Sunday, June 19, 2011

My dad

We are faced with a tough decision right now. My father has severe coronary artery disease and critical obstruction of many, many arteries. He is not a good candidate for stenting - and from what limited reading I've done, the bypass procedure is superior anyway. In all the reading I've been able to do - both refereed literature and Dr Google - it has been repeatedly stated that there is no difference in outcome between surgical and medical management. Further, my father is 74 - and this alone doubles his chances of mortality. Thankfully, he does not smoke, does not have diabetes, or renal disease, and is otherwise fairly healthy.

The bypass surgery is incredibly invasive - the chest is cracked down the sternum, and the patient's heart is stopped. They are then placed on a heart-lung bypass machine to pump blood while the veins are moved to the heart. Strokes and heart attacks are common peri-operative compliations (about 10% from what I've read).

My father is home and now that I can see him standing up - he is incredibly gaunt - down from around 190# to 168#.

Nothing I've read or heard from the cardiologist makes me think that my dad should undergo this surgery - and yet...how to know?? If he should have a heart attack, he will be a much, much poorer candidate for surgery, should he need it.

Lastly, overhearing him and my mother discussing what she will do when my dad is gone...well, that doesn't help much either (my dad is 21 years older than my mom).

I'll keep ya'll posted on what he decides to do.

3 comments:

Holly said...

I've known 3 men who had bypass surgery. My neighbor had a mild heart attack, got transferred from our local hospital to the larger one in a nearby city and ended up with a triple bypass. He is fine today, 4 years later. The father of a neighbor had a double....good outcome. The father of one of the guys I work with had a double, good outcome. Best wishes for your dad!

Anonymous said...

This is a tough decision. Please also consider the relatively high rate of post-op dementia - up to one-third of patients, regardless of on- or off-pump. Many improve. Some don't. It's not nice, even when it's temporary.

I'd also consult a specialist in pain management. Any large medical center will have a pain management center, and this is a legitimate route to improving quality of life.

Good luck whatever your dad decides.

Remember: physicians don't think like we do. You bring a fresh, honest perspective to these discussions.

Tammy said...

Gosh, I'm sorry about the difficulties. My dad had bypass surgery a few years ago, and then had stents done last year as well. He's done amazingly well following both. (He is almost 78 now.) It is so difficult to see parents age. Take good care of yourself as you and your family face these medical issues.