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To: A CA Guy; Simplemines; Amos the Prophet; Mr. Silverback

Simplemines, I'd be sure that everyone does know your and your husband's occupations. Somedays, I think the media are more powerful than the lawyers. (Then I get on FR and remember that we have all the power, here.)

Second, insist on seeing the attending and tell him/her about the haunting. Skip the higher-up residents, they're probably the problem behind the problem, although it could be the attending.Someone's pushing the haunter.
Nevertheless, I would insist on seeing the supervising attending. Especially on Saturday and Sunday, you'll get more respect and action from the attending. Everyone else will step a little more lightly if you are certain and they know that the attending is aware that you are aware.

At the same time that you're asking for the attending, you need to get in touch with your husband's family doctor or internist, or his oncologist - whoever you feel was the "captain of the ship" before this admission.

I would sure like to know why there are plans for a tracheostomy if they plan to wean your husband off the ventilator. Why would he need an artificial airway, then? Also, I'd review with the oncologist what the prognosis after successful pancreatic cancer surgery - It would be rare for that to mean that there's no more cancer.

I'm afraid there are poorly trained doctors and some with a bad ethics base. But, think about doctors you've known in the past and the nurses who keep us straight. Does it really make sense that any of them would act to cause death or fail to act to delay it? That's just not how most of us are motivated.

Finally, CA Guy has a point worth thinking about. "Everything" these days can be pretty extreme, especially in light of pancreatic cancer and the usual progression. When your husband's a little stronger, y'all may want to ask someone about the usual course and whether you want to add dialysis, a feeding tube, and what to do in case of complications that require a transfusion or other blood products


93 posted on 05/13/2006 3:12:15 PM PDT by hocndoc (http://www.lifeethics.org/www.lifeethics.org/index.html)
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To: hocndoc
I would sure like to know why there are plans for a tracheostomy if they plan to wean your husband off the ventilator. Why would he need an artificial airway, then?

Without re-reading...I believe I read that this gentleman had been intubated for 3 weeks...I will assume that he was orally intubated.

Generally speaking most hospitals would be leaning towards performing a trach..at about that time, ( or sooner depending on diagnosis..) if conventional weaning has failed. Oral ET tubes can cause skin breakdown..( lips,facial area's..)oral hygiene is harder, Pt's find it harder to swallow...and of course are just plain uncomfortable.

Trach's can facilitate weaning in many pt's by just eliminating the upper airway, thus reducing airway resistance. Many times, that can be the difference. Plus they are much more tolerated, ( less gag reflex..etc.. )and just make "life" easier.

Without getting too wordy...I hope that's helpful.......

FRegards,

95 posted on 05/13/2006 3:55:28 PM PDT by Osage Orange (I am beginning to suspect that some men may have evolved from chickens...........)
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