My Father’s Advocate: Aging Parents and the Impact of Positive Medical Planning

“What I’m saying is, you could drop dead at any moment.”

Blunt, direct and impatient, my father’s cardiologist meant what he said. Didn’t even flinch.

“So what you are saying is, my father’s heart has weakened since the last MRI six months ago?”

“Yes. One side is overcompensating for the other. I would not recommend back surgery.”

My father crossed his arms over his chest and declared in defiance, “Well, I’d rather die than not have my surgery. If I can’t walk, I don’t want to live.”

I sat there watching the two elderly men stare at each other in a standoff of sorts. Neither was making the situation better.

Annoyed, I inquired…“And he will lose complete use of his legs without the spinal surgery?”

His accent was strong, but I understood. “I’m sure he could get someone to do the surgery for him, but I’m telling you, he won’t make it out alive.”

The man sitting atop the examination table, my sweet father, slumped. My heart wrenched in pain. This was a strong man who never depended on anyone for anything. In fact, dad was 78, and this was the very first time I had accompanied him to any doctor’s appointment at all. Fiercely independent. Now, he sat there defeated. A deep sigh escaped as I took it all in.

We went to the doctor’s office that day fully expecting to get a green light. The green light should have led to a pretty easy surgery on his spine; free up the nerves being crushed, cutting off important signals from his brain to his legs. Surgery would lend full use to legs presently barely able to make it across the waiting room. Wheelchairs would be averted. Dependence on his adult children avoided for the interim. Freedom, anonymity of choices would be restored. Positive domino affect. My father could still come and go when and where he pleased.

Green lights mean go. Docs words had my father seeing red.

Nurse popped her head in the door and reminded us our allotted time with the cardiologist was up. A room full of elderly patients were waiting. Ignored her pretty face and focused on the doctor, “Okay, so there is nothing we can do?” Startled, I did flinch as he jumped at me defensively with his words, “Well, your father said he’d rather die!”

When someone throws a verbal dagger, I retreat momentarily; sum up the emotional veil ripped away by his accusation, and see if there is another way to appeal to the rational beneath it all.

The man in the white lab coat was weary. Jaded. Sad, even. At some point, I assumed he possessed a sincere desire to become a physician. Imagined a younger version, applying himself a noble diligence to practice specialized medicine in the sincere hope of saving many lives. May have just been a tiresome day, but it appeared, his lifetime calling had become a daily task.

The thing is with many in my father’s generation: they don’t self-advocate—they self-medicate. Doctors can only do so much. Until something goes wrong…and then something else…

I knew I had to step in. Appealed to the younger man I was certain had to be hidden under the all the experience and cynicism. “Okay, so you’ve shared the bad news. Now tell us the good news.”

Taken aback, I gave him a moment, pointed to the computer monitor and repeated my request, “Please look at that MRI again, and tell us the good things you see. Can you do that for us?”A subtle flash of sincere pleasure washed over his face making him appear youthful and energized. Swiveled on his stool and studied the shades of gray still up on the screen.

“Well, your arteries are clear. You will never need bypass surgery.”Dad nodded and released his arms, sat up a bit straighter too. I pushed.

“Is there any way my father can make his heart stronger, so he can have the surgery?”

“Sure.” Doc shrugged and gave my father’s belly a once over. “You could lose weight…cut out the salt.”

“Hear that dad? You need to get rid of the watermelon…” “I can do that.” Dad was listening.

Feeling empowered. Having control over your health, or even a say, is something so many hand over. Needed him to regain his voice. The doctor seemed fueled by a patient willing to do his part in the healing process. Win-win.

Doc reached for his prescription pad. “I’m going to prescribe a vest that will zap your heart if it slows down. You’ll just wear this until your heart gets stronger. I’m going to adjust your medications as well.” My father’s companion sat quietly next to me during the entire exchange. I felt her squeeze my hand in agreement with what was transpiring.

“I want you to keep track of your weight loss, blood pressure and generally how you feel. We will see you again in six months to see if your heart has improved. If so, we will talk about a pacemaker…and back surgery.” The energy in the room shifted. No guarantees, but uplifting hope replaced discouraging defeat, and now we had a game plan.

Don’t know how long we will have the privilege of my father’s company—the zapper vest is heavy, uncomfortable—he hates it. Twenty pounds have disappeared, his blue eyes are clearer than they’ve appeared in too long a time. Made it to both my children’s graduation ceremonies, spent a week of vacation with a son he only gets to see once a year, yells with animated aplomb at the mind-numbing politics on television, and we have shared many a wonderful conversation.

Been five months since our appointment that day. Has the heart improved? We will know next month. I do believe, without a doubt, if we had been ushered out of there that day carrying only the bad news, my devastated father wouldn’t have made it another week. Stepping in when and where needed is a tough call. Not sure what prompted me to say, “Hey dad, I think I’ll join you at your doctor’s appointment this time.” But I’m relieved I listened.

My wish is for all of us to have days, weeks, years ahead of us with our beloved aging parents, but even if all we were gifted was the past few months, my siblings and I have our father back. Positive and empowered. And that,is good news.

Photo Credit: Mirøslav Hristøff Flickr via Compfight cc