Tuesday, October 8, 2013

I'd say you're doing pretty well

Dr. Grumpy: "Do you have any other health problems?"

Mrs. Octogenarian: "I have Hufnagel's disease."

Dr. Grumpy: "If I remember correctly, that's a pretty serious illness."

Mrs. Octogenarian: "It's fatal. I'm terminally ill."

Dr. Grumpy: "How long have you been terminally ill?"

Mrs. Octogenarian: "57 years."


Lisa said...

We are all terminally ill. No one gets off this planet alive.

Anonymous said...

I don't get it. Was he mispronouncing Hunter's or Huntington's? Or else, I and Google have never heard of Hufnagel's.

Grumpy, M.D. said...

For patient protection I changed the name of the disease. Mrs. Hufnagel was my favorite character on St. Elsewhere.

Anonymous said...

That's quitter talk, Lisa.

I for one am very irritated with all this fuss about healthcare and health insurance and whatnot. I don't want them to spend uncountable trillions finding more ways to fix up this meatsuit. I want them to get me OUT of it. Either grow me as many new ones as I want - including at least one remote backup - or download me. If I can have an invincible robot body, bonus, but I'll settle for going virtual.

Packer said...

St. Elsewhere was Ed Begley's finest work, his only work for sure, but hey.

Having spent the better part of the last 4 months visiting a mom, a mil, a friend, in sub acutes I can for sure say that No body gets out alive, does not tell the real story---The real story is No Body Gets Out At All. Which is not a good thing.

Seriously I am considering under what circumstances and conditions and illnesses and age they can let me go.

Stroke over age 75= DNR
Only one lung fill up with CHF , next one let it ride.
Cancer in 80's no treatment other than morphine snow job.

Life does not exist as we know it in a "rest home"

Lisa said...

Generally speaking bloggers distain for people who comment annonymously. Own up to your comments. However yours was directed to a 10 year stage 3 breast cancer survivor with a defibrillator. I'm just very pragmatic about where this all leads. The bottom line is that everyone, every animal and every plant at some point dies.

Anonymous said...

Oh Packer - here's a virtual hug from me to you.

Watched Daddy drown in a dry hospital bed last summer.

Traumatized me, and my baby sister, in ways I still don't understand.

Most elderly people don't die like in the movies...close their eyes and go to sleep.

And 'rest' homes are anything but, and nothing like the happy sunshine-filled commercials and website splash pages we see.

I've pretty much decided to sign a DNR first chance I get - once I'm past the age I feel it's worth it.

Packer said...


Thanks, but for me a good life should insure a good death.

My wife refers to me as the angel of death, because she actually sends me to visit people and tell them that it is ok to go, and being some sort of idiot, I go and do it. Gently of course, but I do go and tell them that they can let go, if they are ready, there is no need to hold on through their suffering. I did it for her Dad, her aunt, the lady next door, my brother, the guy across the street. She marvels at how effective it has been.

I think Doctors ought to be saying it is ok to go and stop with some of this end of life extension--not me.

A lot of medical folks read this blog , we need to have the discussion.

Library-Gryffon said...

I've heard a lot of stories of people who have held on until family tells them that they don't have to keep struggling on if they are ready to go.

As for the original post and comment, it makes me think of a Monty Python (?) sketch where a doctor tells a patient the bad news that he's dying. On being asked how long, the response is "only 30 or 40 years".

Anonymous said...

I hold no disdain for us anonymous blogger clan, we like to keep it anonymous and let 'it' out only occasionally.

That being said, after working many years in nursing homes, before the PharmD, I figure dying is inevitable, and might as well make the most of it. Hopefully morphine helps take the edge off, if there is pain and dyspnea.

My father died rather quickly from pulmonary fibrosis. When we 'kids' were younger, he passed on his Army training, college experiences, school teaching career (PE, science, math), home-building pioneer ethic, 'of course you can do it, try it--keep your owly eyes open and let us know what learned'.

He had rheumatoid arthritis and for a very active man, he 'suffered' many years in silence before 'biting the methotrexate bullet'. Which did not deter him from continuing to climb mountains, go spelunking, take up new hobbies, go canoeing with his grandsons on a nearby lake, help with projects, photography, visiting relatives, sons and daughters, and everything else that has made his vitality sorely missed.

Unfortunately RA does a number on the immune system, and certain organ functions. When someone crashed his car, and he fractured ribs, it was oh so important to keep his rib cage moving for adequate exchange of oxygen. When he left hospital on oxygen, the MD had put him on azathioprine which was ineffective for his situation and left him off the methotrexate. He still swam three days a week at the local natatorium, with portable oxygenator, but landed back in ER with oxy sats at 78% and the start of the rapid decline because corticosteroids no longer worked as well as they'd helped before.

Short term memory goes with oxygen deficits, as well as other bodily functions and at the end, all we could do was tell Pa that he had been a good man, and that we'd miss him but that we'd carry on with what he'd taught his 8 kids(!)

We were lucky to hold onto that aspect of his death, a process as important as the 9 months it takes to create a human being. He was grace and consideration for others personified, even as his oxygen diffusing capacity diminished.

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