How do I help my 66 yo husband recuperate at home from 2 heart attacks?

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8 weeks ago, with no warning my 66 yo DH experienced a heart attack. Low cholesterol and blood pressure sure didn't make him a "likely candidate". He was about 60 lbs overweight, Type II diabetic (non compliant in TXing that) and a liver transplant patient--12 years ago. Stressful job, which he loves....considered not to be a factor at all.


He was lucky in that he was able to be treated immediately and 3 stents were placed to open the clogged "WidowMaker" artery. Terrifying, and dr said no reason he should have lived--he was essentially gone by the time he made it to the operating room.


2 weeks to the day later, he has a 2nd heart attack. One of the stents was not set tightly enough in the artery. His artery has spasmed when they inserted the first stent, making it smaller, when he "relaxed" the stent didn't hold the artery open. A 2nd procedure and now it's a tight, good fit. (Like the first time was...hard to trust them now).


He didn't spend a lot of time in the hospital. They got him stable, one day is ICU, one day in a regular room and then turfed him home to me.


After the first HA, our kids drove in from all parts of the country to see him. Son stopped on the way and got out niece who is a registered dietician to write him up a "newer" kind of diabetic/heart friendly diet.


He's been very compliant with that, to the point I have to sneak a few carbs into his diet.


After the 1st attack, he was placed on beta blockers, BP Meds (temporarily), blood thinners & was allowed to disc. Metformin for diabetes. He's lost over 30 lbs...and now he's not considered diabetic.


He came home from the 1st attack and was surrounded by the kids who fussed and helped care for him. They were here a few days.


Post 2nd attack--just me. And after the 2nd one, they sent me home with an angry, depressed, anxious man who won't get out of bed. He was supposed to be walking 3 times a day, minimally 1/2 mile---and he never did it. (Once, and had to call an Uber to bring him home).


He's now on double-drug therapy--double BP, double beta blockers, double blood thinners--plus all his regular anti-rejection meds. All he does is sleep. He complains non stop. Only to me, tho.


Was released to go back to "full activity" 2 weeks ago. Came home and went to bed for 3 days. Literally, gets up to the bathroom and scrounge some food ( I refuse to feed him 3xs a day in bed!!!!!!!!!!!!) and the he's back asleep.


He has sort of gone back to work. Found out from a co worker he's actually sleeping in his car a lot. He'll say he's "working from home" but he may put in 3 hrs and go back to bed.


Just started a cardio exercise rehab 3xs a week. He hates it. Has to do 30 sessions. and is supposed to be walking on the "off" days. Won't.


At my insistence he did see his psych doc who put him on an antidepressant that he took many years ago and it didn't work then, so no hope now.


IF I fuss him and take him food 3xs a day and live my whole day caring for him, he's happy as a clam. The other night I got home from work later than he did--and he was in bed, covered in blankets and CRYING. I kind of freaked--but he was CRYING because he wanted a chocolate milkshake and he can't have one. He was overreacting b/c I had been gone all day and he didn't know what to eat. So he didn't.


Fed him dinner and MADE him eat 1/2 piece of toast (7 grams of carbs!) gave him a pain pill as he said he hurt all over so bad he couldn't move. 1/2 hr later, I was showered and he was on the phone happily chatting with our son. "Oh, I'm doing great!" (Man can't lift a kitchen bag of trash!)


I am so trapped between being "nursey" and "wifey" and running away. If I completely give my life over to caring for him, anticipating what he "might' want to eat, what kind of mood he's going to be in, etc., the stress level is a 12 out of 10. If I let him forage, so to speak for lunch, he is petulant and tells people I really 'don't do anything' for him. Stress level 12 out of 10 also.


I KNOW this has been more stressful than anything he's ever gone through. I GET IT. I have been by his side for all of it. I pick up his meds, I call the drs, I take him to the ER with panic attacks (twice) in the middle of the night....I'm just...fried.


Yesterday I took my granddaughters back to school shopping, I told him no fewer than 4 times. It was on the calendar. I was gone all day--when I got home, he was asleep. Petulantly asked me where had I been? On the calendar, I'd msg him 3 times and told him 4.


I see a man who has completely given up. He's not working his heart, so he gets weaker. All the dr says is "This is his choice, You do what you can, but in the end, it's his call".


So, I get to sit and watch him kill himself slowly through inactivity and non compliance?


I guess so. I keep giving him "one more week" to make ANY strides towards being better than the previous week.

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Thanks to all who followed my little drama--it felt good to know i had a place to vent w/o judgment.

The call (and subsequent ones) from my son made a huge difference, hubby has been making manful effort to get up, go to work, go to PT and best of all, quit the nonstop complaining.

I know son said "Don;t make me come down there. I can work remotelt as long as necessary and I will". Son is an attorney and bit of a bulldog, so I don't love having him here for longer than a couple days.

Anyway, don't care WHAT was said, changes began and while they are mind numbingly slow, they are happening. This is also likely due to the ZOLOFT kicking in--and a higher dose will be upcoming soon.

Didn't sleep all weekend, just all of Sunday, which I did not get on him about. It is what it is.

I a going to shut this down--nobody needs to say anything unless they feel the need.

I 'think' we'll be OK. I'm going through some massive depression, which is kind of what I di when I have been under tremendous strain for long periods of time, Just trying to take care of me, and teaching him slowly how to care for himself.

Thanks to all who listened to my rants and didn't judge me.

-Liz
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Mid; I think that you have to consider a couple of possibilities here;

He's got significant mental health issues (given his mother, he would come by it honestly)

He's developed dementia (loss of hearing, some lack of blood flow to the brain?)

He really would rather be alone.

Any one of those three, two or just one, could be what you're dealing with. Look, I got a divorce after 24 years of a miserable marriage. We are BOTH happier now and we are actually friends. It can be done.
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Midkid58 Aug 14, 2018
Barb--

Oh, without QUESTION his mother is a main contributor to his mental health issues. They are currently nor speaking and she hasn't even acknowledged his heart attacks--just a "get well" on FACEBOOK. May as well not even done anything as be so clueless. He is terribly hurt, but of course, nobody will call out his mother on anything, so she gets away with the meanest behavior.

I wonder some about dementia. But I also know that going through what he has gone through in the past 12+ years, it wouldn't be surprising to find he has some level of dementia. Also, not being able to hear makes him look much older and kind of "stupid" as he misses so much of any given conversation.

Last night, he was humbled by the phone call from our son. He didn't try to cover or pretend he was doing better. He admitted he wasn't trying and wasn't doing well. I asked him, flat out, if he wanted to be left alone, that I would give him a divorce and he could live alone and find his "happy" somewhere else. All he said was "don't be ridiculous". I wasn't---I actually had a packed suitcase sitting right next to his armchair. I had PLANNED on leaving. That suitcase is going nowhere unless I need to leave, for my own sanity.

And I think about 50% of me is planning to leave. I won't do this forever for a man who doesn't appear to love me, life or anything. I gave up EVERYTHING in my life to marry him and give him the family he wanted and he simply can't/won't/doesn't care. At some point, I know it will be too much and I will walk.

I feel horrible even thinking that. Until the HA's, life with him was HARD, but it was doable. Not a lot of joy, for sure, and pretty much, I am a single married woman--but I was used to that.

This new animal--I don't understand. He fights me on everything....literally--w/o Alexa answering half our questions, I'd be in the loony bin.

I will give him until the end of the year to make major progress. I absolutely DO NOT want to divorce him. I want the man I once loved to come back. He's in there, somewhere. Just can't access him.

And no, not a PT day, so of course, no exercise. I'm not even saying a word.
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Blood pressure medications can cause sleepiness and depression. One combination had me spending all day sleeping when recovering from a major septic infection - had to use alarms to pick the kids up from school. At first I thought this was just normal fatigue from the infection and IV antibiotics (never been that sick before), until it continued several weeks after the infection cleared and I was off the antibiotics. Looked up the side effects of my medications and 5 had drowsiness as one of the top side effects. Different meds made a big difference.

On a different note, a great uncle of mine didn't want to get with the recovery program following his heart attack and after trying everything else, my aunt found a track that worked with him.... She started planning her life as a widow: the house she would move into, the senior center she would join, the bus tours she would take, the old boyfriends she would look up (both attended same high school), etc. When my uncle would ask why she was going this - my aunt would tell him that she had always envisioned living in retirement with the love of her life, but since he didn't plan on staying around that long she had to make new plans for her future. She did a good job of letting him know she was hurt by his unwillingness to work on his recovery without nagging. Not sure if this would work with your husband at all, particularly if he has depression. You might try one small jab since you and OD are looking at houses - maybe identify one as something you would like when its just you?
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Midkid58 Aug 13, 2018
I am doing just that!! I actually am in the process of packing a bag right now, assuming we are going to have the fight of the century tonight. I reached out to his cardio doc and he won't get the message for several days as it's not "pressing" and he's in surgery the next 3 days.

Texted my son for some moral support and he chewed ME out for "embellishing" the situation to make myself look better, How the HECK does any of this make me look BETTER? It all makes me look like a witch!

He's calling his dad--and I know when the stuff hits the fan, I am going to get chewed out again. Can't take it. I'm far too sensitive, I know, and maybe this is the case here--I simply care too much.

I would attribute this fatigue to the all the meds if it were a NEW dynamic, but he's been sleeping 48-72 hrs at a stretch since he had his liver TP. I will accept that fewer meds will help, but he's really just being "him".
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Dear Mid; I found this via Google:

If you eat 2,000 calories a day, you should consume about 250 grams of complex carbohydrates per day. A good starting place for people with diabetes is to have roughly 45 to 60 grams of carbs per meal and 15 to 30 grams for snacks.Oct 15, 2010
How to Count Carbs - Health
https://www.health.com/type-2-diabetes/how-to-count-carbs-in-10-common-foods

Does he WANT you to leave? It really sounds as though he's pushing you to do so. So that he can play the victim?
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Midkid58 Aug 13, 2018
I appreciate that info. It goes hand in hand with the diet his niece drew up for him (she's a registered diabetes dietician!!) He had not even bothered to read her email! I have been insisting that he could eat more carbs and finally just printed up the diet (again) and highlighted the salient points. Even then he said it was a typo, so he was going to email her at work today.

The pushback, to me, is a definite "shut up and shut down" message. He can shut me down like no other person in the world. If I get upset or cry, he says "I was just kidding"--but he isn't.

I do often wonder if he would be a lot happier w/o me in his life.
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Midkid58, I have nothing to add here, but just wanted to say that I'm thinking about you and your difficult situation. We are all here for you!
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Midkid58 Aug 13, 2018
Thanks to all of you. I truly at am an impasse. Completely. He wouldn't turn the TV down long enough yesterday for me to even speak to him. I went to church and spent the rest of the day resting and reading. I made him dinner, but he threw it up. (I know he eats way too fast).

I DID find the original diabetic diet form sent by my niece, She said 45 grams of carbs per MEAL and he is eating less than that per DAY. I left the papers with him, he doesn't believe me, so he is going to call/email my niece today. (sigh)

He did get up for a dermatology appt and he has PT at 3:30, so IF he goes to work it will be for about 4 hrs or so.

I'm off to Costco to get as many of the foods he'll eat w/o having to cook that I can find. Then we're going to teach him tonight how to figure out carbs and stuff.
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Midkid, my husband, like your’s, is non-compliant and well, lazy. He has heart issues as well, exacerbated by inactivity and an unhealthy diet for years. He is bedridden for no reason. Scores of tests, several neurologists, months and months of inpatient and outpatient therapies (which, once the therapist was gone, he sat and did nothing) and he is completely bedridden. He cannot even adjust the pillow under his head. Nothing was ever found on any test. After 4 months of inpatient therapy and another 3 of in-home therapy, he made minuscule progress. It’s not just that we have no social life. We have no life, period.

He himself has wondered on occasion if his paralysis is psychosomatic. But after years of inactivity, his legs wouldn’t support him even if a psychiatrist made a breakthrough with him.

My kids are MIA. My son has helped but he has a new baby and his own life. He has chosen to move 45 minutes away. My daughter works 2 jobs and is raising 2 kids with special needs. I ask them for practically nothing.

If a marriage counselor is out of the question, insist your husband see a therapist. I’d be willing to bet 90% of his issues are mental. My SIL has stents too and he lives a normal life. Start hinting now about therapy. I’m sure it would help.
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Midkid58 Aug 12, 2018
Oh, I feel your pain!!!

To be bedridden by chance, not choice is bad enough. This non compliance thing--for me is a deal breaker. I did not know that inpatient was even an option. I KNOW he would work if he had somebody kicking his butt--and if he began to feel better, he might see some joy in life.

If he is found to be unable to rehab from this simply b/c ne chooses not to get up, then I am gone. I will NOT babysit him for 20 more years. None of his kids will, that's for sure.

Hubby WAS seeing a therapist, but wuit b/c he was "fine".She will not take him back as a patient as he cancelled too many appts on her.

We have tried marriage counseling and it was a 'hilarious fail'. The counselor was in his mid-eighties and completely and blissfully lost in the 50's dynamic of hubby bringing home the bacon and little wifey happily serving hubby all his needs. It would have been funny if he hadn't been so completely clueless as to a marriage forged in the 70's and trying to ride out in the sunset. He actually told me I should be "grateful" my hubby didn't "cheat or beat".

I REALLY do not want to involve the kids. Dh's own parents divorced after 42 years and it was HORRIBLE. Of course, his mother had to make it as dramatic and nasty as she possibly could--but my hubby really, really suffered. I am packed. mentally. I have a place to go. I have support.

But, bottom line, I WANT him to want to get better. And that may not happen. I just don't how long I'm supposed to just hang in there, working and waiting for him to get better.
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I would ask about the BP pills. You said he had no problem before the heart attack. Too much medication and they can't function. My husband had AFib. Of course his BP was high but they sent him home with BP meds. I questioned it since he has never had high BP. The reasoning...he had it here. Yes! he had AFib but not now. When he went to the doctor 2 wks later it was so low the doctor couldn't believe he could walk. Same thing happened to Mom. Next time...we see his primary as sokn as he is discharged.
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Midkid58 Aug 12, 2018
JoAnn--

Yes, I think that could be a piece of the puzzle. (It's not a "one size fits all" problem, by any means, which is why this is so hard to figure out!) He has never had high BP. I get the idea of putting him on one post procedure for a month or so to keep his heart calm, but he is on TWO and is supposed t be on them both for 3 more months, then one will be removed. After his "workout" on Fri. his BP was so low, they were going to check him into the hospital! A call went out to the cardio doc about disc. one of the BP meds. But, we've down this road. Same thing happened post op with his liver TP. He could barely move. I took the BP med away myself and called the dr, and he hasn't returned my call in 12 years, so I think it was OK.

That is ONE thing that will be addressed tomorrow.
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Hugs, MidKid. I have read your posts too and admire your strength and grace in how you've dealt with all that you have been through with your hubby.

Unfortunately, it doesn't sound like he realizes that his behavior affects others besides just him. Just like CWillie said, it's exactly like an alcoholic or addict. Self-destructive people tend to be very self-centered.

It might be a long shot, but I wonder, if the chocolate milkshake means so much to him, could you use that to your advantage and maybe let him have one now and then as sort of a "reward" for doing a certain amount of exercise (even maybe a low-fat one)? Bribery, I know, like dealing with a kid, but it might motivate him to do more.
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Midkid58 Aug 12, 2018
Yep--he really and truly believes that nothing he does affects me. It's not reciprocal for sure. I'm late to make dinner and the poor man is lying in bed, too exhausted to lift his head. He ate dinner today with his head in his hands, like holding up his head was just too much. One thing I am ADAMANT ABOUT...if I make a meal and it is on the kitchen table, that better be where he eats it. No more of this 3 meals in bed a day business.

He gets a chocolate shake when he deserves one. He's 66, not 3. And he can have one if he wants. It will make him very sick at this point, since he's been sugar free for 8 weeks. I think he just likes people to think that I am withholding food and joy from him.
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Midkid, it's just like the addict reaching for the bottle or the needle, you can plainly see he is killing himself but it is not in your power to control him - he has to want it and do the work for himself. (I know you already know this)
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Riverdale--

Thank you for taking time to respond..
I think that big part of why I am "suddenly" feeling so discouraged is that my kids adore their dad, and he has walked into the jaws of death 4 times previously and they are kind of terrified of losing him--so anything that I relate to them is taken as "Mom is being a pain. Mom isn't supportive"....they are NOT HERE to see what I see. I am the bigger problem to solve---so it's hard. I feel utterly and completely alone.

I am a lifelong exerciser. He is not. He just thinks it's stupid...well, jokes on him, I guess. I did buy a treadmill which he will not use next to the elliptical machine that also won't use. (I do, so I'm keeping them, even though they take up a lot of room!)

The rehab dr made it abundantly clear to my DH if he did NOT exercise that "new" heart, he has a greater chance of dying, at worst, within about a year or so, or just living a very poor quality life. Alive, but just hanging out--I guess we all had elderly relatives with "ticky" hearts. Didn't do much but sit in the Barcalounger and watch TV.

Yesterday, my eldest (and probably the calmest) daughter talked about my desire to move to a retirement friendly home. We have only a one car garage, LOTS of stairs and altho the SF is OK, I am up and down stairs all day long. My car is not the one in the garage, and DH doesn't shovel the tons of snow we get, nor really do anything "around the house".....and I cannot afford "dudes" to do all this stuff. I want a house that is much easier maintenance wise. DH is solidly opposed. OD is very supportive and is OK with us living much closer to them. I'm not intrusive and I wouldn't be. IF they want me there, I am, if not, I'm not. BUT I will need help with their dad, if he continues in this downward spiral, I will have NO ISSUE putting him a NH and living a studio apartment if I have to. I'm not spending the next 20 years babying him. Been doing that since the liver transplant in 2006. He got the new liver but he never "came back". Been sleeping all weekend, most every weekend since then.

We have NO social life. IF he is in good enough shape, he travels....and he can still work doggone hard at his job. Then he comes home and collapses for 4 days. I don't see him being able to do that again. That will force him into early retirement. And I won't have health insurance. This was not the plan.

Hoping against hope he begins to feel some effects from the AD, it's only been 2 weeks....and he's exercised exactly once.

Mostly I am just beyond discouraged and don't seem to able to find the language to speak to him in that he will understand!!! All he ever says is "this isn't about you, why do you try to make is so? Doesn't affect you at all."

Seriously.
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BarbBrooklyn Aug 12, 2018
Mid; this is just beyond sad.

Have you talked to his cardio doc about what he is and isn't doing? That would be my first call. Ask for advice; does cardio doc have a SW or other support staff that can help you through this?

I think I'd send out a group email to your kids, explaining the fact that their dad is NOT being compliant with his rehab orders and that there is not really anything you can do to change that. Invite their input and ask if any of them would like to move in temporarily to see Dad through this crisis. Because he will become mightily debilitated if he doesn't do the rehab bit.

I know you see a therapist; perhaps that person can be in touch with DH's therapist?

I'm sorry I don't have more positive input, honey. I really feel for you. (((((hugs))))))))
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