In life there are always many discussions that are hard to have, and one of them is being end of life discussions. No one wants to think about end of life, but we eventually all have the same ending. This may sound morbid or depressing, but we aren’t invincible. Knowing what your loved one wants when their time comes is super important. When I lost my mom, my dad and I had no idea what her final wishes were. My mom lost both of her parents at a young age and was never fond of doctors, so when my dad would try and have those discussions with her, it was always put off. Losing her suddenly was a shock to both my dad and I, but then trying to make arrangements without knowing what she would have wanted was even harder.
While discussions about end of life aren’t easy, they are necessary. My dad and I talked several times about this because of his health. We sat down one day and discussed what it meant to be his medical power of attorney, his living will, and about organ donation. Being a power of attorney for someone is a huge deal. It leaves you responsible to make medical decisions on a persons behalf, should they for some reason not be able to make those decisions because of their medical condition.
You truly don’t know how hard choices are to make until you are faced with making a decision on your own. This is what happened to me in 2015. The previous year my dad had gone through a colonoscopy due to having some blood where blood shouldn’t be. The gastroenterologist saw a few polyps that he was able to take care of and sent to pathology to make sure they weren’t cancerous. It was a huge relief when we found out they were benign.
In 2015 the cycle repeated itself, except this time it was much worse. My dad was hospitalized due to a gastrointestinal bleed. They did a couple of colonoscopies and things got really serious really fast. My dad was pretty much bleeding without it being able to be stopped. And because of the amount he was bleeding he had a large number of blood transfusions. He was also on a blood thinner because of his artificial heart valve and because of everything going on in his system, he also received fresh frozen plasma and vitamin K to bring down his INR. Due to the lack of oxygenated blood in his body, during this time he also had a minor heart attack. This is something that usually ends up having a poor outcome. At one point my dad was so unstable that they did a bedside colonoscopy and endoscopy, but the area he was bleeding from was in that perfect spot that it couldn’t be reached from either end, so the gastroenterologist tattooed the area in case my dad needed to have surgery.
The doctor came out and talked to me in the waiting room, as did a general surgery resident. Both doctors were fantastic and said that if his blood pressure maintained where it was at, they would wait for a couple of days to get him a little more stable to possibly do surgery. They both went back to his room to get things cleaned up and the surgical resident came back out and said that his blood pressure had dropped again, and that an emergency surgery needed to be done. Being the power of attorney for my dad, this was a choice that I had to make. My dad was so out of because of the amount of blood he had lost. I called one of my friends who is a nurse and she came and talked me through everything. I was able to ask several questions to the resident surgeon and once we found out who would actually be doing the surgery I signed the consent form for my dad to have an emergency small bowel resection.
I had some amazing friends come sit with me during the surgery and everyone was fantastic with keeping me updated every step of the way. The only thing going through my mind though once they called to say they had started surgery, was that my dad had always told me he did not want a colostomy bag. But I knew at that point, it was too late to change my mind on him having surgery. Thankfully once surgery was over, the surgeon came out and talked to me and my friends. She said that everything went well, that they removed 18 inches of small bowel, and that he did not need a colostomy even temporarily. My dad did well overnight and they started to wean him off of the propofol so they could extubate him. While he was still intubated he could hear me and the nurses, follow commands, etc. I asked him if he was mad at me for having them go ahead with surgery and he shook his head no and squeezed my hand. I was so relieved and had more confidence that if I needed to make another decision like that, that I would be able to.
Being a medical power of attorney is a powerful position to be in, but knowing who you’d want and trust to make choices for you if you are unable is important. No one likes to discuss death, but having the conversations while you are able to about who you want to make decisions for you and so that your loved ones know what your final wishes are helps tremendously when that time comes. Also, discussions about being an organ donor are just as important. Organ donation is a wonderful thing and my personal stance is if I can allow someone to live a better quality of life once I’m gone, then take what you can because I no longer need it. Losing someone is always hard, but knowing these things in advance makes some things easier on you because for the first few days you will be in a fog trying to get arrangements made, an obituary done, and notifying family and friends. Knowing ahead of time if your loved one wants to be buried or cremated, donating organs, and anything else, helps to take a bit of the burden off.