Serious question completely unrelated to guns

[Glock23]

The situation:

Someone is severely injured in an accident. Depressed skull fracture, compound fracture of the left femur (resulting in an above-the-knee amputation during surgery), fractured right arm, fractured right ankle, fractured C7 vertebrae, and a fractured eye socket.

She's on a ventilator (and unconscious) for over a week, as she's too weak to effectively breathe on her own. And a few days after the accident, she suffered a stroke which all but halted any movement on her right side.

It's now day 11 after the accident. She's breathing pretty much on her own, though occasionally needs help from the ventilator, and is on a feeding tube.

She's no longer on any kind of sedation and, while no longer technically unconscious, she's also not technically "awake." She will respond to voice and touch, and even open her eyes, but it's like there's no one there... the eyes never move, and stare off in a fixed position to the left. No response to commands, such as squeeze my hand, follow my finger, etc.

She has both a DNR (do not resuscitate) order and a living will. The DNR doesn't apply, as she never technically died. The living will states that she does not wish to be kept alive from an injury that would result in death, simply for the purpose of postponing that death.

Given the situation, while she is breathing on her own, it's looking more and more like she may never fully regain consciousness. And while her injuries technically did not kill her, there is a strong possibility that the feeding tube will be a permanent requirement to keep her alive; hence, she would likely die without at least some form of life support.

The question:

What would you do?

[jeepster09]

I wouldn't rush into anything.

[skiflydive]

Tough spot. I've been there too. My condolences. We told them not to use the ventilator, because that was resuscitation. He passed peacefully. Only good memories now.

[CPO15]

If you have a family doctor, ask them to review the situation and advise you. With both my parents, who died under hospital treatment, the attending doctors and nurses found it not possible to be straight with my family. My father's GP did play straight with us as Dad was passing and the MDs in my wife's office told her my Mom was a goner a week before we unplugged her.

My sympathies, please do not rush into a decision.

[TheTman]

I'd give her a month or 2 months or whatever is decided, and if she hasn't improved I'd probably remove the feeding tube. I wouldn't want to be stuck in between life and death like that. But I think she needs some time to see if she is going to make any progress. Dad had a DNR, and the damn hospital put him on machinery to keep him alive, so we said since they already did that, let's give him 2 or 3 weeks and see what happens. We ended up disconnecting the devices after the time passed and he slipped away.

[Bawanna]

A very tough spot indeed. I too would not want to be sustained in that condition.
I don't know what the options are legally.
I too would not rush into anything.
My grandfather many years ago for reasons I don't recall was put on life support for several weeks, all out of town family rallied to the hospital, all agreed he would not want to be kept alive, quality of life just not there.


All agreed to pull the life support. He rallied on his own and lived for another 3 or 4 years completely normally for a man of his advanced age.

Sometimes you just don't know. We'll hope for something good like that in this case.

[getsome]

Very sorry to hear of the accident and my condolences to you....A tramatic head/brain injury will require months not days and several Neuro CT scans the Neurologist will compare to see how the injury is healing....Her body has suffered major trauma and 11 days isn't nearly enough time to think about any long term decisions....

Brain injuries and stroke are strange animals no two are completely alike....I was a Paramedic for 12 years and saw some very severe head injuries that I thought were fatal but the patient survived and regained function so don't be discouraged since its only been 11 days...Prayers go out to you and your family...Keep the faith and do keep talking or reading to her as she probably can hear and recoginize familiar voices and that really does help....

[berettabone]

You have my sympathy............I would wait, and get some medical opinions, and then ask myself, if there is no real promise of recovery, what would she want? I think she already answered that question...........................

[pappy42]

I have a buddy who suffered a crushed cortex in a helicopter accident. He remained in a coma for months. He came out of it and rehabilitated to the point where he walks and speaks, albeit like a severe stroke victim.

Tough choice, get as many facts as you can from the medical folks; not dumbos like me.

Good luck and Godspeed.

[Ikeo74]

I have a DNR for myself. If I were in the same situation as your patient (wife), I would want the feeding tube removed. Death is not something to fear. There may be something better for us after death. That is what a DNR and "living will" are for. Don't feel guilty for making the call, no one will blame you for it.

[Glock23]

The call is not ultimately mine to make, though my opinion has been asked.

And to provide a bit more detail, it is not my wife... she's my step-mom.

She and dad were out riding their Tri-Glide weekend before last and were hit by a drunk driver. Dad was gone before he could be airlifted to a trauma unit.

She's been "awake" for several days now, but like I said, it seems like she's not really there anymore. And if she does ever really "cognitively" wake up, she'll be waking up to a missing left leg, a mostly paralyzed right side, an unknown amount of brain damage, and the news that her husband of 26 years is gone.

[getsome]

Sometimes there's just no words to say....I am so so sorry for the loss of your Father and the condition of your Step Mom.......You have many friends here feeling your pain....Prayers sent, God Bless you and your Family....Good Luck and God Speed in her recovery....

[Ikeo74]

It is important that you pass your opinion on to the one named to make the call. They may just be waiting for support to make the call from other relatives, like yourself. Let them know your decision so they can make their decision..

[addictedhealer]

Prayers to you and your family. Sorry for your loss.

[jocko]

you probalby know what needs to be done but what a tuff call to make. So sorry friend. This forum is behind u..

[Xdmac45]

Praying for you my friend.

[RevRay]

No one wants to be in your and your family's position right now, for there is no answer that is the right one. No matter what you do you will wonder if it was the right one for a good long while. Take some time and seek God's peace which He gives to anyone who asks. I will pray that all of you will receive the wisdom you need and the courage to act once you do. May God bless you all.

[Tinman507]

Echoing the good Rev's words. I am sorry for your loss and the situation you are in. God will give you the guidance to do the correct thing for your family.
Only you and He know what that is.
God bless you and your family.

[ltxi]

The call is not ultimately mine to make, though my opinion has been asked.

And to provide a bit more detail, it is not my wife... she's my step-mom.

She and dad were out riding their Tri-Glide weekend before last and were hit by a drunk driver. Dad was gone before he could be airlifted to a trauma unit.

She's been "awake" for several days now, but like I said, it seems like she's not really there anymore. And if she does ever really "cognitively" wake up, she'll be waking up to a missing left leg, a mostly paralyzed right side, an unknown amount of brain damage, and the news that her husband of 26 years is gone.


Knowing this added bit, my answer to your question is I would unhesitatingly pull the plug.

But that is me...and I'm not the least bit qualified to give actionable advice to anyone else in this situation.

I'm truly sorry for your loss. And that's not just cop speak. We lost someone close to us this past weekend so I'm kinda in that zone myself right now.

[GROTMAN]

You have my prayers as well. I work in a hospital and often see people in the ICU who often have to make the same decisions. Some people are at peace with letting someone go.. and others want to hang on as long as possible no matter how hard it it for the patient. I don't know if there is a right or wrong answer but take these guys advice and don't rush into anything. Make sure you and yours are in agreement with whatever course you take and that you can live with that decision.

[Ikeo74]

Actually the decision has already been made. It was made the day your step-mother prepared and signed the living will. By signing that document she has given her wishes and permission for no life support in case she can no longer live and have a normal life. That day is here, and the designated person only needs to convey her wishes to the hospital that is caring for her. Keep in mind, she did give her permission to administer no life support in case this event would happen, and it did happen. If the information is not given to the hospital, then they will do everything medically possible to keep her alive. Your step-mon doesn't want to live in the condition she is in now. She said that in the living will while she was of sound mind and body.
I am in my late 70's and have a living will. I would be mad as hell if my wishes were not carried out as I specified in the living will. You will only be following her instructions if life support is terminated. (It is her decision, no one else needs to be a decision maker.)

[Ol'coot]

Seek God's wisdom and guidance in prayer. And my prayers to you and your family I am truly sorry for your loss.

[ltxi]

Actually the decision has already been made. It was made the day your step-mother prepared and signed the living will. By signing that document she has given her wishes and permission for no life support in case she can no longer live and have a normal life. That day is here, and the designated person only needs to convey her wishes to the hospital that is caring for her. Keep in mind, she did give her permission to administer no life support in case this event would happen, and it did happen. If the information is not given to the hospital, then they will do everything medically possible to keep her alive. Your step-mon doesn't want to live in the condition she is in now. She said that in the living will while she was of sound mind and body.
I am in my late 70's and have a living will. I would be mad as hell if my wishes were not carried out as I specified in the living will. You will only be following her instructions if life support is terminated. (It is her decision, no one else needs to be a decision maker.)

This kind of response is most exactly why folk should not ask questions like this on the internet. No matter how bad they be hurtin'.

[Ikeo74]

This kind of moronic response is most exactly why folk should not ask questions like this on the internet. No matter how bad they be hurtin'.

These are facts wheather you agree or not.

[muggsy]

Where there is life there is hope. As long as there is brain activity I would take a wait and see attitude. If she is in an irreversible coma there is no reason to rush to a decision. Feeding tubes and ventilators are not considered life support.

[Dirty Harry]

Actually the decision has already been made. It was made the day your step-mother prepared and signed the living will. By signing that document she has given her wishes and permission for no life support in case she can no longer live and have a normal life. That day is here, and the designated person only needs to convey her wishes to the hospital that is caring for her. Keep in mind, she did give her permission to administer no life support in case this event would happen, and it did happen. If the information is not given to the hospital, then they will do everything medically possible to keep her alive. Your step-mon doesn't want to live in the condition she is in now. She said that in the living will while she was of sound mind and body.
I am in my late 70's and have a living will. I would be mad as hell if my wishes were not carried out as I specified in the living will. You will only be following her instructions if life support is terminated. (It is her decision, no one else needs to be a decision maker.)

I agree with this.

When my father past. Rest his soul. He didn't want an open casket. He didn't want people to see him like that. My mom understandably wanted an open casket so she could see him at peace and not the way we all saw him die in the ER. I was against it because that's not what he wanted, but I was the minority so it went the other way.

The person who wrote the living will did it for a reason. I feel it is the duty of whomever is in charge to carry out their wishes.

[yqtszhj]

Sorry for your loss. Over the last few years we went through this with my grandparents. The family knows what the patient would want and should go by what they know their wishes would be without thought of the family's personal thoughts or needs whatever that would be.

My Grandmothers both had "No life sustaining efforts are to be given" which included feeding tubes or IV's. As consolation my grandmother saw angles by her bed and was talking to her grandfather shortly before she passed. I was glad she didn't have to suffer any longer.

Tell your family there will be no suffering where they are going.

[olympicmotorcars]

I also echo what several others here have said. Pray and seek the Lord's wisdom, Life and death decisions should include his guidance. I will pray for your family also.

[b4uqzme]

Prayers for you and your family. I'm sure they will appreciate your support in whatever they decide.

[knkali]

Where there is life there is hope. As long as there is brain activity I would take a wait and see attitude. If she is in an irreversible coma there is no reason to rush to a decision. Feeding tubes and ventilators are not considered life support.

I agree but disagree. Where I disagree: Feeding tube and ventilators CAN BE life support. Life support is anything that is used to prevent death with some conditions. IOWs if the ventilator is used to aid respiration on a patient that can respire on their own so that energy is used for healing other injuries then it is not life support. If the ventilator is used for breathing because breathing on their own is impossible, then it is life support. If a feeding tube is used because the pt is unable to swallow due to injury but is expected to regain that function then it is not life support. After all, one would not deny a pt a feeding tube based on injuries to the mid/lower face that prevent eating but the swallow reflex is intact. If the injury is such that the swallow reflex is not intact and never will be then it is life support.

From the synopsis of her injuries, my first thought was what is her neurological state? The other listed injuries will heal. What needs to happen is a consult with her neurologist. Even if there is brain function, it has to be determined as to how much and from where in her brain. If she is mostly using her brain stem, then one should consider implementing her living will. Neurologic injuries are very difficult to pin down. People do recover from very serious ones while other never do. The neurologist can give some perspective of what to expect but usually time will tell on neurological injuries. Also, one has to consider her age and state of health pre accident when assessing recovery.

I know this is not a black or white answer but the situation is not based on the limited information presented.

I am sorry for your loss and what you are going through. Please let us know how things turn out.

[muggsy]

Ventilators and feeding tubes are only considered life support if there is no hope of recovery. They are not considered life support if they are only a temporary measure to aid in recovery. That's a legal definition, not mine.

[knkali]

Ventilators and feeding tubes are only considered life support if there is no hope of recovery. They are not considered life support if they are only a temporary measure to aid in recovery. That's a legal definition, not mine.

Uhmmm.....that is what I said--isn't it? We agree But..................

That is not what you said earlier. You simply said that ventilators and feeding tubes are not life support:"Where there is life there is hope. As long as there is brain activity I would take a wait and see attitude. If she is in an irreversible coma there is no reason to rush to a decision. Feeding tubes and ventilators are not considered life support"

I am out of this thread out of respect to the op. Our banter is not helping this thread

[Bawanna]

Out of respect for op and his situation I think we'll just close this one with prayers to provide him strength to do what needs to be done the way they see fit.