Emergency Surgery


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Emergency Surgery

Postby HelpingDad » Sun May 07, 2017 7:27 am

So it's Friday evening and dad has been feeling ill all day, his primary doctor has been contacted earlier and he advised to only push liquids plus monitor for any changes. Around 10pm dad starts vomiting really really dark brown liquid, I have never seen this so I call the on duty triage nurse, dad gets medical through the VA. She says to transport to ER. After the ER does their thing, wonderful staff by the way, it's determined he has a femoral hernia and his bowel is kinked inside the pocket caused by the hernia. Surgeon called in and he tries to massage externally the bowel out of the hernia, he is only partially successful.

Now we are facing 2 options 1) surgery to fix it, which because of age and the CBD puts him at a high risk or 2) do nothing and hope it slips back into place on it's own. Option 2 is also very risky because the bowel could lose blood flow and tissue dies resulting in a infection, which will probably cause death.

Dad is semi-coherent so the choice is put to him but he doesn't seem to understand, I have PoA and healthcare so the decision is mine. Since time is not on his side I have to decide ASAP, risky surgery which he may not survive, be in bad health afterwards and require nursing home care OR let a man who's probably 5+ years into CBD get some final rest.... I choose surgery and it went ok. He is in ICU now resting with long road to healing ahead of him. Did I make the right decision.... I'll never know....

Ron
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Re: Emergency Surgery

Postby Robin » Sun May 07, 2017 5:22 pm

Ron,
Good work making a decision on your dad's behalf. So glad it turned out OK so far. Hope he can get back to baseline at some point soon.
Robin
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Re: Emergency Surgery

Postby HelpingDad » Tue May 09, 2017 8:20 pm

This morning, Tuesday, things were looking good.. Stomach tube and internal catheter were removed, talk of moving dad from ICU and possible discharge within a day or two. Nurse calls after dinner to let me know they introduced clear liquids and he started complaining of nausea, scan showed excessive fluid in stomach so the tubes put back in, along with catheter and all moves taken off the table for now.

Ron
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Re: Emergency Surgery

Postby Robin » Tue May 09, 2017 10:30 pm

I found that's how it was with my dad -- one step forward, a half a step back.
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Re: Emergency Surgery

Postby HelpingDad » Mon May 22, 2017 7:29 pm

Dad ended up being in the hospital 13 days. The bowel just wouldn't awake up and function correctly. They actually ended up using a PICC line and get him nourishment via TPN. I had my reservations since that is a glorified feeding tube, which dad said he didn't want, but I went with it. My reasoning was if the bowel never functions correctly it could be removed but if they did start working in a few days least it gave him a better chance since he wouldn't be starving.

Three days after discharge dad is noticeably weak and speech much worse. He can't stand at all now, even with help his legs just collapse. Thankfully I already had a hoyer lift so all moves are done using it now. The surgery and medical teams, p/t and social worker at hospital all say dad is a candidate for nursing home, we've not made any decision on that yet.

Ron
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Re: Emergency Surgery

Postby Robin » Tue May 23, 2017 11:58 am

Ugh. Sorry to hear this. We were on this same path ten years ago. Have you been nursing home shopping yet? If your dad is on Medicare, Medicare will pay for a few weeks at the nursing home, if the move to a nursing home is made soon.
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Re: Emergency Surgery

Postby HelpingDad » Tue May 23, 2017 12:58 pm

I applied, with dad's consent, to the local VA run nursing home. Dad's application was approved in early March, with a 12-16 month waiting list. I called them and he is only 3-4 months now. Since he is going to the Max Care unit they have the quickest opening rate, unfortunately. I plan on visiting the facility real soon and everyone I have spoken with say it's nice. One bonus is it's only 15-20 minutes from me.

Ron

PS my previous post about no decison on nursing home wasn't very accurate. No decision to move him right now has been made is more accurate. We had started the balling rolling since the wait times at VA are so long.
HelpingDad
 
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Re: Emergency Surgery

Postby HelpingDad » Sat Jul 08, 2017 7:33 pm

Figured it is about time for an update since surgery was 2 months ago.

Since last post dad has seen his Neurologist, surgeon and optometrist. The surgeon says everything looks good and no need to come back unless complications arise. Optometrist could not get his chin to stay on the vision test machine without pain so she just did a simple test. His left eye does wander some but since it's random prism glasses won't help. He has a pair of reading glasses and a slight distance correction pair. At age 75 his vision is better then mine! Now the neurologist poked, prodded and asked questions for about half an hour. When he was finished his comments were dad is in the latter stage, nothing medically can be done as far as neurology goes and he put in a consult for palliative care to do an evaluation. The evaluation is next week.

Dad never bounced back to his pre-surgery baseline and if a hoyer lift wasn't available he'd be bed ridden. His right side, especially arm, has become really ridged and his right leg wants to cross over the left all the time. At meal times he appears to fall asleep while being fed, I've asked about this and he says he is having a hard time getting his mouth to open so he closes his eyes to concentrate. I guess it's working as he eats normal food still, just really small pieces.

Ron
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Re: Emergency Surgery

Postby Robin » Sun Jul 09, 2017 3:55 pm

Ron,
Thanks for the update. Sounds like your dad is hanging in there. Does he actually fall asleep at the table or has his eyes closed only?
Robin
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Re: Emergency Surgery

Postby HelpingDad » Sun Jul 09, 2017 7:24 pm

I think he is just closing his eyes but he has to be reminded it's meal time so he continues to eat or he may fall asleep.

Ron
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