A Pacemaker at 104!

My father is 104 years old and he has just been advised to have a pacemaker fitted.

One of the disadvantages of living in France is that I am separated from my family but fortunately my sister looks after my father and he is still living in his own home. He can get up and walk around slowly but recently he has been falling occasionally. The “falls assessment nurse” eventually came and found that he had a heart rate of about 30bpm and low blood pressure when he was standing.

He was born in 1906, he has lived through two world wars and in his lifetime he has seen unimaginable technological change. When he was a boy horses were still being used for transport and the motor car had just been invented. He didn’t own a car until the early sixties and before that he went to work on an autocycle (the forerunner of the moped) and we used to have family holidays on the coast by taking the train.

In the late thirties, after marrying my mother, he took a job as a telephone operator because during the Great Depression he was worried that he would lose his job in the Stock Exchange. This led to him being posted to the Signals Regiment when he was called up and he was safely behind the front lines when in 1944 the Allies landed on the Normandy beaches. Later he was very nearly sent to Burma, but when he took the medical exam the doctor listened to his heart and decided he was not A1, as it said in his records, but C2. He had a heart murmur. He has always had a very low heart rate. Without being particularly fit his normal pulse rate was about 50 beats per minute. He had an infection when he was very young which damaged his heart in some way but it was well compensated and never gave him any trouble.
After the leaving the Army he passed the Civil Service Exam and, throughout my childhood, he worked as a Civil Servant. He retired at the age of 63 when it was discovered that he had cataracts and angina, but neither of these stopped him and my mother from touring all over the UK in their motor caravan. They moved to a bungalow in Wantage to be closer to my sister in the 1980’s.
In his early nineties he was still painting the bungalow, working off a short ladder, while my mother stood below exhorting him to be careful! But soon afterwards he stopped taking an interest in his garden and started to lose his short term memory. When my mother was dying in November 2008 he would come with us to the hospital, and was able to answer the doctor’s questions during the visit, but when we arrived back home he didn’t know where he had been.
A few months ago we tried to get him to wear a heart monitor to record a day’s activity but he removed it overnight, not remembering what it was for. Yesterday my sister took him to see the specialist at the Radcliffe who, after some deliberation, recommended installing a pacemaker. When this was originally suggested I was against the idea, thinking that it is a major operation which would be most likely to kill him. These days, however, it is a procedure which is done under local anaesthetic and requires at most an overnight stay in hospital. The hope is that increasing his heart rate, so that it is pumping more blood to his brain, will keep him more alert, which will in turn make him easier for my sister to manage. We worry whether it is the right decision because we are aware that, after every setback in his health, he tends not to be as good as he was before. The operation is scheduled for later in May, the decision has been made, and we will have to wait and hope for a good result!

Postscripts
15th June
My father had the pacemaker fitted on 11th June and came home on Sunday 12th.  He had a sleepy day on Monday but he has been walking around more confidently since.  Otherwise he is not much different from what he was a few months ago, before he started to fall much too frequently.  He certainly has not suffered a setback after the operation and I am hoping that he will still improve a little more.
28th November
Nearly six months later he has not improved much more, but he is much, much better than he was before the pacemaker! He has still fallen a few times, but that is when he loses his footing and there is nothing that you can do about it.  It has happened to both my sister and I when we were standing next to him and neither of us could stop him ending up on his knees!  Fortunately he has not suffered more than a minor graze so far.