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Hi all. My relatively healthy mother has been advised by the ER cardiologist to have a heart valve replacement. There was an article last year in the NY Times that this operation is expensive and causes other problems especially in the very old. Any experience with this?

Her symptoms are difficulty breathing, weakness in her arms and fingers, raspy throat.

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Hi Judda, I just read this long thread. I feel for you. I know the stress you've been under. I went through the same thing with my 96 year old grandmother last year. The big money machine was pushing my grandmother to have a possible TAVR on her aortic valve. It started with her regular cardiologist. This happened not only once, but TWICE. Each time about a year apart, they scheduled visits with a cardiac surgeon for an evaluation to review her options. And each time they told her they would not do it, but maybe someone else might. This was the same surgeon too! All this while her memory was confused and she was given a little hope at same time. At one point she had made up her mind not to do any surgery a year prior, and then a year later she's being forced to consult a surgeon again because she's being egged on by a new cardiologist in her medical group because her mental capacity is not 100%. And they send her to the same surgeon she saw previously who denied the surgery previously! It angers me to no end that the medical profession pushes a 96 year old women who also previously denied surgery herself would exploit her health and mental capacity for financial gain. She was not accompanied by any other family member. This is the way she has chosen to carry out her healthcare and existence. She is a strong independent woman, does not like to rely on others for help yet she is not 100% and clearly is not aware of some of the abuses that are occurring. It's frustrating to us caretakers who are expected to be available to our loved ones yet have one arm tied behind the back. I know Judda your concerns and do hope you have remembered to take care of yourself throughout this time. That is the best you can do. I wish you good health my dear.
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It takes a lot of courage to do the right thing.
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Juda you hit the nail on the head. Just follow the money.
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I'll let you all know what how it goes with Dr. Taylor and Mom and I.
There is a wealth of info on the internet on fixing heart problems at any age without the darn drugs (that only made her weak and didn't solve the problem at all), and if heart surgeons are telling us online how diet and other approaches actually work better, the only reason we are submitting our loved ones or ourselves to their methods is brainwashing by the huge corporation$.
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Yes, Judda mentioned in another thread that she was having trouble logging on with her account, so now she is "reincarnated" as happygal LOL.
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Call me stupid, but does Juddha=HappyGal?
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Mom is already relieved and less fearful. I hope it draws us a little closer too.
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Hi. I'm back! So Mom had the cardio catherization and after all that the hospital told her she can't even have the valve replacement: she has to have open heart surgery or accept that they can't do more for her. "A death sentence," Mom murmers.
So I called my Functional Medicine dr, ND, who is an author, speaker and has practiced curing others of all kinds of things and he agreed to see my mother, see what he can do for her and even to work with her family doctor, (if he is open and willing, we don't know: maybe) With diet, supplements, and his biomeridian machine, he'll steer us better than a doomsday operation will.
If nothing else, he can make it so she ages with her mind intact and no other additional diseases, acquired from the traumatic operation.
I plan on being Mom's "buddy partner" taking care of my own health needs and both of us keeping an eye on each other's progress. I can work on my own heart issues and lose that weight at last. He was very helpful to me two years ago. I need to keep on so I hope our new plan will be fun and fruitful.
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Minimally invasive aortic valve replacement is a new technique. At her age, I would still expect an 8 week recovery time IF there are no "complications". At her age there are too many complications possible make a list.
The person you really want to talk to is the Anesthesiologist, because there is a practical limit to what a 95 year old can survive.
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My mother had the TAVR version of aortic valve replacement 1.5 years ago (at age 88), and she did fine. My friend's father had it at age 98 (and he also did fine).
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Re: Insurance. With most insurance carriers, major elective surgery needs a pre-certification. Has the cardiologist's office gotten that from the insurance company, or discussed with you or your mom the need for it?

Minimally invasive valve replacement is much more expensive than the traditional surgery and my understanding is that it is only approved for certain patients who are over a certain age. My brother in law, who is in his mid 50s applied to have it and was rejected (he has the same congenital defect in his aortic valve that led to my husband's emergency surgery 10 years ago).

Call the insurance company this morning and find out if they've pre-certified both the cath lab and the surgery. they may approve the cath and then wait to see the results before deciding whether to approve the surgery itself.

What are they looking for with the catheterization? In my husband's case, all they could see was an aneurysm on the CAT scan and wanted to see the supposed dysfunction of the valve and evaluate it for repair/replacement.
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Hang on tight to your sanity The insurance sounds like a mess. Will the surgeon/hospital even do the procedure without insurance? I totally understand the mother frenzy mode--it is impossible to have any kind of normal dialog with my mother when she is in that state, but your mother's life/death situation probably is beyond overwhelming to her. Like I said, hang on tight!
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Tuesday I take Mom to the Heart Center for the Cardiac Catheterization procedure. It sounds more "invasive" than the replacement valve operation. Why my mother wouldn't be sane enough to take time to get a second opinion, work out all the things she insists on controlling without taking time to do it, can drive me nuts. Coming up short on time, she now has over-stressed herself to a frenzy. I reminded her that she can postphone the appt a week or so. No one would care. But no: she runs on frenzy energy and makes everything like this. How the heck has her body lasted this long I have no idea. I sure don't do anything the way she does and she gives me zero power to influence her. I hate that. So I watch her make her own mess. When she finally passes on I'll probably have all her stupid decisions to unravel.
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It doesn't take much of a brain to slow down and think over all the parts of this "non-invasive" (yeah, right) operation. Too many idiots are far too willing to submit themselves to the Medical profession and eager insurance companies rather than take the time to figure out things, get a second opinion and talk to her insurance company to avoid financial ruin, and invite God Knows What new opportunities to be sicker than learning alternatives. Or even to accept one's mortality. Our culture is sick itself. What is death? a step over a threshold: no big deal. We have done it millions of lifetimes before!
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Does anyone have any experience with Case Management workers? Does the hospital or insurance appoint one to a surgery? We have an appt with an independent case manager whom someone my mother trusts. That person will teach us about what case managers can do for a patient as advocate, liason, and financial consultant. I have a small idea about them from my work in marketing.

Also, I am trying to slow down Mom in being her typical compulsive and reactive self to taking some time to put the pieces together: the insurance for example. Someone told her her insurance company would not cover an operation like she will have. This has many pieces to it. Mom's family doctor didn't even ever think of this as a possibility, nor did he seem to know anything about it.
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Oh brother. You must be beyond frustrated.
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So more Mama Drama later!

Keep on laughing, smiling, eating ice cream or whatever keeps ya going!
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I spent another day with Mom. We went to her primary doctor. Guess what? He didn't even know that she was going to have the catheter test and the replacement valve. No one spoke to him about it from the hospital since the cardiologist decided Mom needs this operation! Either that or he forgot he talked to him.
grrrrr.
Meanwhile I decided to go and take Mom and then go home and come pick her up later.
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Judda, I often look at things in the light of "what is the worse that can happen?" In this case Mom might die! At 95 her time is limited anyway and she herself wants to do this so encourage her. Yes there will be recovery but it will be minimally invasive probably little worse that the catheter test she has on Tuesday. I would not say the same about open heart surgery where there would be a long painful recovery. This may give her a few more years of comfortable activity and independence.
Anyway listen to Mom not me I roll up into a ball of anxiety with every procedure and insist on general anesthesia for everything.

Is it risky?
Of course everything is?
Is Mom in reasonably good health for her age?
Sounds as though she is.
Is she competent to make this decision?
Sounds as though she is?
Does it matter what her PCP thinks?
No he is not a cardiac surgeon and you don't trust him anyway.
What is your greatest fear?
Of course loosing Mom no getting round that but right now she needs your support.

Now I am just going to pull a blanket over my head and try not to think about having to face something similar in the future.
Make a cup of tea first and watch the humming birds at the feeder. Distraction, it works wonders.
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Hi All. Never was a question in Mom's mind: operation or die and no she "isn't ready yet" for that. Meanwhile I learned that my dentist has a 97 year old patient that just had that operation and is doing great now, just a few months later. I think Mom can make it.
njny: Your Mom is exactly like Mom and you and I feel the same way. Bring on OUR counselors for the next decade!

Mom has befriended the managers where she lives at the Indep Living Senior apts. There are new managers there and I met with them and Mom today. The women explained to me Mom's financial status at the Coolidge and we discussed ways to look at how Mom will pay for the TAVR operation. They pointed us to SHINE to learn about insurance options and how to find out the total estimate from the hospital after Tuesday, when they do the important test with a catheter to see if veins are blocked.

Funny moment today: sitting in the office with the managers, Mom kept interrupting me and putting me down. They wanted me to continue talking. "Well! why doesn't somebody tell me to just shut up?" she asked, trying to sound ambiguously amused and also challenging us.

"Very well, " said the manager. "Shut up and let your daughter talk."

The assistant to the manager, Julie, offered to take Mom to the appt on Tuesday and even to stay with her for a few hours. I have to work so I was mega relieved. Plus Mom is tons nicer to anyone but me and even if she is nutso with fear, she'll at least won't be mean because I won't be there for her to scapegoat on. I'll get her later in the afternoon, if it's possible.

Tomorrow we visit her primary doctor, who I can't stand. So I'll have to bite my tongue while we hear what he thinks. Usually he flatters Mom and allows himself to be manipulated by her. I go as the third, unwanted wheel, asking intelligent questions which annoy them both!
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Judda what did she decide to do?
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Judda, people like your mother with a strong will often can overcome obstacles that others might not. I think so much of any challenge is mindset, and if your mother is determined, that's a major part of the battle right there.
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Juddha--my mother is the same way. She has a strong will to live and a dogged determination to get what she wants that drives me to the brink but keeps her going strong. I dislike so many of her behaviors, but I have to admit that i also admire her independent personality. Good luck. Doctors have told me that my mother will live to be 100 and I believe them. I hope my counselor works with me for another 11 years! 😬😄
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My 94 year old uncle had it with no problems. Did not affect him mentally. Of course he, like your mom, made his own decisions.
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"Why would a 95 year old woman consider aortic valve replacement?" Well, from what I observe of my mother she wants hope to live better, can't give up the notion of control of anything, and has always been the Queen of Denial. Yet I love her for her strong will to live and try to cope in her own way, She wants to be capable and take care of herself and ya gotta give her respect for that unfailing determination.
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Juddha--you are so clearly a beautiful person! I like it that you are going to support your mother's decision, whatever she decides. It sounds as though she is quite with it, high energy narcissist that she is, and will make the right call for herself. Hang in there and take care that you remember to nurture yourself through all of this. You have come so far!
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Judda, I hope you can find peace with this decision. I know it's got to be a tough one.
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Judda; I've been through this surgery with my husband at age 50 and his mom at age 80. Both were open heart procedures; I understand that now they can do a minimally invasive procedure without cracking the chest.

The key, I believe, is the effect that the anesthesia has on the elderly brain. If the full open heart surgery is done, they sort of put you into a very low temperture condition which slows down all the body's processes. Including the brain.

My husband recovered well and although totally drained for about 6 weeks, went back to work none the worse for wear. His mom came out of the anesthesia and was never herself again. I believe that she'd had some cognitive decline before the surgery, but afterwards, she refused rehab, and ultimately starved herself to death in a nursing home. It was very sad.

Talk to the cardiologist and find out what the risks and benefits are.
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Ultimately, it will be my mother who makes her decision. It will be my job to offer support and try to stay on top of things. Her aura and energy level beyond this defective valve is still very strong. She is more alive than fifty people you can gather together anywhere, all rolled into one. The ER doctor said to me, "where do you get so much energy?" Mom didn't hear her. I answered, "Nervous energy!" All you dsyfunctional family members will laugh I bet.
Everyone who sees Mom can't believe how old she is. She still has a lot of beauty. Did I tell you what the one thing she wanted me to bring her when she had to stay two nights in the hospital? Not the toothbrush, not the underwear: make up! And then she told me in front of everyone, "you brought all the wrong kinds!"
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Heartfelt thanks to all of you! You help me feel I am not alone. We will be seeing the cardiologist Monday and her primary doctor on Friday. I am told that the hospital where Mom was has the best care in the state. Still a lot of research to do.

Mom is already a Narcissist, Borderline Personality Disorder and other things so this ought to be a rough ride for she AND I. But from this site, God Bless You All, I have learned to be tough, strong, loving, forgiving, and to take care of myself.

Well tomorrow I take her food shopping and oh, Happy Mother's Day everyone on Sunday!
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