I'm scared ~ please help !!

Nurses General Nursing

Published

Hi everyone,

Once again I am turning to you for support. My dad was diagonsed with severe aortic stenosis ( a bad heart valve ) about five years ago. He refused the surgery to fix it because at the time he wasn't really feeling the effects of it but he quit work anyway and got on disability. For about the past year or so, he has seemed to get much worse with increased chest pain, shortness of breath, and bad circulation. Now these symptoms aren't every day and we have learned to live with them. But it just really scares me when he hurts so bad that he hardly can walk or talk and has to go lie down. Please don't respond by saying that he needs to have surgery because I know he does and that would be great but he is very against that unless it is an extreme emergency. But what I am afraid of is that then it will be too late. I guess what I am really asking is what do you think will happen when he does eventually have a heart attack or stroke ~ will it be too late ?? I know that it varies from person to person but just a general opinion would be helpful. Sorry this is long but I am really scared and really need support and info. Thanks so much.

Specializes in Corrections, Psych, Med-Surg.

"He is just really strongly against such major surgery"

1) Every competent person has the right to put limits on how much and what kind of healthcare he/she wishes to have/put up with. He probably knows more about what is important to him than you or other family members do. Just because your choice might be different does not mean that he is wrong. You need to respect his choices, as you would want others to respect the choices you make about your own healthcare.

2) This might be a good time for him, you, and the other members of your family to all complete your own advance directives, while the topic is "up."

3) Every person, competent or not, will die of something or other, sooner or later. It is built into the system. (Thank goodness. Who would want to hang around, decaying but still "alive," for hundreds of years or more? Nobody sane.) This might be a good opportunity for you to begin learning to accept that simple fact.

IMHO

0 Votes

I'm praying your Dad has a change of heart........

0 Votes

I'm with sjoe, If well informed, your dad has the right to refuse anything. The hardest part may seem to be having no control over this situation, we all want the people we love to be healthy and live long.

But, if he is against the surgery, you at least have time to spend loving him. I've watched too many patients be on long term life support with no quality of life because families couldn't let go.

Ask him why he would have the surgery after he is so decompensated his odds for a full recovery are low, vrs. now when he is healthier? His left ventricle will get exhausted, grow larger and more innefective plus he will likely go into heart failure frequently and need a ICD/pacemaker. If he has the surgery then, the left ventricle is STILL in the same shape, it doesn't heal and go back the way it used to be. All this maybe could be avoided with the surgery, but it's still his choice... hopefully it's an informed choice.

I know this must break your heart to see him not take treatment that could "fix" the problem, but you do still have your dad with you now... take advantage of that.

My thoughts to you and a huge hug

0 Votes
1) Every competent person has the right to put limits on how much and what kind of healthcare he/she wishes to have/put up with. He probably knows more about what is important to him than you or other family members do. Just because your choice might be different does not mean that he is wrong. You need to respect his choices, as you would want others to respect the choices you make about your own healthcare.

2) This might be a good time for him, you, and the other members of your family to all complete your own advance directives, while the topic is "up."

3) Every person, competent or not, will die of something or other, sooner or later. It is built into the system. (Thank goodness. Who would want to hang around, decaying but still "alive," for hundreds of years or more? Nobody sane.) This might be a good opportunity for you to begin learning to accept that simple fact.

1) Every competent person has the right to put limits on how much and what kind of healthcare he/she wishes to have/put up with. He probably knows more about what is important to him than you or other family members do. Just because your choice might be different does not mean that he is wrong. You need to respect his choices, as you would want others to respect the choices you make about your own healthcare.

2) This might be a good time for him, you, and the other members of your family to all complete your own advance directives, while the topic is "up."

3) Every person, competent or not, will die of something or other, sooner or later. It is built into the system. (Thank goodness. Who would want to hang around, decaying but still "alive," for hundreds of years or more? Nobody sane.) This might be a good opportunity for you to begin learning to accept that simple fact.

Excellent post. Basically the same thing I was going to say.

I am sorry that you and your family are being put through this, but, what you call being stubborn may be his way of saying "enough is enough".

It is very hard for the families of people who refuse treatment, but, you must respect his wishes and help make everyday he has good ones. Continuing to bring up the subject of having surgery is not working.

I would just continue to support him, in whatever decision he makes, and enjoy all the time you can with him.

bob

0 Votes

He is afraid of the surgery it seems. I get the impression he would rather take chances with dying suddenly or becoming unconscious which requires someone else to make the decision. Talk to him about YOUR fears too. This is hard because the decision is really his, even if it is not the one you would make. See if you can get Advance Directive so other decisions can be determined.

0 Votes
Specializes in LTC, ER, ICU,.

i wanted to offer you my support during these times. (((((hugs)))))

0 Votes
Specializes in ICU, nutrition.

I would have to say that if your dad does decide to have the surgery, he should do it before he hits his 70s. Most of the valve surgeries of really old people (especially over 80) I've cared for have done really poorly post-op and never get back their quality of life. But if the damage to his heart is not too severe, and he has the surgery while he's relatively young, he may add a lot of life to the years he has left.

The last patient who died on me with aortic stenosis was a real heartbreaker. When I came on at 7pm, he was sitting up in a chair, breathing somewhat labored but holding his own. I helped him to bed around 10pm; around 1am he developed more SOB and his lungs were wet, I gave him some Lasix and waited an hour then called the pulmonologist, who had me give him a huge dose of Bumex and some Demedex. I waited another hour, he got progressively worse and never diuresed, so I called someone to intubate him. The CRNA gave too much sedation (the patient was not fighting at all at this point) and dropped his blood pressure into the 60s. Then he bradyed down and we were coding him 5 min after that witch left the floor. We worked on him for over an hour and there was just nothing we could do. I was doing chest compressions with tears streaming down my face. For a moment he woke up, I thought he was going to make it, but then that was it. He was gone. It was the first patient I ever had code that I didn't expect it. It showed me that CHF can be a ticking timebomb. I couldn't even talk to his wife when she got to the hospital, I was crying so hard. He had been doing pretty good when she left to go home just a few hours before, and now he was dead.

I hope something like this does not happen to your dad. I'll say a prayer for you both.

0 Votes
+ Add a Comment