My mother is about to have open heart surgery. Her heart is extremely weak and we never thought she'd be strong enough for this. However, she has an 80% blockage in her left circumflex artery that can't be fixed any other way. Because of her age, 66, her doctors feel a bypass is the best thing for her.

She suffers from very bad osteo and rhuematoid arthritis. It's worst in her hands, feet and knees. She's still walking but barely. She needs knee replacements but unless her heart becomes stronger, she won't be able to have them. She currently lives in an independent/assisted living facility and is living in the independent section so she isn't getting much help from the staff. This is her choice. I currently see her once a week to do her shopping, take her to doctor appointments, do some cleaning, pay her bills set up her medication for the week or whatever else she needs. At times, I do see her more than one a week. I work a full time job but I work 4 10 hour days so I always have an extra day off during the week.

My mother has never been a happy woman. Like many other daughters out there, I have a mother who can't be pleased. She's been this way my entire life. The negativity that radiates from her can be overwhelming at times, especially now that she is in poor health. I love my mother and always will. I want the best for her and I'll always do whatever I can to make sure she is taken care of. I'm her care giver, her companion, her protector, her advocate. But, sadly, I don't like her and I get no joy from being with her.

My brother and his wife moved 2000 miles away several years ago, my father died 6 years ago and I'm the only person she has left in her life.

I'm worried about getting through this surgery and recovery period. I'm worried about her well being as well as my own sanity.
Does anyone have advice on dealing with the recovery from such a surgery? What kind of issues can I expect her to have? What sort of time commitment should I prepare myself for to help her? How do I help a woman who is never happy to begin with get through the recovery period of such an invasive surgery? And, how do I face the next several years of doing a job that I don't like or enjoy doing?

1) There's no way to know what the specific outcome will be for your mom. Among those who have the procedure and follow the rehab instructions about 20% pop back to terrific condition. 20-30% never really come back to a particularly satisfactory place. The rest are someplace in between. Everyone I've known who has been through it, has had some level of impairment afterward. Chest-cracking procedures are significant trauma events. Healing takes time.

2) Those that resist rehab instructions, pretty universally have the worst outcomes. From your description of your mom, I would be concerned about this. Especially since you say she can barely walk, normal rehab will likely be much different for her. A big part of rehab is exercise -- a lot of walking, usually starting right away - and if she's unable to do that, she likely will not recover as quickly as if she was able to. I would cover this ground with the rehab folks to get a clear perspective of what will be involved in your mom's particular case.

3) Caregiving can be pretty light or arduous, depending on the individual patient's progress.

4) They've been doing these procedures for quite a while, now, and have become very good at them. They should have a pretty clear picture of what you should expect in your mom's case. Talk to them about your expectations -- whether over or under. Get a better idea from them about what's reasonable to expect.

5) Prepare to upgrade her standard of care from mere "assisted living". In the beginning, she'll almost certainly need more attention. With a good outcome, this period may pass quickly but the burden for you as an individual in the beginning may well be too much to undertake.

6) Get connected with private-care people whom you can call on if you do find yourself overwhelmed. If/when such a thing occurs, you won't be thinking straight. Make these arrangements in advance so you don't have to think about it if the need arises.

7) Let the rehab folks have their way with her. It will be very uncomfortable for her. She will probably complain. You may feel like intervening. Don't. It has to happen. They'll have to push her a bit. They know what's needed. Stay out of their way. You may have to explain this to her and deal with her resentment. She'll probably forget it all in due course. Everyone does. But keep her moving and excercising. Regularly. Every day. Couch potatoes, don't do well. If they did well in the beginning when it was forced on them, they begin to decline when they stop. It will be a lifestyle change. New routines. She will become depressed a little or a lot. You'll have to deal with it and keep her moving.

8) Knee replacement or other procedures may or may not be deemed wise later on. One step at a time. Right now, this is the only thing. Keep focused on this and this alone.

9) The procedure will NOT change her personality. Your present annoyances will likely continue as before -- but at least you'll have some new subject matter to talk about.

There are a lot smarter people than me around to ask about this topic. Find them and talk with them.

She will need constant care at first. I couldn't get out of a chair alone or out of the bed with help. I slept in a chair for a couple of weeks. Keep the heart pillow she will receive by her at all times. It really does help cushion movement.

I did the full course of rehab and strongly encourage your mother to do the same. There were days I hated it but knew I really needed it.

I did have some memory loss which they attribute to the heart pump. Also, about a week of hallucinations which could have been the surgery or the meds. You might expect some depression.

I do annual checkups and stress tests. I'm 56 now and no surgery repeats...yea!

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