My mom is 90. She has some dementia but is able to communicate and talk. She had several utis lately. She bounced back from them except the last one and she became weak while waiting for the culture to come back. Usually a few days. She was also doing physical therapy to get stronger. The other day she was vomiting and her white blood cell count was elevated. Went to hospital they found that she had a hiatal hernia and her stomach is up there pretty high in her diaphragm and the end is twisted. So they were going to do emergency surgery. Then tonight they were checking the placement of the NG tube she has in her nose down to her stomach and found pneumonia on the xray. Now she can't get the surgery. At least not now or until she recovers from pneumonia. Which now she will be in bed longer can’t eat or drink and is weak. The surgery was urgent. Not getting the surgery is detrimental for her. I'm very concerned and worried. Has anyone had anything similar or know anything that could be helpful? Thank you!
There are many factors here. I often saw the situation you are dealing with which is basically an obstruction. The NG tube is down to keep everything emptied and the hope is that it may untwist itself, but the sad fact is that the hiatal hernia, which causes huge amounts of upward pressure on stomach and small intestines, may prevent the twist from fixing itself. The longer the "twist" is there, the more danger of infection and death of portions of the bowel. The fact that pneumonia is now on the scene makes this all much much more complicated. I am certain the surgeon already told you that a surgery this involved and complicated is already dreadfully hard for a 90 year old to survive. Now with the complication of lungs which MUST BE strong for the anesthesia? Well, this is touch and go.
If I am being brutally honest with you, your mom may not, given the fragility of heart and lungs that are failing with age, be able to survive this. She may never make it to surgery. She may not survive surgery. If she does somehow miraculously survive surgery she may never come out of anesthesia, may be unable to heal. Her organs could shut down due to sepsis from now a multitude of cause whether kidney, lungs or intestines.
I am so very sorry. As a nurse I would not be able to reassure you at all. The doctors, if you wish treatment, will take this a step at a time, fighting whatever system is under the onslaught of failure, but they may tell you at some point that the fight is too torturous and too cruel for someone of this age to be expected to make. Consider whether or not you would be willing to allow your mother to be medicated out of her agony and put at peace with Hospice end of life care if the doctors tell you they can do no more.
I am so very sorry. The more awful news is that once this happens it can happen over and over. I read a wonderful book by Gretchen Steabler called MotherLode. She cared for her mom 90s to I think it was 104. Her mom had frequent obstructions, until the final one they just could not fix. I recommend her book to you.
Being 90 and having two serious medical crises is tough. Please prepare for the worst and pray for the best. It only takes 1 medical crisis for everything to change at this age. Anesthesia does make dementia worse, it could be a permanent step down, so prepare for a different situation after the surgery.
I pray that God's will be done in this situation. This is never easy to go through, remember to eat well and rest to take care of you too.
If it were my mom who wasn't eating or drinking and was very weak, I don't think I'd want her going through any surgeries as to me that would only make matters worse.
Sadly this situation sounds like a damned if you do and damned if you don't situation.
I pray it all works out as it should.
Keep us posted
Mom sounds in pretty rough shape. I hope she is not in pain.
Pneumonia is very serious but can often clear up relatively soon. I’m not sure how long she would have to wait for surgery after her lungs are clear. Hopefully not long. Have the doctors given you any idea?
I was in the ER a few years ago with some mystery symptoms. Lots of tests and when they finally said pneumonia they had a reason to hospitalize me. My pneumonia was gone the very next day. But since the pulmonologist was brought in (at my request) he gave me a few tips. The main one was to get out of the bed and sit up. But I didn’t have a twisted stomach….so all has to be considered.
The IV will keep her hydrated and nourished. The weakness I suppose goes with the territory. Those UTIs can be awful and it sounds like she has had her share of them.
I’m very sorry. I know you must be very worried and with good reason. Are you alone at the hospital with mom? I will be thinking of you. Post here at any time. We will keep watch with you. Big hugs for you and mom.