Posted by Cathy-WI on 10/15/2009, 7:08 pm, in reply to "Do Not Resuscitatec form & living will advise?"
68.112.179.214

Jarity, and others: You might want to step back and re-evaluate your decisions. I once told my pulmo that I didn't want to be intubated, that if I was that bad to just pull the plug. He cautioned me against that by saying there may be a time when it's needed just to get me 'over the hump.' Boy, was he right. Less than a year later, following some surgery, I took a downturn. CPR was needed, and performed on the way to the ER, where I was intubated. After being intubated for 1.5 weeks, they did a tracheotomy and I was on that for 1.5 weeks. Yes, after 3 weeks it was difficult to wean off the machines that were breathing for me. That can't be helped, but it can be done. It's made a bit easier by the fact that if you're in that situation, you're very likely pretty drugged up and not all that aware. At least, you won't remember much. Talk to your doctors and family and let them know your wishes. If I had insisted on no intubation, I wouldn't have been around for the past four years to hassle my kids.

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Posted by CarolCA on 10/15/2009, 6:32 pm, in reply to "Do Not Resuscitatec form & living will advise?"
98.248.53.53

You need to talk to the orthopedist about this. They may be able to do it with a spinal block but if not you will be intubated if they do a general. I don't know if they have to wean you after surgery as you have not been on it very long but with any surgery the anesthesiologist, doctor and you pulmo need to talk. General anesthesia scares me for that reason. I have been intubated and other than it being scary since I didn't know what was going on and was hallucinating it was not painful or uncomfortable.

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Posted by John O. on 10/15/2009, 6:13 pm, in reply to "Do Not Resuscitatec form & living will advise?"
69.129.197.8

In WI to get a DNR you have to be a "qualified patient" , defined as someone whoa "has a terminal condition or a medical condition such that were the patient to suffer cardiac or pulmonary failure, resuscitation would be unsuccessful,cause significant harm or pain, or would be successful only temporarily." It is mostly for first responders. If EMTs or paramedics respond and you are not breathing, and are wearing the DNR bracelet or someone with you can produce the order, they can still do the following: clear airway, administer O2, control bleeding, provide pain medication, and so on. But they will NOT provide chest compressions, insert advanced airways, administer cpr drugs, provide ventillatory assistance, or defibrillate. So my DNR is for cardiopulmonary situations in which I am not breathing and/or my heart has stopped. It has nothing to do with whether I might or might not want to be ventilated under other conditions, i.e., if I were still breathing. Where paramedics and doctors get uncomfortable is with wirtten directives about wanting this or that done that do not have the force of law. I have things written like that and attached as advisory memorandums to my Power of Attorney for Health Care, NOT my DNR. I signed the following to get my bracelet: I understand that this document identifid the level of care to be renedered by an emergency medical technician, first responder, or emergency health care facility personnel in situations where DEATH IS IMMINENT. I make this request knowingly and I am aware of the alternatives as explained to me by my physician. I expressly releease, on behalf of myself and my family, all persons who shall in the future attend to mt medical careof any and all liability whatsoever for acting in accordance with this request. Furthermore, I direct that this order be enforced even though I may develop a diminished mental capacity at some future time. I am aware that I can revoke this order at any time by removing or defacing the ID bracelet or by requesting resuscitation. So if I am in an ambulance, or on an operating table, or on a vent, and my heart stops, and I'm wearing the bracelet, they CANNOT do any of the things stated above, can't do CPR, can't try to keep you alive. You may say you don't want to be ventilated, but your request will not have the force of law and the doctor will not be bound by your request.

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Posted by ElaineIL on 10/15/2009, 5:16 pm, in reply to "Do Not Resuscitatec form & living will advise?"
98.223.5.106

Jarity, The most important part of this process, IMHO, is talking to the person named as your health care agent. In my case, I have talked to my daughter at length about this. Intubation is probably the one thing we COPDers worry about most. In my case, I've made it clear to my D that it may be necessary to intubate me temporarily for a variety of reasons. The key word is temporarily. In such circumstances she will consult with my doctors (and not just one, by the way). If, in their opinion, they expect the intubation to be a temporary measure, then it should be done. If they expect it to be permanent, or, after intubating me, they determine that I can't be weaned off of it, that's when the DNR comes into play. BTW, I have a close friend who did have to be intubated three years ago. He does not have COPD but had other major health issues. The docs felt he needed to be intubated because his other issues were putting too much strain on his heart. He was intubated for 10 days and had no problem getting off the ventilator when his other issues were more stable. This is just my personal solution, but I hope it helps you to think about how you feel about this issue.

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Posted by Jean on 10/15/2009, 4:38 pm, in reply to "Do Not Resuscitatec form & living will advise?"
173.25.225.255

Jarity, There's always a chance, regardless of having COPD or not, that you might need to be intubated and might or might not survive the experience. That's why you have the living will and the DNR on record. Mine states something to this effect: if it appears that brain function is gone and there is little chance of me surviving with any quality of life, then let me go; if there is a good chance, do what's reasonable to insure that I will be able to resume life with essentially the same quality as I had before. That said, I recently had a kidney stone blasted on an outpatient procedure, and they intubated me because it was protocol. The only leftover from the procedure was a sore throat and neck; both of which went away after a couple of days. Fill out your DNR and say basically what you've said here. Jean

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