Hi all. My relatively healthy mother has been advised by the ER cardiologist to have a heart valve replacement. There was an article last year in the NY Times that this operation is expensive and causes other problems especially in the very old. Any experience with this?
Her symptoms are difficulty breathing, weakness in her arms and fingers, raspy throat.
health.clevelandclinic.org/2014/10/tavr-procedure-safe-for-elderly-with-aortic-stenosis/
I guess my role is just play along with Mom til the end, no matter what. I can't save her and it's useless to try. Just need to support her on her chosen journey. Thanks again!
If not, that's the first step. She/he would know what other co-morbidity issues there are and what the best chances of survival and recovery are.
Frankly, I wouldn't rely that much on newspaper articles, even if the reporter was reliable. Reporters aren't medical people; they don't have access to someone's medical records, and they can't make judgments or projections. They can report generally but I'd look to your mother's treating physicians for guidance on survivability.
I think because of the type of operation it is, and the fact that she is generally healthy other than the symptoms caused by a bad valve that it may be worth the surgery. She may, like my friend, feel like she has a new lease on life.
You should talk to the doctor and make sure you take his advice. Ask specifically about the type and amount of anesthesia and how this can be minimized as I would think this would be the riskiest part of the procedure.
Angel
Mom is already a Narcissist, Borderline Personality Disorder and other things so this ought to be a rough ride for she AND I. But from this site, God Bless You All, I have learned to be tough, strong, loving, forgiving, and to take care of myself.
Well tomorrow I take her food shopping and oh, Happy Mother's Day everyone on Sunday!
Everyone who sees Mom can't believe how old she is. She still has a lot of beauty. Did I tell you what the one thing she wanted me to bring her when she had to stay two nights in the hospital? Not the toothbrush, not the underwear: make up! And then she told me in front of everyone, "you brought all the wrong kinds!"
The key, I believe, is the effect that the anesthesia has on the elderly brain. If the full open heart surgery is done, they sort of put you into a very low temperture condition which slows down all the body's processes. Including the brain.
My husband recovered well and although totally drained for about 6 weeks, went back to work none the worse for wear. His mom came out of the anesthesia and was never herself again. I believe that she'd had some cognitive decline before the surgery, but afterwards, she refused rehab, and ultimately starved herself to death in a nursing home. It was very sad.
Talk to the cardiologist and find out what the risks and benefits are.
njny: Your Mom is exactly like Mom and you and I feel the same way. Bring on OUR counselors for the next decade!
Mom has befriended the managers where she lives at the Indep Living Senior apts. There are new managers there and I met with them and Mom today. The women explained to me Mom's financial status at the Coolidge and we discussed ways to look at how Mom will pay for the TAVR operation. They pointed us to SHINE to learn about insurance options and how to find out the total estimate from the hospital after Tuesday, when they do the important test with a catheter to see if veins are blocked.
Funny moment today: sitting in the office with the managers, Mom kept interrupting me and putting me down. They wanted me to continue talking. "Well! why doesn't somebody tell me to just shut up?" she asked, trying to sound ambiguously amused and also challenging us.
"Very well, " said the manager. "Shut up and let your daughter talk."
The assistant to the manager, Julie, offered to take Mom to the appt on Tuesday and even to stay with her for a few hours. I have to work so I was mega relieved. Plus Mom is tons nicer to anyone but me and even if she is nutso with fear, she'll at least won't be mean because I won't be there for her to scapegoat on. I'll get her later in the afternoon, if it's possible.
Tomorrow we visit her primary doctor, who I can't stand. So I'll have to bite my tongue while we hear what he thinks. Usually he flatters Mom and allows himself to be manipulated by her. I go as the third, unwanted wheel, asking intelligent questions which annoy them both!
Anyway listen to Mom not me I roll up into a ball of anxiety with every procedure and insist on general anesthesia for everything.
Is it risky?
Of course everything is?
Is Mom in reasonably good health for her age?
Sounds as though she is.
Is she competent to make this decision?
Sounds as though she is?
Does it matter what her PCP thinks?
No he is not a cardiac surgeon and you don't trust him anyway.
What is your greatest fear?
Of course loosing Mom no getting round that but right now she needs your support.
Now I am just going to pull a blanket over my head and try not to think about having to face something similar in the future.
Make a cup of tea first and watch the humming birds at the feeder. Distraction, it works wonders.
grrrrr.
Meanwhile I decided to go and take Mom and then go home and come pick her up later.
Keep on laughing, smiling, eating ice cream or whatever keeps ya going!
Also, I am trying to slow down Mom in being her typical compulsive and reactive self to taking some time to put the pieces together: the insurance for example. Someone told her her insurance company would not cover an operation like she will have. This has many pieces to it. Mom's family doctor didn't even ever think of this as a possibility, nor did he seem to know anything about it.
Minimally invasive valve replacement is much more expensive than the traditional surgery and my understanding is that it is only approved for certain patients who are over a certain age. My brother in law, who is in his mid 50s applied to have it and was rejected (he has the same congenital defect in his aortic valve that led to my husband's emergency surgery 10 years ago).
Call the insurance company this morning and find out if they've pre-certified both the cath lab and the surgery. they may approve the cath and then wait to see the results before deciding whether to approve the surgery itself.
What are they looking for with the catheterization? In my husband's case, all they could see was an aneurysm on the CAT scan and wanted to see the supposed dysfunction of the valve and evaluate it for repair/replacement.
The person you really want to talk to is the Anesthesiologist, because there is a practical limit to what a 95 year old can survive.
So I called my Functional Medicine dr, ND, who is an author, speaker and has practiced curing others of all kinds of things and he agreed to see my mother, see what he can do for her and even to work with her family doctor, (if he is open and willing, we don't know: maybe) With diet, supplements, and his biomeridian machine, he'll steer us better than a doomsday operation will.
If nothing else, he can make it so she ages with her mind intact and no other additional diseases, acquired from the traumatic operation.
I plan on being Mom's "buddy partner" taking care of my own health needs and both of us keeping an eye on each other's progress. I can work on my own heart issues and lose that weight at last. He was very helpful to me two years ago. I need to keep on so I hope our new plan will be fun and fruitful.