My mother is 97, has dementia, and is extremely hard of hearing. When a visiting nurse discovered that she has a prolapsed uterus, he urged us to take her to the ER, which we did. Being there for several hours was very traumatizing for her. Two days later, she was examined by a gynecologist who recommended the above procedures. I'm not sure what to put her through. After the gynecologist's exam, she said she had gone through major surgery and was grateful for being fixed. I can see the necessity of the pessary to keep her uterus in place, but why put her through the ultrasound and biopsy? If she had cancer, we would not put her through any aggressive treatments.
How far was her uterus prolapsed? Ask if a pessary would correct her incontinence. Does your Mom walk? If yes, does the uterus drop far enough for the cervix to protrude outside her vagina?
Sounds like she was sent to the ER without an emergency?
Remember when a procedure , especially an operation, is recommended, ask important questions such as:
How will this help her/him?
What will happen if is is not done? How soon.
Is there an alternative approach?
If your parent was in similar condition, would you have it done on them?
Also: It would be great if your parent had a physician’s directive for you.
Do you have one on yourself?
IMHO, the pessary is the best option. At her age biopsies and ultrasound seems unnecessary!
It's a very simple GYN appointment, but maybe a little uncomfortable during the fitting.
Unfortunately, it does require regular cleaning.
Have you asked what the possible complication are if you choose to leave it alone?
I assume given Moms age and prolapse uterus that she has major incontinence issues. The pessary may help a little.
God bless you for caring for her as you do!!
She's blessed to have you!!
By the way, I had Gyn surgery via the vagina and I was uncomfortable for about 2 months. I also was on the verge of developing C. Diff. infection from over-prescription of antibiotics after surgery. Keep this in mind if you decide to go with surgery.
So yes for the pessary, but no for biopsies and pelvic ultrasound.
Although my Granny in Law had a full hysterectomy when she was 93 and lived 4 more years. But she did not have any radiation or chemo.
My mom, 91, with dementia, had a prolapse and got a pessary a few years ago. It had to be taken out and cleaned by a nurse practitioner on a regular basis -which Mom hated. Being in stirrups, she was very uncomfortable (emotionally)with the whole situation.
We had the pessary removed for the last time and kept out after Mom broke her back. She was no longer ambulatory the way she was, and the prolapse works with gravity. Now she spends most of her days seated or laying down and it hasn't been an issue.
Also, she's had 4 skin cancers and we've stopped taking her for check up on those things. Because, why? Same as you, we're not going to put her through any kind of surgery or aggressive treatments, she doesn't want that either. So why put her through the visit. The going out somewhere she's unfamiliar with for something she doesn't entirely understand to be seen by someone she will probably not remember. It just ruins the whole day.
Unless she is bothered by the prolapse, at 97, I'd skip the pessary (which would also mean multiple follow up visits) and the biopsy. I only opt for Mom's comfort as a priority these days.
Considering her age and that she has dementia, don't put her through the ultrasound and biopsy and everything else. If she's in pain and it can be managed with medication then that's the most they should be doing for her.
Hope this is helpful.
It would probably kill her to go thru it.
Juse keep her comfortable.
My Dad will be 97 next month and when he ended up in the Hospital because he couldn't urinate, they wanted to do all kinds of tests on him and the only thing I let them do is put a Cathiter in him and give him fluids for being dehydrated and antibiotics.
I told them No to all procedures and Test they cane up with because I told them no reason to do tests because he was too old fir any procedure.
I guess it's just their job (Hospital) Policy, to ask you to do these things like going thru a Drive Thru and have them ask if you want fries or a pie with your order.
When you go to a Hospital, you most definitely need an Advicate.
My Uncle George was diagnosed with pancreatic cancer at 98; the 'slow growing kind', which I never heard of. He just turned 100. He's done nothing about the cancer, and it hasn't killed him yet.
My motto is this: allow the very elderly to live what's left of their lives in peace and with as little pain & trauma as possible. If this issue is causing your mother pain, and the procedure will not cause her more pain than it cures, go ahead. If not, don't do it.
Good luck!
Now you don't have to follow the advice. That's entirely up to you and your mother. Sounds like the gynecologist prescribed/inserted a pessary. If you don't want any further treatment, don't make any further appointments. But if the gynecologist suspected a tumor, possibly cancerous, what was recommended would be the expected standard of care in this situation. If the gynecologist found abnormal cells or a mass of unknown type and made no recommendation for further testing, that would be malpractice.
It's always OK to say no to doctors. It doesn't occur to them to let you know that's an option. Ask if there are other options, but unnecessary procedures should be pretty low on the list.
I stopped a few of Moms doctors and procedures. She got to the point she didn't want being touched. Like you said, if something was found we wouldn't have treated it.
PS The gynaecologist would be very wrong not to *offer* the full range of options. Explain them to your mother as clearly as possible and as much as she's able to understand, and give her a choice in what happens next.