wordinista (![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png)
wordinista) wrote2009-10-06 12:44 pm
wordinista) wrote2009-10-06 12:44 pm
Well. As choices go, that sucks.
Okay, so. After this post, I'm going to start f-locking things talking about Gramps because I realize that not EVERYONE is going to want to read about it.
Just got back from Mom's, and we had an... interesting talk. She's good friends with a nurse who has worked extensively with dementia patients. From what she says, when the body is under general anesthetic, that can cause a spike in the dementia's progression. This was why Grampa's behavior was so completely weird after his surgery in July -- he was exhibiting that spike. And the bitch of it is, he'll come back a little bit (he's just starting to really be himself again -- since July), but the damage done while he was under the anesthesia is done. There's no undoing the damage. So he can come back a little bit, but he'll never reach pre-surgery mental levels.
Now, Grampa's urologist (who, let me say, is a complete dipwad for a NUMBER OF REASONS starting with performing the surgery in an outpatient clinic that he co-owns, all the way to not arranging for an in-home nurse to help with Grampa's after-care [translation: My mother had to be the one who kept the incision point clean and who changed his urine bag. THIS IS NOT ON.] HE DIDN'T EVEN SEND HOME AN INSTRUCTION SHEET REGARDING AFTER-CARE) -- the urologist wants to do another cystoscopy (note: dipwad either did not use enough local anesthetic or did not wait long enough for it to take effect, because my grandfather was in enormous pain during the procedure -- so much so that my mother could hear him yelling in pain from the other room -- and he remained in pain for three weeks afterward). Now, if he does another cystoscopy and finds that the cancer has come back to his bladder, the doc is likely going to want to do perform another surgery.
Hopefully y'all see the problem here. If he does go in for the cytoscopy (by the way, good luck getting Gramps to agree to undergo another one) and more growths are found, and another surgery is performed, we're looking at another spike in the dementia's progression. And? AND. That part of the brain, as I understand it, also governs breathing. So another spike in his dementia's progression could put him somewhere he can't come back from.
Given this, Mom's wondering if he should undergo the cytoscopy at all. (Assuming he doesn't say "fuck that" and digs his heels in, refusing to go in or the cytoscopy, 'cause dementia or no, he damn well remembers THAT. And my grampa? Is TOTALLY the type to say "fuck that" and a host of other colorful things.) I mean, do you save the body (for a little while, maybe -- this last surgery bought him three months) at the expense of the mind? I can't condone that. We're working so hard to keep the dementia at bay, it seems crazy to entertain the thought of a procedure that could very well push him past some point of no return.
I don't even know. I'm not even sure there's any sort of right answer here.
Under my covers is looking really appealing right now.
no subject
Assuming that they do a cystoscopy and there is something to remove/fix, I wonder if there's a way to avoid using general anesthesia (I assume that's being completely out is what progesses the dementia). If they can do a local the way they sometimes do for C-sections and such, maybe it wouldn't cause so many problems? Speaking as someone who just had surgery while awake, it's just an option that springs to mind - and I wonder why it didn't occur to the doctor who is supposed to know the way anesthesia can affect dementia...
no subject
Dr. Pearson (aka "Dipwad, MD") probably didn't make any effort to educate himself on my grandfather's OTHER problems, unlike his neurologist, who, so far, is AWESOME.
(Funny -- so much of my grandfather's tangling with Medicare is what fuels my resistance to and distrust of govt run healthcare.)