and I know you understand. I know she is going to a better place but we will miss her incredibly. I don't even know what to pray for anymore...i just can't stand to see her like this any more; we try to be sentimental about every moment or romanticise her every movement which we ar eprobably only imagining and exaggerating b/c we can't admit there is nothing left.. We plan to first talk to our pastor and then the doctors before making any decisions but there will always be the self doubt and guilt.

Unfortunately postphoning interviews isn't as much of an option as I'd like to think b/c I have other issues going on which may make interviewing impossible in the near future. I hate to sound pathetic (especially to you who has already lost so much and managed seemingly so well) but my life is a real mess right now and I'm not actually sure how to deal with it..

 

[Psycho Doctor]

I am so, so sorry for your grandmother's condition. It's cliche, but words can't express how my heart hurts for you right now.

I've been in a similar situation with a family member. Although the issue of life support is never an easy one to deal with, I feel that my family was lucky when we were forced to deal with it--my relative had made it very, very clear what she wanted. I know it's awful, but keep the faith right now--everything happens for a reason...

The grief you're feeling now is natural and expected, but I can absolutely understand why you would question your abilities as a doctor. Please don't. Being a doctor and being a family member to someone who is ill are two entirely different things...I hope that isn't putting it too simply.

Hang in there, and feel free to PM me if you want to talk.

thanks, i appreciate your words of advice form your experience. Unfortunately at these times it's hard to be rational when there are so many emotions involved. I'm really hoping God will take car eof this decision for us.

 

[Psycho Doctor]

I'm so sorry. I feel your pain. My Dad had to go through the same thing with my grandfather. He had lung ca, then chemo. We thought he would be ok, but he had a PE and had to be put on life support. It is a very difficult decision, but you have to think what your grandmother would want. I will keep you and your family in my prayers.

Don't question your ability to be a doctor. This experience will make you a stronger, better person and physician. You will be able to relate to others in the same predicament.

thank you and sorry for your experience. I've been through some personal experiences before but it's amazing how different each case is and how it brings up all the emotions all over again.

ok..i'll get back to this later, my sleeping pills are finally hitting me and i can no longer write or think rationally.

 

[akpete]

I am so very sorry. You and your family are in my thoughts and prayers...I'm sure your dad will make the right decision. Have faith. And good luck with everything else that may be going on in your life. Hang in there.

 

[MoosePilot]

thanks Moosepilot and I know you understand. I know she is going to a better place but we will miss her incredibly. I don't even know what to pray for anymore...i just can't stand to see her like this any more; we try to be sentimental about every moment or romanticise her every movement which we ar eprobably only imagining and exaggerating b/c we can't admit there is nothing left.. We plan to first talk to our pastor and then the doctors before making any decisions but there will always be the self doubt and guilt.

Unfortunately postphoning interviews isn't as much of an option as I'd like to think b/c I have other issues going on which may make interviewing impossible in the near future. I hate to sound pathetic (especially to you who has already lost so much and managed seemingly so well) but my life is a real mess right now and I'm not actually sure how to deal with it..

Well if you ever want to talk about everything that's going on, you've got my email. Once you wake up, of course.

 

[cardsurgguy]

We know she would not want to live as an incognizant being and would rather be in the presence of the Lord

if this is true, then you're father would be following her wishes if he released life support

I don't mean to be harsh, but the most important person in this situation is your grandmother-her wishes should come first
if she didn't want to have the horrible quality of life that comes with living on life support for ventilation and nutrition, then it seems like her wishes would be followed if she was let go

my grandparents died within a month of each other, both being in pain for the last couple weeks of their lives, of which both didn't want to be
my grandfather stopped eating and doing anything in his nursing home after my grandmother died, not just b/c of the pain, but obviously b/c of my grandmother dying

this was absolutely not what my grandfather wanted, living in pain without being able to take care of himself in a nursing home, and on top of that without my grandmother

my grandfather then died a couple weeks after my grandmother, and when I got the call, I was happy...
I know that sounds weird, but his suffering was over
given his the quality of life he had, I considered his death positive news, for his sake

the question you and your father have to consider is are you keeping her alive for her? or for you and your father? b/c her wishes that were previously articulated outweigh yours and your fathers, since it's her life, and her suffering


the key idea here is that there's no value in being biologically alive (having a heart beat on an EKG, and brain activity on an EEG) and that's it, with no quality of life, is a life not worth living
quality of life is what makes life worth living, if you don't have it, then life is not worth it

 

[JDAD]

Ok maybe this does not belong on this board, but i couldn't help it since it has dominated my life for the last week or more.

My grandmother suffered a massive cerebral hemorrhage a week ago Tuesday. She has not gained consciousness since I put her in an ambulance (and for this I feel guilty); she has barely opened her eyes and I'm not sure how much she recognizes us. This wonderful woman brought me up and babysat for me since I was born and I love her with all my heart. It is so difficult to watch her hooked up to machines that are breathing and eating for her and running every life support possible. My dad, as the health care proxy, is now left with the heart wrenching decisoin of whether to continue life support on her. I can not bare to watch my dad in such pain of making a life altering decison that perhaps he is too emotional to make. We know she would not want to live as an incognizant being and would rather be in the presence of the Lord, but who are we to decide when that time comes..we do not know what she feels, what she thinks or what she hears. Is there life going on inside her brain? Is she happy? Does she feel any pain? My life has been consumed with thoughts and concerns for her this past week; I've screwed up some interviews becayuse i can concentrate on nothing else and I can no longer sleep (how long does daily doses of sleeping pills lead to an addiction?). But I can not imagine what my dad is going through. I don't know where to turn, how to help him and I feel absolutely useless to my grandmother and my heart is breaking on the thought of losing her. Then I think am I even cut out to be a doctor if I can't handle this? Does anyone have any experience with this? Can anyone offer any advice?

I am unable to offer advice regarding your questions because I don't feel qualified, however, you will be in my prayers. God bless your entire family Psych, and take care of yourself.

 

[DrThom]

I'm sorry man..

My thoughts and prayers are with you.

 

[Psycho Doctor]

if this is true, then you're father would be following her wishes if he released life support

I don't mean to be harsh, but the most important person in this situation is your grandmother-her wishes should come first
if she didn't want to have the horrible quality of life that comes with living on life support for ventilation and nutrition, then it seems like her wishes would be followed if she was let go

my grandparents died within a month of each other, both being in pain for the last couple weeks of their lives, of which both didn't want to be
my grandfather stopped eating and doing anything in his nursing home after my grandmother died, not just b/c of the pain, but obviously b/c of my grandmother dying

this was absolutely not what my grandfather wanted, living in pain without being able to take care of himself in a nursing home, and on top of that without my grandmother

my grandfather then died a couple weeks after my grandmother, and when I got the call, I was happy...
I know that sounds weird, but his suffering was over
given his the quality of life he had, I considered his death positive news, for his sake

the question you and your father have to consider is are you keeping her alive for her? or for you and your father? b/c her wishes that were previously articulated outweigh yours and your fathers, since it's her life, and her suffering


the key idea here is that there's no value in being biologically alive (having a heart beat on an EKG, and brain activity on an EEG) and that's it, with no quality of life, is a life not worth living
quality of life is what makes life worth living, if you don't have it, then life is not worth it

the thing is how are we ever sure that she will never regain total consciousness and be totally cognizant...God does make miracles happen. it would be so much easier if we knew beyond a shadow of a doubt that she'd never be whole again.

so often i've heard of one mate dying shortly after the other or people living until some special event that they tried to make it through...seeing someone one last time to say goodbye....

 

[Psycho Doctor]

thanks everyone, i appreciate it...

 

[tinkerbelle]

Hang in there Psycho You and your grandma are always in my prayers

 

[beanbean]

I'm very sorry for the pain your grandmother's illness has brought to you and your family. Please don't feel guilty for anything you have or have not done. Her stroke was a physiological event and not your fault in any way. Sudden cerebral events can be so devastating for families of the patient because of the quickness of the injury, the uncertainties in prognosis and the long road to recovery if even possible.

I am glad to hear that you and your family are consulting her doctors and your pastor during this difficult time. The hospital chaplin may also be a valuable resource to you, as they are very experienced in guiding families through these difficult times.

Please don't doubt your ability to handle the emotional aspects of medicine. Caring for and making life decisions for a close family member is very different than caring for patients.

I will keep you and your family in my thoughts and prayers.