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Warrick is a practicing cardiologist and author with a passion for improving care by helping patients understand their heart health through education. Warrick believes educated patients get the best health care. Discover and understand the latest approaches and technology in heart care and how this might apply to you or someone you love.

Hi, my name is Dr. Warrick Bishop and I'd like to welcome you to my consulting room. Today, I'd like to share with you a personal experience, which is in regard to a patient I've looked after now for many years. Today, unfortunately, Tom passed away.

Tom was 89 years of age, and I've looked after him for over 15 years. The main reason that I've been involved with his care is in regard to his aortic valve. I monitored Tom up until the time that he needed the valve replaced, guided him through that process, and I've been following him up ever since. A couple of years ago, Tom had a busy year with cancer. This took a lot out of him. He's an intelligent man who continued to live independently with his wife, but he was starting to get frail.

I saw him just in recent weeks with increasing frailty, but also with increasing problems with fluid retention due to his heart but also problems with his kidneys which were starting to fail. Tom came into hospital about 10 days ago, really to try and help with the balance between his heart failure requiring and need to take fluid off and balancing that off against how his kidneys were working which really needed plenty of fluids and good blood pressure. It's a fine line, balancing up heart failure and what the kidneys need. Unfortunately, in the 48 hours prior to Tom passing away, he had significant blood loss into his gullet from ulcers which can come as people get stressed and run down.

Tom was blessed in that he had a family who loved and supported him, but most importantly, they were prepared for the final admission; the last time that Tom would come into the hospital. They understood the difficulty with frailty and the difficulty with different organs coming to the end of their functional capacity. Although Tom passed away at 89 years of age, up until his last admission, he'd been living independently with his loving wife, and active mentally and physically. As best as possible, maintaining his independence.

In his final stages, he passed peacefully, and with dignity. At the end of it all, there was very little I believe we can hope for when death comes. When our last admission is booked in. I think we can hope to have a long life, and Tom certainly did. I think we can hope to have a good life and do some good things, and there is no question this man also achieved that. We want to die before our children. And anyone who has children knows exactly what I mean. It is the way of nature that our children should bury us, not the other way around. Tom succeeded there also.

Lastly, if at all possible, we want to die with dignity. And I'm pleased to say that for Tom that was the case. The last submission. Our time of death occurs and will come for everyone. It is important that we think about it. It is important that we have some understanding and that as a family we understand how to support each other in this unavoidable process of life and death.

I really just wanted to share that with you today. For me, I found it emotional and sad to say goodbye to someone who is both a patient and a friend.

As always, I wish you the very best. Take care and good health. Bye for now.

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