19111364Less than 2 weeks ago, my father underwent 2 angiograms (one upper, one abdominal aorta) which were supposed to be followed by bilateral stent replacements of the femoral arteries.

Fortunately, the angiograms occurred without incident and my father is doing well.  Unfortunately, the femoral arteries were blocked with calcium deposits, as opposed to the normal gunk, making the correction of these blockages  unsuitable for a man in my father’s condition.

Up until last September, my father had a different cardiologist who suddenly vanished under “suspicious circumstances” (“He is no longer a physician in our practice, nor do we know where he will be .”)  That particular physician rarely ordered tests outside the once every 6 months labwork and Guidant device checks.  *The Guidant device is an implanted pacemaker/defibrillator.

This “new” physician has kept us busy with almost weekly labtests, pulmonary function tests, angios, and MORE.

While the medically trained part of me thought “wow, this guy is on the ball; he’s really doing something”, the nurse/daughter part of me suddenly went………….now, wait just a cotton, pickin’ minute. Does an 87 year old man with 2nd stage dementia and a heart that is functioning at 25% of its capacity REALLY need all these tests/procedures?  I began to say “NO” to their requests.

First they wanted the pulmonary function test to determine his lung capabilites.  Ok, I agreed with that because he had been having difficulty with shortness of breath. During the test, the technician explained that she would give a trial of a broncho-dialator (Albuterol)to determine if its use would increase Dad’s pulmonary (lung) function. If it increased it by 10%, they would introduce this medication.  It did not.  I was glad that it didn’t, because upon its administration, my father immediately got a migraine headache. (Apparently that happens in people who are prone to migraines. It dialates capillaries, so that makes sense).

Once we were back in the office, the doctor stated that he wanted to start the broncho-dialator anyway “just in case it helped”.  I said “no……the study showed no greater increase in pulmonary function after he received it AND it gave him a migraine.  We’re not going to do that.”  I’m sure the doc wasn’t happy, but he relented and did not prescribe the medication.  He did, however; prescribe a sleep study.  A sleep study ???

If my father failed the sleep study, and he would ( I have heard him snoring loudly for years !),  he would be placed on a  nasal CPAP mask at night. C’mon !  I can’t even get him to keep his nasal cannula O2 going throughout the night.  I said “No” to this also.  The doctor wasn’t so easy to give up on this test but I explained that as an at home caregiver, I can only do so much, and staying up all night to make sure the mask was secure was NOT something I could do.  He agreed.  (BTW the cost of a sleep study is upwards of $2500.00.)

If you are caring for a parent or loved-one, you need to know that it is okay to question the physician regarding any procedure, medication, test or surgery.  Often they are not aware of conditions or situations that you, as a caregiver, are well aware. Don’t be afraid to speak up.  Physicians appreciate that you are concerned enough about your loved one to want to be educated about their care and they appreciate that you are doing the best you can. Really, they do. (Please appreciate that yourself.  You are not obligated to be super-human in your care giving.)

Remember, it is okay to say “No”.


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