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Thursday, March 31, 2016

I Want To Revoke My "Do Not Resuscitate" Directive

This past week, I learned about the other side of "Do Not Resuscitate" directives.

The Background

An elderly relative of mine is 81 years old and not in good health.  Her bad health seems unfair because although she smoked when she was younger, she has always watched what she ate, was a very active and talented athlete and had (and still has) a positive outlook on life.  She's had some close encounters with death in the past few years, but 2016 has been particularly tough.  The main artery to her digestive system was blocked and when she ate, she often had very severe pains in her abdomen.  She had to be hospitalized.

Even with all the medication at the hospital, things got bad enough that she decided she could not live with the pain and agreed to angioplasty in her superior mesenteric artery.  Full anesthesia was not an option given her other medical conditions, so she opted for a local and twilight. Even with that precaution, she was aware that she might not survive the surgery.  But she wasn't ready to give up just yet.

The Decision

She had a DNR in place, but as she met with her daughters and doctors before the surgery, she said that she would feel better about the surgery if she could be assured that the medical team was going to do everything they could to keep her alive.  She has always been a fighter and she wanted her medical team to be fighters too.  So she temporarily revoked her DNR.

The Outcome

Though the surgeon said it was the most difficult case of this kind he'd ever encountered, she made it. The pain has diminished significantly and she is off of the morphine and dilaudid and is starting to eat again.  Though she will remain in poor health, she won't be bed-ridden and will still be able to share her love and time with her daughters, grandchildren, great grandchildren and friends. She is still with us and everyone who knows her is amazed at her fight and determination.  She is an inspiration.

What I Learned

Often, when we talk about making healthcare decisions in advance, we assume that the outcome will be a "Do Not Resuscitate" directive.  But it doesn't have to be.

An advanced healthcare decision could also result in a "Work Like Hell To Keep Me Alive" directive. And that's OK.  That might be entirely appropriate.  And having that as an option, even if it's for a limited time period, can make any discussions you have about this difficult subject much less emotional.  Whatever decision you make is fine, as long you actually make the decision and the decision is thoughtful and properly communicated.

The Veteran's Administration has a document that you can download for free that provides information and instructions on how to temporarily suspend a DNR order.  You can download that by clicking here.

April 16th is National Healthcare Decision Day.  We at SafelyFiled encourage you to make an advance decision and help those you love make their decisions too.

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