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As the readers of this all know, access to ventilators is one of the key issues the medical system is facing. When Coronavirus got bad in China, the Chinese basically purchased all of the ventilators on the planet that were available, leaving all ventilator models on backorder. Then South Korea and Italy made orders. Then dozens of other countries. Because of the profit driven nature of our medical system and the shortsighted vision of the U.S. government, U.S. orders are at the very back of the queue. (Yay capitalism!) That is the main reason they want to flatten the curve--it's better to have a million Americans need a ventilator over an 18 month period than to have a million Americans need one over a 4-week period.

That out of the way, has anybody here had any personal experiences with ventilators? Have you ever been on one? Have you ever spent significant time with a loved one who was on one? Here is my story (it's quite depressing; don't read any further if illness or medical treatment freaks you out).

A few years ago, my mother was filling a bit ill, and out of an abundance of caution decided to go to a walk in clinic and have it checked out. She was in her early 70's and overall was in great shape for her age. The doctor at the clinic heard something in her lunges, and out of an abundance of caution sent her to the ER at the hospital. Out of an abundance of caution, Alta View Hospital in Sandy decided to admit her for overnight observation.

Her lunges got much worse with pneumonia, and they decided to put her on a ventilator for a day to give her lunges a chance to rest. But what did this mean, being put on a ventilator? It meant taking her to the intensive care unit, putting her into a medically induced comma, sticking a long, thick tube down her throat into the lunges, and then having the machine pump warm air into and out of her lunges. While being on a ventilator can save your life, being on it is traumatic to your long term health; the longer you are on one, the longer it takes to recover. The guidelines we were told was that every day you are on the ventilator extends your overall hospital stay by a week. For example, if you are on the ventilator for a day, you can expect the hospital stay to be extended by a week. If you are on the ventilator for a week, you can expect seven weeks in the hospital, at which point you'll probably be taking an oxygen tank home with you.

After 3 days, she didn't get better, and Alta View decided she needed to be transferred to a better facility. IHC has a regional hospital in Murray with an entire ICU dedicated to lung problems, so mom was air lifted from Sandy to Murray (5 miles?) to be with the specialists (When I told this story to my own doctor in Kansas City, she knew about IHC's specialized ICU for this and believed it to be among the very best in the world).

That is when I flew to Utah to spend some time with her. The IHC specialists cited research that says recovery time is reduced if ventilator patients are conscience rather than in a medically induced coma, so they woke mom up. When they did so, they literally tied Mom's hands to the bedrails so that she wouldn't rip the ventilator out of her throat. She felt like she couldn't breathe, like she was gagging, and like this intensive machine was hurting her. Having a long, thick tube going into her mouth and down her lunges made it impossible to talk, of course. They gave her some medications for the pain and to relax her, but they were looking for a sweet spot where she was relaxed yet conscience--that has the best results, according to the research.

To communicate, we had a card with the letters of the alphabet on it in boxes. She could point to letters to spell out what she wanted to say. She was often shaking and terrified so it was sometimes hard for her to point at letters in a clear, accurate way. But by pointing at these letters with her shaky hands, she asked for priesthood blessings. She told us that God had healed her. She asked me to read a story to her. But more than anything else, she begged us to let her die.

Having your hands tied to bedrails as you are gagging on a thick pipe shoved down your throat that breathed for you was exquisite torture. The minutes slowly ticked by. And the hours. And the days. After about a week of taking one step forward and two steps back, the doctors agreed to pull the plug. In one choreographed sequence of events over about 5 seconds, they pulled out this long, thick tube out right after they pumped her with drugs that took away the gag reflex, took away the pain, took away the sensation that she couldn't breathe.

Over the next 50 minutes, she lied there peacefully, breathing on her own. And on the monitor next to the bed, we watched the oxygen level in her blood continuously go down. And then she died.

My dad and I both decided to add to our living wills that we would rather die than be put on a ventilator.

That is my only experience with ventilators. Does anybody have any experiences with happy endings?

Analytics wrote:That is my only experience with ventilators. Does anybody have any experiences with happy endings?

I've seen a couple of people of ventilators: My brother, my best friend's daughter, and a good friend. My good friend was in a medically induced coma, and has little recollection of the ventilator. He survived. My best friend's daughter was on a ventilator as an infant. She survived.

My brother was on a ventilator at the end of his life after multiple organ failures. I remember watching him struggle against his ventilator, his eyes rolling, looking panicked. Looking back, the ventilator could very well have prolonged the suffering before his inevitable death.

So it's a hard call. I think there are times when ventilators can be life-saving, and other times where they are merely prolonging the suffering of someone.

MeDotOrg wrote:So it's a hard call. I think there are times when ventilators can be life-saving, and other times where they are merely prolonging the suffering of someone.

Exactly.

Knowing what you know, would you choose to go on a ventilator if the doctor recommended it?

In his memoir Travels, Michael Crichton recounts the following story in the context of explaining why he chose not to become a doctor after graduating from Harvard Medical School:

Dr. Z was a seventy-eight-year-old physician who entered the hospital in a near coma, in end-stage cardiac and renal failure. His son was also a physician, but not on the staff of the hospital, so he could only visit like any other relative, and he had nothing to say about his father’s care. He did, however, state that he wanted his father to die peacefully.

The old man was on the critical list for nearly a week. He had a cardiac arrest one night, but he was resuscitated. His son came in the next day and asked, with a certain delicacy, why the staff had resuscitated the old man. Nobody answered him.

Later that day, old Dr. Z suffered sudden massive congestive heart failure. The hospital staff was making rounds; they all rushed to his bedside. In a moment he was entirely surrounded by white-jacketed interns and residents, working on the old man, sticking needles and tubes into his body. In the midst of all this, he somehow emerged from his coma, sat bolt upright in bed, and shouted clearly and distinctly, “I refuse this therapy! I refuse this therapy!”

The residents pushed him back down. He got the therapy anyway. I turned to the attending physician, and asked how such a thing was possible. This man was, after all, a physician, and he was unquestionably dying—if not today, then tomorrow or the next day. Why had the house staff contradicted his wishes, and those of his family? Why was he not being allowed to die?

There was no good answer.

Dr. Z finally died on the weekend, when hospital staffing was light.

Crichton, Michael. Travels (pp. 63-64). Knopf Doubleday Publishing Group. Kindle Edition.

I'm not going to come back to this thread to discuss because the topic is very difficult for me. Yes, I have plenty of experience with a patient on a vent. My mother was intubated several times. She went into the hospital for the last time on my birthday (Mar 4) and died mid-April. I only scanned your post, Analytics, because I don't want to dwell but it looks like my experience matches what you wrote.

The communicating via writing messages and restraints included. Also including one night when I got a call from one of her nurses that her tubing somehow slipped out when they were turning her and did I want them to re-intubate her. (!!!!!!!!!)

There was a period of time when one day the doctor was in her room with me telling me to take her off the vent because she wasn't responsive and they felt like they were fighting a losing battle. I told them she was responsive to me. He didn't believe it. I asked him to step out of the room where he could hear through the door and see through the window. He left the room.

And there followed the last conversation I ever had with my mother.

I asked her "Ma, can you hear me?" She shook her head yes. "Do you understand what he was talking about?" Shook her head yes. "Do you want to do that, Ma?" She shook her head vigoroursly, NO. "Do you want to keep fighting?" Shook her head yes. "Ma, I promise I will make sure you have what you need until you can't tell me anymore, okay?" Shook her head yes.

When I walked out the doctor was in disbelief. He said she was saving her strength for me. I said maybe she's afraid to answer your questions in case you don't ask the right questions and she makes a mistake. I told him that this wasn't his battle and so long as she wanted to fight and could communicate with me, he was to supply her what she needed until I told him to stop. He consented.

During that time when she was still communicative, I brought in cassette recordings of music from the big band era and talked to her. When listening to the music, I would test her cognitive by asking her which band was playing and I intentionally made mistakes to see if she could correct me. One night I went over to file her nails and when I spoke to her she didn't respond. I kept talking, no response. I stopped filing her nails, stopped talking and sat there in silence and I cried because I knew she was leaving me.

I ended up keeping my promise to her. She slipped into a coma and I let her stay there for about a week until I came to terms with what I had to do. When I visited her I noticed how she was swelling and her skin weeping liquid. Prior to that decision I consulted with the hospital chaplain, our pastor back home and the doctor who treated her for at least a decade for her condition. They all steered me in the same direction and her specialist admitted that the last time she was intubated that he wasn't sure he could get her back.

I'm going to say religious stuff now. You can skip over it if you want. I'm giving you my heart and soul here, folks. Please treat this kindly.

There was a morning when I was planning to go to give the direction to remove life support. I locked myself in the bathroom and prayed and prayed hard. I asked God basically to please show me what to do because this was my only Ma and I was the only one who had to make the decision and if I were doing the wrong thing, please stop me somehow. Please show me. I needed to know I was doing right by her. It was a foggy, overcast morning in Washington state.

The night before I had called and told them I was coming and what I wanted to do.

When I walked on the floor of the ICU, the nurse caught me right away and told me not to go in there. I was just weeks from delivering my second child and everyone treated me like I was rolled in cotton even though I was soldiering my way through everything. I asked her why I couldn't see my mother. She said "She just started a seizure" I told her I needed to see and she allowed me to see my mother in a grand mal seizure. When I saw her little body (much like my own) shaking and seizing up and down on the bed with all those hoses and such attached to her, I walked out side with the nurse and told her "Laurie, take all the crap off her. I want it off."

We ended up having to call the doctor on speaker phone while he asked me a series of questions. I answered every one of them in the affirmative. My husband who was on a remote tour to Sicily at the time had come back twice because I needed help. He was there that day with me. Our older daughter was with the sitter we had arranged, a preschool mom.

Jersey Boy told me to to wait outside in the chapel and he would sit with Ma while they removed the life support equipment. So...I waddled down the hallway to the little chapel and just sat there on a chair praying. I noticed there was a large open Bible on a stand at the other end of the room. I went to it, closed it, and opened it and my eyes went directly to a verse I don't recall ever seeing before.

"They who wait upon the Lord shall renew their strength. They shall mount up with wings as eagles. They shall run and not be weary. And they shall walk and not faint"

Isaiah 40:31

That has become my life verse. It's my life verse right this very second. I only have one other verse that I rely on in crises second only to the above.

I sat there and prayed, and not long after that, JB came to get me. He had been gone about 30 minutes and he told me that her breathing was slowing. We walked back into the room and as soon as I walked in, my mother's heart stopped.

Jersey Boy wanted me to leave, I think he thought I would freak out. I told HIM to leave me alone with her and so he did what I told him. I sat there with Ma and talked to her for the last time (not really because I still talk to her). I kissed her and hugged her and stroked her hand and her hair. When I turned my head to look out the window, the sun was shining. I felt peaceful and blessed, and fully felt that I did right by my mother.

Yes, I have experience with a patient on a vent. I could easily in the coming weeks, have that same experience with a family member or the patient could easily be me. I'm not sure if I'd want a DNR or not. I'm sure I will be thinking about it. Do I want to be on a vent? No. Would I give permission to try it on me right now? Yes, I would. I don't mind trying being tortured for a period of time and trying to ride it out if it could possibly help me recover. If that were the case and I couldn't recover, my whole family knows my story about my mother, what I did, how I approached it, and what I ended up doing and why. They know everything about my views and everything about my story.

I didn't mean to write so much. Once I start going through the experience, I feel like I just have to tell the whole thing. I hope none of us are faced with this but sure as I'm sitting here, I know one of us will know at least one person who dies from this virus or it could be one of us. We all need to play the hand we're dealt as best we can. Remain faithful if you have faith and do your part to act on our individual social conscience.

Please don't copy this post if you reply to it. I more than likely will remove it later because I'll end up feeling like I put too much of me out there.

My LORD I never want to experience that. I’m glad you wrote that because now I know what I don’t want it.

- Doc

[hugs]Jersey Girl[/hugs]

Analytics wrote:[hugs]Jersey Girl[/hugs]

Thanks, friend. I had the baby 2.5 weeks later. JB had to return to Sicily when the baby was 9 days old. I set about single parenting two children while grieving, had to settle my mother's affairs long distance (I forged her signature on checks to pay her bills before she died so I only had the big estate stuff to deal with) and began the slow slide into post partum and situational depression. I also felt guilty because I couldn't have a funeral for my mother so it all crashed down on me. Baby was 2 months old when JB had to cut his tour short to come home because I was slowly becoming incredibly impaired in a way that I never had before in my life.

I lost myself and whole parts of my life for about 18 months. But when I came back up all I can say is that it all of that was a transforming experience and I sprouted my roots in advocacy on account of it.

my parents explicitly had in their wills no life-support of this or any kind, and to my surprise, when the end came proved that they really meant it. Apple doesn't fall far from the tree here, if I'm that far gone I'd rather just finish it. Some people are born survivors though, and really can deal with the bad prospects.

Analytics wrote:[hugs]Jersey Girl[/hugs]

Yeah, what he said. I can’t imagine. I’m glad you found something that gave you strength. I think we’re all going to need that for a while.

Res Ipsa wrote:

Analytics wrote:[hugs]Jersey Girl[/hugs]

Yeah, what he said. I can’t imagine. I’m glad you found something that gave you strength. I think we’re all going to need that for a while.

Thanks. What I wrote about might not be clear. My mother's home was in Jersey and we were stationed at McChord. JB got orders for a 1 year remote and she had come out to be my birth coach. She was so excited about that.

Some part of me likes to believe that she held my new baby before I ever did.

:-)