Book Club: Why I Hope to Die at 75

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Ozchrissy
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Re: Book Club: Why I Hope to Die at 75

Post by Ozchrissy » September 20th, 2014, 4:58 am

I doubt I will even make 75, so to me this is hypothetical. I was diagnosed with cardiomyopathy at 45, given a realistic 5 years and lived my life to the best of my ability since that time. However, I really was sick, and the prognosis at that time, 1999, was realistic. Should I have been denied medical care because my disease was classed as terminal, even though I was youngish. I am currently 60, I survived eosophageal cancer, with a serious heart condition. Should I have been assessed as to whether I would be productive in the future, should the cost of my continuing care have been considered before offering me treatment. I do not expect that I am going to get any more productive in the next few years. I am undergoing surgery on the 26th for gallstones, is this just another waste of money, as I may die soon anyway. Is it worth the cost of keeping me going.

Where do you call the line with this type of economic rationalism. The child with down syndrome who needs heart surgery, the premature babies that face the risk of brain disorders, the quadriplegic who wants to continue on with his life.

Who has the right to decide what is a good quality of life. Both my parents lived into their mid to late 80's. They had an excellent quality of life until they died. Conversely my Aunt, whilst suffering from bone cancer, aged 81, fell out of bed and broke her hip. She was given a hip replacement. She consequently died 2 months later, but with a new hip. This intervention with my Aunt I actually find cruel, but she was mentally alert and made the decision herself. I find this article very confronting, but in the long run, we have to consider all these issues on an individual basis, not as some big picture with money and statistics taking over from the personal nature of our own aging and dying.

I also have very strict instructions about prolonging my life unnecessarily, I really believe age does not and should not come into the equation, but should be dependent on the quality of life that the individual person wants. Not what society feels necessary.
“I am not what happened to me, I am what I choose to become.” Carl Jung

Diagnosed with cardiomyopathy in 10/99
LBBB & VT diagnosed Feb 06
Guidant Biventricular Pacer ICD inserted Feb 06: Boston Scientific Incepta CRT-D inserted May, 2012
Oesophageal Cancer, 2012, Gall Bladder & Septicemia 2014 resulting in VFib and severe heart damage
Bare Metal Stent May, 2012 Mitral Valve replaced 2015
Meds: Entresto, Bicard, Coralan, Eurtorxsiq, Frusehexl, Spiractin, Sigmaxin, Creon, Warfarin,
Appropriate Shocks for Ventricular VFib.

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mrag
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Re: Book Club: Why I Hope to Die at 75

Post by mrag » September 20th, 2014, 5:29 am

Chrissy-I'm not sure there are such direct financial issues raised in the article itself, but maybe you are onto something. I just did a search on the author Ezekiel Emanuel and it was very interesting reading. A medical doctor with his own website, he is well educated (if you consider Oxford, Harvard and Amherst decent educational institutions), an architect on Obamacare (oh my) and the brother of the mayor of Chicago, Rahm Emanuel (also former Chief of Staff for Obama). Looking at a few links adds some flavor to the article. And as far as news reporting accuracy is concerned, there was one in particular I found 'insightful.' It is a Breitbart piece for which I strongly suggest you read at least the first few paragraphs. Its opening sentence:
Dr. Ezekiel Emanuel, one of the masterminds behind Obamacare, has now explained that he wishes to die at age 75.
I wonder if ROBO will take exception to that as "the full premise of this article?"
"The greatest enemy of knowledge is not ignorance, it is the illusion of knowledge" S Hawking

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David882
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Re: Book Club: Why I Hope to Die at 75

Post by David882 » September 20th, 2014, 6:59 am

A living cell (not phone) was at one time thought to be a rather simple construct. Now the cell is understood to be a complex bio-machine that has details yet to be understood. Krebs cycle was, once discovered, thought to be a few simple steps and now there are volumes written, detailing the process of energy exchange in the cell. One can find articles dating back to the 1950's were the means to creating life are being put forward. Now it appears that the best we can do is recreate life and the initial start of life is still very difficult to postulate.

My point is that we keep going off making assumptions about life based on the assumption we understand what life is. Perhaps optimum useful life spans, eugenics, statistics value of life, and other such thinking are people trying to establish some sort of control on life. Of course life appears to be unwilling to have anything to do with any of these measures and continues to produce contradictions to such controls.

In large discussions these various measures or controls can be discussed but none of them appear to withstand detailed inspection over time. i suggest that it is very hard to measure something that is so poorly understood. So we use terms like "quality of life" but what does that term mean and if it is different for each person then it is not much of a rule, measure, or even guide. It simply becomes whatever one wants it to mean at the moment.
With Respect,
David

11 Sept 2012 / Idiopathic Ventricular Fibrillation
At about 2AM I started storming at home, and in the ambulance, and in the ER.
Sometimes I restated and sometimes I had to be defibrillated.
A number of times I went into arrest and stopped breathing.
External defibrillation count exceeded 18 and at some point the team induced a coma.
24 hours later I was revived and have never had another event.
13 Sept 2012 / Medtronic ICD was implanted.
My diagnosis is still idiopathic.

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Ozchrissy
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Re: Book Club: Why I Hope to Die at 75

Post by Ozchrissy » September 20th, 2014, 7:13 am

Al, over here we have a new Government, conservatives like your Republicans. Their first budget decided to raise the retirement age to 70, and also to place a surcharge on our general medical care. These haven't been passed, because we have a hung senate that will not pass the legislation, but the reasoning was exactly as your new article stated. Our medicare system was set up when people were dying earlier, and therefore the new longevity was not taken into consideration. That probably explains why I understood the financial reasoning, as I can see it happening here.

David it has taken me 4 readings of your post to fully understand your reasoning, (sorry it is late over here) but I now fully understand your reasoning, and I totally agree.
“I am not what happened to me, I am what I choose to become.” Carl Jung

Diagnosed with cardiomyopathy in 10/99
LBBB & VT diagnosed Feb 06
Guidant Biventricular Pacer ICD inserted Feb 06: Boston Scientific Incepta CRT-D inserted May, 2012
Oesophageal Cancer, 2012, Gall Bladder & Septicemia 2014 resulting in VFib and severe heart damage
Bare Metal Stent May, 2012 Mitral Valve replaced 2015
Meds: Entresto, Bicard, Coralan, Eurtorxsiq, Frusehexl, Spiractin, Sigmaxin, Creon, Warfarin,
Appropriate Shocks for Ventricular VFib.

InSync
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Re: Book Club: Why I Hope to Die at 75

Post by InSync » September 20th, 2014, 9:18 am

Chrissy, I agree that we shouldn't ration care based on what we think is the value of someone's life or contribution in the world. Still, I think the point you make is where we so often go wrong with the healthcare conversation. The healthcare industry is a business, but the delivery of care is medicine. They don't make good bedfellows. The problem we have in the US right now is that we're trying to measure the value of medicine in terms of dollars instead of health. You would be outraged if you read our Affordable Care Act. I think our perspective may be different because we understand life with a serious chronic illness. Most of us here seem to have personal limits on how much intervention we're willing to tolerate and have given the end of our life much consideration. The extraordinary measure that we don't want imposed on us are the same measures we want access to, if we so choose.

I wonder how we would view this article if we changed the age 75 to some quality of life issue. Why I don't want to live beyond my ability to.......
Dilated Cardiomyopathy, LBBB, CHF
St. Jude CRT-D 5/12
The beat goes on.....

InSync
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Re: Book Club: Why I Hope to Die at 75

Post by InSync » September 20th, 2014, 10:15 am

Sorry for the rabbit trail mrag. Specific to this article.......
I love to watch tv but rarely get to. Spending my last ten years in front of it is part of my retirement plan. It doesnt fill me with dread. Why do I have to contfibute after 75. What's wrong with rest and relaxation? His suggestion that we are robbing our children of their opportunity to be matriarchs and patriarchs must come from his own controlling personality. Lots of folks hand over the reins. I want to live a long long time.....in front of my tv. Not contributing. Still, I dont want someone wiping my but and feeding me from a spoon. The problem I have with the way he presents himself is how he judves the value of life.
Dilated Cardiomyopathy, LBBB, CHF
St. Jude CRT-D 5/12
The beat goes on.....

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David882
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Re: Book Club: Why I Hope to Die at 75

Post by David882 » September 20th, 2014, 11:09 am

The idea that we would rob our children of some future value by living is an interesting thought.

What if I apply this to the young as well as the old. Youth has many values but experience is not one. Youthful passions have done many things wrong and caused a great deal of pain and suffering. So if a youth reaches a certain age and has not, at least, give an indication of paying society back for the investment to date, then should that youthful life continue? That is if this is just a cost/benefit value analysis based on the greater good.

You know i have some history books, about the place here, and this concept of the "greater good" appears to have a less than positive reputation.
With Respect,
David

11 Sept 2012 / Idiopathic Ventricular Fibrillation
At about 2AM I started storming at home, and in the ambulance, and in the ER.
Sometimes I restated and sometimes I had to be defibrillated.
A number of times I went into arrest and stopped breathing.
External defibrillation count exceeded 18 and at some point the team induced a coma.
24 hours later I was revived and have never had another event.
13 Sept 2012 / Medtronic ICD was implanted.
My diagnosis is still idiopathic.

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David882
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Joined: July 12th, 2014, 8:58 pm
Location: 49 06' 42.42" N 113 49' 52.52" W

Re: Book Club: Why I Hope to Die at 75

Post by David882 » September 20th, 2014, 11:13 am

Ozchrissy agreeing with me, at least according to my Daughter, can be clear indication of a need for psychiatric care :runaway:
With Respect,
David

11 Sept 2012 / Idiopathic Ventricular Fibrillation
At about 2AM I started storming at home, and in the ambulance, and in the ER.
Sometimes I restated and sometimes I had to be defibrillated.
A number of times I went into arrest and stopped breathing.
External defibrillation count exceeded 18 and at some point the team induced a coma.
24 hours later I was revived and have never had another event.
13 Sept 2012 / Medtronic ICD was implanted.
My diagnosis is still idiopathic.

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ROBO Pop
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Re: Book Club: Why I Hope to Die at 75

Post by ROBO Pop » September 20th, 2014, 1:12 pm

ROBO Pop wrote:No matter your position on this topic, I think it's great to generate these discussions and make everybody think, not just blindly follow. Thanks Al.
I stand corrected, everybody shouldn't be allowed to think for themselves.
InSync wrote: I agree that we shouldn't ration care based on what we think is the value of someone's life or contribution in the world.
So I should continue to sink money into repairing the ole car even though cost to repair far outpaces value. On the obverse, Junk yard purveyors have to eat too and deserve to make a living. Recycling parts is an economic boost and gets rid of all that unsightly scrap lying around the house.
Broken Heart
Nobody has ever survived life, but I'm trying...
My story and sticking to it
http://www.icdsupportgroup.org/board/vi ... 97&p=91375

InSync
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Re: Book Club: Why I Hope to Die at 75

Post by InSync » September 20th, 2014, 5:31 pm

I'm not really into cars, ROBO. But, I have a friend who has a garage full of old cars. They've had nearly every part replaced. He calls them classics. They seem to have great value.

Actually, I get what you're saying and totally agree. Clearly, I didn't say it well. I don't believe the value of healthcare should be measured by the cost, but by the health benefit. If you took the money completely out of the picture, does it change how we feel about how we provide care?
Dilated Cardiomyopathy, LBBB, CHF
St. Jude CRT-D 5/12
The beat goes on.....

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Ozchrissy
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Location: Australian

Re: Book Club: Why I Hope to Die at 75

Post by Ozchrissy » September 20th, 2014, 7:29 pm

David882 wrote:Ozchrissy agreeing with me, at least according to my Daughter, can be clear indication of a need for psychiatric care :runaway:

You have confused me again, is the psychiatric care for me, or for you. whewsmile whewsmile whewsmile whewsmile
“I am not what happened to me, I am what I choose to become.” Carl Jung

Diagnosed with cardiomyopathy in 10/99
LBBB & VT diagnosed Feb 06
Guidant Biventricular Pacer ICD inserted Feb 06: Boston Scientific Incepta CRT-D inserted May, 2012
Oesophageal Cancer, 2012, Gall Bladder & Septicemia 2014 resulting in VFib and severe heart damage
Bare Metal Stent May, 2012 Mitral Valve replaced 2015
Meds: Entresto, Bicard, Coralan, Eurtorxsiq, Frusehexl, Spiractin, Sigmaxin, Creon, Warfarin,
Appropriate Shocks for Ventricular VFib.

User avatar
David882
Posts: 882
Joined: July 12th, 2014, 8:58 pm
Location: 49 06' 42.42" N 113 49' 52.52" W

Re: Book Club: Why I Hope to Die at 75

Post by David882 » September 20th, 2014, 8:06 pm

Ozchrissy wrote: You have confused me again, is the psychiatric care for me, or for you.
Always me
Last edited by freckles1880 on September 21st, 2014, 7:58 am, edited 1 time in total.
Reason: bad link
With Respect,
David

11 Sept 2012 / Idiopathic Ventricular Fibrillation
At about 2AM I started storming at home, and in the ambulance, and in the ER.
Sometimes I restated and sometimes I had to be defibrillated.
A number of times I went into arrest and stopped breathing.
External defibrillation count exceeded 18 and at some point the team induced a coma.
24 hours later I was revived and have never had another event.
13 Sept 2012 / Medtronic ICD was implanted.
My diagnosis is still idiopathic.

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mrag
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Joined: February 10th, 2009, 4:56 pm
Location: The Former Mushroom Capital of World when America was great

Re: Book Club: Why I Hope to Die at 75

Post by mrag » September 20th, 2014, 9:23 pm

I don't wish to break the thread on who here needs psychiatric care, but I was curious about this quote
InSync wrote:I don't believe the value of healthcare should be measured by the cost, but by the health benefit. If you took the money completely out of the picture, does it change how we feel about how we provide care?
because I was thinking about the cost of providing Secret Service protection to the likes of Jimmy Carter or G.H.W. Bush or for that matter, Bill Clinton. What kind of benefit do we get from that?
"The greatest enemy of knowledge is not ignorance, it is the illusion of knowledge" S Hawking

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TruckerRon
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Re: Book Club: Why I Hope to Die at 75

Post by TruckerRon » September 20th, 2014, 9:58 pm

mrag wrote:I don't wish to break the thread on who here needs psychiatric care, but I was curious about this quote
InSync wrote:
I don't believe the value of healthcare should be measured by the cost, but by the health benefit. If you took the money completely out of the picture, does it change how we feel about how we provide care?
because I was thinking about the cost of providing Secret Service protection to the likes of Jimmy Carter or G.H.W. Bush or for that matter, Bill Clinton. What kind of benefit do we get from that?
Keeping them alive keeps their deaths, the chase/apprehension of the assassin, the trials, the funerals, etc., from clogging up our front pages and news broadcasts, not to mention all the retrospective pieces and documentaries, as well as the conspiracy theories from taking over our lives.

Those SS guys and gals are providing a great humanitarian service!
TruckerRon -- Received Minion I on 17 Sep 2009, Minion II on 26 Jan 2015

Non-ischemic cardiomyopathy
Medtronic Viva XT CRT-D
No shocks yet...
My intro is at: http://www.icdsupportgroup.org/board/vi ... 099#p57099

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TruckerRon
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Re: Book Club: Why I Hope to Die at 75

Post by TruckerRon » September 20th, 2014, 10:05 pm

Back to the original topic: I agree that there are times in the progression of our lives that we are tempted to say "no more!" Some of us could, if we wished, end our lives by abruptly ceasing to take our prescribed medicines. Others could just walk into the wilds and wait for exposure to the elements to do us in (I'd vote for a North Dakota blizzard).

Yet there's the little matter of family obligations, the desire to play with another grandchild, to attend (most of you) or perform (me) another symphony... My definition of adequate reasons for leaving this planet is likely to be very different from that author's. I've never climbed a mountain or run in a marathon, so my standards are probably much lower than his!

And my bucket list has a few things left, like visiting NZ someday.
TruckerRon -- Received Minion I on 17 Sep 2009, Minion II on 26 Jan 2015

Non-ischemic cardiomyopathy
Medtronic Viva XT CRT-D
No shocks yet...
My intro is at: http://www.icdsupportgroup.org/board/vi ... 099#p57099

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