WEBVTT 00:00:00.360 --> 00:00:03.839 Welcome to the Light Keepers podcast, this week 00:00:03.839 --> 00:00:07.099 from the Windy City. I'm Clayton Vandiver, your 00:00:07.099 --> 00:00:09.439 Light Keeper, with a show dedicated to everyone 00:00:09.439 --> 00:00:11.820 who wants to get the most quality out of life 00:00:11.820 --> 00:00:14.859 that they can. Join us for the conversation this 00:00:14.859 --> 00:00:20.100 week about could or should, and how they affect 00:00:20.100 --> 00:00:23.059 your medical care, and so much more on this very 00:00:23.059 --> 00:00:25.760 special edition. of the Light Keepers podcast 00:00:25.760 --> 00:00:30.480 from Chicago, Illinois on the shores of Lake 00:00:30.480 --> 00:01:00.500 Michigan. My co -host is always Charlene, our 00:01:00.500 --> 00:01:03.320 very own licensed clinical social worker, licensed 00:01:03.320 --> 00:01:05.480 in the state of Florida. Please leave your questions 00:01:05.480 --> 00:01:07.640 or comments below and join our conversation. 00:01:08.200 --> 00:01:10.719 Questions are answered during our next show that 00:01:10.719 --> 00:01:14.579 airs each Wednesday at 7 p .m. Eastern. The Light 00:01:14.579 --> 00:01:17.560 Keepers Podcast is an exclusive production of 00:01:17.560 --> 00:01:22.200 A Guiding Light Incorporated. So our topic today 00:01:22.200 --> 00:01:28.890 is could or should. What does that mean? So we've 00:01:28.890 --> 00:01:32.450 talked a lot on this show about how important 00:01:32.450 --> 00:01:35.269 it is to have advanced directives and have your 00:01:35.269 --> 00:01:37.689 wishes for medical treatment known. And the reason 00:01:37.689 --> 00:01:40.950 for that is because in the medical world, especially 00:01:40.950 --> 00:01:44.870 in hospitals, doctors will do everything they 00:01:44.870 --> 00:01:50.209 can to keep you alive. And their thought is not 00:01:50.209 --> 00:01:52.870 on what kind of quality of life you're going 00:01:52.870 --> 00:01:56.230 to have. But whether or not you're alive, that's 00:01:56.230 --> 00:01:58.269 all they care about. Are you alive or are you 00:01:58.269 --> 00:02:01.349 not? They're not thinking about, is it a quality 00:02:01.349 --> 00:02:05.930 of life that you're going to be okay with? Is 00:02:05.930 --> 00:02:07.969 it a quality of life that you find acceptable? 00:02:08.629 --> 00:02:12.449 And quality of life should be a determining factor 00:02:12.449 --> 00:02:16.199 when it comes to your health care. You just roll 00:02:16.199 --> 00:02:19.039 back just a second and ask, what is the definition 00:02:19.039 --> 00:02:21.240 of quality of life? What does that really mean? 00:02:21.379 --> 00:02:22.819 Well, I guess it means something different to 00:02:22.819 --> 00:02:24.860 almost everyone. Quality of life is subjective 00:02:24.860 --> 00:02:29.360 because each of us has something different, a 00:02:29.360 --> 00:02:31.479 different idea of what a good quality of life 00:02:31.479 --> 00:02:34.840 looks like. For some people who maybe they're 00:02:34.840 --> 00:02:37.960 fiercely independent, they... can't stand the 00:02:37.960 --> 00:02:40.379 thought of a quality of life where they're not 00:02:40.379 --> 00:02:43.520 ambulatory. Being confined to a wheelchair is 00:02:43.520 --> 00:02:46.259 not something they would ever be okay with. For 00:02:46.259 --> 00:02:49.099 some people, being confined to a wheelchair isn't 00:02:49.099 --> 00:02:51.819 a problem for them, provided they still have 00:02:51.819 --> 00:02:56.259 their mental capacity. I understand. For other 00:02:56.259 --> 00:03:00.819 people, they don't care what mental capacity 00:03:00.819 --> 00:03:03.340 they have. Being alive is the most important 00:03:03.340 --> 00:03:06.969 thing to them. Each of us has a different idea 00:03:06.969 --> 00:03:09.689 and a different definition of what a good quality 00:03:09.689 --> 00:03:12.990 of life is, and that's why it's important to 00:03:12.990 --> 00:03:16.189 include that in your advanced directives. Well, 00:03:16.210 --> 00:03:19.250 you know, I mention often in our conversations 00:03:19.250 --> 00:03:23.150 outside of the show a film by Richard Dreyfuss 00:03:23.150 --> 00:03:26.349 called Whose Life Is It Anyway? Wonderful movie. 00:03:26.409 --> 00:03:28.990 I highly recommend it to all of our viewers and 00:03:28.990 --> 00:03:32.919 listeners. And it was all about a man who was 00:03:32.919 --> 00:03:35.919 extremely intelligent, very live, very vibrant, 00:03:36.120 --> 00:03:40.120 had a very dynamic life. And he was in an accident 00:03:40.120 --> 00:03:42.400 where he became a paraplegic. Below the neck, 00:03:42.520 --> 00:03:48.960 nothing. And his decision was he wanted to end 00:03:48.960 --> 00:03:52.020 his life in the hospital. And, of course, they 00:03:52.020 --> 00:03:54.060 wouldn't let him. Their goal was to keep him 00:03:54.060 --> 00:03:57.310 alive at all costs. and hence the title of the 00:03:57.310 --> 00:04:00.770 movie whose life is it anyway it was a very controversial 00:04:00.770 --> 00:04:05.629 very interesting topic very delicately and brilliantly 00:04:05.629 --> 00:04:09.129 handled if i might say in the script and i recommend 00:04:09.129 --> 00:04:12.169 that as viewing for anyone who has ever had the 00:04:12.169 --> 00:04:14.810 thought or the concern about the controversy 00:04:14.810 --> 00:04:18.550 about whose life is it anyway who determines 00:04:18.550 --> 00:04:22.029 when my quality of life is not acceptable to 00:04:22.029 --> 00:04:25.920 me Well, and I think that so often in the medical 00:04:25.920 --> 00:04:30.740 world, talking about movies, let's talk about 00:04:30.740 --> 00:04:34.579 Jurassic Park, Jeff Goldblum. We spend so much 00:04:34.579 --> 00:04:37.860 time thinking about whether or not we can. We 00:04:37.860 --> 00:04:39.920 don't stop to think whether or not we should. 00:04:40.259 --> 00:04:43.300 Absolutely. Jeff Goldblum playing the role of 00:04:43.300 --> 00:04:45.939 Dr. Ian Malcolm in the original Jurassic Park. 00:04:46.180 --> 00:04:48.920 And in that movie, he said, you know, the scientists 00:04:48.920 --> 00:04:51.300 spend so much time worrying about what they can 00:04:51.300 --> 00:04:55.959 do. they never stop to think about if they should 00:04:55.959 --> 00:04:58.519 do it and what the repercussions are going to 00:04:58.519 --> 00:05:01.379 be. What's the ripple effect to the actions we 00:05:01.379 --> 00:05:04.040 take today? Exactly, exactly. And we have the 00:05:04.040 --> 00:05:07.199 same problem happening in our hospitals and in 00:05:07.199 --> 00:05:11.060 our ICUs and in our trauma units. I talk to people, 00:05:11.240 --> 00:05:15.389 I hear from someone at least once a week. that 00:05:15.389 --> 00:05:18.050 had a very bad experience in the hospital because 00:05:18.050 --> 00:05:21.089 they had a loved one who had advanced directives, 00:05:21.129 --> 00:05:23.910 but the hospital didn't have them on file. And 00:05:23.910 --> 00:05:26.310 so by the time the loved one got to the hospital, 00:05:26.649 --> 00:05:30.230 mom was already on that ventilator, and she never 00:05:30.230 --> 00:05:33.230 wanted to be. And never had the choice to tell 00:05:33.230 --> 00:05:35.550 or chance to tell. And now the very situation 00:05:35.550 --> 00:05:37.910 that mom was trying to avoid by having those 00:05:37.910 --> 00:05:41.149 documents drafted is now playing out because 00:05:41.149 --> 00:05:45.279 the family is having to make the decision. to 00:05:45.279 --> 00:05:48.759 take her off that ventilator. And the doctors, 00:05:48.959 --> 00:05:52.139 if they don't know, are going to do what they 00:05:52.139 --> 00:05:54.860 are chartered to do, which is keep you alive. 00:05:56.360 --> 00:06:00.000 Regardless, basically, they're not concerned 00:06:00.000 --> 00:06:03.060 with the quality of life, the condition of life. 00:06:03.120 --> 00:06:05.560 They just want life. Exactly. Because that's 00:06:05.560 --> 00:06:07.480 what they're trained to do. What you do with 00:06:07.480 --> 00:06:10.300 the life that they give you is up to you. Exactly. 00:06:12.250 --> 00:06:14.170 Paramedics are in the same boat. If they get 00:06:14.170 --> 00:06:17.069 called out on a call where someone's heart has 00:06:17.069 --> 00:06:20.389 stopped beating, unless that do not resuscitate 00:06:20.389 --> 00:06:23.569 order is like glaring them in the face when they 00:06:23.569 --> 00:06:26.089 come into the house, they're going to immediately 00:06:26.089 --> 00:06:33.730 start CPR. That's almost an even more... difficult 00:06:33.730 --> 00:06:37.490 to gauge situation because they're in an emergency. 00:06:37.750 --> 00:06:40.589 They're in a time critical situation. They absolutely 00:06:40.589 --> 00:06:44.709 have to do something. Right. Right. And that's 00:06:44.709 --> 00:06:47.930 why when I'm talking to people about what they 00:06:47.930 --> 00:06:51.410 would want and they say, when I talk about CPR 00:06:51.410 --> 00:06:53.350 and they say, well, I'll let my loved ones figure 00:06:53.350 --> 00:06:54.790 that out in the moment. I was like, there is 00:06:54.790 --> 00:06:57.370 no moment. There is no moment. It either happens 00:06:57.370 --> 00:06:59.889 or it doesn't. And if that document... There's 00:06:59.889 --> 00:07:01.569 no time to debate it. There's no time to worry 00:07:01.569 --> 00:07:02.850 about it. No, they're not going to ask. They're 00:07:02.850 --> 00:07:05.310 not going to ask. If the document is not already 00:07:05.310 --> 00:07:07.610 done, they're going to do. And that's all there 00:07:07.610 --> 00:07:09.490 is. Well, how does that play in with the paramedics 00:07:09.490 --> 00:07:10.990 now? They're not going to see those documents. 00:07:11.290 --> 00:07:14.490 Ah, not true. Not true. So one of the things 00:07:14.490 --> 00:07:16.810 that I always tell everyone is if you do have 00:07:16.810 --> 00:07:19.649 that do not resuscitate order, have it posted 00:07:19.649 --> 00:07:21.430 somewhere where it is visible the minute you 00:07:21.430 --> 00:07:24.410 walk in the door. Okay. You know, if the kitchen 00:07:24.410 --> 00:07:26.410 is visible, a lot of people put it on the fridge. 00:07:27.210 --> 00:07:29.610 If you have someone that spends a lot of time 00:07:29.610 --> 00:07:32.269 in their bedroom, it's posted on the bedroom 00:07:32.269 --> 00:07:34.829 door on the foot of the bed. Gotcha. And those 00:07:34.829 --> 00:07:37.189 paramedics, because a lot of do not resuscitate 00:07:37.189 --> 00:07:39.810 forms are a special color. Like I know in the 00:07:39.810 --> 00:07:42.110 state of Florida, it's on a yellow sheet of paper. 00:07:43.129 --> 00:07:45.410 Paramedics look for any sheet of paper of that 00:07:45.410 --> 00:07:48.110 color. And if they see a red piece of paper or 00:07:48.110 --> 00:07:50.389 yellow piece of paper, they're going to stop 00:07:50.389 --> 00:07:52.050 and say, is that a do not resuscitate order? 00:07:52.509 --> 00:07:56.449 Okay. And so you do have that opportunity to 00:07:56.449 --> 00:08:00.949 make that known. Now, I have to ask, what if 00:08:00.949 --> 00:08:04.370 they're in the car, they have an accident? They're 00:08:04.370 --> 00:08:06.470 on the road. You're going to get CPR regardless. 00:08:06.670 --> 00:08:09.889 So all bets are off when you're away from wherever 00:08:09.889 --> 00:08:12.350 those documents might be. Correct. Unless you 00:08:12.350 --> 00:08:15.019 just... Put it on the window of the car. Put 00:08:15.019 --> 00:08:16.779 it on the dashboard. Tape it up. I don't know 00:08:16.779 --> 00:08:20.680 what you can do. No, it's going to happen. It's 00:08:20.680 --> 00:08:23.220 going to happen. If you do not have a heartbeat 00:08:23.220 --> 00:08:26.060 when they find you, you are going to get CPR 00:08:26.060 --> 00:08:31.100 done. Gotcha. So it's conditional, circumstantial. 00:08:31.680 --> 00:08:37.240 And again, it's a highly personal choice, we 00:08:37.240 --> 00:08:39.679 know. Is there anything else that you can add 00:08:39.679 --> 00:08:42.580 to that? Thoughts about the could or should? 00:08:43.480 --> 00:08:46.080 It is definitely something to give a lot of thought 00:08:46.080 --> 00:08:51.620 to, and not just to think about whether or not 00:08:51.620 --> 00:08:54.600 you want it, but is it something that you're 00:08:54.600 --> 00:08:57.440 going to be okay with in terms of life support, 00:08:57.639 --> 00:09:00.379 CPR, because there is that ripple effect, and 00:09:00.379 --> 00:09:02.759 I'm going to explain to you very briefly exactly 00:09:02.759 --> 00:09:05.720 what that ripple effect is. Okay. Okay, so say, 00:09:05.759 --> 00:09:09.059 for example, you do want CPR done, okay? Right. 00:09:10.259 --> 00:09:12.240 something happens, heart stops beating, they 00:09:12.240 --> 00:09:15.419 do CPR, they're able to bring you back, but you're 00:09:15.419 --> 00:09:17.279 not strong enough yet to breathe on your own. 00:09:17.940 --> 00:09:22.539 So now you're on a ventilator. Okay. Okay? After 00:09:22.539 --> 00:09:25.620 two or three days, you're still recovering. You 00:09:25.620 --> 00:09:28.379 still can't breathe on your own. However, because 00:09:28.379 --> 00:09:30.460 you're on a ventilator, now you can't swallow, 00:09:30.759 --> 00:09:33.820 you can't speak, you can't eat, so now you have 00:09:33.820 --> 00:09:37.769 a feeding tube. Talk about a ripple effect. So 00:09:37.769 --> 00:09:42.240 here in the process of one intervention, you 00:09:42.240 --> 00:09:46.639 have been subjected to three life support interventions. 00:09:47.220 --> 00:09:50.519 So those life support measures, and what if you 00:09:50.519 --> 00:09:53.200 were okay with two of those, but you didn't want 00:09:53.200 --> 00:09:55.679 that third, but it's necessary now that the first 00:09:55.679 --> 00:09:57.340 two have been put into effect. What do you do? 00:09:57.679 --> 00:10:01.139 So now your family is put in the position of 00:10:01.139 --> 00:10:03.600 either putting the stop on it. Say, for example, 00:10:03.600 --> 00:10:05.759 someone was okay with the ventilator, but they 00:10:05.759 --> 00:10:08.700 didn't want the feeding tube. which to me is 00:10:08.700 --> 00:10:10.320 kind of interesting because the feeding tube 00:10:10.320 --> 00:10:12.519 is the less invasive of the two, but that's for 00:10:12.519 --> 00:10:16.679 another show. But they were okay with the ventilator. 00:10:16.740 --> 00:10:19.620 They didn't want the feeding tube. So now the 00:10:19.620 --> 00:10:21.759 family is having to say, well, they didn't want 00:10:21.759 --> 00:10:25.879 that. So we either have to let mom go without 00:10:25.879 --> 00:10:28.539 nutrition and hope she recovers the ability to 00:10:28.539 --> 00:10:31.620 breathe before she starves to death, which most 00:10:31.620 --> 00:10:33.320 of the time someone on a ventilator is going 00:10:33.320 --> 00:10:36.080 to be sedated. They're not going to know that 00:10:36.080 --> 00:10:39.379 they're not eating. or they've got to turn that 00:10:39.379 --> 00:10:41.259 vent off and hope that mom can breathe on their 00:10:41.259 --> 00:10:43.299 own. Well, you know, we're in Chicago. I can't 00:10:43.299 --> 00:10:45.139 imagine getting one of those deep dish pizzas 00:10:45.139 --> 00:10:48.840 through a feeding tube. So I would be resistant 00:10:48.840 --> 00:10:52.679 to that, too. Actually, you can. Oh, my gosh. 00:10:52.960 --> 00:10:56.620 So people live with feeding tubes every day. 00:10:56.720 --> 00:11:00.669 Okay. The feeding tube that... feeding tube that 00:11:00.669 --> 00:11:03.350 is used long term is put into place by making 00:11:03.350 --> 00:11:06.110 an incision in your side and they put a tube 00:11:06.110 --> 00:11:08.169 going through that cut directly into the stomach 00:11:08.169 --> 00:11:12.590 now the tube is a little bigger than other tubes 00:11:12.590 --> 00:11:15.149 and so you can blend food you can blend food 00:11:15.149 --> 00:11:17.440 so you could puree something and put it in. You 00:11:17.440 --> 00:11:19.340 wouldn't get the same pleasure. Believe me, I 00:11:19.340 --> 00:11:21.559 had one yesterday and it's delicious. And that's 00:11:21.559 --> 00:11:23.279 the whole thing. That's where feeding tubes, 00:11:23.399 --> 00:11:26.019 a lot of people don't realize how much of our 00:11:26.019 --> 00:11:29.379 society is focused around food. And if you're 00:11:29.379 --> 00:11:32.120 not taking food in like everybody else, guess 00:11:32.120 --> 00:11:34.059 what? You're not participating in Thanksgiving 00:11:34.059 --> 00:11:37.600 dinner. You're not participating in Sunday family 00:11:37.600 --> 00:11:39.940 dinners. It removes the whole social component 00:11:39.940 --> 00:11:42.940 of eating out of it. Exactly. It does. Oh my 00:11:42.940 --> 00:11:45.039 goodness. Now that's something I'd never thought 00:11:45.039 --> 00:11:48.230 of. until this very moment. Yeah. Well, and those 00:11:48.230 --> 00:11:50.029 are important things to think about and share 00:11:50.029 --> 00:11:52.509 with your family and discuss with them as you're 00:11:52.509 --> 00:11:55.629 talking about how you like things, don't like 00:11:55.629 --> 00:11:59.049 things. And it doesn't have to be an end times 00:11:59.049 --> 00:12:01.210 conversation. It doesn't have to be a last... 00:12:01.210 --> 00:12:04.750 It should be an ongoing conversation. It's ongoing 00:12:04.750 --> 00:12:07.950 because you know something, over your lifetime... 00:12:08.429 --> 00:12:11.549 Your desires, your wishes, your thoughts about 00:12:11.549 --> 00:12:13.690 this or that are going to change. They're going 00:12:13.690 --> 00:12:16.470 to modify. You may see the movie Whose Life Is 00:12:16.470 --> 00:12:18.730 It Anyway and change your entire perspective 00:12:18.730 --> 00:12:22.409 about that subject, which is a very serious subject. 00:12:22.490 --> 00:12:26.429 It's a sad movie. And a touchy topic. It's a 00:12:26.429 --> 00:12:28.389 touchy topic. It's a sad movie, but it gives 00:12:28.389 --> 00:12:31.330 you a lot of... Perspective. Perspective and 00:12:31.330 --> 00:12:34.549 hope and things to think about, which we hope 00:12:34.549 --> 00:12:37.330 also is what this show does for you, is give 00:12:37.330 --> 00:12:40.070 you a lot of things to think about. So thank 00:12:40.070 --> 00:12:43.169 you so much for bringing that to us and talking 00:12:43.169 --> 00:12:45.909 about it here in the beautiful city of Chicago. 00:12:46.529 --> 00:12:49.429 This conversation is to start you thinking because 00:12:49.429 --> 00:12:52.029 most people aren't prepared, and that is the 00:12:52.029 --> 00:12:54.210 truth. Most people are not prepared to even think 00:12:54.210 --> 00:12:56.649 about this, much less talk about it. But some 00:12:56.649 --> 00:12:58.889 are well prepared indeed. From joining us here. 00:12:59.320 --> 00:13:01.179 at the Light Keepers Podcast each Wednesday, 00:13:01.419 --> 00:13:05.200 7 p .m. Eastern. Ah, that's right. The Light 00:13:05.200 --> 00:13:07.860 Keepers Podcast is an exclusive production of 00:13:07.860 --> 00:13:10.919 Animation Studios and A Guiding Light, and is 00:13:10.919 --> 00:13:14.379 available on all audio RSS feeds and on YouTube, 00:13:14.440 --> 00:13:17.580 so you can see great scenes like this one over 00:13:17.580 --> 00:13:20.580 my shoulder. Visit the website at aguidinglight 00:13:20.580 --> 00:13:23.360 .org, where you'll find links to the audio and 00:13:23.360 --> 00:13:26.789 to the YouTube feeds. Or to make a tax -deductible 00:13:26.789 --> 00:13:29.090 contribution, you can send a check to the address 00:13:29.090 --> 00:13:32.330 that's right there below me on the screen. And 00:13:32.330 --> 00:13:35.070 we're so grateful for that support. And speaking 00:13:35.070 --> 00:13:37.769 of that, please hit the like and subscribe buttons. 00:13:37.830 --> 00:13:40.169 It's absolutely free and it really helps us out 00:13:40.169 --> 00:13:43.330 a lot. And that way you'll catch every single 00:13:43.330 --> 00:13:46.250 episode. That's it for this week from Chicago, 00:13:46.529 --> 00:13:49.950 the Windy City. I'm Clayton Vandiver, your Lightkeeper. 00:13:50.330 --> 00:13:52.850 We'll see you next time on the Lightkeeper's 00:13:52.850 --> 00:14:04.259 Podcast. Thanks for watching!