Oldest patient

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nimbus

nimbus

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What’s the oldest patient you’ve taken care of? Recently had a 106 year old for a distal femur fracture. They were physiologically healthier than a lot of my patients in their 50s and 60s. Patient was Spanish speaking so I couldn’t ask in depth about their health regimen. Previous oldest have been a few 102 year olds.
 
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OR 100, ICU 104 and pain 99. I'm not sure I want to live that long. Even with all my faculties relatively intact.
 
DrN2O said:
Was it the unresolved chest pain/heart burn after CABG that tipped off the cardiologist?
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Not sure if it’s true but I once heard a story about a guy who got a shoulder scope for his angina.
 
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DrN2O said:
Was it the unresolved chest pain/heart burn after CABG that tipped off the cardiologist?
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No, he lost a lot of weight because he had pain while eating. Prob had symptoms before the cabg but it was Russian so some things prob got lost in translation.
 
101. Guy had survived an open AAA at somewhere around 95. He fell and had periprosthetic femur fracture. I did a spinal and he did great.

I had 3 hip fractures in one day all over 90.
 
106 was my oldest. Born in 1909. Did them in 2016 I think. Hip. Just moved to Florida from San Diego. I’m sure they dead now.

I did a 103 a few months ago. Another hip pinning.
 
nimbus said:
So I ran into the hospitalist who was taking care of the 106yo. She said the family told her that her special sauce was “never getting married” 😂
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Single women tend to live longer (think of the golden girls )

Single men don’t live as long.
 
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aneftp said:
Single women tend to live longer (think of the golden girls )

Single men don’t live as long.
Click to expand...

Men are life suckers.
 
Within the same 5 hr span I had a 96 yo bipolar hip and a 102 bipolar hip. Surgeon had an 87 yo the next day and I said, “Cmon man. I thought we were going for 108”
 
In the past year I had a 95 yo for an elective hip. I kinda rolled my eyes when I saw a patient that age for an elective hip. I went to the pre op area to see the patient and he was supposed to be in slot 8. I looked in slot 8 and saw an elderly guy on the stretcher, same elderly guy I saw walk in fully upright at a fairly brisk pace without assistance. No way was this my guy. I checked with the nurse and sure enough this was my guy. He looked 70 tops, only had HTN and BPH, and was so mentally clear it was amazing. He told me all about his life, what he had done for a living and various other things. It is really remarkable how some people age so well.
 
dchz said:
The oldest cabg: 96 years old.

He was pretty healthy until he bounced back with esophageal cancer.
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Wtf

The one year mortality of just turning up to preop is > 50%
 
laserbeam said:
Who is the oldest anesthesiologist?
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Until 2 years ago our group had a mandatory retirement age of 70. I know a pediatric anesthesiologist who through hiked the Grand Canyon on his 70th birthday but was forced to leave our group and worked at the local U for a couple more years. We have since stopped forcing people to leave because another medical group in town was sued by 2 of their doctors for age discrimination and lost.

We have had a couple of surgeons at our hospital who worked longer than they should have. One ENT was very frail, living in an assisted living facility but still taking call. He finally retired at the beginning of the pandemic at age 84 and died 2 years later at age 86.
 
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dchz said:
Everyone's CABG is too old unless it's my CABG, huh??

I hope you will voluntarily save the healthcare dollars when you're 90!
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I don’t think I actually said or implied any of this, but yes, towards the end of my life I wouldn’t undergo a procedure with little chance of benefitting me. Not that it should be up to the patient.

It’s not ageist to question the benefit of very invasive interventions in a group that statistically does not live very long. I’ve seen plenty of “healthy” noneganarians who immediately go down the spiral of weakness and delirium straight after their op and eventually end up dead or DC to a care facility.
 
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Radetzky said:
I don’t think I actually said or implied any of this, but yes, towards the end of my life I wouldn’t undergo a procedure with little chance of benefitting me. Not that it should be up to the patient.

It’s not ageist to question the benefit of very invasive interventions in a group that statistically does not live very long. I’ve seen plenty of “healthy” noneganarians who immediately go down the spiral of weakness and delirium straight after their op and eventually end up dead or DC to a care facility.
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Man, glad you're so anonymously honorable behind a keyboard. However, I wouldn't never hold it against you if you decide the benefit outweighs the risks of a cabg for you at any age, especially if your surgeon agrees. Because people don't practice medicine in a vacuum or in actuary tables.

We try to make the best decision with the information we are given.

Don't know how the thread got hijacked into a virtue-signaling contest. For the record, this is a 15-star program with excellent patient selection. The patient was a very spry 96 year old. It did not even cross my mind this pt shouldn't be getting a cabg. His cabg recovery was great, discharged post op day 4.

Obviously if we knew the pt was going to develope cancer immediately after the surgery, we would not have done the surgery. But it's extremely myopic to think you know the right decision simply because you saw some "noneganarians who immediately go down the spiral of weakness".
 
dchz said:
Man, glad you're so anonymously honorable behind a keyboard. However, I wouldn't never hold it against you if you decide the benefit outweighs the risks of a cabg for you at any age, especially if your surgeon agrees. Because people don't practice medicine in a vacuum or in actuary tables.

We try to make the best decision with the information we are given.

Don't know how the thread got hijacked into a virtue-signaling contest. For the record, this is a 15-star program with excellent patient selection. The patient was a very spry 96 year old. It did not even cross my mind this pt shouldn't be getting a cabg. His cabg recovery was great, discharged post op day 4.

Obviously if we knew the pt was going to develope cancer immediately after the surgery, we would not have done the surgery. But it's extremely myopic to think you know the right decision simply because you saw some "noneganarians who immediately go down the spiral of weakness".
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Again, not sure at which point I’ve virtue signalled? We’re just debating a difference of opinion, no hijacking involved.

All I’m pointing out is that healthy 96 yr olds are not that healthy even if they seem to be. I think it’s crazy to offer these pts surgery, you disagree. Lets leave it at that.
 
Radetzky said:
Again, not sure at which point I’ve virtue signalled? We’re just debating a difference of opinion, no hijacking involved.

All I’m pointing out is that healthy 96 yr olds are not that healthy even if they seem to be. I think it’s crazy to offer these pts surgery, you disagree. Lets leave it at that.
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What about TAVR? For some of these people, one could even look at it as a palliative procedure.
 
nimbus said:
What about TAVR? For some of these people, one could even look at it as a palliative procedure.
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All of my 10th decade patients are TAVRs, or hip fracture that could use a TAVR. If you look at the actuarial life table from SSA, life expectancy does NOT drop under 1 year until one is 113 yo.
 
Nothing like major surgery to make someone feel their age. Have done many patients in their upper 90s.
 
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