I did get some answers today... My primary question has been, How worried should I be? (Or rather, how IMMEDIATELY dire is the prognosis?)

Well, he's NOT going to get "better". His heart function is back down to about 20% as it was before his valve replacement in 2004. Why he doesn't LOOK or ACT more ill is because for the past few years he's been nowhere as active is he had been in 2004. He's had congestive heart failure for over 10 years and it's complicated by his coronary artery disease. I was having trouble understanding how everything could be fine until all of a sudden, it's all gone to shit and it was explained to me that the balance in Tom's body is delicate. When it falls off the edge, it does so very fast.

What the plans and options are, I may actually find out from the doctors concerned tomorrow. Today I only talked to the pulmonary guy for a few minutes and then, Tom's primary care was there (visiting another patient, but he stopped in to review Tom's information and visit with us) so he really didn't say much.

Tom had said this morning that one of his doctors was talking about a different kind of defibrillator -- and his nurse gave me more information about that. Instead of a defib/pacemaker only controlling one side of the heart, it would be one that would control both sides. And the rest of the care would be palliative.

The good news is I DID get to talk to Tom's primary care doctor who has been treating him for about 10 years. And I trust him. But, ya know, NONE of these doctors want to say, "Hey, he could keel over dead next week...or maybe it won't happen for a couple months...maybe years..." One thing agreed on is it is highly unlikely that Tom will tie his cousin's longevity -- she's 93 and still going strong. And the doctor was willing to say Tom isn't likely to live, say, another 10 years. But the lot of them really don't want to be tied to a prediction. (Or be the bearer of really bad news.)

This episode really has been a poke to remind me there IS a clock ticking; we don't have the luxury of "forever" or even years. Stop wasting time; do stuff NOW. NOW is the time to get Tom to teach me his "Anglo-Saxon crash-thud" guitar style. Nail down some facts in his history that need to be clarified and no one else can.

This all really isn't a surprise. But a reminder to be more mindful of the passing of time, the shortness of life.

I've got to go make some phone calls...

Linn