My 84-y/o mother is bed-bound and nonambulatory after a hip fracture 4 years ago. She was diagnosed with peripheral vascular disease (aka peripheral artery disease) in both legs. She is having symptoms with leg swelling and pain, and Doppler indicated greater than 75 percent occlusion in femoral, popliteal, and tibial arteries. Angiogram was recommended to remove blockages. Risk of the procedure includes blood clot dislodging; and risk of not having procedure is eventual gangrene; amputations; bedsores; etc. We are leaning toward having the procedure to relieve current symptoms and prevent the worse scenario of amputations, as there is no blood circulation in her lower extremities. However, she is a DNR -- and I'm told that if the procedure is done, she would be considered full code. Not sure what to do in this situation. Any others have this experience? I will lean on the doctors and other medical professionals to guide this decision, but I appreciate anyone's feedback. Thank you.
The DNR can be lifted for a procedure I think. My Aunt requested a DNR and then when she saw them put the sticker on her bed, she reneged. Its not written in stone. Just be aware any surgery is risky. For an 84 yr old in Moms condition even more so.
I do believe they mean that she would be a code during the surgery. I would not agree to that. That is to cover them saying they have not killed her by opting for surgery. She would not be a full code for life; still I disagree with this full code in a person this age.
Gangrene is no joke, but you currently are not looking at gangrene.
Let me put it this way. I would not want this done to me. At 84, in this debilitated condition I would want permission for a final exit (allowed in my state with the 6 month rule) or hospice care. Making the decision for someone I loved I would say no.
With your mother bedridden you would be dealing with very poor circulatory healing, with clots, with blood thinners, then with complications of blood thinners. Those things almost certain. It surprises me that they would recommend this for an 84 years old.
Much of this you must decided knowing your Mom and what she would wish. My brother once told me he wanted surgery on his brain tumor in order that they WOULD almost certain kill him at 85. That was after a doctor recommended it and I had said no. So here we were ready to say YES, and the surgeons changed his mind fast and said "Oh, we would never do that surgery at this age". So there you are. Doctors turn on a dime and one recommends the other forbids. So on you go, making the best decision you are able. Whatever decision you make, and whatever the outcome, this is not a win situation, and I hope you will NEVER blame yourself. Wishing you good luck.
I also agree with what another poster said, there are risk in all types of surgeries. If she were to develop gangrene and have to amputate that leg-the same risk would be there.
I am praying for you and sending you positive thoughts. This must be so hard for you. Get other drs opinions, too if you can.
So sorry you are facing this.
My first answer is based on the belief (perhaps totally unfounded) that the angioplasty is not a terribly lengthy or difficult procedure. I also responded with the understanding that she has already reached a point where unpleasant effects of doing nothing are imminent, if this is some thing that "may" occur years down the road then I might be more willing to take a wait and see approach. And it goes without saying that her overall health and life expectancy needs to be considered as well.