HOW TO GET AN UNFAIR ADVANTAGE whilst your loved one is critically ill in Intensive Care!& "YOUR QUESTIONS ANSWERED"

Published: Mon, 11/10/14

Hi, it's Patrik Hutzel from INTENSIVECAREHOTLINE.COM , where we INSTANTLY improve the lives of Families of critically ill Patients in Intensive Care, so that you can have PEACE OF MIND, real power, real control and so that you can influence decision making FAST, even if you're not a doctor or a nurse in Intensive Care!

In last week’s BLOG I’ve shown you PART 2 of

"How the Intensive Care team is SKILFULLY PLAYING WITH YOUR EMOTIONS, if your loved one is critically ill in Intensive Care! (PART 2)"

You can check out last week’s BLOG here!

In this week’s BLOG I want to show you

HOW TO GET AN UNFAIR ADVANTAGE whilst your loved one is critically ill in Intensive Care!

If your loved one is critically ill in Intensive Care, you and your family are facing some of your worst fears, some of your worst nightmares and in some instances you are facing your own as well as your loved one’s mortality.

It’s not a very nice place to be in and if you and your family are in a situation where you fear for the very health, for the very well-being and for the very life of your critically ill loved one, I can only encourage you to seek out for support and to do your own research.

Even if you come from a closely knit family, having a loved one critically ill in Intensive Care is a highly emotionally charged situation and even the strongest of families can easily reach their mental limits during this stressful, challenging, difficult and overwhelming situation where families of the critically ill tend to feel extremely vulnerable.

And it can also be a lonely road, having a loved one critically ill in Intensive Care. You all of a sudden realize that other people are in control, you experience a sense of loss, you realize that you can’t just carry on with your day to day life, you realize that something profound has changed in your life in an instant and you realize that if you don’t adapt and change your thinking, your behaviour and also how you look at the situation you will feel powerless, with no control, no influence and worst of all without PEACE OF MIND!

You also realize very quickly that if your critically ill loved one is either

very unstable and in a very critical condition
in a life threatening situation
in Intensive Care for long-term treatments and long-term stays
having a severe(traumatic) head or brain injury
THREATENED with an “NFR”(Not for resuscitation) or “DNR”(Do not resuscitate) order
In a situation where the Intensive Care team suggests a “withdrawal of treatment” or a “limitation of treatment” as being “in the best interest” of your critically ill loved one
approaching their end of life in Intensive Care

I can assure you that in more than 15 years Intensive Care nursing in three different countries and after I have literally worked with THOUSANDS of critically ill Patients and their Families that the challenges and difficulties you are currently experiencing and going through are real!

If you are like 99% of Families of critically ill Patients in Intensive Care who have no PEACE OF MIND, no power, no control and no influence, you just silently and passively let things happen to you, you “suck up” to the Intensive Care team, you don’t question, you just take everything for “FACE VALUE” the Intensive Care team is telling you and you basically don’t question.

The Intensive Care team is managing Families all day long and they are used to “doing it their way”

You are at a loss and looking for a solution in this dilemma and trying to get an advantage, let alone an unfair advantage is not even remotely on your radar.

The Intensive Care team is managing families of critically ill Patients all day long, 365 days a year and they are used to doing it and they are used to doing it “their way”.

They are positioned as the “experts” and they are positioned as the “perceived authority” with “perceived power”!

That’s how society and how the general public sees doctors and hospitals, so we have to admit that it was us who gave Intensive Care Doctors and hospitals their perceived power status.

You probably have already realised that you are in a unique and “ONCE IN A LIFETIME” situation and unique and “ONCE IN A LIFETIME” situations require unique and different responses.

Therefore it’s time to look at the solution of the problems at hand, it’s time to stop looking what 99% of other Families of critically ill Patients in Intensive Care are doing who have no PEACE OF MIND, no control, no power and no influence and it’s time to get an unfair advantage!

It’s time to stop putting up with the Intensive Care team talking over you and at you, rather than entering into a genuine dialogue
It’s time to stop putting up with the Intensive Care team being unavailable to you
and it’s time to stop putting up with the Intensive Care team talking to you in their medical and academic jargon rather than speaking to you in a language that you can understand

it’s time for you to get an unfair advantage whilst your loved one is critically ill in Intensive Care and it’s time for you to get PEACE OF MIND, control, power and influence!

It’s time for you to take matters into your own hands, it’s time for you to do your own research, it’s time for you to get a handle on what’s happening and it’s time for you that if your loved one is

very unstable and in a very critical condition
in a life threatening situation
in Intensive Care for long-term treatments and long-term stays
having a severe(traumatic) head or brain injury
THREATENED with an “NFR”(Not for resuscitation) or “DNR”(Do not resuscitate) order
In a situation where the Intensive Care team suggests a “withdrawal of treatment” or a “limitation of treatment” as being “in the best interest” of your critically ill loved one
approaching their end of life in Intensive Care

that you don’t stay at the mercy of the Intensive Care team, like 99% of Families of critically ill Patients in Intensive Care who have no PEACE OF MIND, no control, no power and no influence!

There are many competing interests in Intensive Care that you are unaware of

It’s time for you to realize that if you understand that the politics, the dynamics, the competing interests, the power play, the medical research interests, the intrigue, the psychology and the hidden agenda of the Intensive Care team, that they have a big influence in how the Intensive Care team is positioning your critically ill loved one’s prognosis and diagnosis.

It’s time for you to understand that “what you see in Intensive Care is not always what you get”!

It’s time for you to understand that what’s happening in Intensive Care “BEHIND THE SCENES” is often impacting on how the Intensive Care team positions your critically ill loved one’s prognosis and diagnosis.

Related articles:

The “Elephant in room” or how the Intensive Care team is making decisions whilst your loved one is critically ill in Intensive Care

The 3 things you didn’t know are happening “Behind the scenes” in Intensive Care but you must know if you want to have PEACE OF MIND, control, power and influence

Look at what other people are doing and do the complete opposite

The only way you can get an unfair advantage compared to other Families of critically ill Patients in Intensive care is by looking at what they are doing and do the complete opposite.

And the good news is that you can also get an unfair advantage when you are dealing with the Intensive Care team!

The good news is that the minute you get informed, you start doing your own research, the minute the Intensive Care team knows that you are not buying into their “perceived authority” ,into their “perceived power” and the minute the Intensive Care team knows that you are prepared to stand up for yourself and for your critically ill loved one, that’s the minute when things will change for you and for your family.

The minute you take a stand, the minute you change your body language, the minute you don’t “suck up” to the Intensive Care team and the minute you don’t put them on a “pedestal” (something 99% of Families of critically ill Patients in Intensive Care do with the result that the Intensive Care team is doing what they want anyway) that’s the minute when you know you have PEACE OF MIND, control, power and influence!

The Intensive Care team is not used dealing with powerful families

That’s also the minute the Intensive Care team realizes that they are dealing with a powerful family who’s not playing the game the Intensive Care team wants them to play.

That’s how you get an unfair advantage, by being different, by questioning things, by doing your own research and by not taking everything for “face value” the Intensive Care team is telling you!

Sincerely,

your friend

Patrik Hutzel

Also, check out our "YOUR QUESTIONS ANSWERED" section

where I answer all of YOUR questions

http://intensivecarehotline.com/category/questions/

This is another episode of “YOUR QUESTIONS ANSWERED” and in last week’s episode I answered another question from one of our readers and the question last week was

“My father is in ICU ventilated with LIVER FAILURE and KIDNEY FAILURE, I DON'T THINK HE WILL SURVIVE! HELP!”

You can check out the answer to last week’s question by clicking on the link here.

In this week’s episode of “YOUR QUESTIONS ANSWERED” I want to answer another question that we get quite frequently from our readers and in this week I want to answer

HOW LONG DO YOU NEED TO BE ON A

VENTILATOR AFTER A LUNG TRANSPLANT?

Lung transplants for critically ill Patients are rising in numbers across the world and more and more critically ill Patients receive a life saving lung transplantation.

The major reasons to receive a life saving lung transplantation are

chronic obstructive pulmonary disease(COPD), including emphysema
idiopathic pulmonary fibrosis
cystic fibrosis(cf)
idiopathic (formerly known as "primary") pulmonary hypertension
alpha 1-antitrypsin deficiency
replacing previously transplanted lungs that have since failed
other causes, including bronchiectasis and sarcoidosis

most lung transplantations that I have seen over the many years while working in Intensive Care are straightforward and if all goes well they stay ventilated for up to two days, get extubated(removal of the breathing tube) and then get ready to go on to the ward and then go on to rehabilitation.

Lung transplant Patients are often on a clinical pathway and have certain boxes ticked

Critically ill Patients after lung transplantations often go on a clinical pathway, which means that certain conditions and certain preselected boxes have to be ticked in order to assess the progress of your critically ill loved one after having received a lung transplant.

This means that their vital signs such as Heart rate, heart rhythm, blood pressure, temperature and also vital signs for ventilation such as spontaneous ventilation- as opposed to mechanical ventilation- adequate oxygen levels, as well as good ABG’s(arterial blood gases) need to be prevalent in order for a lung transplant Patient to recover so that they can be discharged from Intensive Care.

Furthermore other tests such as their blood results need to be in order as well.

So, overall, if all goes well and straightforward and if they follow the clinical pathway, most critically ill Patients after lung transplantation don’t stay in Intensive Care for much longer than a few days.

Lung transplantations are high risk procedures

However lung transplants come with high risks attached and it starts with the pre-selection of suitable Patients, it continues with finding the right lung donor and right lung recipient(i.e. Patient).

After the pre- selection has taken place and the surgery has been performed and the critically ill Patient has gone into ICU, the wheels are in motion and the goal is to always get them off the mechanical ventilation as quickly as possible and as I have pointed out the goal is to follow the clinical pathway and get them off the ventilator within the first 24-48 hours after surgery.

However, as I have mentioned, lung transplantations come with high risks attached and sometimes things don’t go as planned, the donor lungs may not be a “perfect match”, there may be some bleeding and also the critically ill Patient will end up with a fair amount of new medications, specific to the management of lung transplantations.

You can find out all about the procedure of lung transplants and the medications required here in our clinical pictures section

http://intensivecarehotline.com/clinical-pictures/lung-transplantation/

Sometimes, when the lung donor- lung recipient match isn’t 100% and if bleeding occurs, ECMO for lung failure as a bridge to spontaneous breathing may be required.

This can go hand in hand with prolonged mechanical ventilation and it can go hand in hand with a Tracheostomy.

Sometimes, even after a new set of donor lungs have been transplanted in a recipient Patient, things may not go all that well.

Sometimes lung transplant Patients end up ventilator dependent with Tracheostomy

Even after careful pre- selection and after matching the donor and recipient, things don’t go as planned and Patients end up on the ventilator with a Tracheostomy.

This is a less than desired outcome, because the goals after a lung transplantation is clearly to improve the quality of life for the Patients and their families.

After more than 15 years of Intensive Care nursing in three different countries and after I have worked with literally THOUSANDS of critically ill Patients and their Families, I have witnessed some lung transplant Patients who end up with rejection of the new donor lungs.

This sometimes happens in the first few days or weeks after a lung transplant so that Patients never really leave hospital or Intensive Care in the first place or it can happen anywhere between 6 Months and 5 years after a lung transplant from my experience.

In any case, whether the rejection occurs relatively quickly or whether it occurs after Patients have gone home and had an improved quality of life, the outcome appears to be the same from my experience.

The issues that those critically ill Patients are struggling with tend to be difficulties breathing, increased oxygen requirements often resulting in mechanical ventilator dependency, Tracheostomy and an inability to wean the Patients off the ventilator.

The Patients that I have witnessed over the many years working in Intensive Care who are in this situation often stay in Intensive Care ventilator dependent with a Tracheostomy for long periods of time with no or a limited quality of life.

The sad reality in those situations is that this slow process often inevitably results in the death of the Patient.

Sometimes Patients end up in ICU for up to 6 months on a ventilator

I have witnessed some lung transplant Patients to approach their end of life and ultimately die after a long 3-4 month struggle on a ventilator in a clinical, sterile and limiting Intensive Care environment.

I am not advocating to stop treatment earlier and I am also not opposing to stop treatment when critically ill Patients and their Families face the dilemma of being ventilator dependent with Tracheostomy with no quality of life in Intensive Care!

It depends on what the Patients and their Families want.

What I do however, is to strongly advocate for Patients after lung transplants who end up long-term ventilator dependent with Tracheostomy then would be the time to look for a suitable alternative, rather than keeping these Patients and their Families in a limiting and inhibiting Intensive Care environment!

Suitable and proven alternatives to a burdensome long-term stay in Intensive Care

A suitable and proven alternative in this situation would be Intensive Home Care.

For example in countries like Germany and Australia, Intensive Home Care nursing services for long-term ventilated Adults& Children with Tracheostomy have long proven their concepts to be a genuine alternative to a long-term stay in Intensive Care and to improve Patients and their Families quality of life and/or quality of end of life in a holistic and more Patient and family friendly home care environment.

Those services, like INTENSIVE CARE AT HOME (WWW.INTENSIVECAREATHOME.COM.AU ) are providing tailor made services for long-term ventilated Adults& Children with Tracheostomy as a genuine alternative to a long-term stay in Intensive Care!

They are also creating an opportunity for Families to stop spending day and night in Intensive Care in order to be with their critically ill loved one.

INTENSIVE CARE AT HOME services are generally focused to provide a win-win situation and focus on the best interest for the Patients and their Families who are faced with the dilemma of long-term ventilation with Tracheostomy in Intensive Care.

INTENSIVE CARE AT HOME services also focus on the needs of Intensive Care Units and hospitals who generally have a shortage of precious and expensive Intensive Care beds and they tend to always have admissions waiting for those Intensive Care beds.

INTENSIVE HOME CARE is providing a win-win situation!

By freeing up those precious and expensive Intensive Care beds by taking long-term ventilated Patients with Tracheostomies home, a win- win situation is achieved.

Furthermore, a stay in Intensive Care is extremely expensive with costs around $ 5,000 per bed day. Therefore, Intensive Home Care is more cost effective, Patients and their Families are in a non-inhibiting and more holistic home care environment and Intensive Care units, hospitals and health care funding agencies pay less.

Again, it’s a perfect win-win situation.

For more information about INTENSIVE CARE AT HOME check out WWW.INTENSIVECAREATHOME.COM.AU

For more information about long-term ventilation with Tracheostomy, you can also find more information here in these articles

I hope this article helps and sheds more light on ventilation requirements after lung transplants.

Sincerely, your friend

Patrik Hutzel

If you want your questions answered just hit reply to this email or email me at support@intensivecarehotline.com and I'll answer your questions!

You can also send through your stories and share them on our BLOG for our readers! Just email support@intensivecarehotline.com or leave a comment on our BLOG

Or if you want to be featured on our podcast with your story, just email me at support@intensivecarehotline.com

FREE Video Mini- Course out now!

If you are interested in more FREE education and information if your loved one is critically ill in Intensive Care, I have created a FREE mini- course

A BLUEPRINT for PEACE OF MIND, CONTROL, POWER& INFLUENCE whilst your loved one is critically ill in Intensive Care!

The FREE Video Mini- course consists of 4 short videos that will educate you quickly and succinctly how you can have PEACE OF MIND, control, power and influence whilst your loved one is critically ill in Intensive Care.

You can sign up and get your first FREE Video here

http://intensivecarehotline.com/free-mini-course/

Also, our cutting edge new information PRODUCT will be released soon! We are NOW finalizing our first cutting edge information PRODUCT that will help Families of critically ill Patients MASTER, take control, have power and influence in all of the most challenging situations in Intensive Care, even if their loved one is dying!

The information product will be an "IN-DEPTH" education product for Families of critically ill Patients in Intensive Care and a SHORTCUT for Families to have PEACE OF MIND, control, power& influence! The focus of the education product will be on PEACE OF MIND, control, power and influence during the following situations in Intensive Care

long-term stays in Intensive Care
end- of- life situations
Family meetings with the Intensive Care team
withdrawal of treatment situations and/or perceived medical futility
what to do if your critically ill loved one is THREATENED with an "NFR"(Not for resuscitation) or "DNR"(Do not resuscitate) order
severe head and brain injuries

The information product will be made available in Ebook, Video and Audio format so that our Customers can consume the information product in their chosen medium!

Keep your eyes on news and updates for our cutting edge new information PRODUCT!

The Ebooks, Videos and Audios will be a solution to the biggest and most challenging areas in Intensive Care for Families of critically ill Patients!

Our cutting edge new information PRODUCT is a shortcut to PEACE OF MIND, control, power and influence for Families of critically ill Patients in Intensive Care!

If you have any questions about our upcoming products or if you have any suggestions

please let me know at support@intensivecarehotline.com

Your Friend

Patrik Hutzel

Critical Care Nurse

Founder& Editor