Saturday, August 15, 2009

My Grandma's End Of Life 'Life Panel'


In response to all of Sarah Palin's codswallop about 'Death Panels', I wrote the following for the folks at Firedoglake who are fighting the real, true and honest good fight for Healthcare Reform down in the States......


Hi Folks.

RossK. here again...

I'm a Canadian who used to live in the States and started my family down there with y'all before I came home again.

So I know how Healthcare works on both sides of the border.

I also wrote quite extensively about a fellow Canadian, and Universal Healthcare Haters' Club Inc. shill, Ms. Shona Holmes here, here and here.

But today I want to tell you about my Grandma who died not long ago at the age of 91 after a long and full life that might have ended much earlier if it hadn't been for the Canadian Healthcare system...


Because my Grandma E. was 76 years old when she had her aortic aneurysm.


Now, I'm sure you all know the story of another much more famous Canadian, Neil Young, who also had an aneurysm, which is essentially the ballooning out of a blood vessel.

It happens when the wall of the vessel weakens due to disease, old age or, in the case of Mr. Young, because of a congenital abnormality.

'Congenital' means that you were born with it.

Which also means that it is a pre-existing condition.

Of course, despite the fact that he now lives in the States, Mr. Young didn't have to worry about any of that 'pre-existing condition' business because he is rich.


My Grandma E. was most definitely not rich.

At the time this story took place, she lived in a one bedroom apartment and owned a very well maintained 21 year-old Plymouth Valiant that she and her husband, my Grandpa A., bought the year he dropped dead of a heart attack while mowing the front lawn of my parents' new house one spring evening while I, a reportedly precocious six year old at the time, was inside watching the latest episode of Adam West as Batman on the television.


Neil Young also had another advantage over my Grandma E.

Which is that his balloon was small, just 8 millimeters long (less than half an inch), which meant that the surgeons could seal it off with tiny coils.

There was no way they could do that kind of minimally invasive procedure for my Grandma because her balloon was gigantic.

And it was located in the largest artery in the body - the aorta, which is pounded constantly, every time the heart beats, by the highest of high blood pressure there is given that it is the vessel that comes directly out of the heart and sends blood everywhere.

Oh, and I should also mention that when the doctors discovered Grandma E's balloon it was leaking internally into her chest and abdominal cavities.

Which meant that she was very, very sick and in big, big trouble.


I was in Gradual School* away from home when all this happened, but I went home immediately for all kinds of reasons, including the fact that my family had to talk with the doctors a lot and, because of my science-geek training, I knew a little bit about anatomy and medical stuff.

Now, I guess, if you were so inclined, you could call these confabs we had with the doctors 'panels'.


What did we talk about in all those 'panels' you might be wondering?


We talked constantly about what was best for her.

And about what procedures or treatments would be best for her and what her quality of life would be when all was said and done.

If she even survived.

And I want to be very clear about the following....

There were no discussions of Economics....

Or Costs....

Or Euthanasia.

And there were most definitely NO BUREAUCRATS involved.

In the end, we, the family, talked to at length with my very weak, barely conscious Grandmother and, together, we, and we alone, made our decision.

And our collective decision was to take the riskiest course, which was the one with the biggest upside.**

Major surgery....

The biggest risk of which was the possibility that Grandma E. would die instantly on the operating table because the weak-walled aorta could have exploded the moment the surgeons touched it.

It did not..... And they managed to sew it up and stent it during a surgery that was interminable as we waited and waited and waited, with regular updates from the nurses.

There was also the risk that Grandma E. would die soon after the surgery due to heart failure and/or lung congestion.

She did not.....It was scary for awhile, watching her struggle for breath as her feet and legs swelled, but she had never smoked, she was not obese, and she pulled through with the assistance of a constantly monitored arsenal of cardiovascular modifying pharmaceuticals.

It was also possible that sepsis or peritonitis could have taken her due to all that bleeding that had occurred inside her, but the massive, longterm doses of antibiotics worked there too.

And then, there was also the possibility that, in the end, the balloon would just move on down the vessel and the whole thing would start all over again.

It did not.

And a month later, my Grandma E. left the hospital.

And she moved back into her appartment where she had a nurse come and visit every day until she got better and started driving that Valiant again (which she eventually gave to my brother when her eyesight finally failed a few years later).

And why didn't I mention the bill for all this?

Well, because, of course, under Universal Healthcare that everyone supports and pays for, there wasn't one.


Grandma E. lived for another 15 years after her 'big surgery'.

And when she finally passed away of natural causes at the age of 91 it was a long, slow drift into peacefulness as her breathing slowed bit-by-bit and then, just like that........ finally......... stopped.

And I was sitting at her side holding her hand when she went.

I will love her forever.

*'Gradual School' is a term that was coined by one of my kids, who is one of Grandma E's great-grandaughters that she got to know and love years after her surgery was just a distant memory. The term, which the kids I now teach refers to graduate school as a place where you go and go and go (and go) until gradually decide you want to stop.
**Of course, all that surgery was also the most costly option.


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