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A dilemma over life and money

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  • #349386
    A. Prashanth
    Participant

    Hello all,

    My grandmother is 89 years old and has had heart related issues for several months now. She also has vascular dementia and at least three heart attacks over the past 25 years. In the past six months alone she has been in and out of hospitals 6 times, each costing me heaps of money. My mother just passed away in the october of 2019, after a prolonged battle with cancer, TB, Radiation aftereffects, low sugar levels, depression, a gaping hole in the chest due to radiation, bone lesions and finally due to Cardiac Arrest. Since 2014 to 2019, me and my dad (especially) have been through so much stress and anxiety over her health and about managing finances for her treatment. Her eventual passing broke us even further after all the hard work. Now my grandmother is ill and admitted to the hospital. Everyday she is in the hospital, we lose at least 20,000 rupees. Angiogram was done to her and the doc said that two out of her three arteries are 100 percent blocked and one is 95 percent blocked. He recommends an angioplasty with the placement of a stent that can redirect blood flow to the blocked arteries as well. But its an expensive treatment costing over 4 lakh rupees. Every relative and friend of mine are of the opinion that she should be allowed to pass comfortably instead of making her go through the surgery. The doctor is 95 percent confident that the surgery would be a success, and 5 percent not sure due to her age and comorbidities (slight kidney issues). Due to the lockdown (corona related), most hospitals are shut and refuse admission due to reduced staff and doctors. So we had to end up in one hospital which is really expensive. Being close to 90 years old, she no longer has insurance. Doctors are also warning that there might be aftereffects due to the surgery like kidney failure, allergic reaction due to the dye used in the angioplasty or even internal bleeding.

    Me and dad have no support from relatives other than suggesting these things. Neither financially nor with their presence due to the lockdown and fear of corona spread. So we have three options now:

    1. Don’t make her go through the surgery and bring her home. This will mean we will save money, she will however die of cardiac arrest any day and we have to remain constantly anxious. We love her so much that we can’t possibly undergo this. Also the guilt of not doing more for her, for all the love and care she has given us over the years.

    2. Make her go through the surgery, she passes away during surgery or due to post surgery complications. We would lose a lot of money and be in debt, lose her, and would have all relatives and friends saying, ”We told you so.”

    3. Make her go through the surgery, she will be fine, but will have low life expectancy anyway due to her age. We will still be anxious as to what would happen when.

    None of these options give us a relief. Whichever decision i make, the other two seems better, and this goes on in a cycle in my head. Everyday we keep her in the hospital we lose money as well.

    We are under too much stress, emotionally, financially and physically. We don’t know what to do. My heart feels like it will explode anytime. Haven’t felt this heavy since my mom’s passing. Life is cruel.

    #349446
    Anonymous
    Guest

    Dear Prashanth:

    I am sorry that your mother suffered so much during her long illness, and that you suffered as well, witnessing her suffering.

    Regarding your grandmother: “three arteries are 100 percent blocked and one is 95 percent blocked. He recommends an angioplasty with a placement of a stent”

    Wikipedia: “Atherosclerosis is a disease in which the inside of an artery narrows due to the buildup of plaque… When severe, it can result in coronary artery disease (happens when the arteries leading to the heart are severely blocked), stroke (happens when arteries leading to the brain are severely blocked), peripheral artery disease (happens when arteries leading to the arms, legs and pelvis are severely blocked), or kidney problems (happens when arteries leading to the kidney are severely blocked), depending on which arteries are affected… Almost all people are affected to some degree by the age of 65. It is the number one cause of death and disability in the developed world.”

    Angioplasty is a minimally invasive endovascular procedure used to widen narrowed or obstructed arteries or veins, typically to treat arterial atherosclerosis… Angioplasty has come to  include all manner of vascular interventions that are typically performed percutaneously (“In surgery, a percutaneous procedure is any procedure or method where access to inner organs or  other tissues is done via needle-puncture of the skin, rather than using an ‘open’ approach where the inner organs or tissues are exposed… A percutaneous access requires only a very small hole through the skin, which seals easily, and heals very quickly, compared to a surgical cut down”).

    mayoclinic. org reads: “Although angioplasty is a less invasive way to open clogged arteries than bypass surgery is, the procedure still carries some risks. The most common angioplasty risks include: Re- narrowing of your artery… 10% to 20% when bare-metal stents are used. Blood clots can form within stents even after the procedure.. causing a heart attack. it is important to take aspirin.. that helps reduce the risk of blood clots. Bleeding.. sometimes serious bleeding occurs and may require a blood transfusion or surgical procedures..”

    “Most people who have an angioplasty also have a stent placed in their blocked artery during the same procedure. A stent, which looks like a tiny coil of wire mesh, supports the walls of your artery and helps prevent it from re-narrowing after the angioplasty”.

    Now back to what you wrote: “He (the doctor) recommends an angioplasty with the placement of a stent… The doctor is 95 percent confident that the surgery would be a success, and 5 percent not sure due to her age and comorbidities”-

    – it makes sense to me (as a non-professional) that the doctor is 95% confident that she will survive the  minimally invasive procedure because it doesn’t include opening her up: the procedure doesn’t even require anesthesia, according to the mayoclinic website. The risks of re-narrowing of the arteries and blood clots may happen after the procedure. Therefore, I see the doctor’s confidence that the procedure (aka minimally invasive surgery) will be a success as limited to the procedure itself.

    I suppose this procedure is likely to extend her life. Did the doctor tell you for how long it may extend her life?

    anita

     

    #349448
    A. Prashanth
    Participant

    Hello Anita,

    First and foremost, thank you so much for taking the time to research and share the information.

    The doctor didn’t mention the possibility of increase in life as he says due to age, we can’t assure anything. We will do our best is his declaration. If he had given some assurance, we would more confidently carry on with it.

    #349450
    Anonymous
    Guest

    Dear Prashanth:

    You are welcome.

    I figured that what I posted to you above are things you already know and researched yourself (and maybe this is why you replied to me in less than 8 minutes after I summited my post to you)-

    -but sometimes, we know something, but we don’t know-know it, that is: we know something superficially, but not deeply. Will you, when you are calm, take your time and re-read what I shared in my post to you, let the info sink in deeper, and see if something new occurs to you?

    anita

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