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Thursday, June 25, 2009

Surgery For My Father, Negotiation Time For Me

Things are starting to get interesting with the medical condition of my father, which I spoke about in an earlier post. He underwent a multitude of tests including several ECG's and an angiogram. The final diagnosis is that he has blocks in two arteries leading to his heart. One of the blocks is 80-90%. Another artery has two blocks in a row, each at about 40 to 60%.

The treatment options have pretty unanimously been narrowed down to an open-heart bypass surgery. My parents and brother have now consulted several well-known doctors and nobody has suggested anything else. The basic problem is that angioplasty or a stent is not an option since there are two blocks one behind the other on the same artery. And drugs are considered reliable or effective enough when the blocks are that close to 100%. Moreover, apart from the heart problems, my father is in good physical shape and has no complicating factors like diabetes. Undergoing this surgery would basically take the heart issue out of the equation for the next 10 to 15 years according to the doctors.

I had hoped that it would not come to this. I don't think invasive procedures are the first option to treat anything. And especially so in the case of a septuagenarian. It is not that I don't trust doctors or modern medicine, but I don't trust them blindly either. I don't trust them to ever know everything there is to know about the human body and how it works. I believe in giving the body's natural ability to heal itself a chance (and perhaps a boost, with some natural remedies) before forcing a more drastic medical solution on it.

More importantly, I don't trust doctors to be absolutely and completely objective about deciding the best course of treatment for a given condition given the amount of money sloshing around the system nowadays. I am not saying that doctors make decisions based on financial incentives and nothing else. I am not even saying that doctors are consciously swayed by the financial implications of the alternative courses of treatment. But it would be difficult to argue that money can be eliminated from consideration even at a subconscious level. But in this case, perhaps it was the only sensible option.

The surgery has now been scheduled for very early in July. He will be in the hospital for the first 8 days after the surgery (3 days in the ICU and 5 more days in the general ward). After that he will come home, but the consensus is that he will require extra help and care for about a month or two after coming home. Even simple things like taking a shower will require external help during this period. So, the idea is that my brother and I will take turns and be around for at least a month after the surgery. The plan is also to employ a nurse and a maid during the recovery period to assist my parents.

My wife knows that I have to do my part in taking care of my parents, but is not fully comfortable with me being far away from her over extended periods of time. She can and does take care of the household without my help on a daily basis right now. She is comfortable handling the routine and mundane such as cooking, cleaning, laundry, grocery-shopping, etc., etc. But there is always the nagging feeling in the back of her mind that something non-routine would choose my being away as the excuse to happen when she is least-prepared to handle it. So, she is trying to convince me to limit my time away to about 10 days at a time.

The problem with my trying to be away for only 10 days is that the actual time I spend with my parents will come down to about 8 days in that case because of the travel times involved in getting there and back. I have enough vacation time at work to be away for 3 weeks if I need to. So, conceivably, I could go and spend 8 to 10 days with my parents, come back for a week or two and then go back again for another stint. Obviously, what time commitment would be required from me would depend also on what constraints my brother faces, from a work as well as family perspective.

So, I will have enough on my mind as I head into this weekend. My mother-in-law has undergone minor surgery to place a defibrillator on her heart. She lives with my wife's brother, and my wife, my kids and I are heading out to my brother-in-law's place this weekend. My wife and kids will stay there for a few days, but I will be back after the weekend. I have also made some plans to hike with some friends from college when I am over there. When we initially made plans for this trip, my father's surgery was not in the picture. Now that things have gelled to some certainty on that front, I have to figure out how everything is going to fit together.

One of the options I am mulling over is to postpone our trip to my brother-in-law's place by a few days. At that time, I can send my wife and kids to her brother's place while I head off back home to spend some time with my parents. And my wife would be less uncomfortable with me not being around because she would not be by herself at home. She can either come back home in a couple of weeks and spend some time alone, or she can choose to spend my entire absence at her brother's place. But I am not sure whether postponing the trip is an option given that my brother-in-law also needs help with managing the care of his mother.

Another option is for her to take this trip as planned, come back in a week or so, spend a week at home, then head back to her brother's place while I head to my parents' place. She can then spend some of her time away from me in the company of her mother and her brother's family without being alone. Obviously, making two separate trips to her brother's place is also inconvenient, especially with the kids in tow and the amount of luggage that entails. So many options, so many constraints, it makes my head spin!

Time to lay out all the options in front of my wife and start negotiating in real earnest. And time to think up options and lay them in front of my brother and in front of my parents too. Life is all about compromises and married life is especially so. But it is not just my life, but everyone's life too. Let us see how this works out, who makes what compromises and what ends up happening finally.

And also, this surgery will end up costing me about $5,000 out of pocket after all the insurance payouts and whatnot. More unexpected expenses, sinking my budget even deeper into the red. Is it any wonder my budget is always so tight?

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