Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM where we instantly improve the lives for Families of critically ill Patients in Intensive Care, so that you can make informed decisions, have PEACE OF MIND, real power, real control and so that you can influence decision making fast, even if you’re not a doctor or a nurse in Intensive Care!
This is another episode of “YOUR QUESTIONS ANSWERED“ and in last week’s episode I answered another question in this series of questions from my client Sue and the question last week was PART 5 of
You can check out last week’s episode by clicking on the link here.
In this week’s episode of “YOUR QUESTIONS ANSWERED“, I want to answer another question from one of my clients Melissa, which are excerpts from phone and email counselling and consulting sessions with me and the question this week is
My 78 year old Mom has lung cancer and developed an infection! She’s in ICU on the breathing tube, can she get off it or will she need a tracheostomy?
I’m Melissa and I was happy to find your website as my mom is in ICU. I have a question. My mom has lung cancer but it hasn’t spread and she is in ICU because her blood pressure dropped suddenly and she could not breath. They think it was an infection.
They have her pressure stabilized now. But she has been unable to breath on her own and the breathing tube’s been in about 11 days.
They first pressured us to pull the plug…not an option in our mind…she was heavily sedated and they told us they doubted her pressure would stabilize or that she would wake up, know us or recognize us.
They were wrong…pressure stabilized. She is awake, off all sedatives, fully whole and aware and knows everything going on. She just cannot breathe on her own and we have no idea why. They are telling us her muscles around her lungs are weak and since it’s been almost two weeks and she shows no signs of improvement they doubt she has much chance to breath on her own. Also, she is older, has cancer and has other issues like Lime disease and has had C-difficile.
They are pressuring us to do an immediate tracheostomy.
They say the longer we keep the tube in as is, the more risk for infection.
They want to do a tracheostomy and at this point, they tell us, there are few alternatives. They say with the tracheostomy, she’d be more comfortable and might be able to speak after rehab and it is much less risk of infection. They also say a tracheostomy is low risk surgery.
But where she’d go after is an issue as there is only one or two places in the state that take people on breathing machines. We do not want her out of the state and we are afraid she will get very depressed. She still might as she is getting impatient and trying to talk.
She could possibly come home, but would require 24 hour care with ICU nurses and could cost as quarter million dollars a year at least. Doctors told us “only very rich people” can do that.
She knows nothing, yet she is trying to talk and getting frustrated.
My mom is 78 and she didn’t have Chemotherapy treatment. She was not a candidate for the Chemo so she had Opdivo instead. Unfortunately, it had side effects and that’s one of the reasons she got so weak. She developed C-Def, Colitis and bruising. They had to stop the Opdivo.
Her cancer has not spread and I think it’s stage 2A. It is a small tumour and the Opdivo did shrink it. The hospital told us to treat the cancer as a secondary issue right now.
Her other medical conditions include Chronic Fatigue, Lyme Disease and Spinal stenosis. She was originally admitted to the hospital for the Flu which she got over.
She was doing well when her blood pressure dropped. Her stomach blew up and rapid breathing started. She’s been on the breathing tube as I mentioned about 10 or 11 days and pressure is stabile and she is awake and alert.
I don’t know what to do, I feel hopeless, on the one hand we are lucky because we have her and she is alert and the tumour has not grown we just found out.
On the other hand, I am afraid my mom will freak out at hearing she may have to go to another facility. I’m worried she will get worse and the hospital seemed to be rushing us. They said the longer she does nothing the more the risks of a “catastrophic event”.
I so want her to breath on her own, every day they try her and every day she can only do few minutes. I would welcome any advice you have about anything I have told you.
thank you for making contact, detailing your Mom’s situation and also for using my 1:1 phone/Skype counselling, consulting and advocacy service, I very much appreciate it.
I’m very sorry to hear your Mom is in such a difficult situation.
I have seen many Patients over the years in Intensive Care struggling with breathing when lung cancer is getting progressively worse and then Patients often end up in Intensive Care on the ventilator with a breathing tube.
Furthermore the Opdivo most likely made your Mom worse and that’s how she became weak and ended up with an infection leading to her drop in blood pressure and leading to her ICU admission!
I’m very pleased to hear that you didn’t buy into the negativity of the Intensive Care team and that “Pulling the plug” was not an option for you and your family.
- 5 POWERFUL THINGS YOU NEED TO DO IF THE INTENSIVE CARE TEAM IS NEGATIVE WHEN YOUR LOVED ONE IS CRITICALLY ILL IN INTENSIVE CARE!
Whilst I’m supportive of a tracheostomy for the right Patients at the right time, there are a number of issues you need to be aware of when it comes to a tracheostomy for your Mom.
- A tracheostomy in Intensive Care in most Hospitals in the USA can be a vehicle to discharge Patients into Long-term acute care(LTAC), rather than focusing on weaning Patients off the ventilator in Intensive Care. From my experience, any Intensive Care Unit is much better equipped to wean Patients off the ventilator and the tracheostomy than an LTAC. Unfortunately, Intensive Care beds tend to be in such high demand that a tracheostomy is being done on some Patients to empty their ICU beds quickly and send Patients to LTAC without informing Patients and families about the implications, drawbacks etc…
In some cases I have seen Patients being discharged to LTAC within less than 48 hours after they have had a tracheostomy, without Patients and families being informed what it actually means.
The term “Long-term acute care” facility implies “long-term care” and I know from experience that LTAC’s are not as skilled in weaning a Patient off the ventilator and the tracheostomy than an Intensive Care unit!
Also, in your mother’s situation I understand that there is no LTAC in your state, therefore sending your mother to another state with potentially no or limited family support is highly unethical and of course your mother would get depressed if you and your Dad wouldn’t be around.
Therefore, the first issue you need to look at is if the Intensive Care Unit has maximized their efforts to avoid the tracheostomy in the first place and if they tried to get your mother off the ventilator, off the breathing tube and extubate her.
Many Intensive Care Units do not openly share when and why a tracheostomy needs to be done and unless you have
- Done your research when and why to do a tracheostomy
- Making sure the Intensive Care team has absolutely maximized their efforts to get your critically ill loved one off the ventilator(breathing machine) and the breathing tube in the first place you should not give consent if you are the Medical power of attorney(MPOA) or Next of Kin(NOK) for your loved one
Here is how you can make an informed decision, have peace of mind, control, power and influence when it comes to getting your mother off the ventilator and the breathing tube
To look into doing a tracheostomy or not, please look at the following articles and videos
Furthermore, do not respond to the pressure the Intensive Care team is putting on to you and your family to agree to a tracheostomy unless they have absolutely maximized all the efforts to get your mother off the ventilator and the breathing tube in the first place.
There is a very good chance that as soon as your mother does have a tracheostomy she will end up in LTAC.
LTAC, once again stands for “long-term acute care” and it implies “long-term care”. You don’t want “long-term care” but you want short term recovery if possible at all.
Unless you start asking the right questions and you don’t respond to their pressure but use your own pressure to push back on the Intensive Care team, they will do whatever they do with 99% of the families of critically ill Patients in Intensive Care who make no informed decisions, have no peace of mind, no control, no power and no influence!
You have taken the first step already by not agreeing to “pulling the plug” or “withdraw treatment” and good for you standing your ground!
And if you are reading this and you are in a similar situation and you feel pressure to agree to a “withdrawal of treatment” or “pulling the plug” or if you have already agreed to it and you now have second thoughts please contact us immediately or have a look at this highly valuable resource here
- THE 5 THINGS YOU NEED TO KNOW IF THE MEDICAL TEAM IN INTENSIVE CARE WANTS TO“LIMIT TREATMENT”, WANTS TO “WITHDRAW TREATMENT”, “WITHDRAW LIFE SUPPORT” OR WANTS TO ISSUE A “DNR” (DO NOT RESUSCITATE) OR “NFR” (NOT FOR RESUSCITATION) ORDER FOR YOUR CRITICALLY ILL LOVED ONE!
Critically ill Patients in Intensive Care need time to recover and Intensive Care teams are often not prepared to give critically ill Patients the time and resources they need to recover.
And unless you start asking the right questions and unless you start applying the right tactics and strategies, chances are that Intensive Care teams will start walking all over you without you even realizing that it’s happening or you only realize it when it’s too late!
Therefore start asking better questions and apply strategies that I teach and that are proven to work!
Next, if your mother will need a tracheostomy and can’t come off the ventilator you should definitely look into home care as a genuine alternative to a long-term stay in Intensive Care.
For example a service like INTENSIVE CARE AT HOME is providing a genuine alternative to a long-term stay in Intensive Care for ventilated adults & children with tracheostomies.
It’s simply not true to say that only rich people can be looked after at home instead of Intensive Care.
The way it works is as follows.
An Intensive Care bed costs $5,000-$6,000 per bed day and it’s a bed that is very expensive, it’s a bed that’s precious and in-demand!
INTENSIVE CARE AT HOME on the other hand is providing a home care solution for half of the cost and Patients and their families can be in an environment where they want to be.
Therefore it’s a win-win situation. Therefore funding is often available from health insurances because they are saving hundreds of thousands of Dollars and Intensive Care Units can free up their precious and in-demand ICU beds!
I know you want to have your mother breathing on her own and if she can’t breathe on her own after about two weeks, she may need the tracheostomy!
Keep referring back to the articles and videos and then we’ll get on the phone again and discuss the next steps.
How can you become the best advocate for your critically ill loved one, make informed decisions, get peace of mind, control, power and influence quickly, whilst your loved one is critically ill in Intensive Care?
You get to that all important feeling of making informed decisions, get PEACE OF MIND, CONTROL, POWER AND INFLUENCE when you download your FREE “INSTANT IMPACT” report NOW by entering your email below!
In Your FREE “INSTANT IMPACT” report you’ll learn quickly how to make informed decisions, get PEACE OF MIND, real power and real control and how you can influence decision making fast, whilst your loved one is critically ill in Intensive Care! Your FREE “INSTANT IMPACT” Report gives you in-depth insight that you must know whilst your loved one is critically ill or is even dying in Intensive Care!
Sign up and download your FREE “INSTANT IMPACT” REPORT now by entering your email below! In your FREE “INSTANT IMPACT” REPORT you’ll learn how to speak the “secret” Intensive Care language so that the doctors and the nurses know straight away that you are an insider and that you know and understand what’s really happening in Intensive Care! In your FREE report you’ll also discover
- How to ask the doctors and the nurses the right questions
- Discover the many competing interests in Intensive Care and how your critically ill loved one’s treatment may depend on those competing interests
- How to eliminate fear, frustration, stress, struggle and vulnerability even if your loved one is dying
- 5 mind blowing tips& strategies helping you to get on the right path to making informed decisions, get PEACE OF MIND, control, power and influence in your situation
- You’ll get real world examples that you can easily adapt to your and your critically ill loved one’s situation
- How to stop being intimidated by the Intensive Care team and how you will be seen as equals
- You’ll get crucial ‘behind the scenes’ insight so that you know and understand what is really happening in Intensive Care
- How you need to manage doctors and nurses in Intensive Care (it’s not what you think)
Thank you for tuning into this week’s YOUR QUESTIONS ANSWERED episode and I’ll see you again in another update next week!
Or you can call us! Find phone numbers on our contact tab.
Also check out our Ebook section where you get more Ebooks, Videos and Audio recordings and where you can also get 1:1 counselling/consulting with me via Skype, over the phone or via email by clicking on the products tab!
This is Patrik Hutzel from INTENSIVECAREHOTLINE.COM and I’ll see you again next week with another update!
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