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Old 07-17-13, 09:41 AM   #1
Pug
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Dnr?

In the Sunday NY Times Magazine was an article concerning a noted bioethicist and her predicament when theory turned in to reality when her husband was paralyzed in a cycling accident.

While I fear dying on the bike, personally I have a greater fear of being paralyzed for life in case of accident.

Does anyone carry, while riding your bike, evidence or proof of your desire to not be resuscitated in the event of catastrophic injury?
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Old 07-17-13, 09:49 AM   #2
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I was at the rehab hospital, after my accident, last year. I have a bicycle tattoo on the back of my calf. My physical therapist said that considering the fact that I was there due to being struck by a car while on my bike, it was her second favorite tattoo seen on a patient.
So, of course, I asked about her favorite tattoo. She had a patient several years ago with "DNR" in bold, capital letters on his chest.

I suppose that removes all doubt for EMTs.
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Old 07-17-13, 10:21 AM   #3
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That's a question I'm not sure how to answer -- I'm in good health right now, and there are days that THAT is hard enough to maintain. The ethical question of self-determination gets severely colored when you throw physical devastation into an already "iffy" proposition.

I would imagine, though, that I would not want any 'heroism' to prolong my life; never really have wanted that, even before I started dealing with the bouts of depression. I can easily see that, in a condition of invalidity, the "bad days" would multiply exponentially.

The VA has asked me several times about a "living will" -- maybe I should get up off of it and investigate that....
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Old 07-17-13, 10:40 AM   #4
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The DNR probably wouldn't protect you from being paralyzed, since those injuries often occur without the need for resuscitation coming into the picture. For example, I used to work for a woman who had become quadriplegic as the result of a car crash in which she was thrown from the car. She remained fully conscious and lucid throughout the incident.
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Old 07-17-13, 11:49 AM   #5
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I have a living will that states my refusal of ALL medical treatment. And in my wallet's emergency card is a similar statement and reference to my living will (as well as contact information for my attorney).. And finally, I also have a road id (which I wear occasionally if riding for just fun) that has similar information.
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Old 07-17-13, 01:04 PM   #6
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In the Sunday NY Times Magazine was an article concerning a noted bioethicist and her predicament when theory turned in to reality when her husband was paralyzed in a cycling accident.

While I fear dying on the bike, personally I have a greater fear of being paralyzed for life in case of accident.

Does anyone carry, while riding your bike, evidence or proof of your desire to not be resuscitated in the event of catastrophic injury?
Not only do I NOT fear being hit on my bike(if I did, I probably wouldn't be riding my bike), I don't carry a DNR card. Because I don't agree with DNR. I actually had this debate with a relative of mine a couple years ago. They don't like me being a Christian, and tried to convince me to side with them on the DNR debate. I refused. They have never brought it up again.
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Old 07-17-13, 02:08 PM   #7
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...I don't agree with DNR....They don't like me being a Christian, and tried to convince me to side with them on the DNR debate. ...
Not a Christian Scientist then, I imagine.
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Old 07-17-13, 02:10 PM   #8
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Several of the docs were pretty sure I wasn't going to make it. One of the trauma surgeons got kind of emotional while telling my wife about my condition. This makes me wonder if I'd had a DNR order, would they have done as much as they did to save me? I don't think they ever had to "get the paddles" or anything that immediate, so I'm not certain it would have played any part.
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Old 07-17-13, 03:00 PM   #9
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Not a Christian Scientist then, I imagine.
Lutheran Church-Missouri Synod.

But the connection I was making between religion, and a DNR, is that, the 'world view' of my relative is skewed. They wanted me to get a DNR because they don't want to be in a vegetative state. But that same individual, won't go anywhere without their car, except if it needs repair. Then they will take the bus. But that is the only time, they will think of a different mode of transportation.
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Old 07-17-13, 03:34 PM   #10
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Chris, your assertion of 'skewed world view' is a little weak; in fact, having grown up in the LCMS, I have to suggest you re-think which way your finger is pointing on this issue. I know what's taught there, and slavish devotion to that will seriously inhibit your life...not what your deity wants for you.
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Old 07-17-13, 04:23 PM   #11
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This California site is useful. The Garden State may have something similar.

http://www.emsa.ca.gov/personnel/DNR_faq.asp

Beyond the requisite legal documents and useful medallions, it's important to have your family on board with your wishes. In many situations family wishes make a big difference in the modes of care offered.
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Old 07-17-13, 04:29 PM   #12
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Several of the docs were pretty sure I wasn't going to make it. One of the trauma surgeons got kind of emotional while telling my wife about my condition. This makes me wonder if I'd had a DNR order, would they have done as much as they did to save me? I don't think they ever had to "get the paddles" or anything that immediate, so I'm not certain it would have played any part.
Your case is why I hate the law today. I don't wasn't a DNR as I'm a tough SOB and fully intend to recover from anything. But I'm a rational man and know there are things I might not recover from. I want to take the best shot and if it fails be able to bow out after trying.

I don't want to concede the game before it really even starts.
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Old 07-17-13, 04:46 PM   #13
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Chris, your assertion of 'skewed world view' is a little weak; in fact, having grown up in the LCMS, I have to suggest you re-think which way your finger is pointing on this issue. I know what's taught there, and slavish devotion to that will seriously inhibit your life...not what your deity wants for you.
That same relative, is religiously 'aloof'. As a child they subjected me to Tarot cards, Edgar Cayce Institute, and Ouija boards. So in their line of thinking, a DNR fits perfectly. They don't like that I agree with an aunt n' uncle about most things, instead of their skewed 'world view'.
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Old 07-17-13, 05:14 PM   #14
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I live in Oregon, so I don't need a DNR. Our physicians have a knack for finishing off the job when someone may be mortally wounded, even if it is just a flesh wound.

More seriously, I am pleased that our physicians are allowed to provide me with what I may need in the event that the fight has gone awry. I'll fight for a decent quality existence with full knowledge that I can end the suffering on my own terms. I just hope they make good use of whatever parts aren't worn out and good luck to whoever gets them.
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Old 07-17-13, 09:13 PM   #15
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Recently I was reading about the consequences of surviving a debilitating heart-attack...if you're not revived within several minutes then you're likely to suffer non-reversable brain damage. The article indicated some doctors have DNR's because the likelihood sufficient care will not occur within the alloted time. It commented on how this side of surviving a heart attack isn't publicized in the CPR campaigns...what's the good in being resuscitated only to live in a vegetative state. The article suggested unless you witnessed a heart-attack occur, not to perform CPR because you won't know how long the person has been without oxygen.

As to DNR's specifically, the article indicated that in an emergency situation a DNR wouldn't necessarily apply...bystander, EMS, and emergency room personnel either will be unaware of your DNR, or not recognize its validity within the short timeframe that they've already administered life-saving care. It said a DNR is for preplanned care, not emergency medicine...something to be presented to your hospital, doctor, or long-term care facility to be used in the event of future episodes.
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Old 07-18-13, 11:26 AM   #16
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Recently I was reading about the consequences of surviving a debilitating heart-attack...if you're not revived within several minutes then you're likely to suffer non-reversable brain damage. The article indicated some doctors have DNR's because the likelihood sufficient care will not occur within the alloted time. It commented on how this side of surviving a heart attack isn't publicized in the CPR campaigns...what's the good in being resuscitated only to live in a vegetative state. The article suggested unless you witnessed a heart-attack occur, not to perform CPR because you won't know how long the person has been without oxygen.

As to DNR's specifically, the article indicated that in an emergency situation a DNR wouldn't necessarily apply...bystander, EMS, and emergency room personnel either will be unaware of your DNR, or not recognize its validity within the short timeframe that they've already administered life-saving care. It said a DNR is for preplanned care, not emergency medicine...something to be presented to your hospital, doctor, or long-term care facility to be used in the event of future episodes.
Back in 1997, I was in a 'family' meeting. I noticed my (ex)mother-in-law wringing her hands. If anyone else noticed it, they weren't saying anything. Since the 'family' meeting was contentious from the start, I never said anything about her hands n' my suspicions. Later that evening, I heard through other 'family' members, that she did indeed, have a heart attack. She was only 56 at the time, but she has never stopped smoking.
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Old 07-18-13, 11:33 AM   #17
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Back in 1997, I was in a 'family' meeting. I noticed my (ex)mother-in-law wringing her hands. If anyone else noticed it, they weren't saying anything. Since the 'family' meeting was contentious from the start, I never said anything about her hands n' my suspicions. Later that evening, I heard through other 'family' members, that she did indeed, have a heart attack. She was only 56 at the time, but she has never stopped smoking.
That article definitely caused me to question my preference for 'never give up'. Rather than still assuming all will be well, it's now a matter of what level of impairment am I willing to accept.

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Old 07-18-13, 11:47 AM   #18
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I live in Oregon, so I don't need a DNR. Our physicians have a knack for finishing off the job when someone may be mortally wounded, even if it is just a flesh wound.
That was sweet.
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Old 07-18-13, 12:24 PM   #19
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In trying to find the article just now, which I wasn't able to do, I found that I was using incorrect terminology.

"Cardiac arrest - when the heart stops beating suddenly and completely - is distinct from conditions often labeled as "heart attacks." In cardiac arrest, if the heart is not re-started quickly, brain damage or death usually results."

I also found an article advocating against DNR and DNI. All you guys who want a DNR, be sure to get your DNI too.
http://www.washingtonpost.com/wp-dyn...030802432.html
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Old 07-18-13, 10:36 PM   #20
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Tattooing DNR or wearing a piece of jewelry probably won't stop EMS from running a Code on you, depending on specific circumstances. The presumption is you may have changed your mind since the tatoo but not had a chance to obliterate the tattoo.

When you get to the ED things may be different depending on what documents are on file and your ability to give rational instruction.

Each person has the right to make the decision in conference with their provider. But don't be surprised if there is some delay depending on circumstances. It is easy to change to DNR status. It is much more difficult to restore life.

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Old 07-19-13, 06:58 AM   #21
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. . . .
Does anyone carry, while riding your bike, evidence or proof of your desire to not be resuscitated in the event of catastrophic injury?
I can't believe it took over 20 replies in this thread to make this observation . . . . You all knew this question was coming . . . .

Isn't anyone who rides without a helmet sending a strong 'DNR' message?
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Old 07-19-13, 07:56 AM   #22
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I didn't read the story in the OP until yesterday and wow, that's a good piece. Well written and thought provoking. So, anyone who hasn't read that story, should do so.

I spoke to my wife about this and she reiterated what Bike Rat and HawkOwl have said. A DNR will not stop them from intibating you or having a machine breath for you. They won't use the paddles to restart your heart, but they will hook you up to a respirator. You will need a DNI to avoid that AND, neither of these is going to come into play with the EMTs; only later, at the hospital.
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Old 07-19-13, 11:17 AM   #23
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I can't believe it took over 20 replies in this thread to make this observation . . . . You all knew this question was coming . . . .

Isn't anyone who rides without a helmet sending a strong 'DNR' message?
Helmets are just North American folklore. Sort of like St. Christopher medals.

But if you want to discuss the efficacy of your particular religion, there's a special thread for it.
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Old 07-19-13, 12:00 PM   #24
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Sometimes you don't know what's better for you at the time...

When I had my heart attack, I simply dropped dead. As luck would have it, there was a cardiac surgeon in the room who kept me going with CPR until I got zapped.
When I woke up 2 days later I was in ICU, but I thought I was paralyzed. Unbeknownst to me at the time, they had put me in a cryogenic bath after the stents that basically shut down all my limbs and extremities, so the recovering heart only had to deal with the critical organs and functions. In essence, I was put into a paralyzed state.

In the meantime, I had no control of any part of my body other than head movement - and I thought I am paralyzed for life. At that time (maybe in a doped up state) I swear that I had made a pact with the attendant/nurse to help me disconnect any life support as I did not want to go through life like that. Of course all these are in dream snippets, but as I started feeling parts of my body being responsive, I got frantic trying to get the attendant's attention to cancel the suicide contract. I could have sworn he was upset at me that I reneged on our deal, and I asked my daughter to stay with me because I think that crazy attendant was out to kill me!

Anyways, at the time something like this happens, what the mind thinks and what reality is may cause wrong decisions to be made. But to be honest, even in my mind at the time, I made my decision to end my life if I was paralyzed for life. Go figure...
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