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 the next question from one of my clients Emma and the question in the last episode was
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 continue answering the next question from one of my clients Emma, which are excerpts from 1:1 phone and email counselling and consulting sessions with me and the question this week is
My sister is in ICU on a balloon pump and ventilated after cardiac surgery! The ICU doctors want to stop treatment against our wishes and let her die, what should we do? (PART 16)
You can also access previous episodes in this series of questions here PART1, PART2, PART 3, PART 4, PART 5, PART 6, PART 7, PART 8, PART 9, PART 10, PART 11, PART 12, PART 13, PART 14 and PART 15 by clicking on the relevant links.
In this series of 1:1 phone and email consulting and advocacy sessions with my client Emma you’ll get real in-depth knowledge about cardiac failure in Intensive Care, how it works, the treatment and therapy options, how to wean somebody off the ventilator and most importantly, you’ll discover how to not take “no” for an answer and get strong advocacy.
You’ll witness how I can lead Emma in going from the Intensive Care team trying to coerce her and her family to agree to a “withdrawal of treatment” as being “in the best interest” for her sister to challenge that and the Intensive Care team having to do everything within their power to safe her sister’s life and turning the dynamics upside down in Emma’s favour.
That’s what happens when you have the right advice from a professional who knows Intensive Care inside out and who knows how to manage the dynamics and who can take the fear away of being intimidated by the Intensive Care team!
Enjoy this consulting and advocacy session and use it to your advantage when you have a family member in Intensive Care!
Patrik: Hi Emma, it’s Patrik.
Patrik: How are things?
Patrik: Yeah, can you hear me?
Emma: I can hear you now.
Patrik: How have things been? I mean, the last email that I had from you was pretty positive, I think, overall.
Emma: Oh, good.
Patrik: Is that how you feel as well?
Emma: Well, I’m pretty much depending on you because I don’t know…
Patrik: What it means, yeah.
Emma: She looks good. She looks good.
Patrik: That’s good. You know it’s one thing to look at the numbers and it’s one thing to look the monitor but I mean the most important thing to me is, really what you say about your sister because you know her.
Patrik: Right. So, the numbers are important but the other thing that’s really important is, she’s obviously off the ventilator.
Patrik: She’s talking?
Patrik: She’s talking to you. Right, and she’s making sense?
Emma: Yes, she’s making sense but she knows who she is, her birthday, she knows she’s in the hospital but she can get that mixed up with… she thinks she’s at UTMB one day and the next day she says she’s at Methodist, which she’s at Methodist.
Patrik: Okay that’s fine. That’s nothing unusual, right. The main….
Patrik: Because after you induce a coma, patients are very confused, okay and when I say very confused I mean… that’s minor. What you’re describing is minor confusion.
Patrik: Would she, besides that, could she tell you what day of the week it is? Could she tell you the date and the months and the year? Can she do that?
Emma: I didn’t ask her that. Two days ago the nurse said she thought that Ronald Reagan was president but she knew that she at Methodist. She knew her name and what her birthday. So, I’ll ask her today when I get off work and go up there.
Patrik: Yeah, I mean, it’s not the end of the world if she mixes up the date and the president. It’s not the end of the world. The side effects from the medication, from the induced coma and the sedation, they do do that, sort of confusion and also keep in mind, she has a disturbed day and night rhythm because of noise, because of sleeping 24 hours a day in a induced coma. There’s no natural daylight in there I would imagine or minimal natural daylight. Is there natural daylight in there?
Emma: Well, she’s got… in her room there is a small window.
Patrik: Yeah, but…
Patrik: so not much?
Emma: Not much.
- THE 5 THINGS YOU NEED TO KNOW IF YOUR LOVED ONE IS CONFUSED, AGITATED AND DELIRIOUS IN INTENSIVE CARE!
Patrik: Okay, right but look the most important thing is she is off the ventilator, she’s talking and she’s breathing. That’s the most important thing for now.
Patrik: I’m very pleased to hear that they managed the wean down the Dobutamine, I mean, it’s not off but it’s down… because what’s important for you to understand about the Dobutamine… when the heart pumps, okay? The Dobutamine is increasing the pump function of the heart. That’s basically what the Dobutamine is doing, okay. The Norepinephrine is mainly increasing the blood pressure and is she still on the dialysis?
Emma: Yes, she’s on the continuous dialysis?
Patrik: Okay and do you know how much fluid they are removing there?
Emma: They didn’t tell me. I’ll ask.
Patrik: Just ask because depending on how aggressive they’re still removing, her blood pressure would be down. She may not necessarily get off the Norepinephrine in the next few days and I think it really depends on how aggressive they will be with fluid removal. What are they saying in terms of surgery? The latest that you’ve sent through was, you said that they’re very vague. Have you spoken to them again? Any more news there?
Emma: They’re still saying that they want her off the vasopressors and they’re not telling us anything else.
Patrik: Yeah, and look, I agree to an extent that she needs to be off the pressers before she has surgery. Generally speaking, I’d say yes. What are they doing? Are they doing physical therapy? Are they doing that now?
Emma: They were supposed to start physical therapy only yesterday. So, I’ll find out only today if they actually started it.
Patrik: So, you see the issue with the surgery, it’s high risk surgery, there’s no doubt about that. Patients need to be in the best shape they can be, right and that’s why I believe physical therapy is so important. So, since she’s been off the ventilator she has not been out of bed yet, as far as you are aware?
Emma: She has not been out bed yet.
Patrik: Right, okay. Is she starting to eat and drink?
Emma: They still have a tube in her nose and she’s getting this white liquid so…
Patrik: Okay, so, she’s not taking any… not even a sip of water? Nothing?
Emma: Well, they said that a couple of days ago she asked for ice and they gave her ice.
Patrik: Okay and have you seen that yourself? Have you seen them giving ice?
Emma: No, the nurse told that so…
Patrik: Look, even though she has the tube, I can’t see why they can’t start feeding her. The sooner she can go back to what I would refer to as ‘normal’ the better
Patrik: The more normality the better. Being critically ill in intensive care is a massive life event, right. No matter what the next steps are, the closer they can get her to normality the better it is. They need to get her out of bed. They need to sit her in a chair, need to do all the breathing exercises. To a degree I’m very pleased that she’s off the ventilator without the physical therapy. That’s an achievement. To a degree that’s great because it means that she is strong but on the other hand, it’s like anything in life, if you don’t practise you’re not getting better at it. In a situation like this, the physical therapy is important. With the surgery, who are you talking to? Are you still talking only to intensive care and not the cardiac surgeons?
Emma: Yeah, that’s the only one that I’ve been able to get a hold to. The doctor that was working in the ICU is the only doctor that has been there and they keep saying they’ll come in tomorrow, and they’re going to have a family meeting and talk about it. They’re hard to get a hold to.
Patrik: I actually think, now is the time where you or your brother-in-law need to ask for a family meeting and see how they react. I’ll tell you why. Number one; you want to engage them, and number two; as you might have seen in the beginning stages of all of this, meetings… when they ask for a family meeting, in my experience, eight times out of ten it’s to deliver bad news, okay. I guess, you want to be, in this case now… I think you want to ask for a family meeting and find out the next steps and see how they react and also try and hold them accountable. What do I mean by that? Try hold them accountable? Look, they… as you know, they have been telling you your sister will not survive without the intra-aortic ballon pump (IABP), right?
- “FOLLOW THIS ULTIMATE 6 STEP GUIDE FOR FAMILY MEETINGS WITH THE INTENSIVE CARE TEAM, THAT GETS YOU TO HAVE PEACE OF MIND, CONTROL, POWER AND INFLUENCE FAST, IF YOUR LOVED ONE IS CRITICALLY ILL IN INTENSIVE CARE!”
Emma: Mm-hmm (affirmative)
Patrik: Well, she’s proven them terribly wrong, which is great, okay. That’s number one. Number two; they have been trying to convince you to stop treatment, okay. Both of their predictions or both of their requests have been terribly wrong but could have potentially cost your sister’s life, okay. Your sister is here with you. She’s talking and she is now… she’s very close to becoming a candidate for potential life-saving surgery, okay. I wouldn’t… at this stage given that she’s come such a long way, I would really now on your end ask for a meeting and see what they say.
Patrik: I think now is the time. Also, keeping in mind that, no matter what they say, building her up for strength. Whether she is going for surgery or not, building her up for strength is going to be the next step no matter what they about surgery or not.
Patrik: You really want to hear a plan from them. Do you think…
Patrik: Do you think they have been… they have been strategic in terms of, getting her off the ventilator and they worked her up for that. It pretty much was, so I thought of… Almost was predicting it and could see it happening. That’s good. On the other hand, you really want to hear it from the horse’s mouth now and see what their strategy is.
- PEACE OF MIND, CONTROL, POWER AND INFLUENCE EVEN IN THE MOST CHALLENGING OF CIRCUMSTANCES THAT YOU, YOUR FAMILY AND YOUR CRITICALLY ILL LOVED ONE COULD POSSIBLY FACE IN INTENSIVE CARE!”
Patrik: How can she go? That’s the question you really want answered. How can she go from theocratically, not surviving without the intra-aortic ballon pump (IABP), now to becoming a candidate for open heart surgery within 10 days? How could that happen? How terribly… what’s the word… they’ve been terrible at reading the play.
Emma: Mm-hmm (affirmative)
Patrik: Haven’t they? I mean, Seriously?
Emma: Yeah, They have. They have
Patrik: So you really wanna know number one; why have they been so bad at reading the play and number two; now that she’s proven everybody wrong, what are the next steps?
Patrik: Now is the time to do that because now you have way more bargaining power than you had before.
Patrik: Look, I totally get how exhausted you must be. I get it and I can’t stress how important it is to look after yourself. You’re back at work and you’re trying to steer your sister’s recovery but you and need to look after yourself.
Patrik: Because you at the end of the day, you have no idea how long this is going on for. Just remind me, you are travelling 40 minutes one way to the hospital?
Emma: 40 minutes to an hour just depending on the traffic.
Patrik: Oh my goodness. So, given that you’re back at work, you’re basically going to the hospital after work.
Emma: My boss calls me in the office and then he told me, ‘I need to get my mind together,’ cause I’m kind of… yesterday I actually rested.
Patrik : Right, is your boss supportive?
Emma: Very supportive. Very supportive.
Patrik: Okay. Okay. What do you do for a living, if I may ask?
Emma: I don’t know how to describe it. I go check… and scheduling appointments and following up.
Patrik: So, admin work. Would that be fair to describe it?
Patrik: Right, okay. I would imagine with your scheduling, it’s a fairly stressful job too isn’t it?
Emma: Oh my God, it is like taking care of a baby…
Look out for the next consulting and advocacy session with Emma next week!
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!
- The 10 COMMANDMENTS for PEACE OF MIND, control, power and influence if your loved one is critically ill in Intensive Care
- What could be the cause if my critically ill loved one is removed from an induced coma but still hasn’t woken up?
- My 80 year old father is in Intensive Care with Myeloma! The Intensive Care team HAS ASKED ME TO SIGN A “DNR” AND I REFUSED! What are MY OPTIONS?
- The 3 most dangerous mistakes that you are making but you are unaware of, if your loved one is a critically ill Patient in Intensive Care
- The 5 questions you need to ask when the Intensive Care team is talking about “Futility of treatment”, “Withdrawal of life support” or about “Withdrawal of treatment”
- HOW TO STOP BEING HELD HOSTAGE BY THE INTENSIVE CARE TEAM if your loved one is critically ill in Intensive Care!
- 5 POWERFUL THINGS YOU NEED TO DO IF THE INTENSIVE CARE TEAM IS NEGATIVE WHEN YOUR LOVED ONE IS CRITICALLY ILL IN INTENSIVE CARE!
- My Mum has been diagnosed with STOMACH CANCER and is in ICU ventilated. CAN I TAKE HER HOME on a ventilator?
- The questions you need to ask the most senior doctor in Intensive Care, if your loved one is critically ill in Intensive Care
- How long does it take for my critically ill loved one to be taken off the ventilator and have their breathing tube/ endotracheal tube removed
- Why you must make up your own mind about your critically ill loved one’s situation in Intensive Care even if you’re not a doctor or a nurse!
- The ELEPHANT IN THE ROOM or HOW THE INTENSIVE CARE TEAM IS MAKING DECISIONS whilst your loved one is critically ill in Intensive Care!
- MY PARTNER IS IN INTENSIVE CARE ON A VENTILATOR! THE INTENSIVE CARE TEAM WANTS TO DO A TRACHEOSTOMY AND I WANT TO HAVE HIM EXTUBATED! WHAT DO I DO?
- 5 ways you are UNCONSCIOUSLY SABOTAGING yourself whilst your loved one is CRITICALLY ILL in Intensive Care and HOW TO STOP doing it!
- How to make sure that “what you see is always what you get” whilst your loved one is critically ill in Intensive Care
- 5 Ways to have control, power and influence while your loved one is critically ill in Intensive Care
- Family overjoyed as top court rules doctors must seek consent before taking a patient off life support
- How to make sure that your values and beliefs are known whilst your loved one is critically ill in Intensive Care
- My loved one has HIV, lymphoma on his brain, seizures, septic and is ventilated! The Intensive Care team is trying to TAKE MY HOPE AWAY and they are all NEGATIVE! HELP!
- MY PARTNER IS IN INTENSIVE CARE AFTER A BLEED ON A BRAIN! WE ARE WORRIED THAT THE INTENSIVE CARE TEAM WANTS TO SWITCH OFF THE VENTILATOR! HELP!
- HOW TO DEAL WITH A DIFFICULT INTENSIVE CARE TEAM, WHEN YOUR LOVED ONE IS CRITICALLY ILL IN INTENSIVE CARE!
- What the doctors and the nurses behaviour in Intensive Care is telling you about the culture in a unit
- How to take control if your loved one has a severe brain injury and is critically ill in Intensive Care
- How can I be prepared, be mentally strong and be well positioned for a Family meeting with the Intensive Care team?(PART 1)
- How can I be prepared, be mentally strong and be well positioned for a Family meeting with the Intensive Care team?(PART 2)
- The four DEADLY SINS that Families of critically ill Patients in Intensive Care CONSTANTLY MAKE, but they are UNAWARE OF!
- My HUSBAND had a HORRIBLE work accident and went into CARDIAC ARREST! Will he be PERMANENTLY DISABLED
- Why decision making in Intensive Care GOES WAY BEYOND your critically ill loved one’s DIAGNOSIS AND PROGNOSIS!
- The 4 ways you can overcome INSURMOUNTABLE OBSTACLES whilst your loved one is critically ill in Intensive Care!
- How to get PEACE OF MIND, more control, more power and influence if your critically ill loved one is DYING in Intensive Care!
- The 5 QUESTIONS you need to ask, if the Intensive Care team wants you to DONATE your loved one’s ORGANS in an END OF LIFE SITUATION!
- MY PARTNER IS IN INTENSIVE CARE ON A VENTILATOR! THE INTENSIVE CARE TEAM WANTS TO DO A TRACHEOSTOMY AND I WANT TO HAVE HIM EXTUBATED! WHAT DO I DO? (PART 1)
- How MEDICAL RESEARCH DOMINATES your critically ill loved one’s diagnosis and prognosis, as well as the CARE and TREATMENT your loved one IS RECEIVING or NOT RECEIVING
- WHAT WOULD YOU DO if you knew that you COULD NOT FAIL, whilst your loved one is critically ill in Intensive Care
- How the Intensive Care team is SKILFULLY PLAYING WITH YOUR EMOTIONS, if your loved one is critically ill in Intensive Care!
- My father is in Intensive Care ventilated with LIVER FAILURE and KIDNEY FAILURE, I DON’T THINK HE WILL SURVIVE! HELP
- HOW TO GIVE YOURSELF PERMISSION TO HAVE PEACE OF MIND, CONTROL, POWER AND INFLUENCE WHEN YOUR LOVED ONE IS CRITICALLY ILL IN INTENSIVE CARE!
- My father has been weaned off the ventilator in Intensive Care and still has the Tracheostomy in. When can the Tracheostomy be removed?