Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
DVT And PE Due To Hip Replacement, History Of A Fib. Back Pain, Confused, Bed Sore. Full Recovery Possible?
Question: I will do the best I can with proper names and spelling but hopefully you will understand my questions ... My almost 93 year old Grandmother is in hospital now due to a hip replacement performed approx 6 weeks ago. She was readmitted due to DVT and PE. She has a past history of A Fib. She has not walked in quite some time. She seems to be more and more confused (not a medication side affect) and basically is in pain frequently. The pain is from her middle back. She has a bed sore under one arm. She is being treated with blood thinners for the clots. Testing today will reveal if they have shrank in size. She is on oxygen. Her leg is still draining from the hip replacement surgery. She does not look well at all. She also is now wearing hew DNR bracelet. The Doc is now suggesting a pacemaker might be his recommendation. We will know for sure today or tomorrow. Im obviously not in the medical field but have watched people die slowly in the hospital. In my heart I question if she will even ever fully recover from her current conditions. My questions are ... how beneficial is a pacemaker to someone in this condition? What about the risks? Recovery? Is it true that if the pacemaker is installed that it would not be possible for her to pass peacefully in her sleep (which is what I pray for) because the pacemaker would prevent that? Should she have the procedure if she still has clots? What quality of life can we expect for her? I hate to say this but my fear is that her Doc is looking at her as a guinea pig and/or cash cow.
Hi XXXXXXX
I am a qualified and certified cardiologist. I read your question with diligence and I could understand your mail completely. I empathize with you have heartfelt best wishes for being enduring the hard times you have gone through seeing your mother deteriorate medically and now to face hard decisions.
You have rightly concluded that long term prognosis of your mother does not appear good. But let us assume there is hope, howsoever, little it may be that she may walk out of hospital if not walking but conscious and on wheelchair. The hope is contingent on the continuing treatment. Let me try to answer precisely to what you have asked, your question first and then my answer
How beneficial is a pacemaker to someone in this condition?
If it is indicated (the attending doctors judgement has to taken at its face value: it is advised in good faith. An ordinary procedure. No commercial benefit to doctor the cardiologist who puts it does not gain great rare experience, it is one of hundreds he/she might have put in) IT IS BENEFICIAL I would suggest please go a head with it.
What about the risks? Recovery?
In the condition your mother is no additional risk. If she recovers other things she will recover from pacemaker also. As an isolated procedures pacemakers are not rare to be put in patients in nineties so not an uncommon age.
Is it true that if the pacemaker is installed that it would not be possible for her to pass peacefully in her sleep (which is what I pray for) because the pacemaker would prevent that?
No that is not true. If it is Almighty's desire that she passes away in sleep. An installed pacemaker is not a resuscitation (I noted her DNR instructions). Her heart will not not obey the stimulus of pacemaker so no discomfort to her. Whereas if pacemaker is indicated as doctors seem to believe she is in discomfort now, which ought to be relieved.
Should she have the procedure if she still has clots?
Ideally not. The indication is in the heart. She is receiving blood thinners for clots which will be continued after pacemaker. Slight problem there will be post procedure but not trying to give pacemaker when it is needed is very difficult to justify.
What quality of life can we expect for her?
If with the grace of Almighty she makes it. I am presuming a reasonable quality of life. You mentioned pain. Pain is perceived by live Brain. So her brain is functioning normally. She will provide much solace to all.
I hate to say this but my fear is that her Doc is looking at her as a guinea pig and/or cash cow.
Possibly you have a point in suspecting. But his advising pacemaker will give a few thousand dollars you do not sell your conscience for that. Have faith in your doctor. I am not supporting someone I have not met. But having gone through such agonizing decision making myself for thirty years, I have intuitive judgement in such situations about the other human being. I hope I am not wrong. May God Bless you. Please do write if you any other query. Good Luck.
With best wishes.
Dr Anil Grover,
Cardiologist
M.B.;B.S, M.D. (Internal Medicine) D.M.(Cardiology)
http://www/ WWW.WWWW.WW
I am a qualified and certified cardiologist. I read your question with diligence and I could understand your mail completely. I empathize with you have heartfelt best wishes for being enduring the hard times you have gone through seeing your mother deteriorate medically and now to face hard decisions.
You have rightly concluded that long term prognosis of your mother does not appear good. But let us assume there is hope, howsoever, little it may be that she may walk out of hospital if not walking but conscious and on wheelchair. The hope is contingent on the continuing treatment. Let me try to answer precisely to what you have asked, your question first and then my answer
How beneficial is a pacemaker to someone in this condition?
If it is indicated (the attending doctors judgement has to taken at its face value: it is advised in good faith. An ordinary procedure. No commercial benefit to doctor the cardiologist who puts it does not gain great rare experience, it is one of hundreds he/she might have put in) IT IS BENEFICIAL I would suggest please go a head with it.
What about the risks? Recovery?
In the condition your mother is no additional risk. If she recovers other things she will recover from pacemaker also. As an isolated procedures pacemakers are not rare to be put in patients in nineties so not an uncommon age.
Is it true that if the pacemaker is installed that it would not be possible for her to pass peacefully in her sleep (which is what I pray for) because the pacemaker would prevent that?
No that is not true. If it is Almighty's desire that she passes away in sleep. An installed pacemaker is not a resuscitation (I noted her DNR instructions). Her heart will not not obey the stimulus of pacemaker so no discomfort to her. Whereas if pacemaker is indicated as doctors seem to believe she is in discomfort now, which ought to be relieved.
Should she have the procedure if she still has clots?
Ideally not. The indication is in the heart. She is receiving blood thinners for clots which will be continued after pacemaker. Slight problem there will be post procedure but not trying to give pacemaker when it is needed is very difficult to justify.
What quality of life can we expect for her?
If with the grace of Almighty she makes it. I am presuming a reasonable quality of life. You mentioned pain. Pain is perceived by live Brain. So her brain is functioning normally. She will provide much solace to all.
I hate to say this but my fear is that her Doc is looking at her as a guinea pig and/or cash cow.
Possibly you have a point in suspecting. But his advising pacemaker will give a few thousand dollars you do not sell your conscience for that. Have faith in your doctor. I am not supporting someone I have not met. But having gone through such agonizing decision making myself for thirty years, I have intuitive judgement in such situations about the other human being. I hope I am not wrong. May God Bless you. Please do write if you any other query. Good Luck.
With best wishes.
Dr Anil Grover,
Cardiologist
M.B.;B.S, M.D. (Internal Medicine) D.M.(Cardiology)
http://www/ WWW.WWWW.WW
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
