Quick Tip for Families in ICU: I was Told by the ICU Team it’s in My Sister’s “Best Interest” to Stop Treatment & Let Her Die.

If you want to know how far a patient can progress in ICU who was supposedly meant to die, stay tuned. I’ve got news for you.

So, we’re currently working with a client who has their family member in ICU who was told that they would die and that it wouldn’t be “in their best interest” to survive, and that it’s cruel to continue treatment and that they should just let the patient die. The family objected to that and obviously wanted to have everything done for their family member.

Today, I will give an update on the progress of their family member. So, our client writes in,

“Yesterday’s report on my family member. I wasn’t able to go in to see my family member today, as I had an appointment out of town. I did talk with the registered nurse today, though. They had my family member in the cardiac chair and doing a spontaneous breathing trial from 9 a.m. to 1 p.m., and I spoke with the RN. My family member was back in bed as they became very restless in the chair but was still doing the breathing trial.

The RN said he was going to try putting my family member in the cardiac chair again later, after they had time to rest. My family member is opening eyes and tracking but not following any commands today just as yet. The RN said my family member was bringing up thick sputum and is still on antibiotics. The white cell count today is 17.3. Yesterday, it was 19.3. The sputum cultures that were taken yesterday are not back yet. I know they did one on Friday or Saturday when I was there, but the RN couldn’t find it.”

Now, keep in mind, this is, once again, a patient in ICU that came in with cardiac arrest, stroke, and pulmonary embolism.

The ICU team from the start said, “Well, it’s not in the interest of the patient to continue treatment because it would be cruel, and if the patient was to survive, they won’t have any quality of life, any future perceivable quality of life.”

Well, I’ve got news for you. If you start thinking for yourself and you keep getting a second opinion, and have someone that understands intensive care inside out, review the medical records, that’s when you can turn things around. You don’t buy into the narrative of intensive care teams that nowadays only want to empty their beds as quickly as possible, and they want to make decisions about who can live and who can die. Because there’s an element of population control. Then you can turn things around.

Our client and member continues,

“As advised by Patrik, I withdrew my consent for the PEG (Percutaneous Endoscopic Gastrostomy) surgery and have a few comments and concerns. I wrote an email to the social worker on Sunday asking her not to notify the proper people and to send me confirmation.

When I didn’t receive confirmation today, I found out she didn’t come in, and another social worker was replacing her. There are two new doctors assigned today for the week, and I left a message for one of them.

When I finally arrived home late afternoon, I still hadn’t heard from the doctor, so I contacted the interventional radiologist’s office and spoke with one of their doctors. I told her I was withdrawing my consent for the surgery for the PEG tube for my family member.

About an hour later, another doctor finally called me back, and I informed her of my decision. She asked me why, and I told her I had my reasons, I did care to discuss. She said, “How do you think your family member is going to get nutrition otherwise?” I said my family member could continue with the nasogastric tube. Of course, the doctor tried to convince me that wasn’t plausible. I told her I was aware that many people use a nasogastric tube for many months without an issue. She brought up infection, and they stopped up. I told her I didn’t care to debate with her and thanked her for calling me and I needed to go. Goodbye.

Within half an hour, another doctor called me wanting to know why.

Although I cancelled the surgery, there are a few things I would like you to weigh in on. Is it advisable to do this type of surgery on someone with a 17,000-plus white cell count on antibiotics, still waiting for blood cultures, and still recovering from pneumonia?

My family member didn’t have a temperature at the time I spoke with the RN, but my family member has been running at least a low-grade temperature, even on Tylenol, for quite some time. Are the risks of doing the surgery under these circumstances’ greater risks of morbidity or mortality? I did look for medical studies to back this up but couldn’t find anything specific for this type of surgery. Do you have any?

Does an interventional radiologist usually do this type of surgery?

I believe so. It’s either an interventional radiologist or a general surgeon.

A fifth-year resident said she would be doing it and had done a few dozen, and the other doctor had done hundreds. If a surgeon should be doing it, is it appropriate for a fifth-year resident to do the surgery with an interventional radiologist only in attendance? I’m asking because ghost surgery is a big problem in our country. I realize it’s quite possible an interventional radiologist can handle it all, but I’m not sure.

Thank you so much.”

So, a few things. I’ve talked about the mobilization part, which is what I have been saying for a long time. Patients in ICU need to be mobilized as quickly as possible. Any good ICU that I’ve worked at, we always mobilize patients early on with very good outcomes. Anyone who claims anything different has no idea. It is common sense that you can’t get better without mobilization. Imagine someone is tying you to a bed for weeks on end, you’d be deconditioned in no time.

So, is it a good idea to do surgery on someone with an infection? Absolutely not. Many surgeries have been cancelled because of infections. So, therefore, your sister should not have a PEG surgery, I will talk about why as well. I will attach to this video, in the written version of this book, a research paper, why a nasogastric tube is much safer than a PEG tube. There is plenty of research out there.

Like I’ve been saying here for the longest on my blog, PEG surgery for ICU patients is very unique to the United States. It doesn’t really happen in other countries, with the exception of someone who can never eat and drink again, does has a tracheostomy long-term, needs ventilation tracheostomy long-term, those are the exceptions to the rule, and they are few and far between.

In ICUs in other countries, nasogastric tubes are prevalent, and they do the job. You probably have a much higher infection risk doing a PEG tube surgery because it’s knife-to-skin. Someone is cutting a hole in the tummy. A nasogastric tube is none of that. It’s just a tube in the nose going into the stomach. Is there an infection risk? Yes, there is, but it’s much smaller infection risk compared to doing surgery for a PEG tube.

Another thing that I have been mentioning over and over again, in health care, a nasogastric tube in ICU in particular, gives the perception that it’s temporary and that the patient will be weaned off the ventilator, and they need to eat and drink again. That is the purpose of the nasogastric tube.

A PEG tube, I can assure you, gives the perception to healthcare professionals, doctors, nurses, RTs (respiratory therapists), that this person will never eat and drink again. No one will bother trying to get them to eat and drink again. Have a look around nursing homes, the people that can no longer eat and drink, they all have PEG tubes, no one bothers, unfortunately, to get them to eat and drink ever again.

Another thing to keep in mind is that PEG tube surgery, again, is a surgical procedure, and the hospital can charge for it, and probably you can charge for it with a lot of money. Whereas a nasogastric tube is a minor procedure; it’s not surgery, they just put in a tube, and they probably can’t charge a lot.

Like I said, once a patient has a PEG and a tracheostomy, the patient is prey for LTAC, and you don’t want them to move to an LTAC (long term acute care). You just don’t.

In terms of who should be doing the surgery? Like I said, a general surgeon, a gastric surgeon, radiologist. It’s not major surgery, it’s a quick surgery. There’s probably a number of people who could do it, but we strongly advise against it.

I’ve worked in critical care nursing for 25 years in three different countries, where I worked as a nurse manager for over 5 years, and have been consulting and advocating for families in intensive care since 2013 here at intensivecarehotline.com.

I can confidently, confidently say that we have saved many lives as part of our consulting and advocacy here at intensivecarehotline.com. You can verify that on our testimonial section when you go to intensivecarehotline.com, and you read our testimonials, and see what our clients say. You can also watch or listen to our intensivecarehotline.com podcast at intensivecarehotline.com, where we’ve done client interviews and they verify the work that we’ve done, including saving their loved ones’ lives.

We have helped hundreds and hundreds of members over the years here at intensivecarehotline.com. That’s why we created the membership for families of critically ill patients in intensive care. You can become a member if you go to intensivecarehotline.com, click on the membership link, or go to intensivecaresupport.org directly. In the membership, you have access to me and my team, 24 hours a day, in the membership area and via email, we answer all questions intensive care related.

In the membership, you also have exclusive access to 21 e-books and 21 videos that I’ve personally written and recorded. And with all the access to the resources, including to myself and my team, you will be in a position to make informed decisions, have peace of mind, control, power, and influence, making sure your loved one gets the best care and treatment always.

I also do one-on-one consulting and advocacy over the phone, Zoom, Skype, WhatsApp, whichever medium works best for you. I talk to you and your families directly. I handhold you through this once-in-a-lifetime situation that you simply cannot afford to get wrong. I also talk to doctors and nurses directly, on your behalf or with you, and I ask all the questions that you haven’t even considered asking but must be asked when you have a loved one critically ill in intensive care. I also represent you in family meetings with intensive care teams.

We also do medical record reviews in real time so that you can get a second opinion in real time. We also do medical record reviews after intensive care, if you have unanswered questions, if you need closure, or if you are suspecting medical negligence.

All of that, you get at intensivecarehotline.com. Call us on one of the numbers on the top of our website, or simply send us an email at [email protected] with your questions.

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Thank you so much for watching.

This is Patrik Hutzel from intensivecarehotline.com, and I will talk to you in a few days.

Take care for now.