Congestive Heart Failure 75 year old/implant defib/pacemaker HELP!

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manifestor
New Member


Date Joined Sep 2007
Total Posts : 2
   Posted 9/27/2007 8:00 PM (GMT -7)   
If anyone could shed some assistance my entire family would be ever so greatful!  My father, who has suffered from congestive Heart failure most of his adult life, is now entering the critical stages.  He had corotid artery surgery and triple bypass ten years ago and has been doing fairly well. He takes good care to exercise daily, although he is too thin! the doctors are consistantly telling him to eat more fat, but he just will NOT. We understand this is an issue and we are constantly on it! However, He also has a leaky heart valve which during this entire phase from bypass until now, it has remained mild to moderate.
Just recently on a trip to the CArdiologist, he was informed his function/capacity of the heart has decreased significantly and if test show (TEE and Angiogram) that there is no blockage then an implant of defib/pacemaker would be in his best interest as his function is now thought to be at 20%.  This is not exactly evident in his daily lifestyle as he is always walking, biking or going on vacation.  After all the tests he underwent this week, based on the CHF they will not be able to do a valve replacement.  My dad has severe issues with anxiety and fear. Although a very religious man, he can not shed the fear.  He does not do well after any type of anesthetic and the procedures he underwent (TEE and Angiogram) just this week are a grand example. The doctors really want him to have the implant but he does not even want to discuss it.  Im wondering if anyone has any information they can share that we can help him make a better informed decision.
 
At this point we will take whatever advice anyone could share with us! I would really appreciate any type of feedback.
Thanks for reaching out if you are able to. This has been a very disturbing week!
 
 

els
Veteran Member


Date Joined Oct 2005
Total Posts : 4031
   Posted 9/29/2007 11:27 AM (GMT -7)   
Hi manifestor, welcome to healing well.  I am so very sorry about your dad.  Please know my thoughts and prayers are with you and your family.
 
First thing I would do is pull up all the research you can regarding this and print...let him read up on the implant.  I am 34 and had a pacemaker implant 2 years ago this month due to sick sinus syndrom and bradycardia.  My heart was only beating in the 20's on it's own.  I fought against getting it also, I dont do well with surgery's and at the time I had a whole list of different reasons.  Now, I hardly notice it.
 
The surgery was very simple and quick I recall about 15-20 minutes.  Of course I was already inpatient in the hospital.  Recovery time was about 2 weeks of not using that side of the surgery...mostly not raising your arm above shoulder and not lifting anything too heavy or else you could pull out the leads.
 
If he knows the valve replacement is out of the question at this point and an ICD or Pacer implant is the only option right now then at some point he is going to have to think about his best health reasonably and hopefully see that the device may be his best option.
 
Please do keep us informed on how things go...

Elisha
Co~Mod: Depression
Moderator: Heart & Cardiovascular Disease
http://www.healingwell.com/donate


manifestor
New Member


Date Joined Sep 2007
Total Posts : 2
   Posted 9/29/2007 12:25 PM (GMT -7)   
Thank you so much for your reply.  I had researched some information on pacemakerclub.com and I really did not feel confident after reading all of the information.  My dad's biggest fear has been just going to the doctor. Really, on Tuesday when he went in for a simple test we had to calm him and very nearly scrape him off the ceiling. He gets himself so completely overworked that I fear he would not make it to the hospital for the test. He has very high blood pressure and this certainly adds to the strain.
 
What I had read on the previous website was that often times patients had to return, albeit another simple procedure to fix if the lead wires come detached but out of 10 stories this happened 9 times.  That alone caused me to worry that not only would we have to prepare him for the first procedure but that there very likely could be more as he is a very active person.
 
My dilemma is that he is normally very happy and realtively healthy. The doctors are in awe that at 20% function of his heart he is still able to walk or bike one mile per day.  He clearly is not the textbook case.  We know that this placement of the pacemaker/defibrilator will not in essence improve his quality of life, however, we feel it may cause some deterioration due to the procedure and the anxiety leading up to it. 
 
We are so in a state of what do we do? All the feedback and helpful information is so welcome at this point. Im sharing everything I find out with him, but as of yet I have not. I want to make sure I have a complete outline of the good vs the bad.  Please continue to send me your help and many prayers.  I thank you so much for all of this!!
 
 
 

sassyfrassy
Regular Member


Date Joined Mar 2007
Total Posts : 224
   Posted 9/30/2007 6:43 AM (GMT -7)   
Hi Manifestor, I had a defibrilator implanted aboutt 5 years ago. To make a long story short, after gallbladder surgery the Dr's found that I had arrythmia's (no history of heart issues) & said I needed it. The surgery wasnt bad at all. I went to the hospital, they did the implant and I spent the night and went home the next day. As Els said, recovery is pretty simple. The surgical site is pretty tender and bruised, but it goes away. For the first month or so I was afraid it would go off, but after, when it didn't, I put it on ignore. I was tired of being afraid. It honestly is not that big of a deal. I was more concerned with the scar than with the actual defibrilator. There really shouldnt be any deterioration of your fathers quality of life, in fact it should IMPROVE! :) Good luck to you and your father.
There arent any strangers here, just friends you havent met yet :)


els
Veteran Member


Date Joined Oct 2005
Total Posts : 4031
   Posted 9/30/2007 11:05 AM (GMT -7)   
Hi manifestor,  I am not too sure about the site you visited before but I have one for you that is wonderful...it is from the Cleveland Clinic and explains everything in detail.  http://www.clevelandclinic.org/heartcenter/pub/guide/tests/procedures/pacemaker.htm
 
Cleveland Clinic is much like the Mayo Clinic so their info is spot on.  I dont know what the % of lead revisions are among people who have the implants but 9 out of 10 seems a bit high.
 
In my case I did say before that I have bradycardia which is low heart rate.  I also have MS and an Autonomic disorder which is neurological and has greatly effected my blood pressure.  So when I became sick with the SSS and bradycardia in 10/05 I also started to have passing out spells when I stood up because my blood pressure would fall.  It is extremely low.  The doctors thought the pacemaker would help my BP but it didnt so I continued to have falls and yes, I did end up pulling out both leads from my heart 1 week post surgery. 
 
You have to understand though that displacing the leads isnt easy because right after the procedure they start to scar into place.  I was also having seizures with my falls due to lack of oxygen to my brain.  So who knows what the cause was to the displacement.  Anyhow, I did have a revision done where the put the leads back into place and this time since my cardiologist knew that the falls would continue he tied them down securely. 
 
All this really did was prolong the recovery time, and of course make the site more sore and noticeable.  Since I am female that is a concern for me even still but hey I have to have it. 
 
Check out the link I have posted and let me know if it helps.  Take care

Elisha
Co~Mod: Depression
Moderator: Heart & Cardiovascular Disease
http://www.healingwell.com/donate

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