Maybe a call to her dr. is in order before you leave for your trip. Best to you and your Mom and hope you have a healthy relaxing trip.

OY! I don't blame you for being furious. I'm sure you will get it all in order, shortly. I have to agree with satine, I'd call before going.

Oh Sleeperblues, something could happen while on the cruise. I know of stories where people got sick and had to get a helicopter to take them to the hospital.

I sincerely hope that everything is fine for her (and you) during the holiday. I'd like to be a fly on the wall at your meeting with the cardio.

Thanks, but I don't trust myself to do that. I'm pretty angry, and I don't want to do anything my Mom wouldn't approve of. Besides, it's a little late now to treat her. Cardioversions are not without risk. I don't want anything to happen to her before we leave. I will just be extra vigilant with her, and if something happens I will at least know WHY. Thanks for the kind wishes.

Jas, it's not the cardiologist I have an issue with it's her primary care physician. My Dad was a physician and in my Mom's eyes the physician is still God. Sorry, but they are people, and people make mistakes. It just seems to me if it had been HIS Mother, he would have treated her.

Do they have URGENT care available close to your Mom? If so, I would take her there as soon as you get there. Hope everything works out well for both of you.

Can understand why you are upset. My first thought is , where possible , it is a good idea to have someone accompany a patient to a non routine appointment. Most people have a limited understanding of what the doctor or PA tells them. Factor in reduced hearing and a nervous payient. A second person can listen and help the person review what was said. Important to have mom sign the release of information paper YEARLY. Listing the names of people they can relay information to, and discuss diagnosis. You said you are not near by, she should tell doctor you will be calling.

Cruise ships have adequate medical staff on board and they can evaluate a patient for treatment or evacuation. Always good to have insurance in place in case an air lift is recomended. Have cruised 36 times and have used medical on the ships.

I am sure you will have a wonderful trip. Just be aware that alot of food on cruises is loaded with salt. Help her make food choices . Always something "good" to eat. Hope all goes well.

Marco, yes I will make sure we have the proper medical insurances with us. Good reminder and thank you. She weighs 120# and barely eats anything anyway, but I will keep an eye on her.

I hope you can have an enjoyable and uneventful trip, and then come back and kick some butt.

Medical schools are in transition. Past emphasis was on rote regurgitation of the large volume of information students need to learn and the most successful (in that context) were the ones who could do that best. More emphasis is being given today to admission screening for and developing soft and interpersonal skills and developing more critical thinking.

Another problem is that too many primary care physicians try to grind out as much money as they can in their daily routines by scheduling short appointments that often aren't long enough for the doc to engage and think about the patient in front of them. j

sleeper, I hesitated to post, because I don't want to sound like a fear monger and your trip with your mother will likely turn out to be wonderful. But I know I'd feel dreadful if I didn't at least speak up and relay my story, on the off chance something goes wrong. Of course I understand that these are two different people and there could be very little in common as far as evaluating a risk level.

We took my Mom with us on a vacation to Arizona to visit my brother. Two years earlier, my mother had been diagnosed with acute heart failure at age 68. (Previous to that, she'd been healthy, with no prior cardiac problems.) My sister took Mom to the ER, when she called one night, saying she was feeling short of breath and noticed some ankle swelling, which was not normal for her.

Long story short, the ER found that Mom was in AF and in acute heart failure. Her blood work told them Mom had undiagnosed Hypothyroidism, with numbers so off the chart that the cardiologist said she must have had it for a while, and this caused her to go into AF. They admitted her immediately, killed her thyroid and spent the next week (after the first cardioversion failed) trying different methods to get her permanently out of AF.

This was finally accomplished and she was fitted with a pacemaker and released with some cardiac meds, to keep her out of AF. We were told that should she in future ever experience either shortness of breath, sudden ankle swelling, chest pain, etc., to please go to an ER immediately, to be evaluated.

Life went on, and Mom was no longer in acute heart failure, and seemed to be doing fine. Two years later, she joined us on our visit to Arizona, after having gone to her doctor to ensure she was healthy enough to fly/travel.

Thankfully, we got to enjoy the visit with my brother first, because Mom passed away on the night before we were supposed to return to Canada, at the relatively young age of 70.

That evening she suddenly mentioned she was feeling kind of 'funny' and admitted that she'd noticed the day before that her ankles were swollen. She hadn't had swollen ankles since her episode of acute heart failure 2 years prior, so this was a red flag to us. I was telling her that DH was calling 911, not to scare her, but just for her to be seen at an ER, to see what was going on with her 'feeling weird." However, she actually collapsed as I was speaking, and sadly could not be revived by us or paramedics.

The pathology results, combined with the paramedic's cardiac tracings, conferred that she had gone into AF which led to a massive stroke. We were told that had she alerted us to her swollen ankles the day before and got her to an ER, they would have discovered she was in AF and probably been able to get her out of it before it had gone on long enough to cause her stroke.

sleeper, please forgive me and disregard if you feel your mother's situation is quite different, as I feel pretty bad, laying all this on you just before you're supposed to fly out tomorrow. But I know I'd feel even worse if I didn't relay our experience and then find out you lost your dear Mom while travelling with her, as happened to me. I just wanted to post so you might have a chance to have her seen by someone else, and see if her AF truly isn't any cause for concern, before you leave.

Oh Picky, I am so so sorry about your dear Mother. 70 is much too young! Don't worry about upsetting me, I am upset enough because I know the danger my Mom is in. The thing is, she doesn't really care. I think she thinks she is ready to die. I don't want her to die, and can't imagine my life without her but the day will come and she has all of her affairs in order. I am glad you were able to have a nice visit with your Brother, and you both got to spend time with your Mom before she passed.

The thing that I am most upset about is that her doctor doesn't seem to value her life. Yeah, she's old, but she's got all her marbles and is loved by all of her 5 children and 12 grandchildren. I'm kicking myself because the last time we went to Lyric Opera (she takes me and my 2 sisters 4 times a year) back in February I noticed she had to rest when climbing the stairs and that her ankles were swollen. I should have known better and intervened then.

Don't place all the blame on the doctor. He may have been quite good at telling her to get immediate help, but she was looking forward to this trip, and she didn't want to bother you, and she'll see the other doctor when she gets back, and she doesn't want to bother anyone, she'll be just fine.

I've heard all those lines. And not from the doctor.

I hope your trip goes well and that you both have a wonderful time. And she gets to the doctor when she returns.

sleeper, I'm relieved my lengthy post didn't cause you any further upset! Don't beat yourself up about not intervening when you noticed some ankle swelling and difficulty climbing the stairs, a while back. Firstly, it's not unusual for an 83 yr. old to need to stop for a breather, when climbing stairs. Secondly, her swollen ankles might not be as serious a sign as it was for my mother, who had experienced an episode of acute heart failure in the past.

I just felt compelled to relay my story on the chance that you could have her seen, (by a different doctor) before the trip, and find out whether her AF needs urgent treatment, or not.

But if your mother does not want to be checked out before you leave, I suppose she could very well be determined that she wants to go on this trip with you and assumes she'll probably be fine, feeling that if worst case happens, she got to spend her last days having a great trip with her daughter.

If you haven't already, I'd for sure speak to your sisters so they're aware of your mother's AF, and that her doctor seems unconcerned about any potential risk. That way you can all confer, about whether to just have faith in her GP's opinion and go on the trip with Mom, or you can all insist she be seen by another doctor immediately, so her AF can be further investigated.

At least that way, you and your siblings will be in agreement about what to do, and if the worst scenario happens, there'll be no "We had no idea mom's health might be at risk, or we would have insisted you cancel the trip."

You may all agree you should go ahead with the trip, as Mom's looking forward to it, and her doctor wasn't concerned that her health was at any strong risk. If that's the case, then try not to let yourself be consumed with constant worry and just enjoy every moment of this trip with your mother. I'm sure she'll treasure it just as much!

OK, here's my contribution: What *else* isn't Mom telling you? Why are you getting the feeling that she thinks she's lived long enough? Is she hiding further medical concerns? Is she depressed?

My mother was 70 when she told me she had a 'minor blood disorder' that was being treated. One day her neighbor called me to say she'd seen my mother in their apartment hallway; she suspected Mom had had a stroke. I telephoned. Her words were scrambled. I took her off to the ER -- despite her strong protests. Another embolism was located in one leg. I found out that her 'blood disorder' was incurable leukemia.

The next 18 months were awful. Mom was continually admitted, given transfusions, discharged, readmitted. This was in the days before DRG's. In her final year she was in hospital more days than she was out. She endured so much, right up to long, drawn-out death at 73.

I'm 75 now. I have come to firmly believe that my mother *welcomed* that stroke. She didn't want to be 'rescued', and most of all, she wanted to spare me all those agonizing months of her dying.

I have afib I have never had cardio version until my heart rate has stayed in the 200s and above for more than a few hours. My resting heart rate even with medication is usually in the 130s-170s . Before they use cardio version on me they usually try to chemically convert me with medications first before I get the big Zap. I have been Zapped so hard because they couldn't convert me on the first couple rounds that I ended up with 3rd degree burns on my back and my chest. Lucklily they knock you out for that.

I have been diagnosed with A-fib since 2009 and I have not taken one blood thinner. So maybe everyone is different, My electrophysiologist is at Brigham and Womans in Boston so not a small place. I see a regular cardiologist for my other heart problems but for the Arrhythmia and A-fib I see the electrophysiologist.

Sleeper, before getting too angry with the doctor, perhaps your mother, knowing that this trip was scheduled, didn't want to do anything. I just got out of the hospital and when I was in, the Emergency Room nurse asked if I have had a colonoscopy, the hospital nurse asked if I had a colonoscopy and the gastroenterologist asked if I had a colonoscopy. All three times when I said no, they then asked who my primary care doctor was. I told them with an immediate follow-up it is not her fault...she's tried. I'm just a procrastinator. Ultimately, one's health care is up to oneself. It's the old You can lead a horse to water but you can't make him drink. This might not be your mother's case, but then again, it may very well be. I hope you're having a great trip and all is well.

sleeper? mom went on cruise and of course failed to take her cane...naturally fell, and was taken off the ship to (can't remember for sure) costa rica? needless to say to our advantage a large American colony, so hospital was wonderful...to this day I wish I hadn't been in such a hurry to get her back home (las vegas) as the drs were wonderful and her care was good...in fact, asked for some fresh fruit, and the little nurse brought her enough for the entire ward...they also had done a mri (her first and almost wouldn't do it, but told her yes or else, lol)...that too was done with respect for her age and fear..i almost regret having her flown home...

btw she has been smart of enough to get the travel ins, ect...cause her home trip (and another patient) was via lear jet....and it was covered...

i'd sure as he!! be on the dr's back...and while i'm thinking about it, get to a lawyer or whomever, and if you're either the only child or closest caregiver, get a POA....

Wonder if primary care doc knew she was going on a cruise or spoke with cardiologist about referral.

Chronic AF is usually treated differently than new onset AF. In the ED we avoid cardioversion of AF due to the risk of stroke. A HR of 109, while not ideal, is not one we generally treat aggressively. I have cardioverted many pts in the ED, never one in AF with a rate of 109 (190, yes).

AF is a major risk factor for stroke and the use of anticaogulants is standard of care - in most cases. If someone has AF and is not on an anticoagulant they should discuss why with their cardiologist.

Please do not think cruise ship medical care is the same as having an ED available. Staffing & equipment is minimal. They do not have a cardiac cath lab to treat your MI or interventional radiology to treat your stroke. While you are waiting to be transferred heart/brain cells are dying.

Sad situation, sounds like trip will not be as enjoyable due to child worrying about parent.

yes for sure mdln, on the aboard care...that's why she was taken off asap...they couldn't help her...

@susan, like your comment about medical care in another country. DF is the international medical director for an insurance co that approves/pays for those "lear jet" trips home. He says in some cases people get care that is as good as, if not better, than what they get at their "home" hospital. Good to hear of your experience.