Bipass (Mouse Over)

Dear Kim,

The situation with my mother is dire.

My brother flew in again yesterday from New York to help supervise my mother's medical care at Rush Presbyterian St. Luke's in Chicago.

It is very reassuring to have a doctor in the family.

(Kim: Actually I think that one's only chance is to have a doctor in the family who will place the wellness of the patient ahead of their fraternity.)

We thought she had a simple urinary tract infection when she went to the emergency room Saturday night.

It turns out, it is not so simple. I am not sure anything is ever simple when people get old.

There is a good possibility that the infection and high temperature damaged her heart. Or, just as likely, she had the heart damage that can come from age as well as from the heart disease that runs in our family.

Her sister, my Aunt Millie, died of congestive heart failure at age 54. And my brother had open heart surgery for a torn valve at the age of 51 just last year.

We've got some stinkin' genes in our family.

So my mother had an angiogram yesterday. It revealed blockage at several sites. The two most significant blocks could not be addressed with balloon angioplasty.

My brother, who is nothing if not thorough, believes that lab did the best it could and that the results would be no different elsewhere.

The question now is what to do.

The Rush team wants to pursue bypass surgery in Chicago early next week. One of the surgeons told my brother that he was the best and the guy for the job. Surgeons tend to be like that. They are real hotdogs. Cocky, eager to take on difficult cases and test themselves.

However, I am not sure that the potential benefits of such major surgery outweigh potential risks. My mother is tired, frail, has incurred numerous health challenges in the past fifteen years including colon cancer, numerous adhesions, a stroke. A lot of things that I would rather not say can happen in such surgeries.

(Kim: I think that my parents would have chosen to not have the surgery. I would choose to have it for myself (even in that condition). But I'd have it done at Rush (unless there was an overwhelming reason why not. But I'm sure your brother knows best.)

Ian plans is to take the films to NYC today to his own heart surgeons for a second opinion. If`surgery is recommended, we then need to think about where and when it should be done.

This, too, is complex, assessing the level of a particular surgeon's competence vs the risk of moving a patient. Not all success rates are determined on the same scale. If someone has 1% mortality but takes easier cases, one may be lulled into a false sense of security.

I just don't know.

There is so much that I do not know.

What I do know is that I am now contemplating several simultaneous realities: My life with my family in Chicago and the life I arrived to live in LA just a few days ago.

Last night, I took Rod, the guy for whom I am house and dog sitting to the airport. As I write, he is still on a plane, headed for Indonesia for a month.

I now need to look into going to Chicago or NY to be with my family and to make arrangements to manage the commitments here that I blissfully and unknowingly assumed just a few days ago.

What a difference a day makes.

Later,

Joan

Thursday, Jan 19, 2006

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