The Ranting Corner 2.0

[Minimalist]

I've been thinking a fair bit about end-of-life scenarios.

I think if I'm faced with months of debilitating chemo to prolong my life another six months or a  year,
I'd tell the doc "Load me up with pain med prescriptions and send me home."

Memorize the word "hospice."

[Chas]

My PCP (primary care physician) of 40 years had promised sufficient barbiturates to get the job done.
But he got late-onset Alzheimer's and retired . My next PCP I saw once or twice, then she died last summer.
I haven't met my new PCP but I will this Wednesday.

[Chas]

I've been thinking a fair bit about end-of-life scenarios.

I think if I'm faced with months of debilitating chemo to prolong my life another six months or a  year,
I'd tell the doc "Load me up with pain med prescriptions and send me home."

Is there a threat of that happening, Chas? Did I miss an important post? Oh dear.

My quality of life has deteriorated over the years and now I have a new batch of problems.  It's getting old.

Over the years I've watched several family members and friends go through the dying process. It was usually drawn out and ugly.

They got treatments which couldn't cure them, just give them a little more time. But that time wasn't pleasant.
I don't want that and I won't have that.

[Chas]

I've been thinking a fair bit about end-of-life scenarios.

I think if I'm faced with months of debilitating chemo to prolong my life another six months or a  year,
I'd tell the doc "Load me up with pain med prescriptions and send me home."

Memorize the word "hospice."

That's exactly what I don't want.

[Aliza]

Is there a threat of that happening, Chas? Did I miss an important post? Oh dear.

My quality of life has deteriorated over the years and now I have a new batch of problems.  It's getting old.

Over the years I've watched several family members and friends go through the dying process. It was usually drawn out and ugly.

They got treatments which couldn't cure them, just give them a little more time. But that time wasn't pleasant.
I don't want that and I won't have that.

I understand that. Know that you are cared about here, and we all want what's best for you. 

(And no one knows what's best for you more than you do.)

[Minimalist]

Memorize the word "hospice."

That's exactly what I don't want.

You can get hospice at home.  It's the palliative care which matters instead of dragging you into clinics to shoot you full of chemicals that may or may not do any good at all.

[brewerb]

That's exactly what I don't want.

You can get hospice at home.  It's the palliative care which matters instead of dragging you into clinics to shoot you full of chemicals that may or may not do any good at all.

That does not halt a lingering death. After watching dozens of hospice deaths I'm not going out that way if I still have the ability.

[no one]

Peacock aficionado:
(And no one knows what's best for you more than you do.)


I don't think I do.

[pattylt]

I’ve made loose future plans for the day my pains overwhelm me. I’m not there yet nor do I know how long it will be but, it’s my body and my choice. Why on earth anyone expects us to suffer until death is beyond me. How can anyone else judge my decision?

It’s one thing when there’s still youth or medical hope. It’s another when you’ve lived your life and can no longer do anything you want to do. Existence isn’t living.

When you’re ready, stop in and let us say goodby unless you’d prefer to just disappear. It’s your decision and I certainly won’t tell you not to.

[Fireball]

I've seen it up close and personal. My mother in law succumbed to Alzheimer's and dementia and was bedridden for about six years. She had a stroke and was then paralyzed on most of her right side, unconscious (more or less) but able to be spoon fed. That was the last two years of her life. Didn't know anything about what was going on. We were out of pocket for some, Medicare (?) paid for some, and we rented her house out. That was a big help. All that money I do not want to see wasted on maintaining my unconscious carcass, when it becomes my turn. I have a DNR on file with my medical insurers, and the wife won't take "no" for an answer, if she survives me.

[Chas]

That's exactly what I don't want.

You can get hospice at home.  It's the palliative care which matters instead of dragging you into clinics to shoot you full of chemicals that may or may not do any good at all.

Thanks, didn't know that.

[brewerb]

I've seen it up close and personal. My mother in law succumbed to Alzheimer's and dementia and was bedridden for about six years. She had a stroke and was then paralyzed on most of her right side, unconscious (more or less) but able to be spoon fed. That was the last two years of her life. Didn't know anything about what was going on. We were out of pocket for some, Medicare (?) paid for some, and we rented her house out. That was a big help. All that money I do not want to see wasted on maintaining my unconscious carcass, when it becomes my turn. I have a DNR on file with my medical insurers, and the wife won't take "no" for an answer, if she survives me.

I have a very specific living will but enforcement if/when I'm mentally incapacitated could be problamatic. As the time draws nearer I will probably have to place an attorney on retainer.

[Fireball]

I've seen it up close and personal. My mother in law succumbed to Alzheimer's and dementia and was bedridden for about six years. She had a stroke and was then paralyzed on most of her right side, unconscious (more or less) but able to be spoon fed. That was the last two years of her life. Didn't know anything about what was going on. We were out of pocket for some, Medicare (?) paid for some, and we rented her house out. That was a big help. All that money I do not want to see wasted on maintaining my unconscious carcass, when it becomes my turn. I have a DNR on file with my medical insurers, and the wife won't take "no" for an answer, if she survives me.

I have a very specific living will but enforcement if/when I'm mentally incapacitated could be problamatic. As the time draws nearer I will probably have to place an attorney on retainer.

Interesting. We already have attorneys on retainer. I probably should talk to them about enforcement.

[brewerb]

I have a very specific living will but enforcement if/when I'm mentally incapacitated could be problematic. As the time draws nearer I will probably have to place an attorney on retainer.

Interesting. We already have attorneys on retainer. I probably should talk to them about enforcement.

Guess I'll have to add the attorney's name/company as a required contact in my living will. While I trust my wife and son I'm not sure I completely trust a desperate and grieving wife and son.

[pattylt]

My daughter in law is dying of cancer. She is now DNR and has home hospice. If she gets, for example, a UTI, she would be treated with antibiotics but if she gets pneumonia, they will only treat the cough. She decides everything. Her DNR is taped to the refrigerator to be visible.

Soon, she will be hooked up to an IV to administer morphine, she is currently taking it orally. She’s completely bed ridden. The only issues are that she’s a very stubborn woman and doesn’t want hospice changing her diapers so, my son is now taking 12 week emergency family leave from work. He was exhausting himself trying to do so much of her care and will now insist that she allow the hospice nurse to help him. This is a case where her death will be a blessing. She’s been battling cancer for five years.

I would have ended my life before this point but, I’m not her.

[adey67]

You can get hospice at home.  It's the palliative care which matters instead of dragging you into clinics to shoot you full of chemicals that may or may not do any good at all.

That does not halt a lingering death. After watching dozens of hospice deaths I'm not going out that way if I still have the ability.

Yes it's a rather unfortunate myth that is still prevalent that hospice universally equates to good or less bad death and that's not necessarily the case although they do usually have a better handle on pain management and prescribing is less rigid than in a general medical setting.

[adey67]

My eczema is bad and frankly my face looks like I've been in a house fire, I picked up the prescribed emollients from the pharmacy after a 10 day wait but there's a crisis here in that literally dozens of basic medications including anti convulsants and other vital meds are currently unobtainable and one of those medications is hydrocortisone cream which I need really badly at the moment as I look like I have carbon monoxide poisoning.
Edit: Jesus as if things weren't bad enough now my haemorrhoids are playing up, the toilet bowl looks like the floor of an abbatoir.

[mordant]

My daughter in law is dying of cancer.  She is now DNR and has home hospice.  If she gets, for example, a UTI, she would be treated with antibiotics but if she gets pneumonia, they will only treat the cough.  She decides everything.  Her DNR is taped to the refrigerator to be visible.

Soon, she will be hooked up to an IV to administer morphine, she is currently taking it orally.  She’s completely bed ridden.  The only issues are that she’s a very stubborn woman and doesn’t want hospice changing her diapers so, my son is now taking 12 week emergency family leave from work.  He was exhausting himself trying to do so much of her care and will now insist that she allow the hospice nurse to help him.  This is a case where her death will be a blessing.  She’s been battling cancer for five years.

I would have ended my life before this point but, I’m not her.

I wonder what the practical limits of palliative care actually are. My wife and I have done volunteer work at hospice and it's hard to evaluate from that because so many people wait way too long to go into palliative care and by the time we saw them they were days from death anyway.

But my wife just went through two back-to-back total knee replacements over a 6 month period. She was on low-dose opioids for this period. Now it looks like she has kidney stones and maybe a kidney infection -- she gets a CAT scan in the morning to confirm. Read up on it and lo and behold, there's a pretty strong association between opioids and kidney stones that we weren't aware of. Of course her bowels mostly quit functioning and half the time she couldn't even pee during this period ... that part is better known.

I have no idea how someone gets on high doses of this crap and stays on it for years, given the side effects.

My guess is that hospice is pretty smart to generally have a requirement that you're expected to expire within about 6 months ... if they are going to put you on morphine and such, doing that for more than 6 months might kill you in its own right, from various knock-on effects.

[Fireball]

My youngest brother had laryngeal cancer and had surgery, chemo and radiation as treatment. For his post-operative opioid medications he had to use a laxative to get bowel movements.

Pattylt and Adey, I feel for your situations. Hopefully the medical community will come through for you both. 

[pattylt]

My daughter in law is dying of cancer.  She is now DNR and has home hospice.  If she gets, for example, a UTI, she would be treated with antibiotics but if she gets pneumonia, they will only treat the cough.  She decides everything.  Her DNR is taped to the refrigerator to be visible.

Soon, she will be hooked up to an IV to administer morphine, she is currently taking it orally.  She’s completely bed ridden.  The only issues are that she’s a very stubborn woman and doesn’t want hospice changing her diapers so, my son is now taking 12 week emergency family leave from work.  He was exhausting himself trying to do so much of her care and will now insist that she allow the hospice nurse to help him.  This is a case where her death will be a blessing.  She’s been battling cancer for five years.

I would have ended my life before this point but, I’m not her.

I wonder what the practical limits of palliative care actually are. My wife and I have done volunteer work at hospice and it's hard to evaluate from that because so many people wait way too long to go into palliative care and by the time we saw them they were days from death anyway.

But my wife just went through two back-to-back total knee replacements over a 6 month period. She was on low-dose opioids for this period. Now it looks like she has kidney stones and maybe a kidney infection -- she gets a CAT scan in the morning to confirm. Read up on it and lo and behold, there's a pretty strong association between opioids and kidney stones that we weren't aware of. Of course her bowels mostly quit functioning and half the time she couldn't even pee during this period ... that part is better known.

I have no idea how someone gets on high doses of this crap and stays on it for years, given the side effects.

My guess is that hospice is pretty smart to generally have a requirement that you're expected to expire within about 6 months ... if they are going to put you on morphine and such, doing that for more than 6 months might kill you in its own right, from various knock-on effects.

I’ve been on low dose opioids for years now.  Luckily, I have no problems with bowel movements and keep som Miralax handy if I do.  My daughter-in-law is on two daily meds to move her bowels because she on higher doses.  At some point, she will likely stop eating…that’s usually one of the final symptoms of their body shutting down and my sons been told that when (not if) that happens to not try to get her to eat.  She won’t be able to process the food. While she sleeps a lot, it’s not all day and she’s awake to watch TV, converse with people and her spirits are good most times.  She’s accepted that her end is near.  It’s the waiting that’s hard but we’ll support her throughout…it’s all we really can do.  She’s a feisty thing.

Thanks for letting me write about it.  It’s a tough subject and most of us really don’t like looking at our endings.

[Alan V]

Over-exposure to Donald Trump, Republicans, and theists has made me hate all of them for their dishonesty, hypocrisy, and self-righteousness. And I don't like to hate anyone.

[brewerb]

Over-exposure to Donald Trump, Republicans, and theists has made me hate all of them for their dishonesty, hypocrisy, and self-righteousness.  And I don't like to hate anyone.

Swallow it down, waaaay down. It'll come in handy later.

[Dānu]

It's not nice to hate.

[Alan V]

It's not nice to hate.

True, but dishonesty, hypocrisy, and self-righteousness are not nice either, and are, in fact, hateful forms of aggression against others.  So how does one fight them without becoming a part of the problems oneself?  It seems that over-exposure is not helpful, but neither is ignoring such problems.

Considering that I am a rather ordinary person with limited social wherewithal and even less interest in reforming people, the best I seem to be able to do is complain to others with semi-sympathetic ears.  And that's not much.

[SYZ]

One could agree with John Lydon...

"Anger is an energy!"

... or not?