stand4hope Posted June 22, 2004 Share Posted June 22, 2004 Hello everyone, I need some advice about my dad. I have two questions coming at the end of this post: 1. What do you think about withdrawing the life support, and 2. For any doctors or nurses online, what to expect as the CO2 builds. As most of you know, my dad has severe COPD and has been on ventilator/life support for several months and really hasn't been well. He is terminal, on a no-code, and getting comfort measures only. The last 2-3 weeks have been a roller coaster ride with up and down oxygen levels. They would set him on 100% oxygen (10 liters), his sats would go up to about 96%, then they would turn him down to 8 liters, and within 24 hours his sats would drop to mid to low 80s, he would be uncomfortable with respiratory distress and they would turn him back up to 10 and give him a morphine shot. Whoever the RT was that would turn him up would go home and the next RT shift would have to fight the low sats. It's really been a roller coaster ride. Last week I finally said ENOUGH and told them to just leave him on 10. Two RTs didn't agree with me, and three agreed. Well, when one of them turned him back down to 8 and it started all over again, I sent a letter to the doctor (yeah right - one doctor for 100+ patients and he only goes to the home once a week), the Director of Nursing, and all the staff in his unit and demanded they leave the ventilator set on 10. They complied. His sats held at 90 to 91 for several days, and then Sat. the bottom fell out. His sats dropped and held at 77% with none of the usual steps taken helping to bring it up. He was started on 10 mg. morphine every 6 hours, and his sats have held in the 81% to 84% range, only dipping into the high 70s when the morphine starts to wear off. Those are the facts. Here is what I'm dealing with. He is not comatose and he is not unconscious, but he is very close to both. He will open his eyes briefly, but just kind of stares without expression. Today, I did manage to get him to open his eyes, and I gave him a kiss and he kissed me back. However, he kept kissing even when my face wasn't there anymore. I would not say he is in a vegetative state, however, his quality of life is nada. They gave our dad a 50/50 chance of getting better if he agreed to go on the ventilator. He did get better with some of the other problems he had, but his lungs have gotten worse. My brother and I promised him that if he got real bad, we would withdraw the life support. I do have the living will and paperwork necessary to do that. What the doctors didn't tell us was that although he could voluntarily go on the life support, the Catholic hospital where he was and now the nursing home where he lives, will not withdraw life support. First of all, I don't even know if this is something I should consider yet or if I should just wait a few days and see what happens. If he slips into a coma, or if I decide to withdraw the life support, I have to get the nursing home doctor to agree, and he has to find a doctor that works at a county hospital to admit him to hospice. Of course, all of that involves transport, trauma, expense and Medicare. Here's the thing. If I don't withdraw life support, I feel like he is now set on "slow kill". Rather than the ventilator helping him, it is killing him because it is causing a building of carbon dioxide in his body. To make it even slower, the RT tonight told me that since he is no longer making any effort (the machine is doing it all - 100% oxygen and 16 breaths a minute), the machine will do an even BETTER job of blowing off some of the carbon dioxide. In other words, slowing down the whole process of natural death. I know this is a heavy-weighted post and difficult to approach. My feelings will not be hurt if not even one of you replies, but I feel better just getting all my thoughts on paper. I am also hoping that maybe one of the nurses or a doctor could tell me what to expect at this stage with the CO2 situation. I'm going to send this link to my brother to follow your comments as well. We are the oldest and will be the ones to influence our younger sisters on our decision. Any help anyone can give is more than appreciated. I apologize that I haven't responded to a few PMs or answered any threads the past couple of days, but I've been spending most of my time with my dad. I did catch up on reading everything tonight, though, so I will get some responses to all of you as soon as I can. Much love and thanks to everyone, Peggy Quote Link to comment Share on other sites More sharing options...
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