Puzzled About HF, HOCM, A-FIB, WEAKNESS, AD CHEST PAIN

On May 17th my 90-year-old mother went into a-fib.  I found out for sure today when we visited cardiologist, although you, Dr. McWilliams, stated that this is probably what was happening. Office visit went well. Mother  out of a-fib.  

When the cardiologist placed my mother in the hospital Aug. 2007- heart failure, when he said, "Your mother is at end of life." She is presently taking 200 mg. of Amiodarone a day.  

During her visit to the cardiologist three months ago he suggested that Mother may not look 90, but that her body is indeed 90-years old. She also as HOCM.

However, during the office visit today, I asked this wonderful cardiologist about my mom's prognosis.  He stated, "Something can happen suddenly and unexpectedly.  Or it can be years."

I had this on my mind upon arrival at home, so I decided to call the doctor's office for insight and clarification.  His nurse said they do no have a crystal ball.  In fact, she said that about 4 times which insulted my intelligence.  I know that.  But I'm receiving mixed messages, so now I dont know what to think.

I realize that physicians cannot tell us everything that is going to happen pertinent to a patient, or even when.That is not expected as they are human. However, since my mother has heart failure, shouldn't a physician be in a position to offer what stage it is in? The nurse said that it is not in the cha.

I'm not upset with the doctor, rather this predicament.  I'm simply trying to educate myself.  Naturally I'm stressed because I'm talking about my mom.  I am on pins and needles daily wondering if this will be the day.

What is the doc. trying to tell me?  I have to read everything between the lines.  Is there no sound information?

Any help in interpreting this dialogue would be much appreciated.

[Michael J. McWilliams, M.D.]

Medicine is a very subjective field.  We can tell people that they are nearing the end of their life and often are completely wrong.  All we can do is use our best judgement from the data we have to deal with.  I think you are stuck in a situation where you want answers and the doctor is probably frustrated because he can't answer the question.  The classic men are from mars scenario --  if physicians cannot answer they question with a concrete answer, we often get frustrated.  It happens all the time.  The way I answer questions like that is to say that you "your mom is very sick and the most important thing now is quality of life rather than quantity."  You will never get an answer to the question for how much time is left.  HOCM is strange because people can do well but often significantly worsen with atrial fibrillation or changes in blood volume.  It sounds to me that you are stressed about this.  I recommend that you enjoy the time you have with your mom without focusing on trying to determine how much time that is.  It is hard but there isn't really any other choice.

I hope this helps.