About to "pull the plug" medically speaking, but it's not that simple

[oldfella1962]

Okay, my wife is in the ICU and her "medical directives" in her will state that she does not want to be kept alive via medical machinery if she is DIAGNOSED with a terminal condition. But the hospital has not officially diagnosed her condition. In other words they don't know what caused the infection/reaction that cascaded into her dangerous condition.
Different doctors give different opinions, but they all agree that if she survives the ICU, she will have to endure months of rehabilitation of various sorts, and will have to be fed through a tube inserted below her throat which will most likely be permanent. But here is my main concern. One doctor says we should take her off the machinery today or tomorrow but another doctor says that we should wait until Tuesday to even think about taking that step. Bear in mind that this is a military
hospital so they will be shut down for a four-day weekend and nothing will be accomplished outside of "holding down the fort" until Tuesday. All the "after death" legalities and procedures they say I will need to accomplish will be handled by experts & counselors right there in the hospital but they don't work weekends. Funeral homes, banks, lawyers, government offices or whoever else I need to work with do not work weekends. Any pending "lab results" that could indicate something
doctors might be able to treat won't be released until Tuesday. And since she is not feeling any pain (she has been unconscious for about 12 days now) why rush into doing something before we have all the data to make the best decision?
Just for a funeral home to get onto the military base to get her body won't happen on a weekend because that office is 'closed on weekends. Everything will end up being "half stepped" over a long weekend. Yes, I will bring all these concerns to the forefront when I and my son (he lives in the area) meet with the doctor on duty later today.

 

[Gator89]

You are in an extremely difficult situation.

I can only offer prayers for the Lord to guide you through this process.

 

[BeerThirty]

I'm sorry to hear you are dealing with this.

We went through this with my dad about 7 years ago. He was involved in a traumatic accident and was basically kept on life support until close family could get there to say their goodbyes, roughly 48 hours after it happened. Even though the hospital had a copy of my father's directive, my mom was still standing power of attorney and had final say on "when". She really struggled with it. And I would have said that the hospital was borderline too pushy about it too. But I do understand why.

 

[livinoutdoors]

Man i dont have much help other than go with what feels right to you. Just would like to say im very sorry sir. I hope you hang in there and find the strength to deal with this.

 

[oldfella1962]

I'm sorry to hear you are dealing with this.

We went through this with my dad about 7 years ago. He was involved in a traumatic accident and was basically kept on life support until close family could get there to say their goodbyes, roughly 48 hours after it happened. Even though the hospital had a copy of my father's directive, my mom was still standing power of attorney and had final say on "when". She really struggled with it. And I would have said that the hospital was borderline too pushy about it too. But I do understand why.

I think a sudden tragic car accident would be overwhelming to my brain. Too much happening too fast. I don't think well when I'm thrown a "curveball".
I understand the doctor/hospital point of view, but I also know what happens on a long weekend. All I will be given is a list of phone numbers and every number - it anybody answers - will be a "we are not here right now, please leave a message". Sidenote about life insurance - some insurance companies won't pay out until they get a death certificate which can be contingent on an autopsy. Right now, the average autopsy in Georgia (that doesn't involve foul play or other criminal activities) takes six months.
Regardless, the death experts on base counseling me on this and many other questions don't work weekends. So why make a stressful situation even more stressful? Waiting until Tuesday just makes good sense.

 

[Cool Hand Luke]

So sorry your family is going through this traumatic time.
Only advice I can offer is make sure you know all the legalities before installing a feeding tube. My sweet grandmother had a stroke, my Mom and her siblings chose the feeding tube to keep her alive. When she woke up, she couldn’t talk or anything, no quality of life. It takes an act of congress to have one removed. She laid there for almost two years before passing. Even though it kept her alive, my Mom still regrets that decision.

 

[oldfella1962]

Man i dont have much help other than go with what feels right to you. Just would like to say im very sorry sir. I hope you hang in there and find the strength to deal with this.

Emotionally I'm a rock. I googled it (what won't I google?) and sure enough that "five stages of grief" or whatever it is do not apply to everybody. Everybody handles grief in their own way. Everybody processes emotions in their own way. I don't feel guilt (but I understand the concept) about anything and this is one of the possible factors in dealing with the life of a loved one. I don't do denial or delusion either. But dealing with bureaucracy
right now would probably test my patience and cloud my thinking.

Bottom line I'm not worried about me, my focus is on my family and how they will deal with it. Obviously they just had a "dress rehearsal" when they thought she was not going to last more than a day or two, and it might be rough on my daughter, but then again so is "waiting for hammer to fall" with my wife in medical limbo.

I don't know how the medical staff working in the ICU deal with constant negative outcomes. It's like being a cadaver dog handler - there are few happy endings.

 

[oldfella1962]

So sorry your family is going through this traumatic time.
Only advice I can offer is make sure you know all the legalities before installing a feeding tube. My sweet grandmother had a stroke, my Mom and her siblings chose the feeding tube to keep her alive. When she woke up, she couldn’t talk or anything, no quality of life. It takes an act of congress to have one removed. She laid there for almost two years before passing. Even though it kept her alive, my Mom still regrets that decision.

Yes I googled the downside of a feeding tube. And one of the doctors explained it too. Coincidentally, one of the very last things my wife said when she was conscious - the day she went into the ER before they moved her to the ICU when her lungs started filling up with fluid - was "I'm getting hungry. I hope they have me out of here soon". Her appetite was coming back after being very tired and sick from diarrhea for three days or so. So assuming the doctors wait until Tuesday for me to make this feeding tube decision Tuesday will be the deadline (no pun intended).

 

[dwhee87]

Prayers to you and your family, Oldfella1962. Lean on family, ask for guidance from the Lord, and make the best decision you can. As far as being the 'Rock'; good that you can maintain that to help you make clearer decisions and be there for the family, but know that at some point, it'll weigh on you. Could be weeks or months after. Just know that when that happens, you have friends and family to help lift you up, like you did for them now.

 

[oldfella1962]

Prayers to you and your family, Oldfella1962. Lean on family, ask for guidance from the Lord, and make the best decision you can. As far as being the 'Rock'; good that you can maintain that to help you make clearer decisions and be there for the family, but know that at some point, it'll weigh on you. Could be weeks or months after. Just know that when that happens, you have friends and family to help lift you up, like you did for them now.

Thanks for your concern. That said there is no "guidance from the lord" because I am an atheist - and taken even further I don't believe in anything supernatural. Not saying that the supernatural doesn't exist - and there are many things that I can't explain - but the supernatural is nothing to hitch your wagon to.
But the gravity of the situation may or may not weigh on me. Most likely not. My brain processes things differently than most peoples' brains. That doesn't mean I won't miss her, but nothing can bring her back once she goes. I helped her to live the best life she could have, and I feel privileged to have had that opportunity.

 

[Mike 65]

I truly hope your wife is not an atheist, considering what’s going on.

 

[dwhee87]

Thanks for your concern. That said there is no "guidance from the lord" because I am an atheist - and taken even further I don't believe in anything supernatural. Not saying that the supernatural doesn't exist - and there are many things that I can't explain - but the supernatural is nothing to hitch your wagon to.
But the gravity of the situation may or may not weigh on me. Most likely not. My brain processes things differently than most peoples' brains. That doesn't mean I won't miss her, but nothing can bring her back once she goes. I helped her to live the best life she could have, and I feel privileged to have had that opportunity.

Then look inward to your own place of knowledge, perspective and conscious introspection, and do the best you can. May you and your wife find peace, Brother.

 

[Ruger#3]

It’s a bit late but Tricare doesn’t require a military hospital. If she gets capable get yourself and her to better help. I’ve had specialized care and surgeries and have not seen a military hospital in decades. Those that take Tricare are bound by their rates. I truly wish you the best, that’s a really tough situation.

 

[oldfella1962]

I truly hope your wife is not an atheist, considering what’s going on.

Why would you hope this? If she was a Hindu or a Buddhist or Muslim would that be just as bad (or just as good depending on one's perspective) as being an atheist?

 

[oldfella1962]

Then look inward to your own place of knowledge, perspective and conscious introspection, and do the best you can. May you and your wife find peace, Brother.

Thanks! Yes I will indeed look toward my own methods of introspection. I will find a way to turn this onto a positive.

 

[oldfella1962]

It’s a bit late but Tricare doesn’t require a military hospital. If she gets capable get yourself and her to better help. I’ve had specialized care and surgeries and have not seen a military hospital in decades. Those that take Tricare are bound by their rates. I truly wish you the best, that’s a really tough situation.

Yes we have both been going "off base" for many years. We were currently engaged in a struggle to get her "primary care provider" to get a referral for a vascular procedure. That's the thing about Humana - many things require referrals which means cooperation & communication between your primary care provider and the off-base doctors.

 

[Oldstick]

I have gone through the same traumatic decision that is facing you and your family, a couple times before. I am very sorry and our prayers are with you and your family. The good thing is you have a living will signed by your loved one. So there is only peace and relief for them, with zero guilt on you all's part if you obey that.

But that said, if I had heard one trusted doctor say "Let's wait a few days to decide.." that is what I would be inclined to do if it was me.

 

[oldfella1962]

I have gone through the same traumatic decision that is facing you and your family, a couple times before. I am very sorry and our prayers are with you and your family. The good thing is you have a living will signed by your loved one. So there is only peace and relief for them, with zero guilt on you all's part if you obey that.

But that said, if I had heard one trusted doctor say "Let's wait a few days to decide.." that is what I would be inclined to do if it was me.

Yesterday myself & my son got a chance to meet with the main doctor in charge of my wife. She laid out the basic framework for what the future may entail for my wife assuming that she pulls through. The feeding tube is not permanent * nor the trachea tube (not the big plastic one going down her throat - the other style they implant) that they will put in on or around Tuesday 20 February. Then a few more weeks in the ICU then to a local off-base specialty rehabilitation hospital until she is finally up to about where she was health-wise before she got sick. It will be a long process but since I am already retired and everything is local, I will get to spend a lot of time by her side helping her, encouraging her, etcetera. Also on or about Tuesday the expert "counselor" will be available to answer my families questions about what Humana/Tricare covers, going over my current will & medical directives, setting me up with a free JAG lawyer to update my will if needed so that my kids don't get financially ruined if I should suddenly die or get sick, etcetera. Bottom line wife may never "be herself" again physically or cognitively. However, she might be able to have a decent "quality of life" so if I can do this without bankrupting my kids or putting them through any emotional trauma, I'm taking advantage of the opportunity.

The hardest part in all this is that my kids hate seeing their mother like this, but I'm trying hard to keep them focused on their own families and trust me to handle everything the best way possible. My son spent a few months employed with a medical transport ambulance company taking veterans to their VA appointments for dialysis and whatnot and their quality of life was grueling for most of them.

* medical science & technology are advancing quickly so improvements are making life better for patients/care givers/doctors constantly.

 

[pjciii]

I am truly happy that the prognosis is better than you thought yesterday. I know from your postings that it will be an uphill struggle. Still sending prayers for your wife and you also the rest of the family.

 

[Core Lokt]

I hate to read this Sir and I am praying for your wife, the Dr's, the family and you as well.