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Gave the doctors a DNR for mom...

MaggieD

MaggieD

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Mom was transferred from the rehab hospital to the regular hospital last evening. Her left lung is filling with fluid and she seems to have some kind of systemic infection. She's in Transitional Intensive Care -- not quite ICU, but close. She's in great spirits now that she's on 3 liters of oxygen.

One of her doctors called me this morning and said, in effect, they could do quite a few invasive things to her -- including draining fluid from her lung, a cardiac catheter procedure to see what's going on, etc. Or, he said, we could try to manage her with medicine. I opted for that. She's been through enough. That draining fluid option is very painful. And to what end? So it can fill up again? No, if her body's giving up, I'm just going to let nature take its course. Getting rid of the fluid is a balancing act of Chemistry 401, since what they give her for THAT will tend to make her numbers go silly.

I brought her physician-executed DNR to the hospital this afternoon, and when I gave it to her doctor, (her doctors hadn't mentioned one) she put her hand on my arm and said, "You're doing the right thing. Your mom's lived a good, long life. We still may be able to pull her through with medications, but I know we'll be able to keep her very comfortable. So many patients' families just can't do it."

And so we wait.

Edit: I talked to Tom about my thought process last night re the DNR, and he was heartbroken. I didn't even tell him what I did today.
 
Sorry to hear this Maggie... I been there myself with my mother.
 
Very sorry, Mags. You'll be in my thoughts, and I hope she pulls through.
 
MaggieD said:
Mom was transferred from the rehab hospital to the regular hospital last evening. Her left lung is filling with fluid and she seems to have some kind of systemic infection. She's in Transitional Intensive Care -- not quite ICU, but close. She's in great spirits now that she's on 3 liters of oxygen.

One of her doctors called me this morning and said, in effect, they could do quite a few invasive things to her -- including draining fluid from her lung, a cardiac catheter procedure to see what's going on, etc. Or, he said, we could try to manage her with medicine. I opted for that. She's been through enough. That draining fluid option is very painful. And to what end? So it can fill up again? No, if her body's giving up, I'm just going to let nature take its course. Getting rid of the fluid is a balancing act of Chemistry 401, since what they give her for THAT will tend to make her numbers go silly.

I brought her physician-executed DNR to the hospital this afternoon, and when I gave it to her doctor, (her doctors hadn't mentioned one) she put her hand on my arm and said, "You're doing the right thing. Your mom's lived a good, long life. We still may be able to pull her through with medications, but I know we'll be able to keep her very comfortable. So many patients' families just can't do it."

And so we wait.

Edit: I talked to Tom about my thought process last night re the DNR, and he was heartbroken. I didn't even tell him what I did today.
Click to expand...

They either pull out of it and get a respite or don't. My mother had a pleural effusion (water in the lining of the lung) and they did a procedure (Thoracentesis) to drain it. Numb the back with Lidocaine, then insert a large needle thru the back. I made sure they waited for the Lidocaine to take hold. It allowed her to breathe better and she made a comeback for 2 years. The third time it happened, she was too weak and when they recommended Hospice, I knew it was time for the DNR.

Sometimes all modern medicine can do is prolong a low quality existence and you have to step in. I wish you peace and sympathize deeply, having been there.
 
MaggieD said:
Mom was transferred from the rehab hospital to the regular hospital last evening. Her left lung is filling with fluid and she seems to have some kind of systemic infection. She's in Transitional Intensive Care -- not quite ICU, but close. She's in great spirits now that she's on 3 liters of oxygen.

One of her doctors called me this morning and said, in effect, they could do quite a few invasive things to her -- including draining fluid from her lung, a cardiac catheter procedure to see what's going on, etc. Or, he said, we could try to manage her with medicine. I opted for that. She's been through enough. That draining fluid option is very painful. And to what end? So it can fill up again? No, if her body's giving up, I'm just going to let nature take its course. Getting rid of the fluid is a balancing act of Chemistry 401, since what they give her for THAT will tend to make her numbers go silly.

I brought her physician-executed DNR to the hospital this afternoon, and when I gave it to her doctor, (her doctors hadn't mentioned one) she put her hand on my arm and said, "You're doing the right thing. Your mom's lived a good, long life. We still may be able to pull her through with medications, but I know we'll be able to keep her very comfortable. So many patients' families just can't do it."

And so we wait.

Edit: I talked to Tom about my thought process last night re the DNR, and he was heartbroken. I didn't even tell him what I did today.
Click to expand...




Went through this with Mom; it is hard, but I think you did the right thing. There comes a point where further efforts just aren't likely to help, and it is time to let go.
 
grip said:
They either pull out of it and get a respite or don't. My mother had a pleural effusion (water in the lining of the lung) and they did a procedure (Thoracentesis) to drain it. Numb the back with Lidocaine, then insert a large needle thru the back. I made sure they waited for the Lidocaine to take hold. It allowed her to breathe better and she made a comeback for 2 years. The third time it happened, she was too weak and when they recommended Hospice, I knew it was time for the DNR.

Sometimes all modern medicine can do is prolong a low quality existence and you have to step in. I wish you peace and sympathize deeply, having been there.
Click to expand...

Mom could barely walk with her walker before she broke her hip. Very weak. But she was making a comeback because she was game to keep trying and gradually got stronger. Now? She can't walk at all, of course. She can "toe touch" on the ground for balance. But she forgets that and puts her weight down on her broken hip side. When they have gotten her to stand, it's because the therapist is straddling her on the parallel bars and holding her leg between HIS in order to keep that leg off the ground. It's very very difficult. And very very painful. It's so damned hard to know what to do.

I hear your mom did well for two years after they drained her lung. It gives me pause. And then I think of the life I would be saving . . . what would that be like for her? She could barely walk before. She can't use a bed pan; she can't use the toilet; she is barely eating (though that could turn around in a heartbeat)...it's sooo HARD to know what the right thing is. I'm fairly confident she will never walk again, even on a walker. And see a nursing home in her future, since if she can't even stand and pivot, I can't handle her. Every single day in bed without therapy sets her back a week or more. What to do, what to do . . .

I like her doctor. I think she gets it. She lost her husband to cancer a year ago; we have much in common. If she recommends draining the fluid, I may go ahead and let them do that if they can keep her pretty comfortable. The only thing I'm sure of right now is that, if her little heart stops, it's time to stop.
 
MaggieD said:
Mom was transferred from the rehab hospital to the regular hospital last evening. Her left lung is filling with fluid and she seems to have some kind of systemic infection. She's in Transitional Intensive Care -- not quite ICU, but close. She's in great spirits now that she's on 3 liters of oxygen.

One of her doctors called me this morning and said, in effect, they could do quite a few invasive things to her -- including draining fluid from her lung, a cardiac catheter procedure to see what's going on, etc. Or, he said, we could try to manage her with medicine. I opted for that. She's been through enough. That draining fluid option is very painful. And to what end? So it can fill up again? No, if her body's giving up, I'm just going to let nature take its course. Getting rid of the fluid is a balancing act of Chemistry 401, since what they give her for THAT will tend to make her numbers go silly.

I brought her physician-executed DNR to the hospital this afternoon, and when I gave it to her doctor, (her doctors hadn't mentioned one) she put her hand on my arm and said, "You're doing the right thing. Your mom's lived a good, long life. We still may be able to pull her through with medications, but I know we'll be able to keep her very comfortable. So many patients' families just can't do it."

And so we wait.

Edit: I talked to Tom about my thought process last night re the DNR, and he was heartbroken. I didn't even tell him what I did today.
Click to expand...

When I'm in that shape don't drain my lung. But for you it isn't going to be that painless. Sorry you have run into this situation.
 
joG said:
When I'm in that shape don't drain my lung. But for you it isn't going to be that painless. Sorry you have run into this situation.
Click to expand...

Thank you, JoG. Thank you very much.
 
I believe you're doing the right thing. Your mom is lucky to have a daughter like you
 
MaggieD said:
Mom could barely walk with her walker before she broke her hip. Very weak. But she was making a comeback because she was game to keep trying and gradually got stronger. Now? She can't walk at all, of course. She can "toe touch" on the ground for balance. But she forgets that and puts her weight down on her broken hip side. When they have gotten her to stand, it's because the therapist is straddling her on the parallel bars and holding her leg between HIS in order to keep that leg off the ground. It's very very difficult. And very very painful. It's so damned hard to know what to do.

I hear your mom did well for two years after they drained her lung. It gives me pause. And then I think of the life I would be saving . . . what would that be like for her? She could barely walk before. She can't use a bed pan; she can't use the toilet; she is barely eating (though that could turn around in a heartbeat)...it's sooo HARD to know what the right thing is. I'm fairly confident she will never walk again, even on a walker. And see a nursing home in her future, since if she can't even stand and pivot, I can't handle her. Every single day in bed without therapy sets her back a week or more. What to do, what to do . . .

I like her doctor. I think she gets it. She lost her husband to cancer a year ago; we have much in common. If she recommends draining the fluid, I may go ahead and let them do that if they can keep her pretty comfortable. The only thing I'm sure of right now is that, if her little heart stops, it's time to stop.
Click to expand...

Don't take my mom's success with the lung drainage as a sign. Two completely different situations but if the doctor thinks it will make her more comfortable, then it's worth trying. It won't lengthen her life to have the procedure as much as make breathing easier. Once my mom stopped eating, she got so weak she couldn't sit up, from that point it didn't take long. I tried to hold her head up and spoon feed her but she could manage only a few bites.

When her last day(s) are here, it'll be obvious and fairly quick. Please don't think anything you say or do will be the cause of her demise, it's simply the way of life. Love her, make her comfortable and be there, that's all you can do. When it gets too much, hand it over to fate or whatever you may believe in.
 
Best thoughts and wishes. Peace.
 
MaggieD said:
Mom was transferred from the rehab hospital to the regular hospital last evening. Her left lung is filling with fluid and she seems to have some kind of systemic infection. She's in Transitional Intensive Care -- not quite ICU, but close. She's in great spirits now that she's on 3 liters of oxygen.

One of her doctors called me this morning and said, in effect, they could do quite a few invasive things to her -- including draining fluid from her lung, a cardiac catheter procedure to see what's going on, etc. Or, he said, we could try to manage her with medicine. I opted for that. She's been through enough. That draining fluid option is very painful. And to what end? So it can fill up again? No, if her body's giving up, I'm just going to let nature take its course. Getting rid of the fluid is a balancing act of Chemistry 401, since what they give her for THAT will tend to make her numbers go silly.

I brought her physician-executed DNR to the hospital this afternoon, and when I gave it to her doctor, (her doctors hadn't mentioned one) she put her hand on my arm and said, "You're doing the right thing. Your mom's lived a good, long life. We still may be able to pull her through with medications, but I know we'll be able to keep her very comfortable. So many patients' families just can't do it."

And so we wait.

Edit: I talked to Tom about my thought process last night re the DNR, and he was heartbroken. I didn't even tell him what I did today.
Click to expand...

Ahhh, Maggie, my heart is with you.

Just last week my sister finally signed the last of the necessary 'orders', including her DNR, as she has stopped chemo and is on maintenance drugs (Tarceva) to hopefully just slow things down. She's had her lungs drained fully twice from a form of pneumonia, and has had a port/shunt/whateveritis that's drained periodically.

Your Mom has a good, strong daughter beside her. You've done the right thing. :)
 
My best to you and yours, Maggie, in this very difficult time.
 
MaggieD said:
Mom was transferred from the rehab hospital to the regular hospital last evening. Her left lung is filling with fluid and she seems to have some kind of systemic infection. She's in Transitional Intensive Care -- not quite ICU, but close. She's in great spirits now that she's on 3 liters of oxygen.

One of her doctors called me this morning and said, in effect, they could do quite a few invasive things to her -- including draining fluid from her lung, a cardiac catheter procedure to see what's going on, etc. Or, he said, we could try to manage her with medicine. I opted for that. She's been through enough. That draining fluid option is very painful. And to what end? So it can fill up again? No, if her body's giving up, I'm just going to let nature take its course. Getting rid of the fluid is a balancing act of Chemistry 401, since what they give her for THAT will tend to make her numbers go silly.

I brought her physician-executed DNR to the hospital this afternoon, and when I gave it to her doctor, (her doctors hadn't mentioned one) she put her hand on my arm and said, "You're doing the right thing. Your mom's lived a good, long life. We still may be able to pull her through with medications, but I know we'll be able to keep her very comfortable. So many patients' families just can't do it."

And so we wait.

Edit: I talked to Tom about my thought process last night re the DNR, and he was heartbroken. I didn't even tell him what I did today.
Click to expand...

God bless you, your mom and Tom and I hope she makes it through to enjoy some extra time with you, but only if it's quality time.

You can always tell, in my opinion, that you're doing the right thing when the doctors who are treating the patient agree it's best. Sometimes you also have to nudge them in that direction because they really want to work miracles and nothing seems impossible. But if the doctor is used to treating the elderly, he/she knows what's reasonable. I could give you horror stories about suggested procedures for my mom at times but I resisted them all and almost every time the doctor said I'd made the right decision.

This has been a hard year for you so far and I admire your strength - be well and be confident in your decisions - your doing good for your mom and her care.
 
I'm sorry, Maggie. Hope that things get better.
 
MaggieD said:
Mom was transferred from the rehab hospital to the regular hospital last evening. Her left lung is filling with fluid and she seems to have some kind of systemic infection. She's in Transitional Intensive Care -- not quite ICU, but close. She's in great spirits now that she's on 3 liters of oxygen.

One of her doctors called me this morning and said, in effect, they could do quite a few invasive things to her -- including draining fluid from her lung, a cardiac catheter procedure to see what's going on, etc. Or, he said, we could try to manage her with medicine. I opted for that. She's been through enough. That draining fluid option is very painful. And to what end? So it can fill up again? No, if her body's giving up, I'm just going to let nature take its course. Getting rid of the fluid is a balancing act of Chemistry 401, since what they give her for THAT will tend to make her numbers go silly.

I brought her physician-executed DNR to the hospital this afternoon, and when I gave it to her doctor, (her doctors hadn't mentioned one) she put her hand on my arm and said, "You're doing the right thing. Your mom's lived a good, long life. We still may be able to pull her through with medications, but I know we'll be able to keep her very comfortable. So many patients' families just can't do it."

And so we wait.

Edit: I talked to Tom about my thought process last night re the DNR, and he was heartbroken. I didn't even tell him what I did today.
Click to expand...

You mums wishes should be respected. That is all that matters.

Te acompano en su dolor.

That is an old Texas saying...meaning "My heart is with you in your pain"
 
MaggieD said:
Mom was transferred from the rehab hospital to the regular hospital last evening. Her left lung is filling with fluid and she seems to have some kind of systemic infection. She's in Transitional Intensive Care -- not quite ICU, but close. She's in great spirits now that she's on 3 liters of oxygen.

One of her doctors called me this morning and said, in effect, they could do quite a few invasive things to her -- including draining fluid from her lung, a cardiac catheter procedure to see what's going on, etc. Or, he said, we could try to manage her with medicine. I opted for that. She's been through enough. That draining fluid option is very painful. And to what end? So it can fill up again? No, if her body's giving up, I'm just going to let nature take its course. Getting rid of the fluid is a balancing act of Chemistry 401, since what they give her for THAT will tend to make her numbers go silly.

I brought her physician-executed DNR to the hospital this afternoon, and when I gave it to her doctor, (her doctors hadn't mentioned one) she put her hand on my arm and said, "You're doing the right thing. Your mom's lived a good, long life. We still may be able to pull her through with medications, but I know we'll be able to keep her very comfortable. So many patients' families just can't do it."

And so we wait.

Edit: I talked to Tom about my thought process last night re the DNR, and he was heartbroken. I didn't even tell him what I did today.
Click to expand...

These decisions suck. It's pretty much a no win either way but quality of life needs to take precedence. If she's going to be stuck in bed and will require endless procedures just to keep breathing and that's as good as it will ever get then the answer is clear and you're doing the right thing.

My heart goes out to you and you and your mother will be in my prayers.
 
MaggieD said:
Mom was transferred from the rehab hospital to the regular hospital last evening. Her left lung is filling with fluid and she seems to have some kind of systemic infection. She's in Transitional Intensive Care -- not quite ICU, but close. She's in great spirits now that she's on 3 liters of oxygen.

One of her doctors called me this morning and said, in effect, they could do quite a few invasive things to her -- including draining fluid from her lung, a cardiac catheter procedure to see what's going on, etc. Or, he said, we could try to manage her with medicine. I opted for that. She's been through enough. That draining fluid option is very painful. And to what end? So it can fill up again? No, if her body's giving up, I'm just going to let nature take its course. Getting rid of the fluid is a balancing act of Chemistry 401, since what they give her for THAT will tend to make her numbers go silly.

I brought her physician-executed DNR to the hospital this afternoon, and when I gave it to her doctor, (her doctors hadn't mentioned one) she put her hand on my arm and said, "You're doing the right thing. Your mom's lived a good, long life. We still may be able to pull her through with medications, but I know we'll be able to keep her very comfortable. So many patients' families just can't do it."

And so we wait.

Edit: I talked to Tom about my thought process last night re the DNR, and he was heartbroken. I didn't even tell him what I did today.
Click to expand...
my 85 year old blind mother in law is the opposite circumstance; the one the doctor alluded to

after triple bypass this summer, followed by what was initially believed to be a stroke (actually was wrong thyroid meds prescribed at the hospital after the heart surgery), the nurse at the rehab facility asked what codes should be entered for her
explained that i had to do this (in consultation with my brother) for my alzheimers inflicted Mother, and concluded it was quality of life, not length, just as my father had decided previously for himself, dealing with pancreatic cancer
but that since my MIL was still cogent, we should go and ask her, and allow her to tell us what she wants
not surprisingly, she wants the works. only if she is in a vegetative comatose state, with no expectation of recovery, will she authorize a DNR; otherwise, no assistance is too extreme to administer. not what i would want for myself, but this is not my life we are addressing
that is all shared with you Maggie to say, i believe i both understand and agree with your decision on behalf of your Mom. i believe too many relatives impose agony upon their loved ones that they would not want inflicted upon themselves. you seem to have pondered what your Mom would want, and made that determination. a heartfelt one. this is about what is best for your Mom. not Tom. don't mean to come off as harsh. just realistic
the best to you and Tom ... and especially to your Mom
 
I know it's difficult, Maggie, but I would have done the exact same thing. I try to consider what I want someone who loved me to do, if it were me in your mom's shoes, and I'd hope they would be willing to let me go, if I couldn't spring back on my own. I see much misery and suffering almost every time I work a shift. I had a particularly heart-breaking case this weekend, and it just makes me want to cry that the human condition is sometimes so so sad. Hugs to you, Maggie. :)
 
GottaGo said:
Ahhh, Maggie, my heart is with you.

Just last week my sister finally signed the last of the necessary 'orders', including her DNR, as she has stopped chemo and is on maintenance drugs (Tarceva) to hopefully just slow things down. She's had her lungs drained fully twice from a form of pneumonia, and has had a port/shunt/whateveritis that's drained periodically.

Your Mom has a good, strong daughter beside her. You've done the right thing. :)
Click to expand...

I'm so sorry about your sister. It's so damned hard. It's not the dying that's hard, it's the getting there. Our bodies are wondrous machines designed to keep us alive "no matter what" until they just can't do it anymore. It's remarkable. And it's heartbreaking.

When mom lost her sister, a little part of her died along with her. In her addled state, until she went into the hospital, every morning when she woke up she'd call out, "Gladys!! I'm up!!" Then Maggie would pop her head in and laugh. She laughed back.

I'm sorry about your sister. I wish her a peaceful journey. And you the strength to carry on.
 
This is unexpected. You must feel gut-punched. *hugs*

You did the right thing, Maggie. I secretly executed a DNR with my own doctor a couple of years ago, when I was quite ill and the doctors were thinking the worst. I knew my husband would never let me go (he's a control-freak... I'll die when he says I'll die, and not a minute before!). If your mom had a moment of lucid clarity from the days when her mind was under her own control, I'm certain she would have done this for herself.

You have given her the greatest gift one human can give to another, unconditional love, respect and dignity during a time when most would have turned away. Bless you, hon. Everyone deserves a daughter/son like you, yet so few actually do. *hugs*
 
MaggieD said:
Mom was transferred from the rehab hospital to the regular hospital last evening. Her left lung is filling with fluid and she seems to have some kind of systemic infection. She's in Transitional Intensive Care -- not quite ICU, but close. She's in great spirits now that she's on 3 liters of oxygen.

One of her doctors called me this morning and said, in effect, they could do quite a few invasive things to her -- including draining fluid from her lung, a cardiac catheter procedure to see what's going on, etc. Or, he said, we could try to manage her with medicine. I opted for that. She's been through enough. That draining fluid option is very painful. And to what end? So it can fill up again? No, if her body's giving up, I'm just going to let nature take its course. Getting rid of the fluid is a balancing act of Chemistry 401, since what they give her for THAT will tend to make her numbers go silly.

I brought her physician-executed DNR to the hospital this afternoon, and when I gave it to her doctor, (her doctors hadn't mentioned one) she put her hand on my arm and said, "You're doing the right thing. Your mom's lived a good, long life. We still may be able to pull her through with medications, but I know we'll be able to keep her very comfortable. So many patients' families just can't do it."

And so we wait.

Edit: I talked to Tom about my thought process last night re the DNR, and he was heartbroken. I didn't even tell him what I did today.
Click to expand...

*hug*

I had to do this for my father. I have never felt physical pain while putting down my John Hancock, but I did then.

Comfort and strength to you and Tom during what is surely one of the ****tiest and scariest things we ever do for our parents. And it is for her -- don't let yourself forget that.
 
It's the last thing you can do for her.
 
Strong and stout of spirit such as you are, you'll get through this, even though it will be painful.

Take care Mags. Thinking of you and sending you all the good Karma I have.
 
I'm sorry you have to go through this Maggie. I recently did with both my dad and my younger sister. We knew we were doing the right thing in both cases - they had both suffered enough - but it was still the hardest most painful thing I've ever had to go through. If you're doing what your mom wants you're doing the right thing. Stay strong. I'll keep you and your mom in my thoughts.
 
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