ICD, AAA, and 3 G's on a passenger?

[Diana]

Any thoughts on how several seconds of 3 G's might affect a willing passenger (family member) who has an ICD and an AAA (on Coumadin therapy)?

Thanks.

 

[bbchien]

Any thoughts on how several seconds of 3 G's might affect a willing passenger (family member) who has an ICD and an AAA (on Coumadin therapy)?

Thanks.

3 Gs is sort of at the upper limit. The problem is with the "INR" ratio. We know that at 3 gs if the INR is high, micro hemmorages that are asymptomatic can become bigger than micro. There is a world of difference between the "international Normalized Ratio" of 3.5 and of 2.5.

There is no data on AAAs but the larger ones- 6 cms or thereabouts I would be subjecting to NO stresses.

So, I sort of depends on the medical detail you have on the family member. How about a 2G(+) profile? Hoover used to do it....but generally if the member is a loved one, I wouldn't do this. Sort of like subjecting the family member to an airbag decelleration accident with his main pipe bulging and the microleak control mechanism disabled. Sigh.

 

[Diana]

3 Gs is sort of at the upper limit. The problem is with the "INR" ratio. We know that at 3 gs if the INR is high, micro hemmorages that are asymptomatic can become bigger than micro. There is a world of difference between the "international Normalized Ratio" of 3.5 and of 2.5.

There is no data on AAAs but the larger ones- 6 cms or thereabouts I would be subjecting to NO stresses.

So, I sort of depends on the medical detail you have on the family member. How about a 2G(+) profile? Hoover used to do it....but generally if the member is a loved one, I wouldn't do this. Sort of like subjecting the family member to an airbag decelleration accident with his main pipe bulging and the microleak control mechanism disabled. Sigh.

Thanks Bruce.

This might be in the category of "last request" of a former pilot. Family members (my family) have all agreed to it. Lot of things to factor in.

I'll see if I can figure out how to do a 2 G loop.

 

[bbchien]

This might be in the category of "last request" of a former pilot. Family members (my family) have all agreed to it. Lot of things to factor in.

How was it I had something like this figured? I wouldn't re-learn a different technique. This is an either enjoy it or not kind of flight. He knows what he's in for. Really.

 

[rfbdorf]

Bruce -
What's the chance of ICD lead displacement during the maneuver? My guess is not large, if they've been in place for some time. What about some added support to hold the ICD in place (like an Ace bandage)? It's unlikely to actually travel anywhere, but might be uncomfortable. No experience myself...

Diana -
I hope he has a great time!

- Richard

 

[bbchien]

Lead displacement is unlikely. They are amazingly close to the S.Grav. of blood- only a tad more dense, so very little net force. But the generator unit probably should have a compression dressing over it - it'll get quite heavy. As it's been there a while, the capsule is quite tough; it'll just be a bit uncomfortable.

 

[Diana]

Diana -
I hope he has a great time!

- Richard

Thank you Richard

 

[Diana]

How was it I had something like this figured? I wouldn't re-learn a different technique. This is an either enjoy it or not kind of flight. He knows what he's in for. Really.

OK, thanks Bruce.

 

[Unregistered]

An update on the ICD. The option of turning it off is being discussed. Being shocked several times a day has been wearing him out. He is refusing further aggressive treatment and dialysis. IV Lidocaine and IV Amiodarone have barely slowed the ventricular tachycardia episodes. He is getting excellent care in ICU. The combination of kidney failure, liver failure, end-stage heart failure, COPD, waning intellectual function and the 6 cm AAA are just some of the reasons why he is not a surgical candidate and is a DNR. His quality of life lately has been very poor and is rapidly diminishing.

The family is looking to me for answers and guidance. He is aware (barely) of the consequences of having the ICD turned off. As he fails more in the next few days he will no longer be able to make that decision, so it will be up to the family.

One of the hardest decisions I have ever made concerned taking him for an aerobatic ride. I’m glad I took him for that ride and appreciate the input you gave me to help me with that decision.

 

[Diana]

Well, that last post was mine; didn't know I wasn't logged in. My computer's a mess and my cookies are acting up. Haven't had time to figure it out.

 

[TeenDoc]

Well, that last post was mine; didn't know I wasn't logged in. My computer's a mess and my cookies are acting up. Haven't had time to figure it out.

Wow Diana, I didn't respond to the initial thread but followed it intensely. I really appreciate your sharing this life experience with us. I am frequently in a situation where I have to advise families in end of life situations and I have learned from your experience. Some of my colleagues are all about "saving" a life to the last effort, frequently in spite of the person who is suffering. I am more of a "quality of life" person.

You did a very gracious, heroic, decision, and because of that you will remember your love one's smile on that day forever, not his last suffering days. My hat's off to you.

 

[bbchien]

Well, that last post was mine; didn't know I wasn't logged in. My computer's a mess and my cookies are acting up. Haven't had time to figure it out.

See your email, Diana....

 

[Toby]

Diana...................just sending a hug and can't find the right smiley. :-/

 

[Diana]

Wow Diana, I didn't respond to the initial thread but followed it intensely. I really appreciate your sharing this life experience with us. I am frequently in a situation where I have to advise families in end of life situations and I have learned from your experience. Some of my colleagues are all about "saving" a life to the last effort, frequently in spite of the person who is suffering. I am more of a "quality of life" person.

You did a very gracious, heroic, decision, and because of that you will remember your love one's smile on that day forever, not his last suffering days. My hat's off to you.

Gil, thank you SO much. Your insightful comments mean so much to me. End of life issues can be difficult to discuss for a lot of people. I also agree with your sentiment of “quality of life”.

In case you didn’t see the thread that I posted in April, here is his aerobatic ride:

http://www.pilotsofamerica.com/forum/showthread.php?t=1004

Thank you again.

 

[TeenDoc]

Diana,

I had not read your original post until just now. It's even sweeter than I had imagined. From your most recent post I made a mental picture, it was close, but not quite. Thanks so much for sharing the story. And again, you made a heroic decision that took a lot of thought. I believe it was successful because it was driven by love, the real love and founded on a scrupulous examination of the situation.

This past September I flew to Puerto Rico with the only intention of taking my dad, who is 75 years old, flying. He didn't know anything, it was meant to be a total surprise. In the back of my mind is always the thought that he may not be with us too much longer. I took a week off from work and flew down (commercially). I rented a C172 from the place where I learned to fly back when I was 16 years (many moons ago! ) and took him all over the island and to Saint Thomas, a flight that brought back a lot of memories of times when we were younger and flew together a lot more often. He recalled detailed events that I had completely forgotten. When I left, on my way to the airport to return to New York, he whispered in my ear "I had the best week of my life." I can't erase those words from my head.

 

[Diana]

Diana,

I had not read your original post until just now. It's even sweeter than I had imagined. From your most recent post I made a mental picture, it was close, but not quite. Thanks so much for sharing the story. And again, you made a heroic decision that took a lot of thought. I believe it was successful because it was driven by love, the real love and founded on a scrupulous examination of the situation.

Gil, your thoughts mean a lot to me. I did spend some sleepless nights worrying before the flight, and was relieved afterwards that it went well without doing any harm to his frail body.

When I left, on my way to the airport to return to New York, he whispered in my ear "I had the best week of my life." I can't erase those words from my head.

That actually gave me goosebumps. What a wonderful thing you did! Thank you for sharing it here.

 

[etsisk]

Diana and Gilberto -
I hope you can realize what precious gifts were passed back and forth, between you and your pax. I lost my brother just after Christmas - he was dx with cancer in September (he announced it when we were down there for my birthday) and only lasted 15 weeks after that. God as my witness, I wish there had been something I could have done for him that was as special as what you were able to do for your special ones. God bless you for it . . . well, actually I guess that's already happened, just in the doing of it and the memories you made and the memories you shared with us.

Thank you -

 

[woodstock]

awwww, Diana, I'm sorry. I'm glad you got to take him on his ride. is he still with us? it was a few days ago that you posted that you were going to disconnect him.

we had our own family probs this past weekend. My Gramma turned 90 yesterday, and we were all set to go home to celebrate over the wkd... when last Wed she had a heart attack. She already has CHF, had a quintuple bypass 5 years ago (4 are clogged, only one is open now) and even had a mini stroke (TIA likely) on Saturday morning. despite all that she was lucid and talking when we saw her Saturday. she's still in hospital of course. when you leave you don't know if you are going to see them again, you know?