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life span of grafts
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life span of grafts

Hello,
My father-in-law had previous heart attacks and went through a by pass surgery at the age of 50 (1989) and then he was completely normal and was in fact very active with strict diet regime and exercise.  He is diabetic also which he controls very well.

In Dec 2004 at the age of 65 he had a massive attack and was told he had a close call but then the doctors did an angiogram and then an angioplasty. He was back to form and we were all happy.

In July 2007 at the age of 68 he had some chest pain and heart related issues and that’s when he was back in the hospital and most of the doctors were unwilling to work on him as they considered his case to be a complicated one and somehow after a crucial discussion among themselves the team headed to perform an emergency by pass and also warned us that since this was his second by pass and also that his heart been compromised so much that they doubt if he would make it. Surprisingly he did very well and recovered than the doctors anticipated and was back on heals. I should hail for his will power and braveness. Unfortunately with in 3 months of this he had another massive attack and that time the doctors were hesitant to open his heart again as it did not heal completely and so they did an angioplasty and again said he would not make it because he had one after another attack while performing the angioplasty. Again, by gods will he made and is very healthy now and back to more active life. He is 70 yrs old.

Just a month ago he said he had numbness and this time he refused to seek medical attention and says he won’t see any doctor anymore and let him be this way as long as it lasts. When we insist he simply gives us excuses saying it could be because of the weather and cholesterol medication. All our worries now, is this some kind of a warning that he is aloof about it or what he says is true the numbness caused because of the medication he is on.



This discussion is related to 85 years old patient's bypass blocked 3 months after the surgery.
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First of all, I really don't know what could be causing the numbness.  I can't help you with the medical part of it.  The problem that I am going to speak to is that he won't even go and see what the doctor has to say.  

Maybe you and/or other family members can just talk with him about consulting the doctor, just to see what the doctor has to say.  He can take the doctor's input under advisement, before he decides what to do.  Medical care is not an all-or-nothing proposition.  There may be some low-level kind of intervention that can be done to make him more comfortable and perhaps even extend his life, without his having to go through surgery or go on the cath table again.  

I'm just speculating, but I think your father-in-law may feel that if he goes to the doctor, he will have all decisions taken out of his hands.  Let him know you respect his option not to have any extraordinary measures, if that is how he feels.  But if he is still on prescription medication, he will need to see the doctor sometime, just to get his prescriptions refilled.  And maybe there is some kind of simple medication adjustment that can help.  

I think the "loss of control" issue may be huge for him.  My main feedback is to assure him that he is in control of his own medical decisions and that his loved ones will respect whatever he decides -- and you should mean it.  Make a decision yourself that you will join with him and not with the doctors, if there is a conflict between what he wants and what they want.  Let him know that you will back him up.  Only then may he feel "safe" enough to seek medical help, because then whatever happens is still up to him.  

It may be time to talk honestly with him about mortality issues and to let him know that you and the rest of the family will be okay after he is gone.  I know that is a hard thing to talk about, but if he hears that and knows that you are sincere, then he knows for sure that you are not going to pressure him to live beyond his time of being comfortable and having good quality of life.  And for him, I think being comfortable and having good quality of life means doing what he wants to do.

Good luck.  He's a tough old codger, and his stubbornness has served him well so far.  You can compliment him on that, and that is something else that might help him loosen up.  You've got to find a way to invite him to let go of some of his control issues, at least a little bit, at least for now.
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Avatar_f_tn
Thank you so much for your reply. You are 100 % correct when you mentioned about his thoughts with regards to why not seeking medical attention. He first of all refuses to open that topic even as a conversation. He admits that he is having the fear that anything might happen to him; however he won’t see his doctor because they might give him same old bad news regarding his heart which he is not prepared to deal with it anymore. He wishes not to know about his current heart's condition and never to go through anymore surgeries.

What so ever as a loved ones it is hard to see this at the same time we do respect his feelings a lot and perfectly understand his pain.
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Avatar_f_tn
Well, I have anxieties similar to his, so I just suspected as much.  It takes one to know one.  I think that what would help me if I were in his situation would be to know that my loved ones were going to support me in whatever I wanted to do, including refusing intervention if I just did not feel I could go through it again.  Under those circumstances, I might be willing to at least hear what the doctors had to say.  But if I thought that my family and the doctors were going to gang up on me, I would dig in my heels.  And I guess I can understand that a person could get to a point where they just did not even want to talk about it anymore.

Take my comments for what they're worth, take what's helpful, and leave the rest.  I feel for you all.  I can tell you love him very much.  That comes through loud and clear.  Thank you for sharing, because your concern is so sweet.  I will say a prayer for him.  Maybe that's all we can do.
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