Advanced Directives – My Personal Experience When Planning for the Unexpected
Like many of you reading this article, I never think a major medical disaster could happen to me or, if something did happen, that I would be competent enough to make decisions for myself. Well, as a ‘relatively young’ guy, this was not the case recently when I needed emergency surgery to prevent permanent paralysis. Two years ago, I was practicing my golf swing on a late Thursday afternoon at Sleepy Hollow in Brecksville, Ohio. I’m a terrible golfer and I wanted to ensure I wouldn’t embarrass myself the next day while playing with a client. Near the end of my practice, I decided I wanted to see how hard I could hit the ball. I hit the ball with maximum effort that ended up landing on the fairway outside of the nets. During my swing I felt a ‘pop’ in my back and my leg went numb. I decided to call it quits and go home to rest.
That night, while resting I leaned over to grab the TV remote. Without warning I had excruciating pain suddenly occur in my back and my legs went limp. I was on the floor unable to move or reach my phone. Luckily, my friend was visiting and he called EMS. When EMS arrived, I was crying from the pain, unable to move my legs, laying on the floor. I have never experienced anything more painful in my life. The paramedics gave me a shot of fentanyl for pain – it did nothing. Upon arriving at the hospital, the nurses gave me a shot of morphine – it did nothing. Then the doctor ordered a dilaudid. After an hour of being on a combination of fentanyl, morphine, and dilaudid, I was finally relieved of pain and in addition, also relieved of my mental abilities.
After an MRI was performed, the doctor came to give me the news. She said that I had a severe lateral herniated disc. The disc exploded and was piercing the nerves that control my legs. I would need emergency surgery within the very immediate future, or I would have permanent paralysis in my right leg for life. She explained that because the herniation was lateral, it required a more complicated approach. It was one that she could handle, but she felt her colleague (who was on vacation) was more adept due to his experience. The doctor suggested that I wait three days, in severe pain and on multiple pain meds, to have her collegial surgeon perform the surgery. She needed to know what I wanted to do. However, because of the effect the medications I was taking for pain, I did not have the mental competency to make this decision myself. Instead, those who I named in my advanced directives would need to make these decisions for me.
Simply put, advance directives are legal documents that provide detailed instructions about who should oversee your medical treatment and what your end-of-life or life-sustaining wishes are. In the event you are unable to speak for yourself, like in my case of mental incapacity, the medical professionals can contact someone else who has authority to make those decisions for you. Though there are many advance directive documents out there, the three most common are Healthcare Powers of Attorney, HIPAA Authorization and a Living Will.
Healthcare Power of Attorney – A healthcare power of attorney allows you to appoint a trusted person to make all healthcare decisions in the event that you are unable to make them for yourself.
Living Will – A living will eases the burden on your healthcare POA to ‘pull the plug’ when you are in a permanent vegetative mental state.
HIPAA (Health Insurance Portability and Accountability Act) – Medical records are private and are covered under the HIPAA laws. You Healthcare POA must have the authority to obtain your medical records through a properly executed HIPAA authorization.
My Healthcare POA
By this time, I was admitted in the hospital and the surgeon needed an answer regarding when I wanted the surgery to take place. The doctor asked to contact my healthcare POA. I said, no problem her name is Kathy and I will provide her number. I reached for my phone and it was then I realized that I had forgotten it when EMS brought me in. Like many of us, I did not memorize Kathy’s number so without my phone, I was stuck. Additionally, since this was during the outbreak of COVID my friend who called EMS was not able to come into the hospital either.
The nurse taking care of me looked through my cart and noticed I already had my healthcare POA on file, naming Kathy as my Agent. I wasn’t thinking clearly so I hadn’t thought to ask the nurse to check. It was then that I remembered, in a slight daze, that I practice what I preach. Three years earlier I completed all of my advanced directives and made sure to upload them with all three major hospitals: Cleveland Clinic, University Hospital, and Metro.
The hospital called my Healthcare POA and she came to my rescue. As a nurse herself, she knew exactly what medications I was on and how to interpret the medical situation. Moreover, and critically important, she knew how to handle the insurance barriers that come with getting medical treatment. Had I not completed my Healthcare POA, Living Will and HIPAA several years prior, I may have had a surgery from an inexperienced surgeon or worse yet, may have been paralyzed for life. Additionally, had I not uploaded these precious documents with my local hospitals, I would not have had my healthcare agent’s phone number.
When I preach to clients about maintaining updated advanced directives I am preaching from experience. I didn’t need them, until I needed them! Advanced directives are easy to obtain and require minimal effort to have them uploaded to local hospitals. I implore you to have them drafted by an attorney or at the very least, complete them the next time you’re at your family care physician. For more information or to learn how Baron Law can help you complete your advanced directives, contact us at 216-573-3723.