A very difficult decision

The most difficult decision for a patient is to reach the point of 'no more'. When it happens, it must be respected. This is also true of someone who wants to have a Do Not Resuscitate order in their medical file and living will. Basically an individual is saying its my body, let me do with it what I want.

It is a decision to die peacefully in a hospice or to keep fighting with chemo and treatments to the end. Or not to be surrounded by tubes and doctors and nurses but to be with family and friends.

A family member is sure to wish to change their mind and keep them fighting to the end. But if you have been told there is no chance or that there will be minimal quality of life, you must decide.

We all want to live as long as possible. But what happens when you don't have the luxury of living to your 90's? What if your health isn't as good? Or an accident happens? We all have approximately a 1% chance of dying in a given year. What would you want to be done if your number was up?

Every time I go in for surgery, I am asked if I have a living will and I can say yes I do. I guess what I am trying to say is don't wait until someone has to ask you your thoughts on this as it would be very difficult to bring it up, let someone know before hand.

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healthiness and dying

I stumbled across two interesting articles this morning. First of all the CDC just released a list of the most common causes of death in the United States

15. Homicide
14. Parkinsons
13. Hypertension
12. Chronic liver disease and cirrhosis
11. Suicide
10. Septicemia (infection in the blood)
9. Kidney disease
8. Flu
7. Diabetes
6. Alzheimer's
5. Accidents - mostly motor vehicle ones
4. Lower respiratory diseases such as emphysema and asthma
3. Stroke
2. Cancer
1. Heart disease

I will say that Cancer and Heart Disease apparently account for approximately half of all deaths just between the two of them. I was surprised to see somethings on this list - suicide causes more death than murder? Blood infections/septicemia still are a leading cause of death. I would have thought that with the antibiotics available these days.

What I read from this list is that while modern medicine has made huge advances, there still is a lot of room for improvement - both on the side of medicine but also on the side of living healthy. So while medical research turns out cure after cure, us patients need to do our part to live healthier. Cirrhosis is mostly caused by alcohol abuse. Many cases of diabetes are the result of obesity. Murder is a social problem - crime control is important. Suicide - is it the result of depression mostly? More mental health professionals please! That's just a start. (I am not going to talk about cancer on this one - I think I have talked about it enough in the past and the answer is still the frustrating reply of 'they don't know'.)

I did also wonder what are the leading causes of death in other countries to compare with. I mean they tell us the US has such a high rate of diabetes and cancer and other Western diseases that are far lower in other parts of the world.

I did find this one article on who lives better as they age - Americans or British? Apparently if you live in the US you are likely to live longer but in the UK but you are less likely to have a chronic disease - so more likely to be healthier. I don't know but I think Darwin fits in here. If you make it to old age, you are likely to be healthier or something.

This too much too early but if I mull it over for a while, I might have a more profound thought. Meanwhile I will ponder causes of death and hope to avoid #2 for a long while to come.

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The ultimate recycling

So what are you going to do when you die? No I am not morbid, I am practical. I can't decide. Probably cremation but then what. For the cat, it is definitely cremation and then a little plot in the back yard somewhere. There is not much of a choice. I have friends who keep their pet's ashes in the closet. But for people it is a little more complicated.

Apparently there are some choices. Its the ultimate recycling instead of just decomposing in the ground. But there are also green burials where they skip the nasty embalming chemicals and use a basket instead of a casket.

Here is a list to choose from.

1. Donate your organs - well that's easy. I can do that one. I can relate.

2. Donate your tissue - that's also easy. Could I do 1 & 2?

3. Will your body to a university - so some future doctor can dissect me? I think not. Yuck!

4. Help doctors practice their skills - Ew again. No. No extra incisions.

5. Leave your body to "the body farm" - this is where they figure out how long it takes maggots to show up on a dead body. No. No. No. No bugs in me.

6. Become a crash test cadaver - No again. I don't need a car accident - even after I am gone.

7. Give your body to a broker - who will sell your parts for science, research and training. Um, no again.

8. Send your body on tour - with those Body Worlds. No. My flabbiness will not be exposed in plastic for eternity.

9. Become a skeleton - for a school or some place where students will pose you in weird positions as part of a prank or you get hidden in closets to fall out on people. Dont think so!

10. Be on display at a museum - A special museum at the College of Physicians. No, see flabbiness note above.

Hmmm... I'm thinking donate tissue and organs and then cremation. That I can do. But would my estate get a tax credit for the donations after I'm gone? I'll go ask my accountant that one.

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Planning on being remembered

We all get our 15 minutes of fame - some people's 15 minutes drags on more than other's. We are born and go through life and then we die. Some of us will be famous and have buildings or city intersections named after us. A few generations later everyone will wonder 'why was it named after them?' unless the person was REALLY famous. Most of us go through our mundane lives and at the end life goes on for everyone else. The space we filled in their lives is taken over by others in time. It is left to us to decide how to be remembered.

If we become the one to set a new record - oldest cancer patient to climb Mt. Everest (not me!) or beat Lance Armstrong's record of winning the Tour de France (really not me!) - there will be a record in life somewhere publicly. But how do we want to be remembered by the one's who really know us? With some planning, we can do this.

This young mother who died yesterday of cancer made a point of leaving a record for her children. Randy Pausch made a record for his family as well - his Last Lecture.

My point is plan ahead before its too late. A photo record, a video, a blog.... Not necessarily a legacy, but merely a remembrance. We are in control of our own lives.

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