When Is Enough Enough?

A Quick Look at Choosing Expensive Medical Procedures After a Certain Age
By Chloe JonPaul

Now that I\’ve reached the age of seventy-five, I know that I have lived the bulk of my life and unlike so many others, I have no desire to live to be 125! Four years ago, I was at death\’s door with gangrene, which had formed because my small intestines had wrapped themselves around old scar tissue from an old surgery.

TThe doctors told me afterwards that if they hadn\’t found the cause of the intense abdominal pain I was having that I would have been dead within six hours. They performed a laparotomy immediately and I recovered in record time. The decision for surgery was made by my son who had rushed me to the hospital and I wasn\’t in any condition to decide for myself.

Since then, I have given a great deal of thought to what the future might hold in terms of undergoing surgical procedures that a doctor might recommend and I know now what my answer would be. What follows in this post helped confirm my decision. Here is some information I discovered :

• Researchers at the Harvard School of Public Health noted that doctors often will operate to repair something that can be fixed but won\’t save a dying patient because they try to avoid having a discussion with the patient since it is so difficult for them. Oftentimes the patient will die from surgical complications anyway.
• In her article USA: USA: For America\’s aged, surgery at any price? Staff writer Marie McCollough provides a wealth of ideas to think about She poses a basic question: Is this never-too-old approach an example of U.S. medical progress or an example of why Medicare is headed for insolvency. She notes that the experts say that the answer is both.
• Did you know that about 27 per cent of Medicare\’s annual budget is spent on care in the last year of life? When you consider that by 2050, Americans 85 years and older will reach 20 million, it should cause great concern as to Baby Boomers.
• Another important study led by Duke cardiac anesthesiologist Dr. Mark Newman showed that 42 per cent of elderly patients who received coronary bypass surgery had measurable cognitive decline within five years after surgery. They found that the older the patient, the higher the risk for cognitive impairment.
• In another study done at UCLA, researchers discovered that surgeons performing lung transplants on the elderly usually implanted less-than-perfect lungs into these patients -organs that would not be considered good enough for a younger patient.
• In a recent article in the Wall Street Journal, Ken Murray notes that “most doctors die differently than their patients”. Dr. Murray is retired clinical assistant professor of family medicine at the University of Southern California. He goes on to say: “Having seen so many people die, doctors know that \’heroic measures\’ to prolong life often succeed only in providing a few extra weeks or months of suffering and indignity. Like most doctors I have made it clear that when my time comes, \’I will go gently into that good night.\’ “
• Craig Bowron, a hospital –based internist and writer in St.Paul MN recently wrote an article in the Washington Post that you can access online. In The Dying of the Light: The Drawn-out Indignities of the American Way of Death he succinctly states: “To be clear: everyone dies. There are no life-saving medications, only life-prolonging ones.” This article is a must-read!

For me, what it all boils down to is being proactive and being in control of what I have chosen for myself. I have made my wishes known; not only in writing, but also on a DVD I had professionally made. My children understand that I have chosen hospice care. On the back of my driver\’s license, I have pasted Do Not Resuscitate.

I am at peace with my decision because for me death is the dawn of eternal day.

Chloe Jon Paul, M.Ed., is a retired educator and writer of several published articles and a previous book entitled “What Happens Next: A Family Guide to Nursing Home Visits” and More… Her many achievements since the age of 55 include winning the title of Ms. Maryland Senior America in 2003, being a Recipient of the Fulbright Fellowship Seminars Abroad award to South Africa in 1996, and being a World traveler – to all 7 continents. Visit her website at http://chloejonpaul.com/

Chloe JonPaul