Illnesses in our older age

I had my first introduction to elderly illness and death when I was about six years of age.  My grandfather, my mother’s father, who lived with us part of the time, was entering a fragile stage in his life when I started to have memories at about five or six years of age.   At my age, we were never told about what is going on with adults, and I simply remember he left out house in Villa de Garcia to return to his house in Monterrey.  Then I remember him having a leg amputated and then sometime later having the second leg removed.  I remember seeing him a couple of times after that and then being taken to his funeral and burial.  Twenty some years later, my other grandfather, my father’s father, became ill from what seemed to be kidney failure and died after a short illness.

In retrospect, it was clear that my mother’s father, Serafín, had several senior ailments, including diabetes.   The most likely scenario was that the high blood sugar levels eventually damage the nerves in the feet. This resulted in not feel pain and did not know that he got an injury and continued to walk without protecting the wound. The high blood sugar levels damage blood vessels, resulting in poor blood supply to his feet, this meant less blood, less nutrients and oxygen, and fewer, if any, white blood cells and T-cells to fight off infection. The injury became infected; the infection grew rapidly and gangrene developed.   A comparable situation probably developed with my father’s father, Catarino, with his kidney failure.  The common factor of these two cases was that both deceases, one in the 1950s and the other in the 1970s, could have been treatable 2014 and they both could have head meaningful lives in their later years.

Medical technology, like communications, industrial technology, as well as information systems and all other aspects of science, have made tremendous advances in the past fifty years.  Our generation has benefited from these and will continue to do so.  My father and my brother-in-law, my two recent reminders of geriatric illnesses, would not have fare well in the era when my two grandfathers were ill. 

My father, like his father before him, was in great health given his 88 years of age.  The random mutations of cells resulted in him developing a tumor in his intestine, something that would have been very difficult to find and treat fifty years ago.  The symptoms seem to indicate a heart condition but the high tech diagnosis, Laparoscopic and robotic surgery and the wonder drugs available that can target different ailments, allowed the doctors to focus on the problem and eliminate it with minimal invasiveness to a point where he was walking within days of the surgery.  He is still not “out of the woods” with his medical problems, but modern medicine has allowed him to continue a “normal” life with the family.

My brother-in-law’s multiple complications have been a real challenge for modern medicine:  The arteries to the heart are 99% blocked, he is a diabetic, his kidneys have failed and is on dialysis, he had a severe infection that caused a fever of over 104ᵒF that has caused him to hallucinate, his blood pressure fluctuates from very low to very high (over 200/120), he has had several small heart attacks in the past week and has had a major heart attack and a stroke in the recent past.  He was ready to throw in the towel and had called his priest and family in.  Because of the holiday, I had a long weekend off and decided to make a quick trip to Philadelphia to visit him.  The strategy of his team of doctors was to stabilize all the other conditions so that they could go in and diagnose and try to treat the problem.

Today they will conduct a cardiac catheterization/coronary angiography; where a long, thin, flexible tube is put into a blood vessel the groin and threaded to your heart.  Through the catheter, your doctor can do diagnostic tests and treatments on the heart.  A special dye in the catheter will flow through your bloodstream to your heart making the coronary arteries visible.  Once in there they will probably conduct either a Balloon angioplasty or maybe install a stent.  The angioplasty involves compressing the fatty matter into the artery wall with a small balloon and stretch the artery open to increase blood flow to the heart.  The Sent involves inserting a small metal mesh tube to provide support inside the artery and allow blood flow.  Given his previous quadruple bypass the stent may not be possible.  The procedure, normally not very dangerous, is difficult for him in his weakened condition.  I am hoping for a successful outcome.  He has a young son that I’m sure he would like to see grow to be self sufficient.  Our best wishes and prayers for him.

I have been watching the evolution of these two medical treatments very closely.  For one, given that I am carrying the same genes as my father and have had similar lifestyles, his ailments are probably hereditary and there is a high probability that I will succumb to the same or similar ailments.  Second, my brother-in-law is only two years older than me, and although we have had different medical histories, our historical environments; foods and habits are comparable.   On the one case I have a hereditary history of certain types of ailments and on the other hand, I have lived in an environment that obviously has had some influence in my brother-in-law’s ailments.

Supplemental information:  The angioplasty and stent could not be done due to the position of the blockage in the artery.  Moreover, he is too weak for open heart surgery.  They will provide him with a pacer-like instrument to prevent the heart from speeding up too much and keep him on medication.  but basically he has to live with a heart that is only working at thirty percent - that will limit his mobility considerably.