BS: Help: Mom heart disease, advice?

Subject: BS: Help: Mom heart disease, advice?
From: Mrrzy
Date: 21 Sep 03 - 12:07 PM

Hi y'all, looking for advice: Mom was recently discovered to have had a silent heart attack at some point in the last 3-4 years, so she had a diagnostic angiogram and found that 3 out of 4 major arteries usually coming from the heart are COMPLETELY blocked (they would have done angioplasty but it wasn't possible, TOO blocked), and her aorta is twisted into a pretzel from her scoliosis, she is growing strange new arteries that don't go anywhere to try to take the blood somewhere, the mitral (main) valve that keeps the oxygenated blood from recirculating into the heart instead of flowing out to the body has failed, and (yes, there's more) clearing out the arteries won't be enough so she'll have to have the valve replaced too, AND because she's a heavy (their term: she's actually down to less than a pack a day from over 4) smoker her lungs may not tolerate the anesthesia for a triple bypass plus valve replacement. So I gather (she won't ask the cardiologist for the details) that there are 4 possibilites: 1) she doesn't have surgery and is dead in a year; 2) she doesn't have surgery and lives for a few more years, deteriorating from where she is which is she can walk with her walker, she just has to stop for breath all the time); 3 she has the surgery and dies within the year anyway, and 4) she has the surgery and lives for years, newly deteriorating but from a point better off than she is now.

Does anybody know how to try to find out the various probabilities of these 4 possibilities? My take is that she shoudl weigh the possibility of no-surgery-dead-soon to surgery-might-live-a-while, so that she has the chance to be remembered by all her grandkids (in 6 years, say, she'd see my sister's twins out of high school, my other sister's daughters out of college, and my twins and the other twins' younger brother out of middle school, leaving only the very youngest (whose mother, my other sister, has divorced us all anyway) to remember her only as a vague impression and some stories. BUT she (Mom) isn't at all sure if she even wants to consider the surgery. Now, note that I would actually respect her wishes should she decide against it, but I want to have DATA to use in the decision. Any ideas? THANKS all. I know you will think good thoughts about this, too.

Subject: RE: BS: Help: Mom heart disease, advice?
From: Sorcha
Date: 21 Sep 03 - 12:10 PM

My mom was a heavy smoker, 3 pks a day. She had the by pass (can't remember 3 or 4)and lived another 10 years. Be warned, though, that it isn't the chest inscision that bothers them the most, it's where they remove the vein from the leg.

Subject: RE: BS: Help: Mom heart disease, advice?
From: Donuel
Date: 21 Sep 03 - 12:23 PM

Hormone replacement therapy will increase heart attack and stroke by 90%.

Subject: RE: BS: Help: Mom heart disease, advice?
From: Mrrzy
Date: 21 Sep 03 - 12:27 PM

No hormones, at least!

Subject: RE: BS: Help: Mom heart disease, advice?
From: Dave Swan
Date: 21 Sep 03 - 02:14 PM

Schedule a consult with the cardiologist which you can attend with your mother. Take with you a list of questions about the risks and benefits of each of these options. Physicians usually appreciate patients and their families being well organized and ready with good questions. Be ready to take notes. If you choose surgery you'll want to have a similar discussion with the surgeon. Ask about surgical risks including complications on the table and in recovery. If you choose to do nothing, at what point will your mother be so weakened that she won't be an acceptable surgical risk if you change your minds?

Don't hesitate to ask for a second opinion. Ask all of the physicians which option(s)they would choose for their own mothers.

You're looking for data and, while surgery is both art and science, you should be able to get some idea of favorable outcomes for each of your options.

Your mother's physician will consider underlying medical problems which will also need to be managed throughout the course of treatment. Hypertension, pulmonary disease, cardiac dysrythmias, and diabetes, for instance are all common problems in the geriatric population and will complicate treatment. Where is your mother's internist in all of this? S/he should also be part of the decision.

In my opinion you should also strongly consider quality of life in you mom's remaining years following each of these courses of treatment.

PM me if you like, I'm up to my ears in this stuff myself.

Good luck,

D

Subject: RE: BS: Help: Mom heart disease, advice?
From: ard mhacha
Date: 21 Sep 03 - 02:46 PM

I would advise surgery, I had a quadruple four years ago and my quality of life has certainly improved, previous to having the operation I found it difficult to walk a short distance, I am now managing 3 to 4 miles a day.
Whatever your mother decides I wish her all the best. Ard Mhacha.

Subject: RE: BS: Help: Mom heart disease, advice?
From: open mike
Date: 21 Sep 03 - 03:03 PM

When my mom was diagnosed with blocked arteries,
several docs said they would not go thru with the
surgery because her condition and age (82) was
not likely to support good recovery. One young
doc charged thru and did the surgery (not by-pass,
but stents to enlarge the blocked area) and she
had a pace maker too. she did not survive for many
weeks after the surgery procedure. Sounds like the
best thing for your mom would be to lose weight
and lose the cigs. any thing else would be complicated
by those two obstacles no matter what.
I heard of Co Q 10 whcih claims to help circulation.
dissolve blockages, and have other positive attributres.
Some swear by it, and cliam increased energy, well-
being , etc.
Your mom's situation sounds quite complicated with many factors involved. I wish you luck in your choices and I hope
all goes well.
how old is she?

Subject: RE: BS: Help: Mom heart disease, advice?
From: Mrrzy
Date: 21 Sep 03 - 04:42 PM

Thanks, all. I'll probably PM you soon, Dave. She's 74, not overweight, not hypertensive (in fact, low blood pressure runs in our family), no diabetes, and boy does she smoke less than she used to. But she won't let me talk to any of her doctors! I haven't found out why, but she won't. Only my eldest sister, who has no ken of biology, is allowed to... which is exceedingly frustrating for me, I need data! If I give her a question to ask, she'll ask it, but she doesn't know enough biology to ask the follow-up question that pops up immediately to me... So thanks, all. Others heard from? Anybody have BOTH the valve replacement and the bypass(es)?

Subject: RE: BS: Help: Mom heart disease, advice?
From: GUEST
Date: 21 Sep 03 - 06:45 PM

Little hope for her.... and at her age it would be a waste of precious resources.... she didn't worry earlier.... she shouldn't worry now.... give her some cigarettes, a gin-martini, and find a clergy....enjoy your time together....breakdown your barriers - she doesn't want to confide in you precisely because of the attitude you show towards her in this thread.....let it go!

As for YOURSELF - heart disease has a powerful hereditary correlation:

1. Lose Weight
2. Exercise More
3. Cut Fats
4. Eat Vegitables
5. Sing and Laugh

Sincerely,
Gargoyle

Subject: RE: BS: Help: Mom heart disease, advice?
From: Sandy Paton
Date: 21 Sep 03 - 08:39 PM

I was 66 when I had a quadruple by-pass -- eight years ago. Three arteries 100% clogged and a fourth 85%, but I had built up a pretty good collateral blood supply over the years (I had my first coronary episode when I was 34), and the damage done by that and the three episodes that followed was minimal. In my 53 years of addiction, I never smoked more than one pack a day, but I only got around to quitting the morning I went in for the surgery. I was a little overweight, coughed all the damned time, yet only occasionally experienced angina. For me, post-op, it was the chest that hurt, not the leg from which the vein was taken, and it hurt for well over a year. Wish they'd warned me about that, even though it wouldn't have altered my decision.
    My cough is gone, along with the addiction. I'm even more overweight; I don't do the 3 or 4 miles every day that I should because my back now bothers me too much. I take albuterol and atrovent by way of a nebulizer to cope with my COPD (didn't they used to call this emphysema?), but I'm alive and still functioning at my job. Quality of life? Infinitely improved. I genuinely believe that, were I wed to a walker and as physically limited as your mother seems to be, I would choose to risk the surgery.
    Any way you could get a couple of other cardiologists and surgeons to evaluate her chances? If she won't even let you talk to her doctor, this would appear to be impossible, but you might give it a try. My son's mother-in-law was denied a by-pass because her doctors felt she was too fragile. That was about five years ago and her condition has been deteriorating ever since, but she's still with us. She must have been about your mother's age when she didn't get the surgery.
    I realize all this provides no advice at all, and I'm tempted to simply erase the whole thing, but what the heck...
    Sandy

Subject: RE: BS: Help: Mom heart disease, advice?
From: Mrrzy
Date: 21 Sep 03 - 08:58 PM

Gargoyle, what attitude is that? Really curious, not thinking you're being obnoxious nor wanting to be same. And I'm with you on the heredity thing...

Subject: RE: BS: Help: Mom heart disease, advice?
From: GUEST
Date: 23 Sep 03 - 01:56 PM

refresh? QUINTUPLE bypass, not triple...

Subject: RE: BS: Help: Mom heart disease, advice?
From: katlaughing
Date: 23 Sep 03 - 06:11 PM

Thanks for sharing, Sandy...good to see you here, darlin'.

kat

Subject: RE: BS: Help: Mom heart disease, advice?
From: vectis
Date: 23 Sep 03 - 07:10 PM

A mate of mine had a triple bypass at the age of 81/2.
After the op he was unstoppable. He did everything the doctors told him to and still looks and acts like a teenager. He said
"I would recommend the op to anyone, even if they didn't need it"
Hope your mum gets to enjoy the rest of her life, long or short, it's her decision in the end.

Subject: RE: BS: Help: Mom heart disease, advice?
From: Mrrzy
Date: 26 Sep 03 - 05:21 PM

Well, she called 911 yesterday because she thought she was having a heart attack, turned out she just (!) broke another rib, which she does every so often. This time she was ironing, the last time she was opening a jar... so she is IN the hospital now and has decided, thank you all and all, to have the surgery, but now she has a gum ionfection and they can't risk it!! If it isn't Isabel, it's something (Isabel is why I haven't been here in a while). I'd still like to hear from Guest - Gargoyle if anyone knows them in the real world... meanwhile the surgeon/hospital combo apparently has about 1/3 to 1/5 the average american morbidity risk for this surgery, so I feel that she will be getting the best care there is, which is great to feel. Of course I'm still worried but it isn't the same worry, thanks all! As usual you are a great community.

NOW we need the music for this... any songs about pig valves in humans, for instance? (She's already wondering what our moslem relatives will think...)