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Here is a link to what carotid artery surgery is all about:
https://www.choosingwisely.org/patient-resources/carotid-artery-surgery/
Carotid endarterectomy is a surgical procedure to remove a build-up of fatty deposits (plaque), which cause narrowing of a carotid artery. The carotid arteries are the main blood vessels that supply blood to the neck, face and brain.
How serious is carotid artery surgery?
CEA can have serious complications, including stroke, heart attack, and death. You are more likely to have complications if you are age 75 or older or if you have a serious medical condition, such as: Diabetes. Severe heart or lung disease.
I'm glad it's NOT bypass being considered here, even though CEA is bad enough.
Best of luck!
My father had major heart surgery later in his life. He did not have any form of dementia though.
My brothers and I were greatly concerned and asked his surgeon if this was his father what would he do?
My father’s surgeon insisted that he would opt for surgery because my father would not live without it. So, we followed his advice.
My mother was on the fence about the surgery but supported my dad because he wanted to go ahead with the surgery.
Dad made it through the surgery fine, but unfortunately he had a stroke while still recovering in the hospital from the surgery. Daddy knew the risks beforehand and took the risk.
His remaining years were difficult for him after his stroke.
Like I said, these decisions are never easy to make.
My mother was not a risk taker and made sure that we knew that if she ever faced a situation where surgery was needed, she would not do it.
Mom’s doctor was extremely cautious and when mom had certain issues that could have been helped by surgery she didn’t hesitate to tell my mother that she didn’t think it was a good idea to have surgery past a certain age and would not ever recommend it. I appreciated her honesty.
All of my brothers have had numerous heart surgeries. My older brother is 71 and is so tired of dealing with his heart issues. It’s on ongoing concern for heart patients.
Wishing you the best in this difficult situation.
I MIGHT consider carotid artery surgery which can be done with minimal sedation.
BUT General Anesthesia, especially of the sort used for Open Heart procedures? No way, no how.
high blood pressure (hypertension)
smoking
an unhealthy diet
high blood cholesterol
lack of exercise
being overweight or obese
diabetes
drinking too much alcohol
atrial fibrillation – a type of irregular heartbeat (arrhythmia) – and other types of heart disease
And as the OP describes their mother as physically great for their age she could easily live another decade. I have the same questions as ElizabethY - if they will put in a stent that's a whole lot different than open heart surgery. My BIL's mom recently had a stent at age 89 and has recovered well (it was determined she'd never survive bypass surgery so the choice was basically stent or die, and was very difficult for the family)
Within 2 weeks time, DH found it harder & harder to breathe and his shortness of breath became a crisis situation. He had a pleural effusion which is a pocket of fluid built up (due to the enormity of the bypass) between his lung and chest cavity, which required ANOTHER large surgery to be performed to drain it and scrape his lung of the build up. He was hospitalized for another week for that situation, general anesthesia was used yet again, and that surgery was almost as difficult to recover from as the original bypass! To this day, he still does not have full lung capacity back & suffers shortness of breath from that pleural effusion.
It's absurd to even consider such a surgery for an elder with dementia, never mind an elder of 81 w/o dementia.
It would be a hard NO for me.
I prayed daily for God to take my mother who was suffering with vascular dementia and loudly asking TO die on a daily basis as a result. The last thing on earth I ever wanted to do was to extend her life in any way, shape or form.
Wishing you the best of luck.
I mean really. Let her live whatever time she has left in peace and without doctors poking and prodding her for no good reason.
And yes, my late husband had vascular dementia, and lived only 3 years with it.
Is this for open-heart surgery where she'd be under general anesthesia, with a breathing tube, and on a bypass pump with a surgeon performing the procedure?
Or are they offering something like stenting of the coronary artery under mild sedation, where a cardiologist advances the equipment up to her heart from her leg or wrist artery (done inthe cardiac cath lab)? They would be doing the fixing the same route that they used to take the pictures to look for the blockages?
Asking specific questions about the odds of something happening during surgery, prognosis with and without surgery, potential for adverse reactions after surgery can get them to slow down and answer.
I don't know anyone that has had a heart procedure that didn't have a stroke afterwards. Just my experience.
Any doctor that won't give me information, is NOT treating me or my loved ones. That is a waving red flag that says they couldn't care less and they just want to operate for the experience. NOT on my watch.
This is a hard decision. Alva is a Nurse so she is very aware what can happen. Make a list of pros and cons. The cons will probably win out.
I would almost, to be honest, be glad that she may have an OUT of the awful dementia that imprisons her.
But, that’s me. Watching my mother suffering with this awful condition is brutal for me. And, it’s brutal for her to be living with it.
My mother had congestive heart failure and various other issues including dementia, but eventually I had to make the decision that we were done with hospitals because she'd go nuts in hospitals. The staff at hospitals are terrible at dealing with dementia patients, so I finally said we'd treat whatever ailed her at her nursing home or not at all. (Had she fallen and broken a hip, that would have warranted a trip to the hospital, though.)
That's when we started hospice care, and it was wonderful. She had better care under hospice than she did in hospitals.
Like Barb, I would consider what your loved one's wishes might be were she able to make this decision for herself, and I think I would likely ask for Hospice consult.
There is no good answer here. While your loved one is in danger of a stroke with this amount of blockage, she is also in danger of a stroke from its "cure", as well as from other complications from medications such as blood thinners. Strokes don't always kill; they often just make the remaining life more miserable.
This isn't an easy question. And if the doctors don't have time to FULLY discuss risk and complication, choices and recommendations, then I definitely would not go forward with this surgery.