My 47 year old sister is in ICU with Pneumonia and the Intensive Care team wants to “pull the plug”! Help!

Published: Fri, 08/19/16

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 last week was

My Partner in Intensive Care after MVA with a head injury and he’s not waking up after 3 weeks (PART 2)

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 from one of our readers and the question this week is

My 47 year old sister is in ICU with Pneumonia and the Intensive Care team wants to “pull the plug”! Help!

This question from Bridget formed part of a 1:1 email counselling/consulting session with me!

Bridget writes

Hi Patrik,

my sister is in ICU in a medically induced coma and on a ventilator for Pneumonia.

She suffered a stroke back in April 2015, she has several issues with her heart, COPD, kidneys and she now has septic blood poison due to her Pneumonia!

She’s been in ICU for a week now and I know they want her daughter to agree to pull the plug on her on Monday when they all have this meeting with the doctors, the social worker and the family.

I know her daughter isn't going to agree to it but is there anything you can suggest question wise we can ask the doctors when they suggest to pull the plug on my sister?

She’s only 47 years old and when I was up in her room last week I know she heard us talking and when I left she had a tear coming from the corner of her eye, her rate of breathing would increase and such while we were there like she could hear us and everything.

I can't control what gods will is and if it's not his will then I want a say in it as well as does her daughter.

I’m looking forward to your response!

Thank you

Bridget

Hi Bridget,

thank you for your email and your question and thank you for using my 1:1 email counselling service.

I'm very sorry to hear what you and your family are currently experiencing with your sister’s predicament and potential withdrawal of life support situation in ICU.

I can guide you through this situation, just as I have successfully done with many other families in Intensive Care, as I am almost certain the Intensive Care team is trying to paint a "doom and gloom" scenario and a very negative picture for a number of reasons and they may withhold critical information to press their hidden agenda and get what they want! They often do this for a number of reasons, mainly due to what's happening "BEHIND THE SCENES"in Intensive Care.

What's happening "BEHIND THE SCENES" in Intensive Care and the insider knowledge that I can give you, is what stands between families of critically ill Patients in Intensive Care, getting what they want whilst making informed decisions, get PEACE OF MIND, control, power and influence!

Related:

THE 10 THINGS YOU DIDN’T KNOW ARE HAPPENING BEHIND THE SCENES IN INTENSIVE CARE THAT HOLD YOU BACK FROM HAVING PEACE OF MIND, CONTROL, POWER AND INFLUENCE, WHILST YOUR LOVED ONE IS CRITICALLY ILL IN INTENSIVE CARE!

The fact of the matter is that if you don't have the insider knowledge and you don't know what questions to ask and how to correctly position your sister's critical illness, correctly position your sister's diagnosis and prognosis, as well as her care and treatment you will almost always fight an uphill battle.

Intensive Care teams tend to be very shrewd and very adept in "selling" you of what they think might be "in the best interest" for your sister without telling you and your family what they've discussed internally and “behind the scenes” prior to talking to you and your family.

My first feeling is that at age 47, no matter the clinical challenges and clinical situation at hand, that a withdrawal of treatment and a limitation of treatment are not in the best interest for your sister. She is way too young to be given up on and one week in Intensive Care isn't very long, especially after Pneumonia and sepsis.

In fact sepsis can be a bi-product of a severe Pneumonia and needs to be treated with intravenous antibiotics, induced coma and mechanical ventilation accordingly.

I have answered many questions from my clients in similar situations and you can find many of those answers to questions from readers here.

In your sister’s situation the following is important for you to know.

Very rarely would I have experienced or heard of a “withdrawal of treatment” or a “limitation of treatment” for such a young person with a septic Pneumonia.

I understand that your sister has many health challenges and with her previous stroke, the Intensive Care team probably thinks or even wants to use it as a justification that your sister won’t have any perceived quality of life if she comes out of Intensive Care alive!

I get very frustrated when I hear stories and justifications like that, because it’s not for the Intensive Care team to judge what your sister’s perceived quality of life is going to be in the future, because they simply don’t know and neither can or should they make a judgement on it.

The Intensive Care team’s job is to give your sister the best care and treatment there is available for her and make sure she gets the best shot at life there is.

The fact of the matter is that despite the clinical challenges at hand, your sister is way too young to be given up on!

And yet, Intensive Care teams tend to be very quick in suggesting a “withdrawal of treatment” or a “limitation of treatment” as being “in the best interest” for critically ill Patients!

What they haven’t told you as well is that one week in ICU is not a very long time! Not for a Pneumonia anyway!

Related article/video:

HOW LONG IS MY LOVED ONE GOING TO STAY IN INTENSIVE CARE WITH PNEUMONIA?

Furthermore, you mentioned that your sister is in a medically induced coma, therefore she is in the right situation to have the septic Pneumonia treated.

If the intravenous antibiotics, the induced coma and the mechanical ventilation don’t help your sister’s Pneumonia, there are other treatment options that the Intensive Care team has but obviously hasn’t shared with you as yet. They keep their cards very close to their chest!

For any form of reversible respiratory failure- and clearly, a Pneumonia is a reversible form of respiratory failure, ECMO is a form of therapy that might help your sister.

The fact of the matter is that only few Intensive Care Units offer ECMO due to the specialisation it takes to offer this advanced form of therapy for respiratory failure.

It takes expert knowledge, specialised skills and many staffing as well as equipment resources to provide such ECMO treatment.

It’s a shame that the Intensive Care team hasn’t offered your family and your sister such treatment, which shows me that they are not upfront with you and your family about treatment options!

I’ve had a client recently whose 57 year old Dad was in ICU with Cardiomyopathy and they didn’t offer ECMO as well.

ECMO can be used for heart failure as well. My client’s Dad died without having been given the option in the first place because the ICU didn’t have ECMO as a therapy option available and they were reluctant to refer my Client’s Dad to another ICU!

ECMO is usually only available in the bigger Intensive Care Units.

Nevertheless, you, your sister’s daughter and the rest of your family need to be given the option to have her transferred to another ICU where ECMO is available as a treatment option.

Needless to say that not telling you and your family about these options and suggesting a “withdrawal of treatment” sounds highly inappropriate and negligent from my perspective.

Your mindset and your thinking make all the difference!

You also mention that you and your sister’s daughter “want to have a say” whether the Intensive Care team is “pulling the plug” or not.

The fact of the matter is that if you and your sister’s daughter think that you won’t have a say, you probably won’t!

This thinking and this mindset gets you right in the 99% bracket of families who don’t question, who are intimidated by the “perceived power” and the “perceived authority” by the Intensive Care team and therefore are not in a position to make informed decisions, get peace of mind, control, power and influence!

Chances are that if you and your sister's daughter think and believe that you will have a say in how to interpret and position your sister’s diagnosis, her prognosis, as well as her treatment and care options that you’ll have a very good chance to influence the outcome!

Therefore you and your sister’s daughter need to change your thinking and your mindset quickly that you will have a say in this!

Keep in mind, the Intensive Care team is just doing what they always do, they try and intimidate the families, especially when it comes to perceived end of life situations so that they can “withdraw treatment” let you sister die and get the next Patient in…

Related article/video:

The difference between “real” and “perceived” end of life situations when your loved one is critically ill in Intensive Care!

Therefore you and your family need to very quickly learn and understand that “what you see is not always what you get” in ICU.

There are just too many moving parts in Intensive Care, too many things that are happening “behind the scenes” that you need to quickly get an understanding about and then use to your advantage.

What’s happening “behind the scenes” in Intensive Care is what often determines how the Intensive Care team positions your critically ill loved one’s prognosis, their diagnosis, as well as their care and their treatment or lack of such.

Furthermore, before the Intensive Care team says that they think a “withdrawal of treatment” or a “limitation of treatment” might be “in the best interest” for your sister, they have probably also thought that you and your family may not challenge them and their positioning.

Therefore you and the rest of your family need to very quickly change your demeanour, your attitude and you probably need to become “difficult and demanding” very quickly, since time may be your enemy.

After all your sister’s life is at stake and she deserves just like any other Patient in Intensive Care the best care and treatment!

Further reading and resources: