Looks like the time is almost here...

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UNCatTech

UNCatTech

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Update: So my dad did turn down the operation. I didn't want to start a new thread, so I'm repurposing this one.

But he's really not doing well. I really doubt that he makes it to Thanksgiving.

My wife and daughter left to go to their house this evening. I'm going to wrap some things up at work and probably go up Thursday night, if I don't have to go earlier.

I'm at a weird place right now. My wife and I were talking about it last evening. I don't know how to deal with this. I don't have any answers for what my mother is going to do after he dies. They were never planners, and he was too stubborn to ever listen to advise about retirement or death. I'm worried how my crazy brother, his crazy wife, and their crazy daughter are going to react. Especially since my wife and I have advised my mother to sell the house after he dies. She cannot afford to live in that house. She can't maintain it. But he doesn't understand.

I'm sort of torn. I'm sad that he is close to death, but I also know that it is probably the best thing considering his health, quality of life, and very limited finances. I feel bad for even thinking about it in those terms, but it is reality.
 
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Not a doctor but I have taken care of several LVAD patients and they were all much younger than your father. It is my understanding that the LVAD is often supposed to be a bridge until people can get a transplant, or to keep you alive for longer than you would live without one. The people I have seen with LVADs have gotten along quite well. Obviously they can’t stray too far from a battery charger, so going hiking for 3 days would be out of the question, but they can live their day to day life quite well. The question I have is what is the end game? Are they trying to extend meaningful life? If so, the LVAD can largely do that. However, his doctor knows him much better than anyone on this board does.
 
2ManyBlueCups said:
Not a doctor but I have taken care of several LVAD patients and they were all much younger than your father. It is my understanding that the LVAD is often supposed to be a bridge until people can get a transplant, or to keep you alive for longer than you would live without one. The people I have seen with LVADs have gotten along quite well. Obviously they can’t stray too far from a battery charger, so going hiking for 3 days would be out of the question, but they can live their day to day life quite well. The question I have is what is the end game? Are they trying to extend meaningful life? If so, the LVAD can largely do that. However, his doctor knows him much better than anyone on this board does.
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Honestly, I just don't see him as a good candidate. He doesn't qualify for a transplant.

I'd be surprised if he could survive the procedure.

Plus, I don't believe my mother can take care of him with it.
 
UNCatTech said:
Honestly, I just don't see him as a good candidate. He doesn't qualify for a transplant.

I'd be surprised if he could survive the procedure.

Plus, I don't believe my mother can take care of him with it.
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I see. I’m sorry you are in this situation. It sounds as if you have no great options and are trying to choose between the “least worse” one.
 
UNCatTech said:
Honestly, I just don't see him as a good candidate. He doesn't qualify for a transplant.

I'd be surprised if he could survive the procedure.

Plus, I don't believe my mother can take care of him with it.
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If you don't trust the advice you're getting from his medical Dr., then get a second opinion form another medical Dr. I don't think and asking us randos what to do will result in him ending up with a better treatment plan.

I do sympathize. I have aging parents and aging in-laws and we'll be looking at rafts of tough medical decisions in the next decade or so. But my advice is prioritize medical Dr.'s advice over non medical Dr.s. And prioritize medical Dr.s advice that have actually examined your father and are familiar with this medical record over those that haven't.
 
I was a poli sci major and was a technocrat--so there is that
My only comment is that as folks get 80 ish-and it sounds like Medically it is like your dad is 80-as folks get older any invasive procedure is way over rated-because of risk. My personal family experience is ansthesia sucks for older folks I have no clue how much anesthesia is involved in this procedure
 
Ddseddse said:
If you don't trust the advice you're getting from his medical Dr., then get a second opinion form another medical Dr. I don't think and asking us randos what to do will result in him ending up with a better treatment plan.

I do sympathize. I have aging parents and aging in-laws and we'll be looking at rafts of tough medical decisions in the next decade or so. But my advice is prioritize medical Dr.'s advice over non medical Dr.s. And prioritize medical Dr.s advice that have actually examined your father and are familiar with this medical record over those that haven't.
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That's part of the issue. I'm 300+ miles away. I can't go up and meet with the doctors every time something happens. My brother and his wife are worthless and cause more stress than help. Just trying all options to see how we can help my mother cope with this.

There were many doctors on the other boards. I'm not really looking for a diagnosis just maybe some direction from someone with familiarity.

I've also been reading and trying to understand. What I read, I don't like the option, but it's not my choice. I know my dad, hell forget to charge it or clean it, there's a lot of maintenance to use the device, and it will stop working.

I will be very surprised if he lives another 6 months. If he has an operation and lives 12 months with no quality of life, is that really better? I don't believe I would want that.
 
One question I forgot to ask: Does he have a DNR? If not, he may want to strongly consider getting one. It is a sobering decision to make but at a certain age and with certain medical problems, trying to resuscitate someone, even if successful, can lead to needless suffering and expense on the part of the patient and their family.
 
2ManyBlueCups said:
One question I forgot to ask: Does he have a DNR? If not, he may want to strongly consider getting one. It is a sobering decision to make but at a certain age and with certain medical problems, trying to resuscitate someone, even if successful, can lead to needless suffering and expense on the part of the patient and their family.
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You may also want to request a meeting with palliative care at the hospital. They can take you through the family's goals for your father. Does he want everything done? Does he want to have a better quality of life but maybe not live as long or a worse quality of life sitting in the hospital bed but live longer? They are trained in having those types of discussions and have them everyday.
 
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Typically an evaluation my social work/case management as well as supportive and palliative care are parts of the LVAD workup, and it sounds like at least completely those would be helpful in your dad’s situation. LVADs require significant home care in terms of dressing changes (supplies for which can be quite expensive), risk avoidance (submersion), use of anticoagulation if he’s not already on that, require a fairly lengthy initial hospital stay and a lot of post operative visits in the early post placement period, and social work may be helpful to determine if he’s a good candidate from cost and ability to care for it period.

Supportive and palliative care will explore issues of quality of life and what is important to him. They’ll go through what would be acceptable if things don’t go perfectly, like would he accept a trach and long term vent if couldn’t extubate, a feeding tube for prolonged artificial nutrition, etc. And they should help match up what is important for your father to what benefit the LVAD might provide. And if he’s not sure the LVAD would provide any better acceptable quality of life they can discuss code status or even hospice as he’s only likely being offered this surgery because his doctors believe his 6-12 month mortality risk is fairly high.
 
2ManyBlueCups said:
One question I forgot to ask: Does he have a DNR? If not, he may want to strongly consider getting one. It is a sobering decision to make but at a certain age and with certain medical problems, trying to resuscitate someone, even if successful, can lead to needless suffering and expense on the part of the patient and their family.
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My dad is, on a scale of 1 to 10, a 23 as far as being stubborn.

We tried to talk about this a few years ago, he basically told me to stick it up my butt and left. Same with downsizing, retiring, taking on an easier job, etc.

the answer is no.
 
gtyellowjacket said:
You may also want to request a meeting with palliative care at the hospital. They can take you through the family's goals for your father. Does he want everything done? Does he want to have a better quality of life but maybe not live as long or a worse quality of life sitting in the hospital bed but live longer? They are trained in having those types of discussions and have them everyday.
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Thanks, my mother has a meeting with palliative care on Monday.


There's really a lot more to this conversation.

My brother and his wife are complete pieces of shit that have been taking advantage of my parents for years.

My brother has an HVAC company, but doesn't have a license, he uses my dad's license. So, if my dad dies he no longer has a license to work under. So they are at the hospital working against my mother and father's wishes. They want him to have the operation, not because they care, but because they are freeloading pieces of shit.

After we talked with my mother the other night she went to the hospital and said that she wanted to discuss this with another doctor. They provided another doctor. He was very straight forward and honest. The biggest thing is that he will never be able to work again. My dad's life is work, it's really all he knows how to do. He still tries to work at 75 with all of his medical issues because that is what gives him purpose. And, of course my brother takes advantage of that.

After talking with the doctor my parents are surer that he doesn't need or want the procedure.

Also, to show where my brother and his wife are in this. They went to the hospital when my mother wasn't there and told my dad to sign the papers. So he has actually signed the papers even though he has said that he doesn't want the procedure. Fortunately my mother has to sign also.

My brother and his wife are absolute pieces of shit. And of course they vote trump. :sick:
 
Life isn't fair my brother and I have compassion for how you are having to deal with all involved. Nothing will be easy at this point in time. Praying for you and all of yours.
Godspeed
 
theel4life said:
Update?
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Update: So my dad did turn down the operation. I didn't want to start a new thread, so I'm repurposing this one.

But he's really not doing well. I really doubt that he makes it to Thanksgiving.

My wife and daughter left to go to their house this evening. I'm going to wrap some things up at work and probably go up Thursday night, if I don't have to go earlier.
 
🙏😞
Hoping for the best outcome for all involved.
Perhaps your brother will finally see the light, let it go, and go get his own contractor’s license. But there’s nothing you can do about that… it’s totally on him. Here’s hoping you find strength to not worry about him and his issues.
With your father, mother, wife and daughter remember: life is short and we haven’t much time to gladden the hearts of those who travel with us. So be swift to love, and make haste to be kind.
Hoping for the best outcome for all involved.
😢🙏
 
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