Navigating the Hospital and ICU
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Mettle Health founder and counselor BJ Miller, MD and Deven Kothari, Director of Surgical Critical Care at Banner MD Anderson Cancer Center in Arizona host an informal and interactive conversation on navigating the hospital.
Hospitals are amazing places filled with the latest technology that can make some pretty incredible things happen, but what if the problem isn’t acute, but chronic and ongoing? Hospitals have their own sense of time, of process and of care and if you’re not careful, you can end up on a conveyor belt that takes you away from your preferences. Understanding what goes on in hospital’s acute settings like the ICU can help prepare for your future as well as give you an insight into how the system works and how patients and families fit into that process.
We discuss:
0:00 Introductions
6:00 Historical look back on how medicine has changed, and how the role of doctor has changed. It used to be that one person took care of you throughout your life, but that has changed and that means the onus is on the patient and family.
11:05 The concept of organ reserve - people’s new normal is being sick, and we might be living on less function than we think we are.
17:19 What are ICU interventions? Common items: ventilators, trash, dialysis, etc. - these machines take over the function of what you need to survive. Yes, machines can support you, but can’t return your quality of life.
24:30 If you end up in the hospital, you need to make sure the team knows if you don’t want to be put on machines. Once you leave the hospital, that starts over so if you go back to the hospital, you need to say it again. This points to the importance of advance care planning
27:14 What should people know in order to navigate the ICU well? There are multiple teams with multiple members, how to interact with them.
35:50 Doctors are also part of our society that doesn’t discuss hard topics and also have a hard time being honest and frank in a crisis setting. What they might say is not exactly how they want to say it. Ask: “What would you do if you were me?”
41:23 Doctors are human beings too, they’ve been taking care of you and is emotionally invested in you and the success of treatment. These emotional bonds can make doctors less objective. Doctors also grieve.
45:36 Importance of having someone you trust at the end of your life or during a crisis who can listen, and see you as a person
47:15 Advice for someone who has severe allergies and is in the hospital?
53:35 Symptoms and effects after someone experiences a coma in the ICU? Is there ICU delirium? What does an ICU stay do to our mental health and thinking? There is ICU related PTSD. The ICU is to keep you alive, not getting you back to your life.
01:00:00 Multiple types of suffering, it’s not just pain
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