My mother, “Yiayia” (Greek for “Grandmother”) showed no outward indications that she might need a pacemaker. That is, no outward indications until the day she went the wrong way on a major road.
After this terrifying episode, her primary care physician sent her back to the cardiologist, who she generally saw only for an annual checkup. He prescribed a device that would monitor her heartbeat and transmit the results electronically to the device manufacturer. After wearing it for about two weeks, we went back to the cardiologist for the results. Here’s how the conversation went:
- Cardiologist: “Well, we know what the problem is. Your heart is stopping.”
- Yiayia: “OK. For how long?”
- Cardiologist: “Well, the longest episode was 14 seconds.”
[Me, to myself: “OMG! 14 seconds!!! How is that even possible?!!!”]. But I kept quiet, intent on hanging on the cardiologist’s every word.
The Rest of the Pacemaker Conversation
- Yiayia: “So what can we do about it?”
- Cardiologist: “You need a pacemaker.”
- Yiayia: “No.”
- Cardiologist: “No?”
- Yiayia: “No.”
- Cardiologist: “You have to get this pacemaker installed.”
- Yiayia: “Why? What will happen if I don’t?”
- Cardiologist: “You’ll die.”
- Yiayia: “So what? Doctor, I’m almost 90. I don’t know if I want to go through with this.”
The cardiologist was appalled. He explained to her that the pacemaker was likely to help her live another ten years, something my mother found horrifying. But her immediate concern was just surviving the procedure and not suffering some catastrophic event during the procedure that left her worse off.
Making the Decision
Over the next few days, we had some difficult, emotional discussions. Your situation will, of course, depend on your own beliefs, your family dynamics, and the myriad other variables at play, but here’s how I felt: My mother had indeed lived a good, long life. Most of her friends had already passed away. She had a lot of aches and pains and was taking a million medications (ok, she was taking something like 17, but still; her daily medication regimen was a military operation that she miraculously documented and adhered to). I felt strongly that it was her choice, and that as much as we would miss her, the decision was hers to make.
Finally, after much discussion and debate, she decided to go ahead. The surgery went fine, although afterward, she always claimed that she never felt right. It’s impossible to know if that was purely psychological and every patient is, of course, different. But what I do know is this: she had no more blackouts after that.
For more information about pacemakers, visit the National Heart, Lung and Blood Institute’s “Pacemakers” page.
Do you have a family member who’s resisting their doctor’s advice? Are you looking for support and ideas for how to broach these and other difficult conversations? Visit our Facebook group INSERT LINK or leave a comment and we promise to respond!♠