Welcome to the Light Keepers podcast. I'm Clayton
Vandiver, your Light Keeper, with a show dedicated
to everyone who wants to get the most quality
out of life that they can. My co -host, as always,
Charlene, our very own licensed clinical social
worker, certified in the state of Florida, joining
the conversation this week about intubation versus
ventilation. And so much more on this episode
of the Light Keepers Podcast. Before we start,
leave your questions or comments below. We love
to hear from you. Questions this week will be
answered during our next show that appears online
every Wednesday evening at 7 p .m. Eastern. The
Light Keepers podcast is an exclusive production
of A Guiding Light Incorporated. We'll tell you
a little bit more about A Guiding Light at the
end of the podcast. But we don't have much time,
so let's get right into this week's conversation
about intubation versus ventilation. What in
the world are they? Doesn't it just make you
feel all warm and fuzzy thinking about it? Oh
my goodness. Yeah, no, not at all. Yeah, it feels
a little bit invasive just hearing it. Tell me
what they are. Okay. Let's start with intubation.
So intubation is actually a very common procedure
that anyone who has ever been put under for a
surgical procedure has had done to them, whether
they remember it or not. Intubation is very simply
where a tube is placed down the throat. You'll
hear it referred to in the emergency room or
in the medical field as protecting the airway.
And basically it's a protective measure so that
if while you're unconscious you become unable
to breathe, they don't waste valuable time trying
to get an airway open. The tube is already there.
All they have to do is hook it up to oxygen and
you're getting air. So it's more of a preventive
measure, I guess. It's a protective measure.
Okay. What is the likelihood that your throat
might collapse or that airway might collapse
during an operation? It's entirely dependent
on the procedure. For example, if you're going
in for a hernia repair and you're being put under,
odds are you're not going to need to be hooked
up to the oxygen, but they're going to intubate
you anyway just to be on the safe side. Now,
if you're going in for open heart surgery and...
You code on the table. Guess what? They're probably
going to hook you up to oxygen to make sure that
you're breathing and you don't have to do it
on your own. That's a very good idea then. Absolutely.
Yeah. Absolutely. Well, then what is ventilation?
So ventilation is when someone is not able to
breathe on their own and that tube that's going
down the throat, the other end of it that comes
out is connected to a machine that pushes air
in and out of the lungs. So the machine is doing
the breathing. Okay. Well, I remember back in
many, many years ago hearing about iron lungs
and breathing things. Is that sort of what I
was hearing about back then? I don't know. Shows
how old I am. Okay. That one, I don't know. But
I can tell you that public knowledge of ventilators
really came into its own with COVID. Okay. Because
with COVID. People were not breathing on their
own as easily and challenging. Exactly. Okay.
Exactly. So those were actually helping them
maintain their breathing and keeping the airways
open. And there's a few different ways to think
about it. A lot of times people think that someone
who needs. that ventilator support they're not
breathing on their own at all and that may not
be the case like with kovat you have people who
have been worn down by the virus they're exhausted
they don't have the energy to take a full breath
and so they're breathing but it's shallow and
they're not getting enough oxygen for the body
to be able to heal and so what happens is they're
intubated the tube is placed okay That tube is
then connected to the ventilator. The machine
starts pushing and pulling air in and out of
the person's lungs. They're no longer having
to breathe on their own. That machine is doing
it for them, which is allowing their body to
rest and to take a break from having to do that.
So they're not working as hard to breathe. They
can put their energy more toward recuperating
in other ways. So having ventilator support can
be a recuperative process. Or it can be a means
of life support. For example, if you have someone
who was in a major accident and they're now paralyzed
from the neck down, they may not have the, let
me see if I can pronounce this right, the diaphragmatic
control to be able to breathe on their own, in
which case that ventilator is going to be required
for them to be able to live. I see. Diaphragmatic.
That's a $5 word. You can win Scrabble with that
one. I bet you. I wouldn't have that many tiles.
Well, do you have a choice in whether you're
intubated or ventilated, or is that something
that's purely medical personnel chosen for the
applicability? So in previous episodes, we've
talked a lot about advanced directives and making
sure that your family knows what your wishes
are. If you were to be in a situation where you
needed life support, well, this is one of those
life support interventions. Because if you are
not responsive, which by the way, most of the
time when someone is put on a ventilator, they're
kept sedated because as I'm sure you can tell,
it does not sound very comfortable. Okay. But
the point is, is if you're unconscious and you
become unable to breathe on your own, guess who's
going to make the decision of whether or not
you get put on a machine? Your family. Really?
Yes. And that's if. You're declining slowly enough
that the doctors can give them that choice. Now
we're talking about ventilator. Ventilator. Ventilator,
okay. If you crash, if you go from perfectly
fine to I'm not able to breathe, what's going
to happen is whether you're awake or not, the
doctors are going to ventilate first and ask
questions later. Again, as we've spoken many
times, they always look to preserve life, save
life, do the measures that are necessary. So
this is the sort of thing, how would this fit
into your advanced directives? At what time would
you make choices or identify intubation or ventilation?
So contrary to popular belief, the best time
to make these kind of decisions is when you're
perfectly healthy. Oh. Because you don't want
to be... in the crisis having to make this decision.
And you certainly don't want to be the one unconscious
in the hospital bed with your family making this
decision for you. Of course. This is something
you want to have already thought about ahead
of time. And for some people, that's easy enough
to do. If you have someone who has COPD or lung
cancer or an illness like that, they've thought
about that loss of oxygen. They've thought about
what they want most of the time. But if you have
someone who maybe has never had a situation where
they've had to be intubated and ventilated, they
haven't given it a lot of thought. And it's an
important thing to give thought to whether or
not you want to be hooked up to a machine because
that machine will change your life. Not only
will it decide. whether or not you live, if you're
completely unable to breathe on your own, but
it's also going to decide where you live. Because
if you live with mechanical ventilation, most
of the time that cannot be done in the home setting.
You're going to be in a facility. Because that's
a machine that is not only... Has to be maintained.
And it's sort of cost prohibitive to be a portable
type unit. It doesn't work that way. No, it doesn't
work that way. Wow. So you do have some choices
ahead of time. Ahead of time. And that can determine
the choices that your medical team will be able
to make, hopefully. But you should express those,
as we've said many times, to your family members,
to your medical team. You should have those written
out. Correct. It's important to not just have
them in writing. One of my biggest pet peeves,
and I cannot stress this enough. I know I've
gone into this. A social worker with a pet peeve.
Imagine that. Oh, I know I've gone into this
multiple times on previous episodes, but so many
times I've worked with people to get their advance
directives written down, and they get the documents.
And do you know what they do with them? What
do they do? They put them in the file cabinet,
and nobody knows they have them. Oh, no. And
so then when they get into a medical crisis,
after the crisis is over, you have family members
going through the important documents and going,
oh, wait, look, mom had papers. And it doesn't
do anybody any good. If you have those documents,
if you know what you want, don't keep them locked
in the fog cabinet. Where's the best place to
put them? The best place to put them is make
a copy, first of all. Don't ever give away your
originals. Okay, that's good. Make a copy. Give
a copy to all of your loved ones who are involved
in the decision -making process. Give a copy
to your doctor so that it's a part of your medical
chart. That's a great idea. If you know you're
going to wind up at a particular hospital and
you've been a patient there, provide them with
a copy of this. So if you have specialists that
have been seeing you for whatever, make sure
they have a copy of it on file. I'm actually
hearing an episode of a very popular talk show
and you get a copy and you get a copy and you
get a copy. But that's good advice to make sure
that there isn't just one and it isn't hidden.
Correct. And it isn't filed away. Some people
have their attorneys draw up papers and important
documents and then leave them on file with those
attorneys. your family may not know you've ever
done business with that attorney. Absolutely.
That may never be known, and the attorney may
contact your family long after you're gone and
say, oh, by the way, I know that you've had a
loss. I'm sorry for your loss. Here are some
papers they left with me. It's a little late.
And, you know, it's a common thing, especially
with our older population. They go through these.
practices of preserving things you know and they
go through the the expense and the hassle of
creating a trust and on page 13 of this 17 page
document here's your medical advance directive
and nobody knows it's there because they're not
going to read through the first 12 pages to get
to page number 13 and you're not going to provide
the whole some odd page document to your doctor
to keep on file but what you do need to do is
to make a copy of those few pages and make sure
that they're on file with your medical professional.
That is great advice. That is absolutely great
advice. And of course, all of this is a highly
personal choice. No conversation that we have.
on the Light Keepers podcast should ever take
the place of your own medical care team or other
professional advisor who should always be consulted
by you on your specific situational needs. And
it's always good to be willing to talk about
quality of life because every single one of us
will face some of these issues someday. either
not prepared at all or very well prepared indeed
from joining us here on the Light Keepers Podcast.
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