Medical Directive: No Futile Heroics No CPR No Agony | Comfort & Mercy | Life Quality Over Quantity

Medical Directive: No Futile Heroics No CPR No Agony | Comfort & Mercy | Life Quality Over Quantity

SUMMARY

• alex trebek aims to ‘fight’ pancreatic cancer with 5% odds of success; that is futile care/effort.
• anti-smoking ads and combat vets prove death a better option vs a lifetime of trauma/coping.
  
  
• in a 2012 article in The Guardian, "How Doctors Choose to Die," retired MD Ken Murray reveals that many doctors refuse everything from chemotherapy to CPR in their directives.
  
  
• "when an animal is suffering and not turning a corner with nutrition hydration in 24 hrs and chance of survival is only 20%, it's time to do the humane thing: euthenize." ~exotic animal ER
  
  
• a moth, fly, bug trapped inside flying against the window trying to get back to life outside, if nobody helps, they will live high stress lives until they starve or someone sets them free or snuffs them out, all better options than living permanently trapped under duress.
  • all critters i kill incl bugs/mice die quickly as i’d want to be ‘put down’ when its my time.
    
    
• these are my wants, many not yet legal, but should be in a bill of rights, if free will matters.

TREATMENT PREFERENCES

• open to limited basic stop-the-bleeding triage incl minor reconstructive ex. setting broken bones (no pins/plates), suturing, but no futile heroics no CPR no code no agony.
  
  
• check gene profile biocompatability: A-, compound heterozygous MTHFR, COMT, etc.
• focus on jump-starting/optimizing the immune/inflammatory systems’ natural healing process.
• prefer whole foods european/mediterranean/paleo angle vs rely on isolated nutrition/rx regime.
• request holistic lead MD or ND who grasps the spirit of this guideline: life quality over quantity.
  
• if prognosis of 85% functional recovery and 85% reversal of prior debilitating symptoms (ex. neurological/autoimmune/metabolic) is not realistic in 6 months and/or a procedure has less than an 85% success rate for a desk jockey weekend gym type with my prior condition/genetic profile, then non-surgical non-rx holistic bioelectric interventions and comfort measures only as a stopgap while a merciful 5min end-of-misery emancipation dose is organized (euthenasia).
  
• if infectious disease or critical accident, apply all mercy options legal for ‘6-months left to live’ terminal prognosis to all volatile scenarios and threats if things could turn at any moment.
  
• avoid near every invasive/surgical intervention, even under threat of ‘you may die if we dont’. 95% are elective and many are over-rated incl. appendectomies, c-sections, brain/spine, root canals and crowns, almost always there’s a safer more natural and conservative option that takes longer ex. natural birth, remineralization of bone/teeth via dietary alignment with nature.
  
• avoid most surgical/penetrating traumas/procedures incl catheterization, intubation, defibrilator, dialysis, ventilation, chemotherapy, radiation, spinal and bone taps, implants, transplants, transfusions, vaccines. avoid risking any additional longterm pain/complications atop existing pre-existing debilitating symptoms and related progressive issues incl neuropathies/anxieties.
• • if tumor, cancer, edema and most else, explore all non-invasive technology therapies only.
  • excising cancers/tumors is not a cure, never prevents relapse and all surgery risks micro trauma and infection.
  • a slippery slope, avoid all surgeries to a maximum degree; risks tend to compound.

• my system fast-metabolizes local anesthetics and while caines numb all soft tissue, they twice failed to numb bone during extractions (molars #19 and #30) even when injected into the bone.
  • if surgery inevitable, have many doses on standby; rather not wake early or feel anything.
    
• due to MTHFR gene/enzyme issue, suboptimized b2/b6/b12, high homocysteine:
  

  • avoid common dentistry:  heavy flouride, heavy metal, leachy plastics/bpa
  • avoid MTHFR-risky sedatives: Nitrous Oxide and Propofol can be detrimental even fatal within days of procedure.  Also avoid Epinephrine.
  • MTHFR-safe sedatives: Carbocaine; Sevoflurane; Versed; Fentanyl or NuCalm (if these aren’t options, epsom bath prior may help, and higher dose methylated Bs afterward)
    
• prefer bioelectric modalities (vs strong medicine surgery/rx) to optimize the body’s self-healing mechanisms incl vibration resonance therapies incl ultrasound, telsa coils, rife, pulse emf to stimulate regeneration of nerve/muscle/ligament tissue, DNA, autoimmunity and stem cells.
  
  
• open to 72 hours on artificial life support ex. defibrilation, catheterization, dialysis, ventilation, hydration, nutrition but only as a comfort measure stopgap while a merciful 5min end-of-misery emancipation dose is organized (euthenasia). pull plug only if death is quick or peaceful enough for family to witness. dont pull if it risks agony, choking in horror or struggling for an extended period.

• CPAP and portable oxygen to me are ‘life support’ yet ok as a comfort measure stopgap while a merciful 5min end-of-misery emancipation dose is organized (euthenasia).
• a daily injection regime and excessive daily pills (ex 2x/day) are chemical life support be it glucose vitamins minerals or nutrients.
• if not-futile triage, medically assisted artificial hydration/nutrition might be ok for 72 hours.
  

• if i refuse to continue treatment ex. shots, feeding, rx, rehab, no matter the consequences, honor refusals as relevant last ditch animal-nature ways we have to communicate our will.

• refusal to rehab should not be chastised but respected. physio rehab is worth engaging if it can regain 85% of your desk jockey weekend gym strength/flexibility within 3-6 months and reverse 85% of pre-existing debilitating symptoms (ex. neurological/autoimmune/metabolic). longer odds could seem futile and be overly frustrating.
  
• refusal to eat/drink, take pills/rx and to exercise/rehab shall be honored as an expressive end-of-life choice, and no amount rehab/rx/nutrition/treatments should be forced onto me at risk of new injuries and contributing to end of life confusion/anxieties vs clarity of will.
  • if i refuse pills, food or drink, turn my head away, or make efforts to avoid being fed, if coughing, gagging, spitting up, choking, or seem indifferent to being fed, then discontinue. no matter my condition, do not coax, cajole, coerce, harass, or force me to eat drink or take pills. the reflexive opening of my mouth is not to be misinterpreted as a desire for food or drink or as giving consent to being fed.
  • dying by starvation is natural and peaceful and a clear final expression of one’s own will.
    

• if 30% of my body is severely damaged/burned needing multiple surgeries, months of intensive care and rest-of-life support atop all the existing progressive debilitation, then non-surgical non-rx holistic bioelectric interventions and comfort measures only as a stopgap while a merciful 5min end-of-misery emancipation dose is organized (euthenasia).
  
  
• if amputations needed, but bionic prosthetics and a semi-active semi-sedentary normalcy within 3-4 months of rehab is not reasonable, atop all the existing progressive debilitation, then non-surgical non-rx holistic bioelectric interventions and comfort measures only as a stopgap while a merciful 5min end-of-misery emancipation dose is organized (euthenasia).
  
  
• don’t feed the phobias, don’t immobilize: no straps/cuffs, straight-jacket, keep neck/face clear.  
• anyone incl family/friends who bring up misplaced toddler-grade ‘mind over matter’ and ‘think positive’ examples must be asked to leave the room until they recognize implied blasphemy.
• agitated by high-pitched voices/rattles/squeaks/lisps/hisses/straw-sucking/mouth-smacking.
• death as Rx side fx seems ok if sudden painless horror-free, but most side fx tend to add more layers of issues, pain, suffering, complications, MDs and Rx. avoiding most rx is the key goal.
  
• if frightening issues persist beyond 5-10 days in a row to where i dont feel safe/stable enough to leave the house, drive a car, walk and do basic routines alone, then non-surgical non-rx holistic bioelectric interventions and comfort measures only; after 15 days then non-surgical non-rx holistic bioelectric interventions and comfort measures only as a stopgap while a merciful 5min end-of-misery emancipation dose is organized (euthenasia). (ex. dizzy/breathing spells, pain/numbing neuropathies, amplified sensitivities incl cold/hot and phobia/anxiety, excess wit/memory spells, 'need more air' spells, swallowing errors).

• if i can't dance or sway aka enjoy music, help roadie a little, what's the point? let music be therapeutic and a metric, as long as it moves me and i seem to enjoy it, let that be some kind of bottom line if i can't otherwise communicate. the day it loses its medicinal value, and my chances of 85% functional reversal/recovery look bad, it’s time to leave the party, head home.
  
  
• walks: while asphalt is softer than cement, i avoid flat paved paths, prefer soft shoulders, uneven dirt gravel bark thatch (frizbee golf parks like walden park ideal): its better for head-to-toe active proprioception/balance.
  • i rarely trip even if distracted, and if do, i always recover in stride. ex-infantry/ex-soccer i know how to tumble so i never actually fall. when i do, it’ll mean something.
    
    
• if diagnosis of progressive debilitation, terminal or not, a ‘calm not hyper’ therapy dog ex. border collie (no small yappers/droolers) ideal in tandem with other comfort measures.

IF DEAD: NO CODE NO CPR

• it isn't death we fear, it's getting stuck half-dead half-alive, trapped in limbo, in a prolonged state of fear pain horror for longer than is humane, longer than we let any animal endure.
• natural or not, i prefer to die fast, sudden and without terror vs slow, in agony or full of anxiety.
• see merit in euthenasia protocols veterinarians use over inhumanity of ‘keep alive at all costs’.
  
• if no pulse, do not CPR; risks outweigh benefits. prefer to die only once.
• • specially if quality of life already on slippery slope, and interventions are unlikely to reverse 85% of existing issues yet risk adding new traumas ex. broken ribs, neurological issues.
    
    
• if dying (black tag) in agony choking terrorized, then administer a merciful 5min end-of-misery emancipation dose (euthenasia) stat.
  
  
• if near-futile ‘life-threatening’ critical injuries (very red tag) and it looks like trauma center or days in the ICU and 6+ months of pain/uphill hurdles plus rest-of-life issues/rx/support atop existing progressive degeneration (ex. neurological/autoimmune/metabolic), then ideally don’t crowd me (arms length x2 ideal), move me into grass, face me toward nature/sky aka comfort measures and administer a merciful 5min end-of-misery emancipation dose (euthenasia).

• last wishes
  • dont cover face/neck and no body bag, box, drawer, coffin for 30min. blessings ok or skip.
  • if brain dead 30min, drain blood, basic autopsy, harvest organs, prevent brain reanimation.
  • cremation with certificate, no funeral; music gathering, ashes to wind, plaque on bench ok.

RX

• due to MTHFR gene/enzyme issue, suboptimized b6/b9/b12 and detox, high homocysteine:
  • avoid common anesthetics: nitrous oxide, propofol, epinephrine 
    avoid common dentistry: heavy fluorides, heavy metals, leachy plastics/bpa
  • lactated ringers may also pose issues re mitochondrial dysfunction 
    
    

• no Rx i am genetically predisposed against, check biocompatability with blood/gene profile
• prefer natural remedies as first line i.e. activated charcoal, iodine, baking soda, peroxide, saline drip, herbs, minerals, etc.

• prefer Rx with longterm studies (trust 25+ year old drugs more than new overhyped v1.0)
• prefer Rx with fewest nerve/heart/brain/immuno side fx (sudden/pain/horror-free death fx ok)
• avoid all long-term/lifelong Rx treatments, but open to short-term painkillers to 'take edge off'.
  • most natural least processed with least horror/pain/neurological side fx (natural opiates ok, not synthetic opioids); but they must not add to total burden i am already long coping with.
    

COMFORT CARE: PALLIATIVE HOSPICE & HOSPITAL STAYS

• to go naturally in comfort sounds ideal, but in many cases artificially can be more humane.
• comfort & pain control may not offer much for conditions involving neurological issues incl balance/coordination, dizziness, swallowing, breathing, motor control, numbing, gait, bowel motility, hypersensitivities of sound/vision/touch, etc.
  
• palliative care is good to prevent invasive futile heroic treatments typical in hospitals so is a preferred option in many cases, but any care facility should affirm its willingness to honor this comfort+mercy directive; avoid a facility with policies that may impede vs fast-track all legal end of life options incl euthenasia doses and refusal to eat food fluids, refuse exercise, etc.
  
  
• find a holistic MD who understands these wishes and can accelerate healing or the end game.
• get me from a sterile (and infectious) hospital to a 1-story hospice/home as soon as possible.
• maximum natural light, dim all artificial; rural sounds i.e. chirpy birds, owls/coyotes at night.
  
  
• indoor air: keep it moving gently on my neck and face, no stagnant air, 70-72F.
• frequent outside garden visits (with n99 mask if outdoor air polluted < 60% baqi).
• claustrophobic tendency: don’t crowd me, arms length x2 ideal, dont immobilize me.
• prefer 85% natural fibers on body, head to toe, let skin breathe over fancy synthetics.
  
• prefer to get my last breath in open air outside among trees and wild grass, alone not crowded by anyone aka not in a hospital under LED lighting, scrubs/masks and sterile stainless steel.
  
  
• inspiring/eclectic audio playlists incl jazz, blues, country, bluegrass, afro-hispanic, world, rock, funk, gospel, soul, R&B, classical lullabies ex brahms – tasteful easy listening, not too intense or tinny (hint: jennifer hudson is super irritating screamer, many sopranos shrill and intense violins). also nature rural sounds incl chirping birds, river, coyotes, weekly owl, sunday wood pecker, horses/farm, token rooster or distant suburban midsize dogs ok.

DYING WITH DIGNITY – END OF LIFE – RIGHT TO DIE – AID IN DYING

• 'keep alive' is the cultural medical default that does not regard a victim's ‘quality of life’ history.
  
• whether natural or artificial, my ideal for self and loved ones is to die instantly with no excess choking or chance of survival, whether by lightning strike, blunt force or a hail of bullets or by a merciful 5min end-of-misery emancipation dose (euthenasia), quick is ideal, peaceful a bonus.

• mercy euthenasia laws are still way too conservative, impose hurdles too high, requiring two MDs to agree you have only 6 months left to suffer, sometimes a psych to confirm you’re in good mental health, two verbal and one written request to qualify for the euthenasia dose.
  • in my view, anyone with any symptoms progressively spreading and not reversing, should be qualified to get the euthenasia dose to self-administer based on intensity and months of pain/symptoms already lived with, and later have euthenasia administered to them if they can no longer administer it to themselves or speak for themselves.
  • nobody should need to wait until the last ‘6 months left to live’ to access a euthenasia dose.
  • have we ever seen an amputated or paraplegic farm animal? farms have euthenasia doses on hand for emergencies. every household should be allowed the same freedom.
  • veterinary medicine does western wonders for wildlife and livestock, but when things go south, we never let an animal suffer long before administering a merciful 5min end-of-misery emancipation dose (euthenasia). i want all the end of life options granted livestock and wildlife that ‘civilized’ humans are systematically religiously denied worldwide.
    
    
• i prefer not to wait until i can not take care of myself, so please fast-track all end of life options:
  • if i lose sensation or motor control in 50% of my body
  • if i can’t breathe/swallow or feed myself properly
  • if i can not control my limbs/bladder/bowels, not go #1 and #2 on my own, clean myself up
  • if i can not dress/bathe/groom myself, wipe own drool, brush own teeth etc.
  • if i can’t change the radio and tv channels, ring the bell
    
    
  • if I can not get around, leave the house and enjoy basic outdoor activities incl walking alone on unpaved uneven shoulders ex. dirt/gravel/thatch.
  • if i can not evacuate myself via stairs/windows in an emergency (am helpless/dependent thus destined to drown or burn aka die horrifically).

• if i cant speak/write/express myself, if my mind goes soft/fuzzy to my signature 4D analysis
• if i can’t follow/contribute to conversations, if i look/sound like a shell of myself, if recall fails

• any of the above are clear indicators that ‘quality of life’ has left the building and it is no longer a life I wish to prolong vs fast-track merciful euthenasia as we would for wildlife/livestock with neurological/metabolic/autoimmune/thyroid/heart disease/infection/parasites issues, etc.

functional medicine references:

• Kate Troup naturopath: mthfrsupport.com.au/2016/10/kate-troup-naturopath

• Dr. Josh Axe naturopath: https://draxe.com/about-dr-josh-axe

• Dr. Ben Lynch naturopath: http://mthfr.net/about/dr-lynch

• Chris Kresser acupunturist: https://chriskresser.com/about (bay area)

neuroscience references:

• Dr. Charles Parker holistic neuroscience at CorePsych.com and drcharlesparker.com

• Dr. Mark Steinberg, brainwave neurofeedback, relieve symptoms/pain: marksteinberg.com