Will it help my mother to put her through Enhanced External Counterpulsation for her angina?

It seems to me that if she can tolerate the treatment and it would improve her quality of life it's a good idea. For people like your mom, my opinion generally goes to "will the treatment improve the quality of life?" If the answer is yes - go for it. If it's no, then I wouldn't. Everyone is different, but her anxiety is hurting the situation and you never know if anxiety or heart is causing the chest pains. She may well benefit.
Good luck with this. It's hard on you, I'm sure. You sound like a very caring person.
Carol

My 76 yesr old husband is on his 3rd round of EECP. He had emergency open heart bypass surgery in 2000 and again in 2006. He was diagnosed in the early stages of Alzheimer's in 2008. His second round of EECP was in 2010.
Further heart surgery and stents have been ruled out. He is on Imdur and nitro as needed. He started EECP again 3 weeks ago and now is less tired, more energetic and able to play in an orchestra again.
But during the course of treatments the angina episodes become more frequent as the corolary circulation increases. He has sciatica in the left leg and an artery in the right calf is blocked with plaque. EECP is arduous. His pacemaker inserted in 2008 compounds the problems of keeping a regular rhythm in the sessions. So...........He knows he can stop treatments if he feels the gains are not worth the pain. I support any decision he makes as he is still capable in doing so.
For me, the bottom line - I would not encourage him to undergo a 4th round of EECP in another year. I am 50-50 about this session.
Could you ask to observe someone undergoing this treatment?

Thanks - I am thinking my mom wil not handle it, and I put it off a week to even try it for now. The very nice lady who does it at our local faciity let me come in and have a look at the setup, Just the transfers to the table will be hard, but do-able - I am still on the fence. It might imrpove her quality of life, but iwth her PAD it could end up detracting too if the leg is injured at all, and she WILL NOT LIKE the treatment much I don't think...

How old is your mother? How long has she been diagnosed with Angina Pectoris?

She has had angina pectoris for a few weeks now. And she will be 80 in July - but at the moment things are not looking good, she did not tolerate sitting in a wheelchair for even 5 minutes yesterday, none today, and her confusion is much worse most of the time. I am letting them give her some meds for that which I would not have wanted before, just because she is in so much distress now. Her BP is lower since she had a blue, unresponsive spell Thurs AM and they are using morphine instead of nitro tabs for pain now. That and the oxygen seems to work OK and only makes her a little drowsy but not real bad. But she sleeps a lot if they give her Geodon, though its about the only thing that relieves anxiety at night so she can even rest at all. She hates to even admit she is in pain, but once we figured it out tonight she was so grateful for getting her meds and we had a few lucid, nice moments before she went to sleep...I think she does not want to be woozy or knocked out and might be avoiding getting them as long as she can stand it, and I'm telling her that just being in pain is not good for her heart either. She knows it is serious and talked and prayed with the chaplain a little a couple days ago. We are actually in an inpatient hospice since the spell, I "forgot" to mention that - I asked for hospice to be involved after the hospital stays so she could get a little more help and not have to go back to the acute care hospital every time her chest hurt, which is what the skilled nursing faciity was going to have to do despite our advance directives. etc...I was real suprised to get the call that they were moving her to the inpatient hospice facility, and more dismayed now to realize this is where she most probably needs to be...they are talking about having her go back to skilled nursing in a day or two because this is meant to be very short term, but I'm not sure that's going to happen. Sorry for the "downer" post here, and the fact that my original question is likely to become moot...

How very difficult and sad for you, vstefans, with your mother not yet 80 -- we don't expect this to be happening so soon, do we? My heart goes out to you, and I know you will make the best decisions for her care.

My mother is 89 she has Congestive heart failure and Arrthymia plus she has alzheimer's they want her to have a pacmaker is she to old to have this done all she does is sleep and eat I dont want her to have pain if in the end it doesn't work for her!

PT , I think it is OK to opt for palliative care only in this situation, especially if that was her express wish beforehand, and even if it is just your heart telling you it is best for her. I want to prevent my mom from dying but I can't, and I want to prevent her from suffering and I can't totally do that either, it seems all I can do is see that it is eased as much as possible. Passing away from an arrhthymia may not be as hard as going on and on with dementia and repeated pneumonias and all the other things that usually take them away from us. On the other hand, as it has been said earlier in this thread, if the pacemaker would make her feel better and alleviate her CHF symptoms, and they think she would do OK with the surgical procedure itself, it could be really worthwhile. So its a tough call, and if your doctors are presenting it thoughtfully as an option they think would help and not just insisting on it to keep her alive at any cost, maybe its the right call. A lot of people tell me that if you make your decisions out of love they are always right - I don't know that is totally true but it is a comforting thought that the best we can do with what we know might be good enough...

PT, what a hard decision! I guess I'd ask "them" (the folks who want her to have a pacemaker) what specifically the improvements will be. Is she having uncomfortable symptoms now that a pacemaker would allieviate? If she spends most of her day sleeping, is she in end stage?

My husband had a pacemaker and defibralator when he developed dementia. In his lucid moments he was very concerned with getting his advance directive in place and making sure his wishes would be followed at the end. He decided that having a defibralator was not consistent with his DNR wish, so he asked to have it removed. The heart doctor was totally amazed. He'd never had that request. He said he wouldn't do a separate procedure for that, but when it was time for battery replacement he would make the switch to only a pacemaker if Hubby still wanted that. And that is what happened. We consider the pacemaker a quality-of-life device, useful in the present.

But in your situation, PT, I would really want to know how this will improve quality of life. Even then it will be a hard decision. Best wishes as you deal with this.

I do not consider a pacemaker/or a defibillator an extraordinary means of end-of-life care. It is consistent with a DNR.

Hubby doesn't want a person to give him CPR, and he does not consent to have an implanted device do that task. At the time he had it put in, of course, he was otherwise healthy and would have wanted his life extended. That is not the case now. He would much prefer sudden cardiac death to prolonged dying from dementia. That is still his wish -- to die of a heart attach as all of his brothers and his father did. He certainly isn't suicidal, but he does not wish to extend his life artifically at this point. The heart surgeon apparently gave his request a lot more thought, and when he came out after the procedure to tell me that hubby came through it fine, he said to me, "I think he made the right decision." But it is a very personal decision.

N1K2R3, I strongly respect your opinion on defibrillators. You should base your decisions on you and your husband's beliefs. Each of us must work through these decisions in our own ways. It is NOT EASY.

I wish for all of us clarity to know our own beliefs and desires, strength to carry them out, and self-forgiveness when all we can do is our best.

What is this treatment? I have never heard of it. What does it do?

EECP is Enhanced External Counter Pulsation. It is used to treat blockages in the arteries that supply blood to the heart. It is non-surgical.
The patient lies on a table that has tubes connected to wraps that are put around the legs from the ankles to the hips. The tubes are connected to a machine that is a computerized combination of an EKG and air compressor.
The EKG leads are attached to the chest of the patient.
During the EKG wave of the heart the air compressor is activated and the leg wraps squeeze the legs from the ankles upward to the hips.
It is noisy, like the auto tire shop. The sudden increase and decrease in pressure jostles and shakes the patient.
The purpose of the EECP is based on the discovery that this leg pressure at a certain moment in the EKG wave puts back pressure on the coronary arteries, but not on the other organs in the body. This pressure helps the heart to open new, collateral blood vessels to bypass the blocked arteries.
The patient's heart rate is the trigger for the machine to cause the compression. Thus if the pulse is 60 times a minute, it fires 60 times a minute -- or 90 times if the pulse is 90, or irregularly if the pulse is irregular.
My husband has a pacemaker ( no defib) so extra effort is required to adjust the pacemaker to avoid the machine getting confused by random normal beats and shutting down the machine. My husband gets very tired when the rate is irreg and he is bounced around to an unsteady beat.
The EECP sessions are 1 hr long, 5 days a week optimally, and require 35 sessions or at least 7 weeks, 5 times a week.
They usually increase episodes of angina during the course of treatment.
My husband is on his 3rd course of treatments in the last 5 years. They do produce good results but they are not permanent. He has more energy and his color is better.
In China, EECP is required in non-emergency situations before open heart bypass surgery is done.
My husband is in early stage Alzheimer's, has had 2 bypass surgeries, previous stents, and is not a candidate for another surgery. And he does not want more surgery. He says this is his last round of EECP as they seem more difficult for him each time.

We didn't get to try it. Mom had a good day or two but overall worsening everything - possibly an addtional stroke with vertigo and then trouble talking and swallowing, and lots of confusion needing heavy medication, and finally, an apparently very severe MI with chest pain relieved only by two nitros and extra IM in addition to the oral morphine and then appeared to go into severe heart failure very quickly with labored breathing like I had never seen her do before. I was with her as it slowed down and beacme irregular, before she passed I told her it was OK and she'd done her best. We did our best too, but you can't help feeling you wish it cuold have been better, could have done more...etc....

I'm so sorry for your loss.

Vikki, I am very sorry to learn of your mother's death. I am glad you were with her and could give her your blessing to go.

Thank you for all your input on these discussion boards.

Don't worry about the sleepiness. Go with the meds that take care of her immediate problems. Age 80 is not old, but you must be aware that life may come to an end for her in the next few years. Be kind, Be gentle, Be attentive and SMILE when you are with her.