Quality of life

After working at Henry Ford in the oncology department becoming depressed with death and watching the suffering I started to change my views on life and death.  This past month I had reaffirmation after what a doctor presented about a case.  I give this doctor all the credit in the world because he did what most cannot do.  

When the body goes without oxygen for a period of time, the brain dies.  That can leave a patient hooked up to life supportive measures for a long time, depending on whether or not they develop infections that post a secondary problem.  Technically you cannot be considered brain dead if you do not have sustained apnea (stopping of breathing).  Sometimes just taking one breath every few minutes is enough to not consider a person "brain dead" even though they have absolutely no other reflex.  

Parents hope for a miracle.  Hell, I would hope for a miracle for anyone, but we must face reality.  

A doctor spoke up.  He let a family know that a child grows.  You must think about your quality of life as well as the childs' quality of life when their whole body is not functioning.  

A little baby or child grows up into a grown adult.  A loved one will have tunnel vision when the cute little one is in front of them.  All they are thinking about is a positive outcome, because why would we ever want a negative one?  While it may be easy to change and bathe a child now, when they are 20 and weigh 150 pounds changing them on your own gets a little bit difficult and causes stress to the caregiver.  

Don't take this as a debbie downer post.  Take this as a lesson, a lesson that life is fragile.  

Know what you want for yourself.  Adults are not the only ones who die.  Sick people are not the only ones who die.  Perfectly healthy newborns die.  The guy who runs 5 marathons a year can die. 

 Death knows no boundaries, it can take us all.  

Therefore we must be advocates for ourselves.  Fill out the paperwork and discuss with your loved ones what you want and keep it handy if needed.  If you want life sustaining measures, make sure your family is up to the challenge it is going to pose to them as your caregiver.  

Think about all avenues before making your decision, and make your decision now.  

ECMO

Talk about a scary situation....walking into a room when there is a patient on ECMO (extracorporeal membrane oxygenation).  For those of you who do not know what this is:  it is a pump that circulates blood through an artificial lung and back into the body for a very ill patient whose heart or lungs cannot adequately work.

My preceptor last month took me into a patients room to see this going on.  A baby, surrounded by machines, lines, drips, and the most patient, smart medical staff there was.

I learned so much from the situations encountered with this patient.  The nurse that was taking care of the baby when I went in was so composed and confident.  I was ready to crap my pants from everything that was going on.  How do you keep it all straight?  A patients body cannot keep them alive so you are relying on these machines to keep them alive.  What if something goes wrong with the machines?

Oh, yep. That happened too, on a daily basis.  Every time there would be clots in this machine and they would have to change the "artificial lung" out the patient could not withstand being taken off the machine for the switch.  Their heart would stop, CPR would begin, drugs would be given.  It took a lot of the staff to help code this patient everyday to keep them alive.

This is where I learned teamwork no matter what your experience is.
For a new person in the ICU, I was even valuable at times (I had to go get a code form so they could write everything down).  Yeah,  I know it does not seem valuable, but I took in the information.  In years to come, it will help me keep a patient alive.

Anticipation is key in these sick patients.  When you anticipate what could go wrong, you are prepared and usually prevent the escalation.