request (written) to surgeon

Tomorrow morning I plan to use the written request to help create better understanding between myself and Dr. Lowe the surgeon.

Request to  Dr. Bruce Lowe, Surgeon

Background:  Based on April 19 day surgery for removal of a bladder tumor I understand that I have Bladder Cancer, or more precisely

“Urothelial carcinoma, high grade, invasive in the muscularis propria”

So, we have agreed on the following surgery: 

Radical Cystectomy (including prostate and lymph node removal), Ileal Conduit and Abdominal Stoma creation.

My goal is to maintain a high quality independent life.

I do fear a stroke.  I do fear long-term chronic pain.

I do fear losing my independent high quality life.   

I do not fear dying. 

Therefore

1. I’d like the anesthesiologist to work with us in helping minimize my pain in the days after surgery…maybe an epidural?

During surgery or later:

2.    IF you find that the cancer has spread beyond the bladder please consider alternatives that would allow for higher quality and perhaps a shorter life. (I understand and agree that the alternatives you choose might include deviation from the normal protocol of a radical cystectomy.)

3.    IF during surgery or my hospital stay, something goes wrong and my body is unlikely to return to the pre-surgery base line of a high quality independent life, let the body die. 

Notes: I have discussed these matters in great detail with my wife and three adult children.  All five of us are in complete agreement with the above requests.  I have signed a POLST and an Advance Directive.

 If the cancer has spread beyond my bladder, my intention is to choose palliative care only…  forgoing further surgery or chemo treatment.

Given of my own free will, May 23, 2011

John R. Wish DOB 7 November 1934

Witnesses