Our father, Saifuddin Kisat, came to United States in his early fifties to provide a bright future for his family. Like many other immigrants, he spent his early years working day and night to take care of his family, keeping his own health at the back burner. About five years after his move, he suffered a massive heart attack requiring three vessel coronary bypass surgery. He was also diagnosed with type 2 diabetes. It is likely that he had diabetes long before he was diagnosed. His hga1c at the time of diagnosis was over 13. Although he started to sporadically take medicine, he was still unable to afford continuous care for his diabetes or heart disease.
Five years later, he had another heart attack. It was found that he had Diffuse Small Vessel Disease which is common in South Asians. This meant that smaller branches of his blood vessels supplying the heart were blocked, so despite his previous surgery to open his big coronary arteries, his heart was still not getting enough blood due to the blockade of smaller arteries. His kidney function also started to decline.
For next 10 years he had several small vessel stents placed every 2-3 years. His diabetes was better controlled; he was taking insulin injections, Over the next few years his kidney function continued to worsen. He had persistent lower extremity cramps and pain due to peripheral vascular disease.
He had progressive decline in kidney function and developed end stage renal disease requiring dialysis. His heart disease had progressed significantly. He had developed heart failure. He was advised surgery for his feet, but he could not go for surgery until he had a defibrillator placed which would protect his heart from going into cardiac arrest.
While waiting to get the defibrillator his condition worsened, and the gangrene in his feet started spreading to his lower extremities. I grieved with my family when doctors told us there was no choice but to remove both his limbs due to the Gangrene. Sadly, he passed away the day before the surgery could occur.