At 4 a.m. on an early Friday morning a few days ago, my 90 year-old mom woke up with chest pains. As instructed by her doctor, she took a nitroglycerin pill and waited for relief. After 15 minutes, she took a second nitro pill, and thankfully the pain began to subside. Later I asked her, on a scale of 1 to 10, what level did she estimate the pain to be and her answer was between 8 and 9. Knowing my mom as a stoic German, I knew she wasn't exaggerating and that her pain was pretty extreme.
Three years ago, she had a couple stents put in her heart and the doctors explained to her at that time that she had blockage in another artery, but they weren't able to put a stent in it. They showed her a picture of her heart and she could see exactly where the blockage was and still is. They warned her of the likelihood that she could suffer a heart attack from the remaining blockage. She suspects that is what happened, that she experienced a mild heart attack.
Like many people, particularly elderly people, she is determined not to go to the hospital unless she absolutely has to. She says if the pain became bad enough, she would go, but other than pain management, she knows there is nothing that can be done for her any more. She has literally had heart problems all her life. As a child she used to pass out for no reason and as an older adult has been under the watchful eye of a cardiologist for years.
She argues that, if she were to go to the hospital they would put her on morphine and oxygen and slap on a nitro patch. They'd hook her up to some machines, like an i.v and other monitors. They'd probably insert a catheter, just because. And then they would run a bunch of tests and suggest she have an angiogram, which she would refuse. They would wake her up every hour to take blood or check this or monitor that, which would rob her of the rest she needs.
At age 90, she has decided that she doesn't want to have any more tests done and she definitely won't have any more procedures done. She doesn't want any more stents, no angioplasty and says open heart surgery is out of the question. All four of her kids support her decision and agree that, at this point, she can recover better at home than in a hospital.
She slept almost all day that Friday, but she got up on Saturday morning, had a light breakfast and took a shower. She played with her cat, Holly, and watered her plants. She "puttered" around a little while, then laid back down and slept. She spent most of the day resting, but did get up and do a few things as well. She had no pain, but still had a sense of fullness and pressure in her chest and her left shoulder and arm were bothering her. Sunday, she spent a little more time up and about, but took it pretty easy and laid down frequently. Her shoulder and arm felt better, but she said she was still breathless and got winded easily. She sat outside on her deck in the sun and enjoyed some fresh air.
On Monday and Tuesday she said she's feeling pretty good. After you have experienced an 8 to 9 level of pain, it's all relative, I think. She still has some pain, but it is relieved with half of a pain pill. She gets outside and walks up and down her driveway, which is pretty long. She used to do 10 laps, but now admits that just one lap wears her out. She knows something has happened and that her body is not the same as it was, but she realizes she must keep going and I admire her determination.
Today is Wednesday and she has been checking into her long-term care policy to see what it covers and if it's time to consider assisted-living. Ironically she's probably still too healthy. My brother lives next door to her, so help is very close at hand. She has a device she wears like a necklace that has a button she can push any time if she needs help. In addition, if she falls and can't push the button, the device has a sensor that notifies the screening company, who will then call family members.
She has her ducks in a row, so to speak. She is trying to find a necklace to hold her nitro pills so they are always handy. It is so impressive the way she takes charge of the few things that remain in her control. I should start recording some of our conversations because they are filled with pearls of wisdom that I want to remember. Some of the things she says are just priceless. Things like, "I think I'm going to have to stop raking." She has always loved to rake and it has provided her with good exercise, but those days are over. She also said, " I'm not dying! I'm going to be fine. In my mind I can do anything!"
She has encouraged family members to continue with their lives and their plans. She doesn't want to inconvenience anyone or cause too much of a disruption in our lives. Always thinking of others. This incident happened right as Jack and I were planning a vacation. When I told her we were struggling with the thought of leaving her, not knowing for sure if she's okay, she responded in true fashion. "Oh heavens," she said. "Of course you should take your vacation. You and Jack work so hard and you need time away. You can't live your life in fear of what may or may not happen. I want you to take a big sigh of relief and book that trip. Mom's gonna be fine."
But back to the hospital dilemma, my family saw my dad die on July 27, 1988, in the hospital after heart surgery, hooked up to machines with a huge scar running down his chest and his legs. If my mom wants to avoid that scenario, we all can certainly understand why and we will all do our part to support that decision.
