what would you do?

[diamondsrock]

I''ll try to make this short!
My father has severe vascular disease in his legs, which means his arteries are all clogged up. It was a late diagnosis since his primary care missed it (another doctor found it). That''s another story there.
As it stands, he is at risk for amputation of one or both feet. There is almost no blood flow to his feet at all right now.
His surgeon tried an angioplasty to open up the arteries in his abdomen but his arteries were so blocked he couldn''t thread the balloon and stent through. So he will need major surgery to open arteries in his abdomen and do a bypass on both legs.
He is waiting for the heart doctor to give the ok for the surgery (people with his condition are at a much higher risk of heart disease). I don''t know if his body could withstand such a major operation.
My problem is, this is almost all from smoking and he continues to smoke!!! Every day for 3 weeks I''ve been hounding him to quit smoking if he wants to avoid an amputation. It always ends with me near tears and stressed out, and silence on the other end of the phone from him. Then he plays dumb and acts like he doesn''t understand the consequences of smoking which really aggravates me even further.
Would you continue hounding him even though it doesn''t seem to be doing any good? Obviously I care about him and don''t want to see him destroy himself but honestly I''m driving myself nuts with worry and frustration. He''s not doing his part. I expect the doctor to refuse to treat him if he continues smoking anyways. I''m trying to be supportive but it''s hard to be supportive of someone who is destroying himself. Any advice?

 

[Miranda]

This is such a toughie! Both of my parents suffer from addiction. They are slowly killing themselves. It is tough to watch. I''m sorry you have to go through this. I don''t think harping will help your cause. I''d tell your dad one last time that you love him and you are sad that he is killing himself. Explain why you are sad...Is it because of all of the things he will miss (I don''t know if you are married or have kids). Have you offered solutions to the nicotine addiction? Gums, patches, etc? I dunno, maybe that would help. Anyway, I think I''d bombard him with love and solutions and all of the reasons he is important to you one last time. You will know you have done all you can do. It''s hard to accept that there is nothing you can do (well, it is for me, but, I''m a bit of a control freak) and let go. Anyway, good luck...I''ll keep you and your family in my thoughts.

 

[diamondfan]

This is a real awful place to be. But, the sad part is unless he is incompetent, you have no control over what he does. He knows the risks, I am sure he truly does know, and so his choosing to continue smoking is deliberate. You cannot stop him if this is what he wants, clearly you have expressed your feelings and tried to this point to get through to him and have not been able to. Can you simply ask him WHY he is doing this when he knows the consequences? Amputations are not pleasant, maybe if he went to one of those rehab places and met people who have had amputations he might have a different view...anyone that has a choice would more than likely stop the behavior and do what the doctors advise, once the foot is gone that is it, so maybe he needs some tough love or something...but I think you have made yourself very clear and it is not getting you anywhere...he is an adult so he can decide what to do and what not to do, I just do not see any other option for you at this point...it is hurting you and he is acting like he doesn''t get it...so I am not sure what else you can do now...sounds like you are wasting your breath. Until someone wants to hear you or get it, there is not much you can do...I know it is sad, but it is the reality of the situation...

 

[njc]

I am sorry you are going through this. I think Miranda gave you some good advice. Just tell him how much you love him and try to provide him with a means to help him stop (the gum, patches, etc). There are even perscription medications you can get to help(drawing a blank on names).

Knowing smoking is causing your failing health, yet still doing it, is something Ive never been able to understand. I watched DHs aunt die of cancer after going into remission, yet she kept smoking. I have an older 1st cousin (late 60's) that has buried 2 husbands from smoking caused cancers, yet she continues to smoke 2 packs a day. I have wanted to just smack sense into all of them!

I understand you frustration, and I hope you are able to help your father. It is an addiction/disease and not easy to stop/overcome.

 

[movie zombie]

before you try to change someone else, remember how hard it is to change yourself. wise words i carry around with me as a reminder.

unfortunately, we can love someone but accepting their choices is another story. the best you can do is tell him you love him, that it hurts you to see him this way especially knowing that his continuing to smoke is making things worse, and that you will miss him when he is gone. then don''t say another word about the situation.

it is his choice and nagging hasn''t worked. perhaps stating the above and dropping it will have a greater effect.

not easy but nagging him is also hard on you.

movie zombie

 

[merrijoy]

Hi DiamondsRock,

I am mostly a lurker, but I just want to let you know that my father is in a very similar situation. He has been battling (although it is not really a battle as once the veins are dead, they don''t come back) peripheral attery disease for many years. He has no blood circulation to his feet and it is very painful to walk. The painfulness walking started about 15 - 20 years ago - his feet would always cramp up; his feet are so white! It hurts me so much that he is in pain. It is genetic as well as related to smoking. He started smoking when he was about 12 years old. He finally quit (thank god) on Mar 11, 2001 - so he smoked for 50 years! I had been begging to quit for as long as I can remember - I grew up with Strep Throat and Bronchitis and I hated the smoking - I still do hate anyone smoking around me - it is a nasty habit.
Anyway, on Mar 11, 2001, my dad had the bypass surgery on one leg (I believe the left). When all was over, he quit smoking. I thought that this was all good news and now he would be better forever. I guess I missed the part where the doctor said that the life expectancy on this surgery was about 5 years. So, this year, the pain gets worse, and we go to the doctor and one doctor says immediate amputation (just below the knee). My dad would not have that as he could not imagine life without a limb. This all pains me to write. He went to another doctor for a second opinion and they said that they do not want to amputation yet and there are different things they may do (part of it is related to stem cell research) - he doesn''t have any arteries left in that leg to bypass and if they used the other legs arteries then when they would need it there, they wouldn''t be able to do anything. Does your dad have any gangrene? Also, if you don''t mind me asking, how old is your dad?
Unfortunately, my father is so stubborn and does not want me to be "his parent" and lecture him. He quit smoking but just recently has been gaining weight. He has always had a "pillow" belly, but he recently put on about 25 pounds. This is horrible on his legs and the doctors tell him he needs to lose weight. Well, since he lost weight years ago on Atkins, he thinks Atkins again! Well, that is wrong, as it can be very high in fat and salt if not done properly. So I try to tell him low fat and maybe go to the pool for exercise and he gets angry and tells me not to "parent" him.
Anyway, I could write on this for days and days. I don''t talk to many people about this because most don''t understand it or never heard of it, and when you say bypass they think heart.

So, I just want to let you know I understand your pain and frustration. My mom tells my dad he needs to be around to see my children. I don''t know if that is falling on deaf ears or not.

One more thing, off topic. I see your Mini Schnauzer in your avatar. We just had to put my beautiful girl Shayna (a beautiful Miniature Schnauzer who looked very similar to yours) to sleep on Dec 19, 2006. It was one of the hardest daysof my life. I miss her tremendously. She was 14 years 3 months old. She was a wonderful dog and a wonderful spirit. She was so calm and caring. She rarely barked! Is yours like that as well? I think Mini Schnauzers make such amazing pets!

Take care,

Meredith

 

[diamondsrock]

well I want to thank everyone for taking the time to write a response. It means a lot and you''ve all given good advice which I will take to heart.

merrijoy, first off i''m sorry for the loss of your little friend. They are so much a part of our lives, aren''t they? Remembering all of the fun times with her will help you through this difficult time. As far as my schnauzer goes, I have to say that actually she is as barker! I posted a thread somewhere on here about my neighbor''s issues with her barking (which have since been resolved.) She considers herself a bit of a watchdog and has to let us know when someone is outside, although I think part of it is she is so excited to see someone and she wants them to come and give her attention! She loves people unlike any dog I''ve ever known. She is calm for the most part and very smart, too. She only gets really excited around people because she wants to be petted (although if she sees a cat or dog in the yard she will bark for them, too!) Once she gets petted and loved, she calms right down. I love schnauzers as a breed and think they are fantastic dogs. My childhood dog was a mutt, but mostly schnauzer and he was so wonderful.

Thank you for sharing the story of your father''s trouble, which I know is difficult to write. It does sound similar to mine. My father is 62 years old. He doesn''t have gangrene yet but is at risk for it. The doctor said one injury to his foot and that would be it since, with so little blood flow, it wouldn''t heal and the foot would probably end up having to be amputated. So I''ve tried to get him to wear shoes or slippers around the house (per the doctor''s instructions) so that he could protect his feet a bit if he drops something on it or stubs his toe. However, he won''t wear them and walks around the house in socks!

He, too, doesn''t like to be parented and gets annoyed with me, although he knows I am doing it because I care. Being an only child, most of the responsiblity for him falls upon my shoulders. My mother suffers from severe depression and is unable to provide support or advice (that''s another story - she has refused treatment for depression for many years now). Sometimes I feel like I have so much weight on my shoulders, as I need to parent my own parents. My husband and son try to be supportive but there is not much they can do or say that will help. I have friends, as well, but like you said, many people don''t understand this disease or have never heard of it, even though it is quite common in milder forms.
I hope your father will lose weight as I can understand how that would make the condition worse. I guess that''s all any of us can do is hope, as we can''t be responsible for another''s behavior. Thank you again for sharing your story. I wonder if there is a support group somewhere for loved ones of smokers with medical problems? It would be a large support group most likely.

 

[FireGoddess]

I just wanted to offer my support to you DR, and to you, MJ. I can't imagine how stressful and upsetting these situations are to you. It is very difficult to see a loved one continuing to hurt themselves even though they know they are doing it. All you can do is reiterate your concerns to them and offer them help if they will accept it. I hope they find the strength to do so, for everyone's sakes.

My FIL continues to smoke even though one of his sons died from throat cancer related to tobacco. It is such a horrible addiction, but he never listens when I tell him he really needs to stop. All you can do is keep trying. If he won't listen, there's not much you can do.

 

[merrijoy]

Hi again DiamondsRock,

Thank you for your condolenses on Shayna. She too loved people so much. I know she loved people more than animals and all she wanted to do was to lay down on someone, or any article of clothing or bedding on the ground. She was just too cute!

I mis spoke earlier. I spoke to my mom and he does not have gangrene. It is actually just ulcerated (I think that the ulceration has gotten better) and very painful. I know he puts medicine on this to make it feel better.
And now he has gout, which he tells me is very painful and it just pains me to hear that. It is similar to ruematoid (sp?) arthritis.

My dad turned 67 this past year.

It is very frustrating when you are doing everything in you power to help them and they don''t see it that way. They unfortunately see it as nagging, I guess.
Yes, the best we can do is give them our love and hope that they listen.

That would be great if we found a support group; if you find anything, please let me know. I try to find info for my dad online regarding procedures or medicines, etc., and he always says that is helpful. Here is one article I found recently on MSNBC - http://www.msnbc.msn.com/id/16157923/from/RS.1/

Do any of these issues run in your family? A lot of other family members on my dad''s side had bad circulation in the legs and this may be TMI, but their toenails are very hard and discolored because no blood goes down there. Also, has he had the issues with the cramping of the foot and the painfullness walking throughout the years, or does he have this now? Also, just curious, what was the doctor''s misdiagnosis - did they think it was something else? If so, what did they think it was?

Has your dad had any bypass yet? Hopefully, they can do the bypass and this will put off amputation, at least for a few years and maybe they can do another bypass then.

Have you spoken to your dad at all regarding how he would feel without a leg? It is such a hard topic for me to discuss with my dad, but I have tried a few times.

Also, I am very sorry to hear of your mom''s depression. I really feel for you.

I hope the article helps somewhat. It helped me in realizing there are others going through similar situations.

Take care,

Mer

 

[monarch64]

My father was diagnosed at 62 with stage IV colon cancer...he is also a smoker. The surgeons at Mayo Clinic in Rochester, MN would NOT operate on him until he quit smoking--they gave him Wellbutrin and he quit for a few months before and after extensive surgeries, 30+ minutes of cardiac arrest, and recovery in a nursing home in the same town, then travelled home and started smoking again. He''s still smoking 2 years after the fact, but remains cancer free.

Many folks his age in my life have said this to me: let him have whatever vice he has left that makes him happy. I don''t agree with that, and it saddens me deeply to see my father continue to smoke, but honestly I''m not going to go home and take his cigarettes and lighter away from him because I think I''m right.

I can totally see every side of the issue, and understand all ways of thinking. For my father, though, he honestly will never change, and that''s just the way some people are. No amount of cajoling, pleading, or lecturing will make them stop doing harmful things to their bodies, especially at a mature age. Better, IMO, to enjoy the time left you have with them and not add further stress. I''m sure I might get flamed for my comments, but I''ve lived through this with my dad, changed careers to be with him, and I''m not going to be angry with him for living the rest of his life the way he wants to. It''s his body, he knows and understands what he''s doing to himself, and all I can do is hope he will beat the odds and stay with us for a few more years. He has a permanent colostomy bag attached to him, horrible scars all over his torso from surgeries, and the burden of tying up loose ends just in case...who am I to tell him he can''t indulge in the one thing that gives him sort of peace a few times a day?

Diamondsrock, and everyone else who has family going through the horrors of cancer: I offer you my support and listening anytime you need it, and even when you don''t. I hope and pray for you and your families that things get better.

 

[ladykemma]

even though it''s a nicotine addiction instead of an alcohol addiction, addiction is addiction. YOU are going crazy carrying someone else''s burden.

i think al anon would definitely be a support group for you. it''s the same dynamic and you are carying all the worry for the people who should be carrying the worry. alanon will teach you how to hand the worry back.

 

[diamondsrock]

merrijoy I found this support group which you might be interested in

http://groups.yahoo.com/group/vasculardisease;_ylc=X3oDMTJmbHF2NGs4BF9TAzk3MzU5NzE0BGdycElkAzE5MDUwMjcyBGdycHNwSWQDMTcwNTA2MTU
4OQRzZWMDdnRsBHNsawN2Z2hwBHN0aW1lAzExNjgyOTE1OTk-
I didn't answer your questions in your last post. There are no vascular issues in the family regarding legs, although his father died of a heart attack in his 40's.
He has had complaints of his legs being tired for a couple of years, but his primary care doctor told him it was nothing and it was just his nerves.
In other words it was all in his head. So he was way off on that diagnosis.
He can walk believe it or not, just not uphill or long distances. I think he's more in discomfort than severe pain.
I'm not aware that he has any pain in his feet, just an achy, cramping feeling in his legs.

My father continues to smoke and shows no real signs of quitting. The doctor told me on the phone that if he does the bypass and my father continues smoking, then he will be back in 6 months for another surgery. So obviously I have reservations about him having the surgery. The doctor scheduled the bypass without telling my dad any of that. If my dad would just quit smoking, I would feel better about the surgery but if he doesn't want to quit it seems like a guaranteed failure. Oh, and he didn't mention anything about the 5 year thing you said but I did find that online and that is so very important to know. After a communication breakdown with this dr., we have decided to get a second opinion which is always a good idea anyways.
I just wanted my dad to be informed and it just wasn't happening with this particular doctor.

Hope you're doing ok with your dad and I hope that link helps you out. Take care.

 

[merrijoy]

Hi DiamondsRock,

I have been thinking about you and wanted to ask how you and your dad were doing so thank you for writing. And thank you for the link, I will certainly check it out.
My dad still has pain, and when I ask, he does not tell me too much. But AMAZINGLY he and my mom have started eating really, really healthy. I have not re read this thread so I am not sure if I mentioned that my dad would do the Atkins diet thinking that it is ok that since you lose weight it is ok and the studies claim that your arteries clear up from Atkins. I so do not agree with eating a pig for breakfeast and a cow for dinner. I agree with lean proteins - ie fish, chicken, etc. I kept telling them to add in whole grains and vegetables - my dad does really like brocolli but was adding cheese to it. Anyway, as of the past few days, my mom told me they are eating lots of chicken, spinach and brown rice and whole wheat flour when flour is called for - they are now following the South Beach diet or modified South Beach diet. So this is good news on this end. My dad can change my mom's ways of eating and doing things, but my mom usually can not do the same. That is his stubborness and it is usually only him who will make the decision to change.

I think I mentioned that my dad has been battling with gout in the foot which I know is very painful.

I know all of this is hard for you and I am here if you want to drop a line. Just spend as much time as possible with your dad....This is a very coincidental that you posted again now. We have a friend of the family who just passed away suddenly at the age of 59. She was a smoker with asthma. Her children asked her to quit many, many, many times. I don't yet know what actually ended up taking her young life, but it is unfortunate how people are so stubborn. It is hard because you want so much for them to listen to you and to reason and hoping to prolong their life, but spending the time pleading takes away from the good moments you can be having together at that time. It is such a catch 22.

I am glad you are getting a second opinion. It is always a good idea in these circumstances. And I hope you find a great doctor if you decide not to stay with the current one.
So the doctor is saying that if they do the bypass now and he continues to smoke, that he will need another bypass in 6 months? Have you seen xrays at all? How do the arteries look?
I am going to reread your original post now to refresh my memory.

On a side note (sorry), I added my beautiful angel in heaven, my beloved Schnauzer, as my avatar.

ETA: Also, thank you for answering all of the questions that I had asked. It is so nice hearing stories and information that is similar to mine.

Take Care,

Mer

 

[diamondsrock]

yup, that was me. I figured it was worth a shot to see what the dr. on there says.
We will be getting another doctor and yes this dr. did say (to me) the surgery would be ruined in 6 months if smoking continued. That''s why I''m so hesitatant for him to have it. He didn''t relay this to my father (the actual patient!), however, and I think it''s something that should be discussed before doing anything, which is why we are getting a second opinion.
Second opinions are always a good idea anyways. I''ve given up on asking him to quit smoking. It was just too hard on me to keep bugging him, and you''re right, it ruins our time together.
I''m glad your dad is improving his diet! That is great news.
And by the way, the picture of your angel is adorable.

 

[merrijoy]

Date: 2/1/2007 4:43:51 PM
Author: diamondsrock
yup, that was me. I figured it was worth a shot to see what the dr. on there says.
We will be getting another doctor and yes this dr. did say (to me) the surgery would be ruined in 6 months if smoking continued. That's why I'm so hesitatant for him to have it. He didn't relay this to my father (the actual patient!), however, and I think it's something that should be discussed before doing anything, which is why we are getting a second opinion.
Second opinions are always a good idea anyways. I've given up on asking him to quit smoking. It was just too hard on me to keep bugging him, and you're right, it ruins our time together.
I'm glad your dad is improving his diet! That is great news.
And by the way, the picture of your angel is adorable.

This is rediculous! I was thinking I could maybe, maybe understand this if he was like 90 years old and hard of hearing and the doctor wanted to tell you instead of your dad so that there would be no loss of communication - but he is 62! Wow about that doctor.
I know you have given up on trying to get him to quit smoking, but the people on this board are so wise, maybe someone will still weigh in regarding getting our loved ones to quit bad habits.


Mer

 

[gail013]

Diamondsrock-

Your father is in denial-he is either denying anything is wrong, or he may tell you it''s too late anyway. I watched my husband smoke 3 packs a day for 20 years although his father died of a heart attack at 47. I tried nagging, crying, arguing-it was all a total loss on him. He refused to believe anything could happen to him. What did the doctors know anyway? When he had a few ''scares'' at the age of 42 and 43 and doctors told him to quit smoking or it would kill him, he quit for a day, and then lit up on the way to the car! Nothing I said mattered, and he continued on his path of destruction. Finally, he had a heart attack, and it was the only thing that got thru to him. He saw life and death and that day changed him. As scarey as rock bottom is, it may be the only thing to get thru to your dad. I''m sorry you have to watch it, I wish you and him the best, and that he can get thru this.

 

[Skippy123]

I am so sorry. I will keep him in my prayers.