Death Test - Predicts Chance of Dying within 30 Days - Death Panels Part 1
- Thread starter CajunCrimson
- Start date
It sounds like a good idea, so long as it's not used to kick patients out of hospitals. If it's used to have a doctor or counselor sit down with the patient and explain the options, it could be a big benefit, particularly by preventing last moment "heroic efforts" by some doctors and some hospital staff. In the case of my own mother, it wouldn't have been needed. She was clearly terminal with pancreatic cancer. She wanted to die at home. We children - all five of us - practically forced the doctor to readmit her to the hospital, which is where she died, intubated, hooked up to IVs, monitors, etc. Of course, there was no hospice back then and it would have been almost impossible to care for her, with four of the five of us located out of her hometown. It doesn't sound like Britain has hospice and that's hard to believe. This is my pragmatic - not ideological - view, from my own experience, both with my mom and with hundreds of clients over the years...
Earle, I totally agree with you.....people should have the option to die at home....as pain-free as possible, and it should be their decision (or their loved ones, if they are unable to make the choice)...
My concern (as with most other - "Government" based 'task force') is that these decisions will be based on a grid -- and if you fall within a certain area -- you won't get care, regardless of what you as the patient or as a loved one might want/think/need.... etc.
I perfectly well understand that fear. It's all in the way it's implemented...
Something similar is already happening in most cases. However, it's informal, usually just a subjective judgment of the doctor. Most times now, it's not even the family doctor. Instead, almost all patients are handed off, when they enter the hospital, to a group of specialist, including a "hospitalist," whose job it is to coordinate the patient's care. This breaks the chain between the patient and family extending to someone who knows them and knows the patient personally. This is not going to change, because of economics. I'm not impressed with the hospitalists I've come in contact with so far. To give one example, when I was in the hospital ER with what felt like heartburn, they discharged me that evening, because of my troponin-L levels and my normal cardiogram. The hospitalist visited me in my room (they'd already admitted me) and told me there was no way the incident could be related to my heart
I'm trying this post again, as, every time I try to finish it, either my computer or TF is bouncing me back to the beginning of the post. Anyway, his mistake could have killed me, as the heart cath had to be put off for 6 days, until my own cardiologist got back into town. My LAD artery (widow-maker), the artery feeding your main pumping chamber, the left ventricle, was 99% blocked. My cardiologist said I should have never been allowed to leave the hospital. (And that I was at the wrong hospital.) All this to say that any grid or technological aid which would help these people to make better decisions and communicate better information to the patient and family, I would heartily welcome...
My next door neighbor died this past week from just such an occurrence. Even though he had over 95% blockage in his heart, the doctors still let him undergo a major back surgery, which was his third within a year. On the day he was supposed to be released, he was getting up from the bed when he suddenly collapsed and went into cardiac arrest. They tried for over an hour to resuscitate him but he was already gone. He was 71 y/o.
Well, I understand perfectly. I've had five caths now. I complained of shortness of breath about six months after the stent placed in the LAD. They went back in to check on that. They tried for several hours to place a stent in my right coronary artery (RCA), which feeds the back of the heart and the lungs. They had tried the radial artery in my arm. I had to go back two weeks later, when they placed it via the femoral artery. Of the five caths, only two were really productive (the last one was just precautionary last April - all was clear). I have hip replacement surgery scheduled for 2/9 and my cardiologist has to clear me, although the record shows that I shouldn't have any problems. I broke my right hip in a ladder fall 25 years ago, which is when the disease process started. I turned 75 last month...
I am looking at hip replacement in the future so keep us informed of the type of procedure and your recovery process.
Will do. Dr. Davis of the Andrews Group is going to do it. I would have had it done here, but I got caught in an awkward situation where I'd done recent legal work for one hip guy and another was recommended by my ortho, all in the same group. I'd suggest seeking out a doc who's done many direct anterior approach surgeries, the more, the better. There are a lot of advantages against only a few disadvantages. It's trickier, but most of the usual restrictions associated with the posterior approach go away. I mean the no bend more than 90 degrees, shower stool, etc...
Given the present political climate, I see no possibility that the federal government will ever exercise the authority to come up with such guidelines. However, I hope there is some national agency, maybe the AMA, which will come up with decent guidelines. If not, then it's going to be every hospital making up its own procedure. As many times as I've had to be in hospitals in the last few years, that doesn't fill me with the warm fuzzies. YMMV...
My aunt had a hip replacement 2 years ago and my brother's father in law had one last month. Both were done by doctors in the Andrew's group. My aunt's was done with the incision to the rear while my brother's FIL's was done with the incision toward the front. Both have been very happy with the results, but my brother's FIL with the incision toward the front had much less muscle spasm pain and his recovery has been significantly faster. Just anecdotal food for thought. Good luck.
Thanks! Yes, those are some of the reasons for going for the direct anterior. For curiosity, did the FIL have any numbness on the outside of his thigh? That's the main risk, because they have to temporarily relocate the femoral nerve, and nerves in general don't like being handled. It's usually temporary. The other downsides to anterior are minor, if the surgeon is competent. They actually use a fluoroscope to get a reading on placement of both the socket and new stem/ball. Also, they get an exact reading on leg length, which is hit or miss with the posterior approach. The surgeon has given me the option of having a spinal or epidural and staying awake, and I favored staying awake. I went through carpal tunnel awake, but, after seeing a video of the entire operation, I'm now not so sure... :eek2:
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