SnakeCharmer, What a lovely response, thank you. I'm tearing up.

I am so sorry you and your husband are facing this, too. As a matter of fact, I received a packet of Advance Directives in the mail today. It is hard to focus on them but, as you note, it must be done.

I have felt anxious lately about the Sudden Cardiac Arrest possibility. I asked my heart doctor if I would more likely experience a gradual decline vs. Sudden Death. He said, "Sudden Death." So I'm kind of afraid to go to sleep... I try to process this, yet I remind myself I have only been admitted for heart failure one time, not counting the pacemaker and defibrillator implants. I mean, I'm doing ok, as long as try not to become to active. So it's kind of a mind screw. My defibrillator hasn't shocked me...and my doctor hasn't suggested hospice...so I take these all as good signs?

My focus in therapy has changed. Now we are talking about end of life issues...T wants to talk about spiritual issues, too..her idea.

I have been doing some research on heart transplant criteria and LVAD (heart pump) criteria. While I am not a candidate for heart transplant right now, I may be eligible for the heart pump when I become sicker. There are physical criteria and psychosocial criteria for both procedures. I admit I am worried about the psych criteria. I don't know what they mean about "underlying mental illness," below. Surely most people with long term heart issues have some degree of depression and anxiety? :

..."all VAD candidates should undergo evaluation by a trained mental health professional and social workers in order to ensure that they are able to receive adequate postoperative care and medications before the decision is made to proceed with the surgery. Psychosocial criteria that may predict a poor postoperative outcome include previous noncompliance, chemical dependencies (alcohol and drugs), lack of an adequate support system, personality disorder, underlying mental illness, organic brain disorders, or mental retardation."

Anyway, thank you if you have read this far. It has helped me to write it.

Best wishes,
Pre