Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM where we instantly improve the lives for Families of critically ill Patients in Intensive Care, so that you can make informed decisions, 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!
This is another episode of “YOUR QUESTIONS ANSWERED“ and in last week’s episode I answered another question from our readers and the question was
The ICU Team Just Wanted To Empty Their Beds And Get Rid Of My Dad. Is This Medical Malpractice?
You can check out last week’s question by clicking on the link here.
In this week’s episode of “YOUR QUESTIONS ANSWERED“, I want to answer the questions from one of my clients Katie, as part of my 1:1
consulting and advocacy service, telling that her husband in ICU is doing better but the ICU team wants to withdraw treatment.
My Husband In The ICU Is Doing Better? Why Does The ICU Team push towards Withdrawal of Treatment?
Katie: Hello.
Patrik: Hi, it’s Patrik here from Intensive Care Hotline. How are you?
Katie: Yes, not too good.
Patrik: Right. So um…
Katie: My husband suffered cardiac arrest, about a week ago. He’s now had anatomic brain surgery and the Doctor is wanting me to pull his plug, which I do not agree to do, neither is his family.
Patrik: Right, are you the medical power of attorney for your husband?
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Katie: Yes, I am.
Patrik: How old is your husband?
Katie: He is 42.
Patrik: Oh, my goodness, 42.
Katie: Yes, Yes.
Patrik: Okay, alright. So what we will be doing is that I will be getting more of the information from you, what exactly happened. And then I will advise you, how I can help you? If I can help you, I do charge a few going forward. But I will inform you about that after all the details. And let you know how I can help you.
Katie: Would you mind, can you put everything into an email because I am kind of driving right now.
Patrik: Absolutely, I can send you the consulting options then in an email. But the next step is really tells me more about what exactly happened. So he had a cardiac arrest about a week ago?
Katie: Yes.
Patrik: And they are saying he has an anatomic brain injury.
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Katie: Correct. So we went to hypothermia. And then after that they revived him, but they say he has some movement. So then he say that he suffered cardiac arrest. His EEG shows seizure activity.
Patrik: His EEG shows seizure activity, does it?
Katie: Yes.
Patrik: Okay. Can you hear me?
Katie: Yes, I can hear you.
Patrik: There was some noise in the background. What about after they did a cat scan, a CT scan of the brain?
Katie: The CT scan showed normal, but the MRI showed that his brain is damaged.
Patrik: Say that again please, the MRI showed what?
Katie: The MRI showed that his brain is damaged, but two CT scans showed good. They say that is normal but the MRI showed that his brain got damaged, because not enough oxygen flowed to the brain after he had cardiac
arrest.
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Patrik: Okay, when did they do the MRI, when?
Katie: The MRI was done, I believe last Sunday, I think.
Patrik: Last Sunday, and have they done an MRI.
Katie: Yes, they have done another MRI. I think, maybe yesterday, on Friday.
Patrik: Okay, any changes between the first and they second MRI?
Katie: They are saying that no changes.
Patrik: No changes, okay.
Katie: Yeah.
Patrik: Is there a Neurologist involved?
Katie: Yes, there is a Neurologist.
Patrik: Okay, what about the heart, the cardiac arrest, is the heart recovering, do you know?
Katie: Yes, his heart is beating on his own right now.
Patrik: Okay.
Katie: And unlike many other patients I see, my husband is responding to my voice and he is crying every time I talk to him. So I do not give up the hope, that, they keep saying he is saying he is brain dead, I don’t think so.
Patrik: Okay.
Katie: Every time I come in, my daughter comes in, he cries.
Patrik: Have they done testing for brain dead?
Katie: They have done testing, what?
Patrik: Have they done testing for brain dead?
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Katie: Well, what they are saying is that he is not going to wake up.
Patrik: Well, there’s a big …
Katie: He doesn’t, they did not do the blood flow yet.
Patrik: Okay, there is no difference.
Katie: Because I did not want to do it.
Patrik: Right. Right, there is no correlation between not waking up and being brain dead. There is absolutely no correlation between the two.
Katie: Right, It’s been a lot and I think that you have it covered, but, the only thing is that on Monday, they had the results of the MRI, the first one. And on Tuesday right away, I asked what the doctor planned and suggestion for us, and right away, they said to pull his plug. And then the next day, they, you know they send a, not a social worker, but a..
Patrik: Pallative care?
Katie: Yes, then she kept on pushing me, pushing me, every day they come in and I told them, I believe in miracles. And I told them, do you guys celebrate Easter? Is there a reason why you guys not celebrate Easter? And then they’re just shocked. So I don’t know why you get pushed, because I believe in miracles and I want to have time for his brain to heal and some miracle to happen.
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Patrik: Yeah. So what is your biggest frustration you are feeling now? Is it the pressure from the hospital?
Katie: Yes. That’s what I am feeling every day. You know, this doctor comes in, no change, no change. But I think he is getting better every day. Today he actually opened his eyes.
Patrik: Good.
Katie: But they said no pupil reaction.
Patrik: No pupil reaction to light?
Katie: Yes.
Patrik: Right. So what do you think might happen if you don’t take action? What do you think might happen if you don’t get help?
Katie: Well they keep telling me, to either, they keep saying that his body is hurt badly and don’t put him through this pain. And I told them that is a strong guy, he’s a strong guy and I understand my husband, he’s not going to give up. And neither is our family. And so, they want us to pull the plug and right now he is on dialysis and his kidney doctor doesn’t want to do dialysis right now. Because they say there is no brain function, so there is not point of doing dialysis.
Patrik: Okay.
Katie: Which, you know, yeah, upsets me more.
Patrik: I can, I can imagine.
Katie: Because they are doing some tests, that they say that his blood is showing some carbon monoxide.
Patrik: Carbon dioxide. CO2.
Katie: Diazoxide, yeah. And I told them that is because they are not doing the dialysis. And then, they are like, “We can’t do that, because his blood pressure is dropping every time we draw blood.” I said, “I’ve seen it done before, you put a medication in there so his blood pressure goes up, so you can do dialysis, just two days ago. So why are you saying it’s not being done right now?”. “Oh your husband is not stable enough to do that” I said,
“He is, he is stable”
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Patrik: Right, right. Prior to his cardiac arrest, did your husband have any other significant medical issues, or previously fit and healthy?
Katie: He had kidney failure. And then when he feels it’s just he is in a lot of pain, he comes into the hospital, to get help, and then they say, they do some x-rays. They say that his heart has three vessels that are clogged up. So, they say they want to do a balloon test, to
see if they can fix that. And then the day that they did the balloon, which was two weeks ago on Monday, and they say that he has coronary disease, and that all his vessels were damaged so bad, that they cannot do the balloon. So they have to do the bypass surgery, which was scheduled for Friday, but he went into a cardiac arrest on Thursday at the hospital.
Patrik: Right, I see.
Katie: Inside the hospital.
Patrik: So that’s basically the story that was leading up to the situation.
Katie: Correct.
Patrik: Right, okay. So…
Katie: And then in here right now, they find some his lungs have pneumonia, which they already cleared that. Some mucus in his lungs..
Patrik: So he does have pneumonia,?
Katie: Yes, he did have pneumonia, he was in a coma, so he did have pneumonia.
Patrik: Right, okay, okay. So, what do you think would happen if you don’t take action, if you don’t get help, if you don’t challenge the assumption? What do you think would happen?
Katie: I don’t know. I just feel a lot of pressure, I don’t know.
Patrik: Right. What road blocks have you encountered in changing the sort of pre occupied sort of, pre occupied opinion of wanting to pull the plug? What road blocks have you encountered?
Katie: What do you mean?
Patrik: Yeah, so have you really challenged their presumptions? Have you really said,”Look I really don’t want that to happen, I want full treatment” Have you really challenged that?
Katie: Yes, I told them that, my whole family would like to keep him, even if he is going to be in vegetative state, he is going to be vegetative, I would still want to take care of him. So I would like to keep him like this. And they keep saying that, that, they know he is already in pain, why am I putting more pain on him.
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Patrik: Yeah, right. Are you aware of your rights in a situation like that?
Katie: No, I don’t….
Patrik: Right, and that’s where I can help you with, that’s exactly where I can help you with. So, basically where I can help you with their, it’s a variety of things. But your most pressing issue is that they, quote, unquote, that they want to pull the plug and that’s a terrible term.
Katie: Yes.
Patrik: You know that’s a terrible term, you know, that’s a terrible term.
Katie: Yes, and all his doctors are saying the same thing. “Oh, he’s not, you know any better, he’s not going to be better” And, I saw his conditions, he is better. To me he’s better.
Patrik: Yeah. So we don’t want to use the term, pulling the plug, because it it’s a terrible term. And we want to refer to the hospital
Katie: And the lady that does palliative care, palliative care you know, And I told her straight to her face, that you know, that we believe in God and that and you know what, only God has the power to take away a life or give a life, into this world. It’s not up to me, it’s not up to you and I’m not calling that, cause I don’t want, I’m not going to do that. And none of my family members are going to do that.
Patrik: Right.
Katie: And I told her straight to her face.
Patrik: Good.
Katie: And she still wants to come every day and she said he is in bad shape, there is no place in Minnesota that would accept him as, even if…
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Patrik: Right.
Katie: Even if, they want him on a ventilator. And that’s all wrong. I checked different places and they have it. I just have to contact them to see if they have the that for him.
Patrik: Right, right. You see the other thing that you don’t know at the moment. You also don’t know if that are giving him the best treatment they can. You know with them sort of trying to quote, unquote, sell you on a withdrawal of treatment. They might slowly already wind down treatment, so we got to work on that very quickly. You see the biggest problems for families in intensive care, in fact, you don’t know what
you don’t know. You know, you couldn’t look at the …
Katie: No, I already see the reaction, because after they subjected me to call back, then all they put in my husband’s room is trainers. So for like the intern, the Nurse…
Patrik: Oh, no, no, no, no, no.
Katie: It takes them a long time to come to the room, if we need something. This is the other thing that the oxygen level was at 80%, and that is in danger zone. And she comes out and calls him right away, cause she too is on an oxygen machine every day, so she knows. And she told him, you know, my brother, he like, needs oxygen. They like “No, that’s normal” And she said “No that’s not normal, 80% is not normal, 80% is the danger
zone.”
Patrik: Absolutely, and that’s, you know, this is the biggest problem, you know your getting a better understanding now about what’s happening, but you know, in intensive care the devil is in the detail. If you don’t have the specialised knowledge, they will not tell you the truth, you know. No, they don’t and that’s where you need advice, external advice, form like me, to find out what’s exactly happening. But more importantly you know we need to
stop them from withdrawing treatment. We need to make sure you can exercise your right. And number two, we need to make sure he’s getting best care and treatment. You know I can’t tell you how many families.
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Katie: An adequate treatment so that he can recover.
Patrik: Correct.
Katie: And not like they say.
Patrik: Correct. I can’t tell you how many families come to us when it’s too late. You know they came to use like, “If I have only known about a service like this, now my loved one is dead, you know, I know you could have helped me.” You know, so you, you’re not too late, we can do something about this, that’s the good news.
Katie: Okay.
Patrik: We can do something fast, for sure!
Katie: Okay, yeah, is the, if you can put up a proposal and I’ll talk to his family to tell them everything.
Patrik: Absolutely. So I ll tell you how I can help you. I know in your situation, I can help you over the phone very fast. Like, that will be sufficient to help you fast.
Katie: Maybe we do..
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Patrik: Absolutely. Absolutely, yeah, no, no, I understand, I understand. Let’s leave it there for now and let’s set up the next call for tomorrow, shall we? What time is good for you tomorrow?
Katie: Okay, thank you so much. Can we make it 10am Eastern standard time?
Patrik: Sure, no problem, let’s talk then!
Katie: Thank you talk then, bye-bye.
Patrik: Okay, thank you so much, all the best for now, talk tomorrow at 10am. Bye-bye.
The 1:1 consulting session will continue in next week’s episode.
Kind Regards
Patrik
