Shielded group - phone call from GP

[Defaultuser]

I am on the shielded list and yesterday I received a phone call from my GP asking if, should I get coronovirus, I would want to be admitted to hospital for treatment or left to die at home.

I am on the list as I am coming to the end of cancer treatment, however I have a good prognosis. I am only 42 and have a young child, not that either of these things should matter.

I realise they are asking everyone on the list but it has made me feel really unsettled. This wasn't even about CPR, just any hospital treatment.

Has anyone else had this and how do you feel about it?

Your prognosis is good and you’re young. Where I work you’d have a full escalation plan. To not admit you to hospital would be negligent. I think this is quite shocking actually.

Ps do you have a cancer nurse specialist? I would let them know and they can write to your GP. It would be helpful to let your hospital know this has happened and they can intervene.

Thank you for your reply. I felt for the GP as she'd obviously been told to ask everyone but I thought these decisions were usually for people who were terminally ill.

I should also point out that I wasn't pressurised and my answer was that I definitely do want treated, but I was shocked to be asked in my situation.

I'd be unsettled by it too, but it sounds like it was a box ticking exercise so try not to think too much about it. J don't know anyone in your situation that wouldn't want treatment. All the best with your treatment/recovery

Yes, it’s unsettling, as is the advice to keep a hospital bag packed.

It’s being asked of all the exceptionally vulnerable, and you do not have to agree. Especially not if you are otherwise in good nick (bring shielded does not mean you are inevitably decrepit and likely to die in a year or two anyhow)

Resuscitation is however intrusive, usually brutal and potentially life changing procedure. So some people may decide they do not want those procedures (remember it’s not a synonym for not being treated).

I am rejecting DNR - because I am in good nick other than having a chronic cancer. And I was reading that the drug used for the other chronic leukaemia (CLL) is being trialled for COVID. My CML drug is also a TKI, but of a very different type. So I dare say they might like to see how I get on, just in case they learn anything useful

I think your GP has misinterpreted a memo. It’s important to know a persons preference but this should have been targeted at people who are likely to be palliated if they are admitted. Even then (unless they are at end of life) we often take our essentially palliative patients to hospital to treat UTIs and other infections.

iVampire if CML is your only illness then you shouldn’t need to be in the shielded group. They’ve unhelpfully lumped CML in with other leukaemias. If you google BSH CML Covid you’ll find the expert working group statement for CML patients.

‘ I thought these decisions were usually for people who were terminally ill‘

You’re correct. And it is still
only relevant if you die (heart or lungs fail) And they’re asking about DNR because risk of death to the shielded population is high (not a nice thought, but one we have to come to terms with)

You will of course be treated if you get CV. And you may well respond to treatment - even with comorbidities you are more likely to live than die. It’s just that if you die (your heart or lungs stop) they will not attempt to resuscitate

But the OP says they were asked about any hospital treatment - not just getting resuscitated,

IheartNiles Thanks for that heads up!

I’ve had a routine appt since shielding began. I was told that CML patients are the ones they worry about least, but evidence is insufficient so precautionary approach being taken. So staying under the shield, but individual medical advice can amend it for your specific circs (I think: response to treatment, and state of outbreak where you are)

I decided to stay indoors until peak is definitely flattened where I am. After that, going out occasionally for exercise and change of scenery is not banned for me by my haem team (rigid approach to distancing required though)

Going indoors/shopping/public transport etc all still off-limits

I think it’s easier to be shield grouo with some individual variations, than non-shield with additional restriction

Crikey - good point Lumene and sorry Defaultuser

I did put two things together wrongly. That’s because in (zoom) get together a in cancer support group we talked about the number of us asked about DNR, but no-one has been asked about all treatment. So I assumed, wrongly, that it was a garble for DNR

I'm dreading my dad getting this call. He has stage 4 lung cancer but immunotherapy has kept his tumour stable in the 15m he's been having treatment and other than reduced lung capacity he feels fine. To the point he believes he's not terminal. I hope they don't call him and take any decision out of his hands, I believe his positive attitude is helping him hugely.

Yes, the question was about admission to hospital, not a DNR.

@whitedaisies sorry to hear about your dad. I hope if he gets a similar call it doesn't set back his positive attitude. The GP was very nice and respected my wishes but part of me did feel that I was seen as back of the queue for treatment, even though logically I know that isn't the case!