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My nan has been asked whether she wants resuciating?

(15 Posts)
pamelat Tue 12-Aug-08 18:38:08

Please bear with me, am a bit upset

3 weeks back my grandma had a heart attack, caused by acute blood loss, following an internal tummy examination.

She came out of hospital 2 weeks later, sort of ok ish.

A few days later she suffered an angina attack and was back in hospital.

They have now discovered a blood clot on her lungs (because she was taken off warfarin to prevent internal bleeding). Only a third of her lungs have worked for a number of years and she has oxygen at home. They have said that they can not remove the clot but that she is back on her blood thinning medication.

However, went to visit today and the consultant has said that her arteries are "furry" and that really she needs a heart bypass but would not survive it.

He has asked her to say whether she wants resuciating if she has another heart attack? He has said that she is likely to have another angina attack (as they cant get enough oxygen to her heart) and that a heart attack is possible because of all she has been through.

Was strong for her at the hospital but crying on and off since ... ? It doesnt sound very good does it?

My granddad even cried and I am wondering how much to panic.

I have a 6 month old and want to visit more but am scared of taking her in to hospital because of bugs etc? but I could regret not vising more forever?

cocolepew Tue 12-Aug-08 18:42:18

Is there someone who could look after your DD while you visited? Sorry for your sad news.

Chandra Tue 12-Aug-08 18:44:47

I always advocate that hospitals are not the best place for children, particularly the young ones, but visit as much as you can just take care of washing your hands and those of your child with the alcohol gel that is by the entrance to the ward. (on your way in and out)

Regarding the non-resucitation order, it is a routine question. My grandmother had the chance to sign several of them over the years and at the end, died nearly a decade later quietly in her asleep. I understand the prognosis is not good, but don't give up yet. [hugs]

pamelat Tue 12-Aug-08 18:45:30

My brother did today.

Visiting hours are strictly 2pm until 4pm and 6pm until 8pm (husband gets home by 630pm but hospital is an hour long journey). I might make 15 minutes but have tended to call instead. She has lots of visitors (6 or so every night, bless her, all family mind)

Ideally I want to visit and sit with her for the 2 hours in the afternoon when other people are at work.

I think I am right not to take DD though?

Does anyone know whether angina attack could mean a heart attack?

SoupKitchen Tue 12-Aug-08 18:45:39

Sorry for your news, but how did your Grandma take the decision making.
It sounds like she has been through the mill and has been in poor health for some time.
She may have had enough as well.
I would visit more if at all possible

SoupKitchen Tue 12-Aug-08 18:48:50

BTW they tend not to ask this question unless it is unlikely to be successful anyway

morningpaper Tue 12-Aug-08 18:51:22

I have taken mine to the hospital regularly since they were babies because DH works there and we have elderly friends there

I think that the value of letting your Grandma see your DD is worth the small risks involved - wash hands, use alcohol gels etc if you are worried. TBH there are probably more fatal germs in the average Mother and Toddler Group

cocolepew Tue 12-Aug-08 18:52:31

I took my DD when she was a similar age to visit my Gran when she had a stroke. I just kept her in her car seat and washed my hands, she never got any bugs. If your Grandma is on a ward for heart patients there may not be bugs as such.

susiecutiebananas Tue 12-Aug-08 19:13:40

HI, sorry for your news. I just wanted to say that it doesn't mean that they are expecting her to have an angina or heart attack imminently.
Angina attacks are not the same as heart attacks. They are caused by a constriction ( temporary) in the vessels, causing pain, which is relieved by glyceril trinitrate ( GTN) or similar drug. Which opens up the vessels ( all, systemically - causing headache often) A 'heart attack' is a blockage in the vessels, and causes often permanent and fatal, damage as it stops blood supply and tissue damage/ death of tissue in the heart. Unfortuately, angina is usually a pre-curser to heart attack (myocardial infarction) but does not necessarily precede an MI. i.e. if you have angina, you are more likely to suffer an MI at some point in the future.

The DNR order, is taken in the event that should your granny have a cardiac arrest for what ever reason, then they would not attempt to re start her heart as it would a) be unlikely to succeed, b) if it did, it would unlikely prolong her life as she knows it now. i.e. she would most likely be very unwell and uncomfortable if conscious. Resuscitation with the patient regaining full, normal health only, and rarely occurs in a patient who was fairly fit and well prior to the illness/accident that caused it. I can't remember the statistics off the top of my head, but they certainly are weighted against positive outcome. Sorry
This way, if she already decides it, then should she die in hopsital ( I hope it's not the case, and is not necessarily going to be the case, just because it's being discussed) she would be let go peacefully with dignity, without a group of us jumping on her and trying to resuscitate her.

Lastly, I'd have no worries about taking my daughter into hospital, and indeed didn't when visiting my grandmother and other friends too. I just made sure her hands were clean on the way in, to protect my granny ( she was more likely to pass something on to her than vice-versa wink then we washed her hands in the sink on the way out and used the alcohol gel too - which is what everyone should be doing. So, i'd really say, go and see her as often as you like just use common sense on the hand cleaning

Sorry I've gone on a bit, and also if any of it sounded too blunt, just wanted to explain a little.

pamelat Tue 12-Aug-08 20:13:12

Thank you everyone

I have decided to take my DD and feel like a weight has been lifted off my shoulders. I will call hospital first and check that they will allow her in (germy little monkey).

Thank you susiecutebananas. The DNR bit makes more sense now. Its not like "do you want to die" but more about her dignity

She hasnt made a decision yet. She is so like me (genes skipped a generation!) and is scared to die. She was crying today about being lonely in death - its very painful to hear. This is where religion would be a blessing.

x

tink123 Tue 12-Aug-08 20:19:10

I often think that people think a DNR order means that they are going to die soon. I think these days it is more about giving the patient more choice in their care.

A few Years ago, a doctor would just write a DNR in the patients notes, often without their knowledge. Now there are strict policies about DNR orders and that they have to be discussed with patient or next of kin. I have even heard of patients that are asked on admission to hospital about a DNR.

monkeyme Tue 12-Aug-08 20:43:11

The team of doctors who are caring for your grandma should talk you through what the DNR order means - it can vary from being a full withdrawal of any active treatment (for example in someone who is terminally ill and is expected to die imminently) to meaning that it would not be appropriate resucitate in event of a cardiac arrest,or to take the patient to intensive care and ventilate them in the event of a deterioration of their condition, however they are still for all other treatment. DNR orders are not written in stone - they have to be reviewed on a regular basis to see if it is still appropriate for the patient.
I would also speak to the ward manager and explain the problems you have with the visiting times, they should be able to help you on that one.

bozza Tue 12-Aug-08 20:52:05

I would think take your DD unless she has a cold or something herself. I have taken both my children as babies/young children to visit elderly relatives assuming they were not harbouring some germ or other. Will very likely be a morale boost to your nan also. smile

emma1977 Tue 12-Aug-08 21:23:35

Don't take the discussion of the DNR order as a sign that your grandmother is going to die imminently or that she has been written off by her medical team. It is pretty standard procedure in hospital these days to discuss the wish for resuscitation with most patients in the unlikely event that a cardiac arrest occurs.

In all honesty, I have attended several hundred resuscitation attempts and have known very few succeed. They are extremely unlikely to succeed in someone with lots of previous health problems. In which case, I think it is probably far more dignified and peaceful to dallow someone without a fruitless resuscitation attempt.

pamelat Thu 14-Aug-08 08:56:03

Thank you everyone

Latest update is that yes she did suffer the predicted angina attack but she seems to be ok (for now).

More than anything we need to keep her morale up and give her something to fight for?

Update re my DD though is that she has a cough (havent taken her yet), she seems unwell and I have (re) decided that I cant take her. However, am able to visit for half an hour this afternoon as my brother has the afternoon off work. The thing is, he has the time off to see grandma - not really to babysit my DD in the car park! He says he doesnt mind.

Grandma does want to see my DD, will ask staff today for their opinion.

I feel more positive so hopefully it will rub off on grandma.

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