Decisions, Decisions, Decisions

Decisions, decisions, decisions. We face endless numbers of decisions during our health journeys. From the mundane, should I fast to lose weight? To the tedious, what statin should I take? To the heartbreak, should we do everything possible? Yesterday, after playing music, someone told us that he fasted to lose 20 pounds. How many weight loss discussions have we had in an endless number of settings. I can remember one time discussing it with my Primary Care doctor – no decision, no choice of action – just an observation that my weight had been steadily increasing over the years. My cholesterol is high, and my Dad died young of a heart attack (not from high cholesterol). I’ve taken six different statins. My Primary Care doc thinks the evidence is strong for me to take statins. We regularly change brand based on effects on my liver enzymes, cost, and insurance coverage.  A friend’s elder mother had major heart surgery. The cardiac surgeon reported success, she’s doing great – the blockage was successfully removed. She’s still in a coma, intubated. She’s never had end-of-life conversations, no advanced directives. Her husband will want to do everything possible. No decisions lead to a decision.

I’m overwhelmed with the number of decisions we face about our and our loved ones’ health. We make them in the course of daily life with people in our social networks, alone at night, with our doctors, or by not making decisions. I’m curious how it all turns out. What outcomes resulted from decisions made or not made. Was weight lost? For how long? At what emotional cost?  Did the cholesterol level stay down?  Was the heart attack or stroke prevented? How was health affected by years of taking the statins? What happens if they’re stopped after age, 70? How long will she live in a coma? Will she regain any function? How will caring for someone in a coma affect family, caregiver, and care partner physical and spiritual health? How do we glean evidence from all these decisions?

Danny

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  • Sue says:

    Thanks Danny–this health care/end of life decision-lack of decision making occupies my awareness a lot. I’ve got a Living Will and named my hubby my healthcare proxy, and keep adding to the detailed instructions at the end–telling what procedures/nourishment/water/antibiotics other life-prolonging measures I do NOT want when my physical/mental/awareness state is sufficiently impaired. Every time I hear of another way of going to the end–I’m likely to think, and if THAT happens to me, don’t try to fix it. And tell my closest kin about it. I forgive everyone in advance for letting me die a little bit before the possibility of a quality day or few hours arriving after arduous physical horrors, rather than prolong needless suffering for me and everyone around me.

  • John Hoben says:

    Hi Danny – what’s your genetic marker indications for your propensity to be in the small, small percentage of the population who actually benefits from taking statins?

    See Eric Topol’s research in this area starting at http://www.forbes.com/sites/matthewherper/2012/03/04/top-cardiologist-argues-we-should-dial-back-on-statins-because-of-diabetes-risk/ this article from over four years ago.

    Thanks for all you do for SPM, Danny.
    John Hoben

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