WEDNESDAY, FEBRUARY 10, 2021 - End of life issues

 WEDNESDAY, FEBRUARY 10, 2021

END OF LIFE ISSUES

Yes, eventually you and I will die.  It might be a long, drawn-out, and painful; or it might be gentle passing into death.   But, whatever way, your life will be over.

Let’s talk about the long, drawn-out, and painful options.  

Doctors (generally) have a “fix” mentality.  Aside, from my recent reading and research, this can also be a male/female issue.  Men like to “fix” problems, women aren’t quite as worried about fixing it, but understanding it.  When my wife was talking about her terrible day, I wanted to fix it - I wanted to call the person who had spoiled her day and get it solved, but frequently she didn’t want that.  She would solve the problem her way, she just wanted me to listen - really listen, not just nod and say “Um” but to hear her - and emphasize with her.

So, if you come to a doctor and are diagnosed with a tumor in your stomach, the doctors generally want to fix it.  They may suggest surgery - cut you open and cut out the tumor; followed by radiation, or chemotherapy.  (After all, they were trained to find solutions - and to a surgeon, most solutions require surgery!!!)  

Now, you (assuming as a patient) have options.  You can say “no” - don’t operate, don’t do radiation, don’t do chemotherapy - just let me die in peace.  Or, you might find out this is a slow-growing tumor and not really going to be a problem for several years - so let it be for a few more years.  What are the side issues?  How is your quality of life?  It might be that “take two aspirins and call me in the morning” just might be the best (or all) you can do.

According to the “Being Mortal” book, I’ve been listening to, the author (who is a surgeon) says doctors get paid more by treating cancers radically.  While I’m not sure if there is a pay scale, I would guess a three-hour knee replacement surgery will put more money into the hospital (and surgeon’s) pocket than a doctor suggesting a walker or a cane or a wheelchair!!! But, that can cut into a quality of life situation.  If you are 50 and just got a diagnosis of breast cancer (as one of my online authors), you get it treated.  If you are 85 and just got a diagnosis of breast cancer - you might view it differently.  It might see if it is a fast-growing or slow-growing, what estimate of the time you have left.   

Some treatments may cause you to go to rehabilitation centers - or even to nursing homes (or stay in hospitals).  Some patients may say “NO” - “I’ve had a great and productive life, let me go home, and when death comes, I’ll be in my own bed.”  

This particular “Being Mortal” book suggests that doctors like to tell only the good news to patients.  “Like - this drug and treatment have a good chance of stopping your cancer”. But, they might not talk about the side effects - you probably will be nauseous - or you will have trouble sleeping - or you may sleep twenty hours a day - or you may be in such a drugged state that you are almost a ‘vegetable’.  Or that even though they say “a good chance”, that might be 20% or even less.  

The emphasis is on “fixing” the problem - but not necessarily working on the quality of life.  The side effects of nausea, or depression may outweigh the slight gain in longevity.  

(Doctor to the patient) “We have a new treatment option.  It is estimated to be about 30% effective and it will give you about two more years of life.  But, it may also cause you to become bald, with increased bone loss, and have kidney problems.  I suggest you take the new treatment.”  

(Patient thinks) Let’s see a 30% effective evaluation (of 70% of not working) - two years of life - with balding, bone loss, and kidney problems.  That might be a good reason to say “no”

*****

You might also add - what is going on in your life.  If your only daughter is getting married in six months and wants her father and mother to give her away, it might be worth it to live at least six months.  If you are living alone, your spouse has died, your children live a long way away, you already use a walker and no longer drive, you might pass on the new treatment.

I tend to go with the sanctity of life until “natural death”.  But, I can allow the possibility of alternatives for situations where the physical body still has blood pumping - but there is little else going on.  

From Time Magazine: 

On Aug. 6, 1941, 6-year-old Elaine Esposito went to the hospital for a routine appendectomy. She went under general anesthetic and never came out. Dubbed the "sleeping beauty," Esposito stayed in a coma for 37 years and 111 days before succumbing in 1978 — the longest-ever coma, according to Guinness World Records.

And, a similar (positive story) - from Everyday Health

“Their questions were answered on June 11, 2003, as, incredibly, Wallis awoke from his 19-year coma — making him the survivor of the longest coma on record.”

These almost match Washington Irving’s story of “Rip Van Winkle” - who in the story slept for 20 years.  (Although: “The lovable rogue of Washington Irving’s story was a real man who abandoned his wife and children to become an 18th-century barfly in New York City, claims literary detective Steven Press.”).

Can I put myself in their shoes?  If I was in a coma for a year, two years, five years - should I still be a functioning human being?  

We talk of being a “vegetable”.  Does being in a coma (or a stroke victim) for several years allow somebody to love me and care for me?  Would a spouse care for his/her wife/husband for several years - bathing, feeding, changing adult diapers, keeping the person moving to avoid bedsores?  If the spouse has the supernatural love to do so, that would be okay.  But, if this causes the spouse to lose his/her job just to care for the coma victim and to cause the person to go on public welfare - it is a tough question.  I don’t want to “play God”.  

Some people have designated “do not resuscitate” directives.  (My mother at 98 had such a statement).  

What is the quality of life - for the person, for the caregiver, for the medical personnel? Again, a tough decision.  

And, to close.  This article gives ten things your doctor won’t tell you about dying.  Things like clinical death (heart stops beating), and biological death (the brain dies from lack of oxygen).  I won’t talk about it, but give the link for you to follow if you desire.

https://www.everydayhealth.com/news/things-your-doctor-wont-tell-you-about-dying/

*****

The premise this week is that we are dying - and there are issues that we and our families should think about that relate to the death process.  

How do you want to die?  

(My father was a jokester - he said he wanted to be shot by a jealous husband at age 102

Another friend - a pastor - when asked what he’d like to hear at his funeral - his answer was “LOOK - HE’S AWAKE!!!” )

LOVE WINS!!

Hugs

Karen