Health, when they should let go?

Question:

My dad had a heart attack. 15 years ago. They gave him a pacemaker. A newer model when they say his heart rate was very low(mid 40's and even dipped down into the 30's. That freaked them. So when they put in the pacemaker and cranked it up to 60, my dad did not sleep for days..he had to beg them to turn it down so he could sleep.
His pacemaker took 3 wires instead of 2. He has been having problems with it and has been going back to the hospital on a regular basis so that they could adjust it(or whatever) Something was funny. It didn't read the way it should. Xrays indicated that one of the wires did not connect into the heart muscle. Not a major so they said, it will be read as a 2 wire as it works that way. Okay. now every once in awhile the pacemaker would do "double-time" heart beat would go from 50 to 200. Rush to the hospital. After it happened the 3rd time, they decided it would be better to install a defibrillator in him just in case the heart beat took off again.(like the paddles)$40thou. So he has a machine to make sure his heart does not go too slow and another to make sure it does not stop nor go too high.
He is not a candidate for another heart as he is too old(65) and the rest of his system is not in great shape-he will have a complete system shutdown.so they say.
He has a drink once a week, doesn't smoke, doesn't overexert himself, has a good mind, and is a handicraft sort of person able to function all around except for the heart, you would not know he had a problem. Liver, kidneys, lungs, all work fine.
Seems to me that the doctors are being a bit lazy, opting for the mechanical means rather than possibly getting better results with a heart transplant.
My dad has to take a whole wack of pills - blood thinners and the like.he is miserable cause everytime the "defib" goes off it is like receiving a thunderbolt inside the chest.
He is in that much pain, he says "let me die already". He never complains nor has ever visited a hospital due to sickness all the years I have known him.
That has got to be bad, when the doctors are experimenting and not paying attention to the wants of the patient.

I don't know what to say. What say you?

Answers:
Without a doubt, an extremely frustrating situation. When a person has an ICD placed, it's because his heart cannot function properly on its' own. I have known several patients' that complain about the ICD initiating a jolt. It feels as though "the wind was knocked right out of me". And, it's scary. But, the only other alternative would be a heart transplant which, needless to say, is a very intense, even complicated procedure, providing that there is a heart donor that matches him. Even then, he would be placed on additional medications to prevent rejection. I feel bad that your Dad is in this situation. He could always get a second opinion but, to me, the cardiologists' are doing the best that they can. I don't know what else to say except that I hope your Dad can adjust to his situation and gain determination to be strong. I hope that this helps and God Bless to your Dad.

A heart transplant is the last solution to these problems because the risks are serious and the side affects are many and. deadly. The medications one has to take to make sure their body does not reject the transplant causes cancer among other problems, and they only last 5-10 years, if that, before the host needs a new one. My sister has undergone 3 open heart surgeries and also has a pace maker. The pace maker will not make the heart speed up, it only keeps it from going too low. Its really best to work with the heart that you have before going the transplant route. Your doctors are doing the best they can and are working with what they've got.

Before he gives-up, has he tried different doctors? I know it sounds like a long-shot, but how does he sleep? If he snores a lot, maybe he has some sort of sleep disturbance. A sleep study would clear that up. Sometimes sleep disorders look like heart problems. Maybe it is a matter of cardiologists doing what cardiologists do, ignoring other possible causes?

My grandmother had a doctor who loaded her with all sorts of pills. A pill to counteract the side effects of of a pill to counteract another side effect. It was crazy. A new perspective might help. Perhaps looking for a young cardiologist? I have experience working with pulmonologists and when a new one right out of school started, there were all sorts of significant differences in patient care that I saw/participated in. They know of newer techniques, medications, etc.. I hope this helps.

HI

Sorry to hear about your dad's dilema, but it seems as though he is functioning pretty well at the moment. Not trying to be insensitive to your situation, but a heart transplant is no joke. Firstly you have to be pretty ill to make it to the list, or near the top to get a new heart, most of these patients are bed bound, and can pretty much do nothing for themselves, they are constant oxygen, and very weak. Secondly it is a very big operation with lots of risks. Your dad's other organ systems seems to function fine, which be in his favour, but after such a big operation, the lungs can take quite a knock, and you often develop ARDS (adult resp distress syndrome) which if it gets bad enough is impossible to get enough oxygen in the blood, and you die of suffocation, experience have told us older people are much more suceptible to get it than younger people, and the mechanism is not quite clear. Lastly, you think he has a bag of pills now, try taking all the meds after the surgery, and they are potent imune suppressors, so he runs the risk for getting life threatening infections, if he does not end up with his body rejecting the new heart, if that happens he will need a new heart asap, which might not be available, and it is the whole process all over again. That is why there is such strict criteria for transplant surgery, and why age is also a factor, believe me it might not look that way now, but he is much better off with a pacemaker and internal defibrilator, than being on a transplant list. I hope this answers some of your q's. Your dad can always sign a dnr form, and get them to remove the defibrilator, that seems to cause the most trouble, esp with the pain when it goes off. Once pacemakers are fit properly, they usualy don't cause trouble, I would leave that in, it will prevent him from going into heart failure, which is not fun. Best of luck!

It's sad to see some-one we care about in pain, and heart problems are so worrying. My brother had a bad heart all of his life, enlarged,he was always in the hospital to get the paddles to put him back in rhythm, finally he made it to the list for a new heart which he received 8 years ago, he was 45 yrs old then. Immediately he became stronger and it didn't take him long to start living. There are a lot of risks to a heart transplant, rejection, infection, and talk about pills, my brother takes a regimen of meds every-day just to keep his new heart functioning normally. Recently he under went surgery again to remove a tumour from his heart, as well as replace a valve that operation took more out of him than the transplant itself. I guess what I am trying to say is that, yes he was given more time to live his life and be healthy for once even if only for 8-10 years and it was good to see that, but he still has a fragile heart and even if your Dad were a candidate to receive one he may experience more trauma than he does now. I don't know, it's not for me to say, I wish all the best to you and to your Dad , Take care and God Bless

Health, when they should let go?

Health Resources