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In that angiogram they found that he had 80-90% blockage in all 3 arteries. But he had a stroke and I'm told in the ICU that they found that he had heart damage due to done enzyme test but that it must've been a while ago. Thankfully he was able to regain most of his function back with physical therapy. Now he has stage 3b CKD, CHF and diabetes but he's actually been better now that he lost a lot of weight and is exercising. His cardiologist referred him first to see if a bypass could be done but the bypass surgeon said it was better for him to get even 1 or 2 stents rather than open heart. And he agrees that open heart is too much and didn't want that anyway. Now he's going to do a coronary stent and initially he said he wanted to get it over with and so they scheduled him. I thought he mostly understood what the pros and cons but now he's saying he's just doing it because we want him to do it. Honestly I'm not sure if he should do it. He does seem more stable except for shortness of breath and headaches which he uses CPAP for, it helps him he says. But as for me I'm thinking why can't we just keep things as is. When I spoke to his doc if a stent is really needed and why cant we just do more meds, they repeated he has 90% blockage in 3 arteries. I think it's his way of saying dad really needs it? But I'm scared that he might have another stroke or worst with this stent procedure. I'm not sure what to do but it is in a few days. He seems to now going into it blindly and I'm terrified of bad outcomes. But for some reason we are hopeful that stent might help his quality of life and extend it... are we unnecessarily risking him? I'm not sure what to do and it will be this week.

I have no medical background and would defer to others on this Forum who do, but my question to the doctor(s) would be, "Why must it be done in the next few days"? Barring a crisis, what would be lost by waiting another week or even two? This time could be put to good use by seeking a second opinion and even for conducting more online research. At least, that would lessen the chances of "going into it blindly". There may be compelling reasons against this approach, but I think it's worth asking.
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Like Elizabeth I defer to those with medical knowledge and experience, but I have heard the suggestion of asking the doctor, “Would you have this procedure done if it were your parent?”

I wish all the best for you and your dad and family, whatever you decide.
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Thank you for your replies. I apologize for the confusion. It's not just a few days, in fact it's been a few months, after his recovery his cardiologist asked us to consult with a heart surgeon who said it's better to do a stent because he had a stroke and open heart would be a difficult recovery. So we had another month or more to prepare and his cardiologist (who will do the stent) had him do blood thinners in preparation. So it had been a while and now it's happening this week and I'm having second thoughts. Initially i thought my dad had already made his decision but now he seems to just go into it blindly since he's now saying he's doing it because mom and i wanf him to. I dont want him to but it seems the Cardiologist thinks something has to be done. After his angiogram the cardiologist did in fact wanted to have a plan in place in a month but back then he had the stroke.
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I think it's pretty normal to have second thoughts about surgery. Surgery has inherent risks and you/he have to weigh the risks vs the benefits. If he doesn't have it, what are the bad things about this? Probably have a heart attack within X amount of time, for example? Or he'll probably be "OK" and maybe be a little tired? I don't know but that's what I would ask, if you don't already know the answer.

How is your dad's competency? My mom is 81 but she has dementia that is pretty advanced and is not competent and I would not do any surgery on her at this point.

Regardless of what path is taken, be at peace with it. There is no way to know which path is really best or safest and there are no guarantees either way. What will be, will be so don't stress or beat yourself up.
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HnKizu Oct 15, 2024
Well they said he is at risk for a heart attack, although back when he had a stroke they said he seems to have had heart damage a while ago. His competency is great but he tends to not listen when in front of the Doctor and relies on me to repeat everything. I'm not sure if I should keep asking him if he really wants this but it's sad that he always have headaches, out of breath, less activity. But I suppose what I'm more afraid of is him having a heart attack or another stroke (although we think he had a stroke because of the angiogram). So here I am stressing. But I will try to be at peace and thank you for your reply.
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Your dad is obviously high risk here for any type of surgery, but if his doctors feel confident that it will help him and your dad is willing to give it a shot, I would just say my prayers and hope that everything turns out well for him.
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HnKizu Oct 15, 2024
I'm definitely praying. For now I'm just going by what the doctor says. This doctor has been very sympathetic and did initially refer him to see if CABG should be done first. I don't know what else I can do. I'm hesitant to ask dad again what he really wants to do. He already decided once, not quite sure if I should ask again coz the last time I did his answer changed to it's because you and your mom want me to.
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What if the stent is successful? He will still have ckd, chf and diabetes. The longer you live, the more likely you reach the last stop, which is dementia.
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My husband had a CABG for 3 blocked arteries in 2020. The recovery is tough, to put it mildly. He wound up needing a 2nd surgery afterward for a large pleural effusion (fluid trapped between lungs and heart). His blockages were less than your dad's and he was rushed into emergency surgery. So no, there's no time to sit on this and think it over, I don't imagine.

The trouble with stents is that they're placed via angioplasty methods, the same thing that caused dad's stroke to begin with. None of these heart procedures are w/o risk. But the alternative is certain death with 3 seriously blocked arteries.

I have stage 4 cancer and took immunotherapy in an effort to extend my life, even by a little bit. Yes, the immunotherapy caused permanent disability for me, but I am still alive 20 months later, and cancer free for now.

These treatment options are ALWAYS a trade off, my friend. There are no guarantees with any of them. But why not try to extend our stay here for a little while longer, especially if we have family who love us?

I echo Funkygrandma's words. Just pray that all turns out well and dad is with you for awhile longer once these stents are placed.

Best of luck to you.
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HnKizu Oct 15, 2024
Thank you. He did tell me and mom he wants to live a little longer for us, that's why he wants to do it but also he thinks the problem is already here so might as well do something about it. I'm praying a lot more these days actually, sometimes I feel like it's all I have. Also I'm glad for your results. I hope the best for you.
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Yes, as a cardiology nurse I can tell you he MAY have a stroke. You are correct. He may have a hemorrhage as well due to blood thinners. These are side effects (among OTHERS ) that will be explained. If you are MPOA then they should be explaining them to you as well. I see he has told you he has a 90% blockage. You are correct that means he is telling you that he could go at any second due to that. BUT is he telling you he could go at any second also from the stent?
A stent is a minimally invasive procedure. I am assuming that they explained what it is. Basically think of s teensy tube to hold those vessels open.
But you already KNOW what the side effect of a minimally invasive procedure may be, right? Because of the angio.

So that takes care of the facts in the case. Correctly placed stents in a minimally invasive procedure, well done and WITH GOOD LUCK may make the remained of your Dad's life a lot more comfortable.

BUT............your father already has a failing heart and is 84 years old.
I am 82. I am not doing anything anymore. I just got a triple negative second breast cancer beginning of the year. Yes to lumpectomy, no to chemo and no to radiation; I won't be doing them. Any spread to other organs I will do palliative, hospice and MAiD (the good last cocktail). For me now, the threats of stoke sound worse than the threats of just dying. I am ready to die. I don't care to be tortured to death or to die in pieces if it can be prevented (big "if").

What I am telling you is that this is up to your dad. Time to sit with HIM and with the DOC and for the doc to tell him ALL risks of doing this and ALL risks of not doing this, and then giving him time to decide FOR HIMSELF by HIMSELF.

What you need to tell your dad now is "Please don't do ANYTHING for ME. Do what you want and need to do for you. I am NEVER EVER going to be ready for you to leave me, but at the same time I am saying that I want you to know I feel enormously lucky in having you in my life this long, and I will be OK, and I don't believe you will EVER be gone from me; it will just be I cannot look on your lovely face nor hear your wonderful voice. Please do it your way and know I support you every second with all I have in me".

Leave it to your Dad. There's no safety in life. My old man is out walking the Foster dog. Those gals taking their kids to school in their SUVs do NOT pay attention. He might not come back home. If they don't hit him they will SCARE his 84 year old self to death! No guarantees.

I so wish you the very very best.
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AlvaDeer Oct 15, 2024
I would love it if you would update us when dad comes to his decision? I will think about him. I hope you will let us know the outcome if he has the stents placed. And again good luck.
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I absolutely can’t believe operation like this are done on a 84 yo man. If you have medical POA say no. It a money grabbing pointless exercise
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Southernwaver Oct 15, 2024
In the US they do these operations on 90-95 year olds.
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I guess the other choice for you would be to see if he wants to enter hospice care. 90% blockages in 3 arteries is deadly: it’s a matter of time.
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My fil was a dnr until he and mil experienced stroke and cancer respectively. Now he’s all full code as he’s experienced stents, cardiac devices, loss of a kidney and a third of his intestine, copd, etc. it’s all about him being there for mil and vice versa.

The last stop should they reach it is dementia.
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Sorry, double posted the above reply.
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AlvaDeer is an excellent voice to help guide you. Experienced cardiologists can give you their best estimate of the risks as a percentage if you press them. One caution, only listen to experienced cardio, as new interns may be overwhelmed and "book smart" with "too much information" on very rare "worst case scenarios." That happened to my husband and I, and shut down a very safe and successful stenting procedure for a few days until wiser cardio heads undid the unintentional damage. Experienced staff know their track record, pro's/con's, and any patient's risks very well. Just be sure that if you hear something contradictory, to check if they are really part of the experienced core team or just fresh to actual medical practice.

And, you can ask more diffused questions to get to the heart of your dad's wish to either do the procedure "just for you" or also "for himself." Fear, of course, may always taint even our own true feelings, but as said, the chances of much worse outcomes are extremely likely if the stents are not placed. The chances for full recovery and elimination of adverse events in the future are much more expected if stents are placed.

Here's my experience with 71-year-old high risk husband with 99% occlusion of the "widow maker" artery, and 80% of another, and a page-long list of serious co-morbidities and disabilities, who also only considered such a frightening procedure "for me" ... until we explored his real wishes closer. Asked to describe what a really good day would be like for him, his response included spending time at home relaxing on the back patio, with the dogs and me. So, it hinted that he wanted to return to home life with the hope of full recovery that a stent would give. Asked what he felt about possibly having further heart attacks, stroke or even being on a ventilator if he chose Rx drugs as an alternative, he was clear that he'd want to avoid that at all costs. More questions might help your dad consider which option he really desires more for himself?

Yes, your dad really needs this, unless he is satisfied with a much higher chance of further stroke or worse with meds going forward. Ask the experienced doctors, would he regain restoration to prior health levels after the procedure? We were given that promise, and after a month post-op of dicey health (until his prior meds were adjusted down to balance with a now healthy heart) his recovery then got faster and faster. Took a few months, but rebounded better than ever. Also, we were told that after a year post-op, any risk of further complications were basically very small. What joy, as we now celebrate that 1st anniversary; no more questions hanging over our lives regarding the strength and health of his restored heart.

Wishing you, your dad, and mom, strength, peace in the midst of turmoil, and comfort in whichever road is ultimately taken. Please keep us all updated.
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I wasn't sure how to edit or reply back precisely... but to those who wanted to get an update to my dad, they did it successfully and did 2 of the 3. Having him stay overnight I think made a huge difference for both him and myself. His recovery is doing pretty good like miles better than last time including healing time. The doctor is wanting to do the 2nd procedure this Thanksgiving but I'm still not sure. We have our follow up tomorrow so I will ask more questions then like why do we have to do it again soon? Like advantage of that or if it can wait. Thank you for all your support!
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slkcma Oct 27, 2024
So glad to hear his recovery is going pretty well!
Best wishes as you make further decisions.
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Thanks for the update.
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