Christopher Reeve--did decubiti kill him?

Published

intro:

several people have asked me about this since i changed my signature to say that decubiti killed him. so, i thought i would address the information...

first, as you will read below, we will never know for sure what killed christopher reeve. whether it did or didn't, even that it might have possibly been responsible for his death i think is worth emphasizing, so that it will increase folks' awareness and be more attentive. certainly, decubiti were a contributing factor, and not terribly indirectly, imo.

my editorializing:

what i found on the internet was this below, from http://www.paralysis.org, which is also on one of the reeve family sites. even in spite of what dana reeve says, i still feel the root cause was the decubiti. would he have needed the abx if he didn't have the decubiti? that is not addressed. it seems to me that she is going out of her way to make sure that people don't think it was due to poor health care (which is certainly understandable, and with which i have no argument.)

there's still something that doesn't quite make sense to me, like,

* wouldn't he have had some epi around if it was known he was "sensitive" to medication?

* how many ppl die of anaphylaxis if they are given immediate care? i don't know...anyone? anyone?

atthe time of reeve's death, i sent something to the reeve foundation asking them to help fund research on decubiti, far less glamorous, and far more needed, imo, than getting nerves to re-generate. and, i suspect, the money would go further (i.e., less money could make greater advances). and so it goes.

i guess it's my way of taking on "underdog" medical causes...

article from paralysis.org, also found on at least one reeve family/foundation site:

"skin care

the death of christopher reeve last october was attributed to heart failure due to sepsis (also known as septicemia), an infection that spreads from a specific location (such as a skin sore or bladder infection) to the blood and other organs. what exactly happened to christopher reeve isn't known and may never be; there was no autopsy. clearly, his death was related to pressure sores; at the time of his death reeve had been battling more than one skin sore. he had even experienced life-threatening sepsis just weeks before he died.

indeed, reeve died as a result of heart failure, which was included in the death certificate. there were complicating factors, however.

according to dana reeve, speaking on national television, neither a pressure sore nor infection directly precipitated reeve's coma and subsequent death. despite what was reported at the time, reeve's body almost certainly did not go into septic shock (a type of blood poisoning that can lead to organ failure and death). the most probable cause of death, dana reeve said, was a reaction to a drug reeve was given to help treat a suspected infection. he had been given the drug on previous occasions, successfully. reeve had a history of drug sensitivity. shortly after getting an injection of the drug, reeve's body went into shock (anaphylactic) resulting in coma and eventually, the shutting down of his organ systems. he never emerged from the coma and died less than 18 hours later.

dana reeve was very clear about the quality of care her husband received. she praised the medical staff and noted that their actions in the final hours were appropriate and unequivocal.

there may be lessons to be learned from the high profile life and death of christopher reeve. by all accounts reeve's final days were totally normal; he was on the road making a speech, he was busy being a moviemaker, an advocate and a dad, basically doing the things he wanted to do. he never paid heed to the actuarial life-limits placed on his type of paralysis by statisticians (11.4 years).

certainly, reeve's medical staff urged him to heed the fundamental protocol for dealing with any level of pressure sore, that is, to get out of the wheelchair and let the wounds heal up. but reeve chose to live his life fully and well and as much as possible on his own terms. he was not, as his wife explained, a man who was easily persuaded to slow down.

the primary lesson, of course, is to be especially aggressive with wounds. it may not be possible to prevent the occurrence of a pressure sore. with appropriate seating and sleeping equipment and attention to basic care, though, most people who are paralyzed can enjoy health and skin integrity for years to come.

while it may not have been a factor in reeve's death, septicemia is a real possibility if a pressure sore gets out of control. this degree of infection is generally controllable, however. "

It is time for a vactation:) :balloons:

Specializes in Utilization Management.
When the hospital administrators face loss of accreditation, or loss in terms of lawsuit--somehow, "doing the right thing" suddenly becomes quite affordable by comparison.

Exactly. Falls and decubs constitute the bulk of litigation against facilities. Yet of the two, I'd say decubs are way easier to prevent than falls.

Specializes in Utilization Management.
It is time for a vactation

Enjoy, Bob! I'll be thinking of you as I slather my patients' rumps with moisture barrier!

It is time for a vactation:) :balloons:

:idea: :smackingf You might find some enjoyment here :Melody:

http://www.toolivenurse.com :yelclap: :yelclap: :yelclap:

:Melody: One of the co-administrators of the site, Ted E., is one of the members of the company that put this on. :flowersfo :flowersfo

NurseFirst :icon_hug:

Why not use celebrity as a route to educate? No one is ever going to care about every Jane and Joe that have an MI or a CVA. We can't beat ourselves up over that. As long as he/she had people that cared about her, that's what matters. People are going to care about celebrity. You don't have to care about it and follow every thing in US Weekly. But I like the opportunity to get it in the public discussion. How many people would be open for a discussion on decubiti before knowing he died of it? Yes, that's the problem. However, I think the pros outweigh the cons.

Well, and not everyone wants to be the dead spokesperson for their disease. Plenty of formerly unfamous people have gone on to be spokespersons for a foundation or a cause. Not everyone wants to be in a headline.

A lot easier to go with the flow and make the best of it, as long as it isn't hurting anyone.

Theres more to surfaces and products to treat or prevent a bedsore/pressure ulcer....Fluid intake, nutritional status, muscle tone, and etc......

I had a patient die of renal failure on friday, non-compliant diabetes....Because of HIPPA i cannot put her name here, but lets let her headline the papers and news stories.......

How about the guy before that, had a massive Myocardial Infarct.......Or the guy before him, Subdural Bleed from a fall on the ice.......

Neither one of these even made it to the local newspaper.....Well the obituary page, i forgot about that one........

Specializes in ICU, step down, dialysis.

There is a type of decub that is caused from a catastrophic illness that can occur overnight. I've actually seen one of these; pt coded on floor, was in ICU, had multisystem organ failure...darn if I can think of the name of it. Develops from the inside, works its way out. I'll try to find out what it is...does anyone else know its name?

There is a type of decub that is caused from a catastrophic illness that can occur overnight. I've actually seen one of these; pt coded on floor, was in ICU, had multisystem organ failure...darn if I can think of the name of it. Develops from the inside, works its way out. I'll try to find out what it is...does anyone else know its name?

Kennedy Terminal Pressure Ulcer..

Sounds like Chris Reeve was doing his thing...didn't want to slow down and take care of a "little old sore". I've taken care of pts like him...they are well educated etc, but refuse to let us take care of them or take care of themselves. They don't want to accept the fact that their body is at risk for a bed sore or when they do get them that it is an issue. I'm sure his nurse, wife etc told him that he needs to be turned, repositioned, get out of his w/c more often etc, but he was busy doing the things he loved...acting, directing advocating....

Specializes in Critical Care/ICU.

Actually, I think you could say that Reeve's love of horses killed him. But technically I think that Reeves' quad status killed him. He wouldn't have had decubiti if he wasn't a quad. If he didn't have these devastating sores, he wouldn't have developed sepsis and MODS. I think he actually lived a pretty good long time for someone in his condition.

Specializes in LTC,Hospice/palliative care,acute care.

His cause of death is an endless chicken or egg discussion.He and his family clearly had close,trusting relationships with the medical personel that cared for him and his wife has gone to great lengths to avoid placing blame for his death......That said I believe that HIS failure to comply with his treatment plan whenever he developed a pressure ulcer through the years was clearly denial on his part.His efforts to focus attention on cure instead of assistance for those living with spinal cord injury is another example of that...When I saw the video clips of him "walking" I was further convinced ..... I think he has done a diservice to victims of spinal cord injury-certainly he has helped many but many,many more are living in or near poverty without the equipment and staff he had at his disposal...We are so eager to listen and learn from any celebrity whether or not they know what they are talking about....it's sad really that many people's current events news comes from People magazine..The President (IMHO)was voted back into office by a majority of people whose political views are influenced more by the pulpit then the truth.....

His cause of death is an endless chicken or egg discussion.He and his family clearly had close,trusting relationships with the medical personel that cared for him and his wife has gone to great lengths to avoid placing blame for his death......That said I believe that HIS failure to comply with his treatment plan whenever he developed a pressure ulcer through the years was clearly denial on his part.His efforts to focus attention on cure instead of assistance for those living with spinal cord injury is another example of that...When I saw the video clips of him "walking" I was further convinced ..... I think he has done a diservice to victims of spinal cord injury-certainly he has helped many but many,many more are living in or near poverty without the equipment and staff he had at his disposal...We are so eager to listen and learn from any celebrity whether or not they know what they are talking about....it's sad really that many people's current events news comes from People magazine..The President (IMHO)was voted back into office by a majority of people whose political views are influenced more by the pulpit then the truth.....

Thanks ktwlpn, I think you've helped me focus on what I've been trying to say. Right, the people who would benefit from nerve regeneration surgery are going to be those with very good medical insurance or at least, lots of money-- at least for some time after it ever proves to be effective. The SCI folks living at or near poverty are much more likely to develop decubiti because they DONT have all the advantages that Reeve had, is my guess. Granted, I don't have any "evidence-based practice" to back me up. My populist, underdog tendencies have me agree, then, with your idea that Reeve did a disservice because a few were helped where the multitude who could have been assisted, were not.

Sidebar:

Ummm...hmm. pulpits and truth. I guess it all depends upon what you to believe to be "true". It's a very tricky proposition figuring out what is true. While I am scientifically trained, I do not think science is the final arbiter of truth (but that's a whole 'nother thread...). I do believe that there's this tricky thing that needs to be done, at God's desire, if you will, that somehow we find the place where truth and love come together, because (agape) love is the ultimate truth.

Back to our regular programming :) :) :)

NurseFirst

Theres more to surfaces and products to treat or prevent a bedsore/pressure ulcer....Fluid intake, nutritional status, muscle tone, and etc......

I had a patient die of renal failure on friday, non-compliant diabetes....Because of HIPPA i cannot put her name here, but lets let her headline the papers and news stories.......

How about the guy before that, had a massive Myocardial Infarct.......Or the guy before him, Subdural Bleed from a fall on the ice.......

Neither one of these even made it to the local newspaper.....Well the obituary page, i forgot about that one........

DUH none of them were SUPERMAN. Its a bird, its a plane...

Specializes in Psych, Med/Surg, Home Health, Oncology.

You know, I just happened on this discussion;

It interests me why?????

15 yrs. ago I had a hip replacement. age 45, good health, just happened to have arthritis;

Had Surgery on Wednesday; On Friday, all ready had sacral bedsore.

That bedsore caused me more pain then the hip replacement surgery. It took a long time to heal.

Since then, I have been a crusader on good skin care, turing patients & when they do develop sores, adequate and proper treatment.

Mary Ann

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