Wednesday, May 8, 2013

What is To Die for? (Warning - some real life rant inc!)

We use that term so lightly!

I was thinking about my pathetic attempts the other day as I tried to figure out what Souglyy and Roshii meant about standing to the edge in Alysrazor (Firelands) so that the stuff doesn't agro on to you while the guys flying in the sky took down Alysrazor (as I tried to get the achievement Do a Barrel Roll).  Poor Luxy and Lush spent the better part of an hour as I ran all over the place, trying to fly and failing because I was too slow to get thru the rings (and trying to get them as well made their dps horrible) and then trekking up the mountains so that the stupid giant birds wouldn't get me.  Probably after about 7 goes I asked Souglyy what she meant and she told me you have to KILL the birds first before you go running to the edge - well that explains why I couldn't do it.  I tried guardian and resto to try and heal myself before the birds ate me but that was blah.  Anyway, my stupid Alysrazor achievement is still unfinished but I will try again when I have free time.  I was happy to keep killing myself trying to get this stupid achievement.  Unfortunately, me not getting it means I have to go back again...

Of course, people might think that killing myself over and over is crazy.  We do it for achievements all the time - something goes wrong, wipe it up and try again.  Of course you can only do that if your group mates are happy to do that as well.  

It made me think to real life - what would YOU die for?  And I don't mean how we jokingly talk about dying for a smoke, or dying for a drink.

There is a patient that I am going to be involved with in the future.  This lady has had a 10 year history of infertility, 3 failed IVF attempts and a few miscarriages.  She went back to her own country to have IVF and was successful - with twins.

Sounds awesome and happy right?

Wrong.  It's scarier than it sounds.

This lady has a health problem that is extremely risky in pregnancy.  The aorta (which is the major vessel leaving her heart) is dilated where it joins the heart, and there is a high risk of that rupturing as the pregnancy progresses.  She already has underlying blood pressure problems (which also exacerbate that issue) and a twin pregancy will cause more strain than a single pregnancy.  My colleague and I, who have been consulted about her, think she's probably got a 50% risk of rupture whilst she is pregnant, which is associated with an 80% mortality.  She also has abnormal heart valves, to top it off.

So in other words, she has a really really high risk of dying.  To have babies.

She has said that she would do ANYTHING to have them.  She doesn't care if she dies.  She does not want to lose these babies.  And a lot of people would think the same thing I'm sure.  Having babies is one of those things that people really feel their life is not fulfilled till that is achieved - and that's understandable .  Probably not something I would want to die for - though dying for your own children who are already born, I can understand.

Though in my own mind I think "If I was her, wouldn't it be nicer to live for the family you already have, your husband?  What if you die and your babies die with you (for there is that possibility which would also be a great tragedy) and then all that effort would have been for naught?", I realise that though I can make recommendations about what she should and should not do, I really can't tell people how to run their life.  Medicine is changing - people want to do things and though doctors can advise against it, patients will just do what they want to do.  And the sad things is that some doctors will let them do it because of the money they will get for it - because think about it, if someone wants something and you don't want to do it for them, because ethically it's not right, or it's not in the best interest of the patient, they will just go see someone else, who will happily take their money to do it for them.

Anyway, so where does that leave me and my colleagues now?  We now have this high risk lady, who is, admittedly, an exciting thing to have from a teaching and learning perspective, but we need to make plans for her, monitor her and her babies constantly.  And if her aorta starts to dilate to risky proportions?  Well, then imagine the awful scenario of trying to repair that when you have two babies whose lives are at stake - I am sure this lady will not want anything done.  And if she does rupture during labour (and I would have to recommend to the obstetricians from the anaesthetic perspective that she be delivered electively and NOT be allowed to labour because that would cause it to pop and the s*** would hit the fan then.

From a selfish perspective now, I wish patients would SEE that their choice affects not just their immediate family and friends, but also the health care workers who are involved in their care.  The stress of the situation if anything happened would be devastating for whomever was looking after her at the time.  Though I hope that I will be directly involved with her care because high risk obstetrics is my specialty and what I am good at, at the same time I also dread what would happen if she died under my care.  The frantic minutes of her going from alive to bleeding to death and then struggling to save her babies as well - they could all die whilst I am looking after her, and I know what I would feel - I would feel like a failure, I would feel like I was an idiot, I would feel like I would wish someone else had done it as maybe they would have done a better job than myself, I would feel upset and cry for the rest of the day... and this is after I have already consoled myself beforehand with the knowledge that I am one of the right people to be involved (as well as the cardiac anaesthetists), that I would have done my best, and ultimately it was the patient's choice to do this, and she accepted the risk of death.

But that doesn't make me feel any better if the worst happened.  That's not going to help me sleep that night if she and her babies died.

If only real life had a battle rez and some cooldowns so we could feel like we had a second chance.  No wonder I love playing a healer in game so much - a second chance to make things come good would be awesome if that could happen in real life.







15 comments:

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    1. Yes yes I know. I whinge too much.

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    2. That's not it at all Navi. If anything--glimpses into your real world are some of the most powerful things I read. Please don't ever say you whinge too much again.

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  2. I also know someone who has had a lot of infertility problems. So much so that she has basically been told that there's not much else they can do since she's had so many IVF attempts. It's hard to imagine what you would do in the same situation until you're there yourself. I can see where she's coming from and I can also see where you're coming from.

    Ultimately, we can only hope for the best possible scenario but given the high risk of complications, I know you will all do what is best given the circumstances.

    I wish them all the best as everyone deserves to have a little piece of them live on when it's all said and done.

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    1. A good outcome is what would be great for everyone.

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  3. Oh Navi :( I hope for her sake, her family's and her twins' sake and for yours and your colleagues, that it all goes well and everyone makes it through intact. what a scary situation..

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    1. Me too Ang! All of us hope that.

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  4. The most frightening outcome to me is that she might die and the babies live without their mother. I just hope for a good outcome for all concerned.

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    1. Maybe with so much hope from my friends, it might go ok! :)

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  5. What a truly scary and heartbreaking situation for everyone concerned. I just hope for a successful outcome.

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    1. Thanks for reading my whingy whiney Zeirah. On the real day I'll be thinking of you all and fingers crossed!

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  6. The world is such a scary place. I can not imagine having to make such a choice. Or having to work with such a situation. Hopefully everything will turn out alright.

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    1. If it goes well I'll treat myself to a chocolate. If it doesn't... might have to get out something stiff to drink.

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  7. I wish her the best, and hope everything goes smoothly. Don't really know what else to say, except you definitely don't whinge Navi.

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    1. Thanks DiP. I feel like a whinger though. My medical friends would prob say stop worrying about it, and I'm not worried about it exactly, just psyching myself up, I guess.

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