DNR/Pull The Plug

Serious Business Backup 11 replies 364 views
ernest_t_bass's avatar
ernest_t_bass
Posts: 24,984
Jul 7, 2011 2:06pm
I've been thinking about this lately, as I've had some people close to me go through these types of situations, and I've seen how it can put a strain on the family... but I've also seen the opposite.

If you are living on life support, do you have a timeline for how long you want to be on it? Forever?

For me, if I reach the point where the doctors feel that I will be a vegetable, the people will have to help me do everything, etc., then I would like the plug pulled. I don't want to burden my family with taking care of me, especially mundane tasks.
M
MontyBrunswick
Jul 7, 2011 2:14pm
I won't die, so this thread doesn't apply to me.
T
tuskytuffguy
Posts: 615
Jul 7, 2011 2:18pm
You would be surprised how many times my wife(a critical care and ER RN) has had to code people because people aren't signed to be a DNR, or family won't approve of it. I mean, we're talking 90 year olds who are so frail, that when chest compressions are done, it breaks nearly every rib. She literally tells family members every grotesque detail about what will happen if their ancient relative is coded, and there's been many that still want every possible thing done, which at an old age, if they survive, will live very painfully and miserable, and wish they had died.
SnotBubbles's avatar
SnotBubbles
Posts: 4,492
Jul 7, 2011 2:37pm
^^^
Yeah, it would depend on how old I was. Anything under 60 and I would want to hang on as long as possible. After that....I've pretty much lived a full life already.
I
I Wear Pants
Posts: 16,223
Jul 7, 2011 2:45pm
Unless I'm brain dead I want to stay the fuck alive.
4cards's avatar
4cards
Posts: 2,551
Jul 7, 2011 2:49pm
...Is J.J. H on the DNR list?
FatHobbit's avatar
FatHobbit
Posts: 8,651
Jul 7, 2011 2:49pm
I hope to live long enough to see the singularity.
J
June18
Posts: 298
Jul 7, 2011 3:11pm
I'm torn. I think the "sexy" answer is to say that you want the plug pulled. But what about the stories of people who come out of comas after years? I do agree with the above posters. I don't want to be put in pain to keep me alive. Hopefully I'm never in this situation or put anyone in this situation.
sonofsam's avatar
sonofsam
Posts: 2,052
Jul 7, 2011 6:18pm
tuskytuffguy;823666 wrote:You would be surprised how many times my wife(a critical care and ER RN) has had to code people because people aren't signed to be a DNR, or family won't approve of it. I mean, we're talking 90 year olds who are so frail, that when chest compressions are done, it breaks nearly every rib. She literally tells family members every grotesque detail about what will happen if their ancient relative is coded, and there's been many that still want every possible thing done, which at an old age, if they survive, will live very painfully and miserable, and wish they had died.

Been there, done that. I cannot describe the feeling of the first pump on a 90 year olds chest when the sternum snaps in half and about 6 ribs dislocate or break. The crepitus you feel with every compression is enough to gag you. Throw in the "mush" that the chest cavity becomes, which would you rather your geriatric family member endure? A peaceful death, or a pulverized chest with a minimal chance of living (if revived) and a lot of pain?

Is it easier on you to see them kept alive while they suffer and prolong the inevitable? I hope it was worth it, because if they could get up off that bed, they would smack the living s*** outta you for the pain and suffering you put them through.

I have no problem signing a DNR for myself or a family member... The very sad thing is when a MPOA (medical power of attorney) has a brain fart when something goes wrong with their dying family member and they go back on the DNR... I HATE that. You signed it for a reason, quit making them suffer for your own satisfaction of seeing a chest rise and fall...
Fab1b's avatar
Fab1b
Posts: 12,949
Jul 7, 2011 6:35pm
No life support for me, wouldn't want to live like that, just let me go!
HitsRus's avatar
HitsRus
Posts: 9,206
Jul 7, 2011 11:08pm
I hope to live long enough to see the singularity.
This!
F
friendfromlowry
Posts: 6,239
Jul 8, 2011 5:00am
I've done a lot of reading on this, and I think more and more, medical professionals are "encouraging" people to choose DNR status over being a full code. Sonofsam described why pretty well. CPR is a invasive and often times violent process. And it's incredibly unsuccessful on top of that. The most recent statistics I saw were that when a patient goes into a witnessed cardiac arrest in a hospital, they still only have no more than a 15% chance of surviving. If you're NOT in a hospital or witnessed, might as well forget about it. Reminds me of a patient I had back in December -- 50ish year old guy with a heart in awful condition. One minute he was good, the next he had kicked the bucket. We worked on him for 45 minutes doing everything in the ACLS handguide, but we couldn't bring him back. I can't say that he would have died peacefully had we never tried, but by performing CPR, we definitely made his last hour of life miserable.

There's actually different parts of being a DNR. If you're a Full Code, you're basically giving medical staff to do whatever necessary to save you. Others might want basic CPR, but NOT to be intubated and on a ventilator. If CPR is not enough, then fine. Then there's DNR-Comfort care where you've basically accepted your time is now, give me morphine every 2 hours to keep me 'comfortable' while I die.

There's a patient we frequently see, he's a 30 year old ventilator failure. When he was 15 years old, he tried to commit suicide by hanging himself in his closet. His mom found him during the attempt and tried to save him, but by this point he had already had bloodflow cut off to his brain long enough where saving him meant he was a vegetable. So for the past 15-17 years he's lived in long term care facilities with a tracheostomy (for those of you who've never been around a tracheostomy, they have to be the most awful thing to live with) on complete bedrest, living as vegetable. Then a couple months ago, working in the ICU, I had a 20 year old patient who tried to kill himself by overdosing on a bunch of different shit (barbituates, alcohol, narcotics) and his mom found him after he had been unconscious for 18 hours. He will probably be a vegetable now, too. Those two cases are probably off-topic, but it just goes to show how suicide can reaaaalllly backfire....