Tuesday, September 23, 2008

Sucky Ways To Die

I always thought of the many ways we destroy our bodies that liver failure would be the worst way to go. Yellow skin, yellow eyes, swollen belly, bleeding from every orfice, brain in shut down from over-abundance of ammonia, crapping every 15 minutes due to the meds to take said ammonia out of the system...yup a very sucky way to die.

I have revised my list to include total renal (kidney) failure. The kind where you have to have dialysis three times per week or swell up like a puffer fish and suffer agonizing pain all over and slow shut down of every system...most importantly...and not to be under-estimated your respiratory system.

I've had two patient's in less than than many weeks with basically the same thing. They both refuse dialysis...they know they are gonna die...but choose to live their last days without being hooked to the dialysis machine. That is their choice. My problem??? Doctors...who know the patient is in agonizing pain, can't breath because of the fluid overload and they want them to go for pointless and useless tests to tell them what they already know...duh...they are in kidney failure. Happened last week, Doc tells me to "convince" the patient to go for the CT Scan (humm, she is now 350# due to all the fluid, her legs are so heavy she can't move them, it is agony for us to just turn her to wash her bottom and back and the doc wants her to lay flat...transfer to a gurney...transfer ...still flat...to a tiny table that goes into the machine. Lie flat, possibly with her arms over her head...if they will go that high...then transfer back to the gurney, stay flat for the 15 minute trip back to her room and transfer back to her bed.) Now, if she survived all that "testing" just what good would it do? My answer to the doc. "Dude, she signed a DNR, She is wanting to go home with hospice, She is refusing hemodialysis...and this test is gonna help her, how?" "oh"...well he cancelled the test. She went home with her family by ambulance a couple of days later. I heard last night that she passed away, as expected, surrounded by her loving family.

Nuff said...I don't want liver failure or renal failure...


Aleta said...

Ok, the beginning of this post creeped me out, but then, death scares the daylights out of me too.

From a nurse's point of view, what can we do to prevent liver failure and total renal/kidney failure? What type of lifestyle do we need? What type of vitamins/foods/exercise - whatever, can we do to prevent this?

Debbie Y. said...

Why didn't she just leave the hospital? Would it have been AMA and her insurance wouldn't pay or what?

If I get told I am dying I just want to go home and die. I want the doctors to quit poking and prodding and let me go quietly.

My momma died of liver cancer and for four months she was given pain killers, but left alone as she requested after the first round of chemo. She was a very brave woman. I think she was better off dying of the liver cancer than getting worse with the lung cancer. I heard several patients go in the middle of the night gasping for air and it didn't sound pleasant.

GingerJar said...

Well the first one I had last week, refusing dialysis and all, her family were taking her home but afraid she would die in the ambulance...so they were basically paralized by fear, but they didn't want to put her in a nursing facility with hospice. They did finally take the poor woman home.

The one this week because a study in fustration for all of us. She didn't want to go home w/hospice because "I don't like those people", did not want to go to a nursing facility...and did not want to go home. Likewise did not want to sign DNR..but refused her medication, dialysis, tests, and basically everything except turning her and feeding her...a total waste of a PCCU room. Our hospital doesn't have extended care (in hospital rehab) and last night I was there she was refusing everything...so she was still too sick to send home...what do you do???

My dad was dying of cancer...he did the course of radiation, but refused chemo. He wanted to be able to fish until he died. He died peacefully at home, two days after going fishing in his wheelchair.