I'm scared ~ please help !!

  1. 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.
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    About CVnurse08

    Joined: Feb '03; Posts: 293


  3. by   P_RN
    Now that he is feeling its effects, do you think he would listen to you and see the doctor again?
  4. by   VickyRN
    I am very, very sorry about your father. I can only imagine how you are feeling seeing him go through this. What occurs with severe aortic stenosis is something called compensation. The body tries to compensate for the decreased blood flow through the aorta by enlarging the left ventricle. An enlarged left ventricle is very dangerous--the heart is not able to beat as efficiently and the electrical pathways may be off. Once the heart enlarges, to a certain extent, it will stay enlarged. This is called cardiomegaly and is very dangerous. Sounds like he already is in an extreme emergency. Is there anyway you can get him to go to a cardiologist?? Perhaps you can get your minister or another family member to go talk to him.
  5. by   CVnurse08
    Thanks for replying but all of our family has tried extremely hard with my father. He sees a cardiologist yearly and goes to our PCP every 6 months just so he can keep getting his blood pressure meds. And every time he goes both of them tell him straight out that he is going to die. That really does not help me any to hear that. He is just really strongly against such major surgery. He thinks the surgeon is, in his own words, going to "plop his heart out on a table, fix it, put it back in, and then shock him back to life." I know that it is major surgery but I really think something bad is going to happen to him. What eventually will happen ~ a stroke, a heart attack, or what ?? And like I asked before do you think it will be too late then to do the surgery ?? Just a general, honest opinion would be very helpful. Thanks again.
  6. by   renerian
    My dad was stubborn to get help too. He did not survive. I am sorry your having to watch that.


  7. by   Katnip
    I'm so sorry you have to go through this.

    I don't know if you and your family have tried a different approach? Instead of telling him how badly this is affecting him, do you talk to him about how hard it is on all of you? Sometimes a person will get a procedure to put the family members at ease. Or just to shut them up.

    Other times there's just no talking to them. In that case you will have to try to learn to face this somehow. Not easy, I know. But you've got a lot of caring support here.

  8. by   CVnurse08
    Thanx again for your replies but I am still curious when my dad does eventually "take a turn for the worst" what will happen ~ a heart attack, stroke, or just cardiac arrest ?? And will it then be too late to do emergency surgery ?? I know that every person is different but like I said a HONEST general opinion would be very helpful. Thanx a lot again for your support ~ I really need it ~ keep it coming please !!
  9. by   plumrn
    It sounds as though your father could suffer heart failure, or have a heart attack at any time. If he does, he will likely have pain or discomfort unrelieved by rest, increased shortness of breath, or sudden death. If he does survive, he will most likely be very weak, very short of breath, and unable to tolerate activity.
    My heart goes out to you.

    My father is suffering from kidney failure, and is also very stubborn. He does not see the Dr except when he has to, and doesn't tell him everything when he does. I know he is only making matters worse. We have all pleaded with him, but ultimately it is his choice. He doesn't like going to Dr's offices, and he absolutely dreads all the neverending tests.

    It is very hard. I'm so sorry you are also suffering.
  10. by   Pete495
    Hi there,

    I have taken care of several patients who have had aortic valve replacements, and many of them do very well. I tell everybody that Heart surgery by any means is not a routine procedure, but it is more common than it used to be, even for much of our older generation. If you're father is young, I would tell him to go ahead and have it done, but I don't know about how old he is. I also do not know his history, because his history can mean a lot. I can say for sure though that if he doesn't have the surgery done, something will happen, and he could make it worse for himself in the future.
    By your description, it sounds as if his heart is already failing. If you wait too long, his heart will be become weaker, and it will eventually hinder his quality of life, esp. if he has the surgery done. Also, I think it is better to have it done when one's heart is stronger. We just did an aortic valve replacement on a lady who wanted to give birth to a child of her own, but couldn't until she had her aortic valve replaced.

    If it does come down to an emergency situation, emergency personnel can be very persuasive, and my bet is that he will end up having it done in an emergency situation. Aortic Valve replacement does require the use of the heart and lung machine, and this sometimes has complications, such as renal failure, stroke, heart attack, and infection among others. If you're wondering will he ever have a quality life after heart surgery, by all means I think he could depending on his history. We have done a lot of aortic valves, and had a lot of good outcomes. Yes, sometimes this surgery requires one to be on blood thinners for the remainder of one's life, but if the patient is old enough, they may use a tissue valve, and that would not neccesitate the long term use of blood thinners.

    I hope you make the right decision for your father and your family

  11. by   Pete495
    I just wanted to add that your father could suffer from any of the situations that you mentioned. It is impossible to know what he really could suffer from though. He could have a stroke, heart attack, or he could end up being treated in a hospital multiple times for heart failure. If I were to bet on one, it would be the latter, only because aortic regurgitation due to aortic stenosis in his case is probably a progressive disease, meaning if it is not fixed, he will only get sicker. The downside of this is that it can often be a long, hard, & burdensome process. Sometimes getting sicker slowly is more painful for a person, but then sometimes it give you more time to prepare for the inevitable. You and him need to be the judge of that. That is why I think to have the surgery done sooner is better because he may start to feel better after the surgery is done, and his quality of life would hopefully improve. Hopefully this helped a little more.

  12. by   ratchit
    It is so frustrating to watch people make decisions we disagree with. Especially such a big decision with such severe consequences.

    Would your dad consider even meeting with a CV surgeon to get more information, with no pressure to schedule surgery? Or how about attending a cardiac patient support group (run by many hospitals) to help teach him how to live with and manage his symptoms?
  13. by   CVnurse08
    Thanx again ~ once again ya'll have given me the support I need !! Today, my dad is feeling much better and it is days like this that make him refuse the surgery. I really do think that it will have to come down to an big time emergency ( his heart fails him ) and him laying in a hospital bed with no other option, or him being unconscious, one of the two, before he has the surgery.
    For those of you who were wondering how old he is, he is 60.
    Like I said he was diagonsed with this condition about 5 years ago and I can definitely see it has gotten worse since then.
    I really posted this thread for support because the more I learn about nursing the more I think about my family's health and it is scaring me. Pleease keep the much needed support coming !!
  14. by   sjoe
    "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.

    Last edit by sjoe on May 14, '03