Gloomy news.....for some ..

This is depressing!  On HLN News today they said Florida (and maybe other states) is in a health crisis especially for outbreaks of flu that  may require ventilators. They say that the  (quote) "terminally ill patients and end stage MS patients will be turned away from life saving care" so for pete's sake don't get to the end stage of MS..  People are calling in outraged and people with parents who have  MS are also calling in.  They don't apparently have enough ventilators so the very sick will be excluded.   I am not yet terminal but am getting to the 'sit ion one place and don't move' stage. I am  having trouble breathing sometimes and often cannot muster up enough ooomph to cough.  In the last year I have gone downhill with a vengeance and I don't know what will be next.  I still try to be optimistic...

Marcie

[Quixotic1]

Oh, dear, I am saddened to hear of your increasing problems.  I worry for you and am always glad to hear from you.  You were one of this forum's first members and remain dear to my heart.

Yes, it is horrible to hear that some triage decisions are being made regarding terminally ill or end-stage MS.  The problem here is not a governmental overhaul of medical care, but a shortage of ventilators.  

I have seen this kind of thing happen before during RSV epidemics and the shortage of pediatric ventilators.  The solution is not readily come by - being the purchase of many more expensive machines.

The ethics are also very difficult.  Is it "okay" to let someone suffer or die when the person right next to him will likely pull through with the aid of the ventilator and live many more healthy years?  When you only have the one ventilator you have to consider that someone who already has a severely compromised pulmonary system will likely not survive the infection and the time on the ventilator, yet they may occupy the ventilator for days or weeks.

It is the same question that you have to ask when an extremely ill elderly might a new heart and would be in competition for it with a young person who could live decades more.

Most transplant programs have an upper age limit on getting certain transplants and rules about how otherwise healthy the person receiving a new heart must be.  Those ethics have already been explored, so there is a precedent for this discussion.

I hate it that the discussion must sometimes take place, but it has arisen over and over in my lifetime and always will come up.  Do I have an answer?  No.  In pediatrics I rejected the triage argument everywhere it came up, but sometimes the decision was beyond my hands.

SOAPBOX ALERT:  One of the partial responses to this dilemma must be the prevention of the flu.  When we decide whether to get a flu vaccine, we must consider NOT ONLY our own health and preferences/fears, but also who we might infect with the flu if we got infected.  If we are around people at risk for severe consequences of the flu (infants, elderly, weakened, compromised lungs or heart, transplant recipients, chemo patients) then we owe it to them to reduce our own risk of contracting the flu.

Yes, this is another urging for everyone to get the flu vaccine.  Also, in general, the relapse that you MIGHT get from the vaccine will be far milder than the relapse from the infection itself.  The difference is a few days of an antigen in your system versus 10 days of the virus replicating itself millions of times in your body with each one capable of continuing the stimulation of the immune system.

In addition, we must reduce our own exposure by not mingling with crowds and with good hygiene.

Take care Marcie, I will send you good thought so that you do not come anywhere near testing this decision.  Make the people around you get the vaccine, but follow your doc's recommendations for you.  In general, people with MS are encouraged get vaccinated.  At the first thought that you have been exposed make sure your docs know to get you on prophylactic antiviral meds.

Hugs,

Quix