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RFI - 85 year old mother and possible ileostomy

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RFI - 85 year old mother and possible ileostomy

Postby rickschroe » Tue Jan 12, 2010 9:01 pm

Greetings -

I am new to this group and would appreciate any advice or help folks can provide. My 85 year old mother has had ulcerative colitis for over 15 years. Following a recent colonoscopy, it has been recommended that she have her colon removed and have an ileostomy. The results of the colonoscopy did not show cancer, but did show low grade dysplasia with multiple mass lesions (DALM). The doctor said that even though they did not find cancer, there is a 40% chance that she already has cancer. He was firm in stating that she should have her colon removed. My mother would like to wait on any surgery, and instead get another colonoscopy maybe in 6 months. The family is concerned that the surgery and recovery will be very difficult for an 85 year old person. Another complication is that my mother has macular degeneration and thus cannot see very well. We are wondering if she will be able to deal with an ileostomy and be able to see well enough to keep things clean and functioning properly.

So, I realize this is a very personal decision, but I was hoping folks on this board might have suggestions or advice for us. Thanks in advance.

Rick Schroeder
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Re: RFI - 85 year old mother and possible ileostomy

Postby SkiFletch » Tue Jan 12, 2010 10:11 pm

That's a tough one at 85 years old Rick. Your surgeon is right, total colectomy is definitely the surgery for what ails your mother, but at 85? Did your surgeon talk with you about surgical risks/complications for someone your mother's age? Also did he mention if she would be a candidate for laproscopic assisted surgery, or would she need a full abdominal incision? Much easier to recover from the former... Other than the macular degeneration does your mother have other health problems/risks?
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Re: RFI - 85 year old mother and possible ileostomy

Postby Terry » Wed Jan 13, 2010 12:01 am

I say at 85 years old do whatever your mother feels the most comfortable doing. What did the doc say when she suggested waiting and just doing another scope in 6 months?

If her eye site is bad, illeostomies are pretty messy because they are so liquidy, it might be tough for her.

It's a tough situation to be in, I don't envy you.

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Re: RFI - 85 year old mother and possible ileostomy

Postby willtowin » Wed Jan 13, 2010 12:47 am

My grandmother had a colon resection at 80. It is different than having an ileo, but she really did pretty well. She probably did better than i did really. She did not have cancer, but a flat lesion that they thought was. Anyway, her only problem is the diarreah now, which your mother would not have with an ileo. She has also had a hip replacement since and the wounds are the only problem that she has had with healing.

Caring for the ileo would probably be the biggest problem. I understand it is a tough tough call.

If she waits the 6 mos and gets the same result is she wanting to do the surgery then?
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Re: RFI - 85 year old mother and possible ileostomy

Postby NWgirl » Wed Jan 13, 2010 2:11 am

My mother is 86 and she also has macular degeneration. She currently lives alone - with my sister close by to help her as needed. I myself had an ileostomy for a year while I went through chemo/radiation. It's not the ileostomy that concerns me as much as that invasive of a surgery on an 85 year old woman. My mother had knee replacement surgery when she was 84 and the recovery and physical therapy were very hard on her. The surgery was a success and it has allowed her to continue living on her own - but she said had she known how hard the recovery would have been, she probably wouldn't have chosen to go through with it. As it is, she has chosen to "live with" her other knee. My mother does function pretty well with her limited eye sight. However, when you empty the bag and change it - poop can drip here and there - and my mother probably wouldn't be able to see it to clean it up.

If it were my mother - I'd give her the choice and support her in whatever decision she made; but I strongly suspect she would not go through with a surgery of this type at her age.
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Re: RFI - 85 year old mother and possible ileostomy

Postby CRguy » Wed Jan 13, 2010 10:42 pm

rickschroe wrote:So, I realize this is a very personal decision, but I was hoping folks on this board might have suggestions or advice for us. Thanks in advance.
Rick Schroeder

OK but first you gotta tell us if you are THAT Rick Schroeder ??? Only joking. ( but if you are..I loved Silver Spoons and just about everything since !! )

Advice : What does Mom want ? I would weigh this heavily, and a repeat c-scope and recheck in 6 mo. will likely not be too much to ask. A second opinion would also be reasonable in this situation.

Macular degen. & managing a stoma : Is she having severe clinical signs now ?? you need to weigh the pros and cons of what will be worse ..for her..about losing a degree of control over herself, privacy issues about ileo, or a deteriorating medical condition ???? All depends on her personality and determination. Is she going to still be able to stay in her home ? Are there other health concerns or signs of dementia which may affect her wellbeing ???

Good doctors want to help their patients with what they think is the best option for better health. The best doctors will also weigh the fact that some patients need to be given what they can HANDLE...not necessarily what the doc thinks they need. Not an easy road to travel. ( I've been a vet for 30 years and believe me, I have had this discussion with owners, weekly, for all 30 years. )

Just the surgery itself would also be worthy of very serious consideration for someone of her age. Will it prolong her life or enhance her quality of life for her remaining years ???? Again not easy discussions when it is your mother.

Hope I have not touched too "personal" nerves here, but I have aging parents going through the same issues and a M-I-L in a nursing home with advancing dementia and macular degen. I think if you feel the whole surgery option is too much and your mom really doesn't want to go the route...then I think you have your answer.

Hoping things work out for your family

Cheers, In Harmony
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Re: RFI - 85 year old mother and possible ileostomy

Postby Ashlee H. » Thu Jan 14, 2010 12:39 am

Such a difficult decision. But, if your mom is of sound mind, listen to what she wants. I remember my grandmother at age 93 was still very active and had a sharp mind. She was told she had colon cancer and decided she did not want any treatment. Grandma did not feel the pain of treatment to give her a few more months of life was worth it to her. She was happy with her decision and was looking forward to Heaven. She died two months later. No one wants to lose a loved one, but it is important to listen to what they want, not what we want for them.
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Re: RFI - 85 year old mother and possible ileostomy

Postby rickschroe » Thu Jan 14, 2010 2:42 pm

I am deeply appreciative of the helpful and thoughtful replies I received about my mother. The personal experiences of those who replied will be very helpful as she makes decisions. At this point she wants to wait and get another colonoscopy in 6 months. She is of very sound mind, and I agree fully that it is her decision to make. I may be back with additional questions, but for now I just wanted to express my sincere gratitude to everyone who replied.

Rick
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