any medical peeps here?
03 January 2007, 10:10 PM
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any medical peeps here?
Long post so make yourselves a cup of tea
Dad got rushed in to hospital on christmas day as he collapsed and had black outs, he was also incoherent for a bit when he came round.
He has been having these turns for a good few months but since christmas day he has been having the blackouts where previously he would feel his legs begin to tremble and he would get down on the floor so he didnt fall, but all the time he was aware of what was going on.
The doctor thought it may have been some of his medication causing low blood pressure so they reduced the dose, however no change, they also fitted a blood pressure monitor on him for 24hrs which checked his pressure every hour during the day, and then every 2 hours at night time. I didnt see the point in this to be honest as if he is sat down then his blood pressure is fine, it was only occasionaly when he got up that it dropped, and if the monitor wasnt operating at that time then it wouldnt pick anything up. Shock horror the check came back "normal"
The hospital dont seem to be doing anything apart from assessing him in their assessment centre (a flat type layout with kitchen and bathing facilities etc) on the day of his assessment he didnt have any collapse so the hospital were going to send him home without finding out the cause of his problem. We made it clear he was not to be released as he lives on his own and it could be hours before anyone knows anything is up if he collapses and blacks out. He is apparantly though seeing the consultant tomorrow (10 days after being admitted)
When in A&E on christmas day, the doctor checked his heart with her stephoscope and said there was some noise there and it could be a problem with a valve, however she did say that it wouldnt cause the problems that he is having.
He is 75yrs old, and is in general poor health. He had to retire from work when in his late 40's due to a chronic back problem and he then looked after his mum during the day who was house bound/ bedridden as she had suffered a major stroke.
He has angina which prevents him from now doing any exercise, so this has caused him to put on weight (he is currently 14st 9 and is approx 5ft 6 tall) He also smokes upto 15 hand rolled ciggies a day and drinks upto 2 cans of beer per night (either guiness or carlsberg)
HAs anyone got any idea of what can be the problem.?
I look at epilespy but his symptoms dont really match that, they are more in common with postural(orthostatic) hypotension. I did suggest to the doctor in a&e about maybe giving him salt tablets but she laughed that off and said that would raise his pressure to much and high pressure is worse than low (I know that is right however if the salt intake was monitored then surely it would be an improvement)
To top it off, my dad is in a ward and some of the people appear to have mental issues (not on a geriatric ward) and this now seems to be affecting him as he is getting confused, forgets names, and when I told him that I wouldnt be able to make it tomorrow and that it would be friday, he said that he will try to stay alive until then. He didnt look like he was joking.
Sorry for the long post but not getting any joy at the hospital so was just wondering if there were any doctors / consultants on here
Cheers for any replies
Dad got rushed in to hospital on christmas day as he collapsed and had black outs, he was also incoherent for a bit when he came round.
He has been having these turns for a good few months but since christmas day he has been having the blackouts where previously he would feel his legs begin to tremble and he would get down on the floor so he didnt fall, but all the time he was aware of what was going on.
The doctor thought it may have been some of his medication causing low blood pressure so they reduced the dose, however no change, they also fitted a blood pressure monitor on him for 24hrs which checked his pressure every hour during the day, and then every 2 hours at night time. I didnt see the point in this to be honest as if he is sat down then his blood pressure is fine, it was only occasionaly when he got up that it dropped, and if the monitor wasnt operating at that time then it wouldnt pick anything up. Shock horror the check came back "normal"
The hospital dont seem to be doing anything apart from assessing him in their assessment centre (a flat type layout with kitchen and bathing facilities etc) on the day of his assessment he didnt have any collapse so the hospital were going to send him home without finding out the cause of his problem. We made it clear he was not to be released as he lives on his own and it could be hours before anyone knows anything is up if he collapses and blacks out. He is apparantly though seeing the consultant tomorrow (10 days after being admitted)
When in A&E on christmas day, the doctor checked his heart with her stephoscope and said there was some noise there and it could be a problem with a valve, however she did say that it wouldnt cause the problems that he is having.
He is 75yrs old, and is in general poor health. He had to retire from work when in his late 40's due to a chronic back problem and he then looked after his mum during the day who was house bound/ bedridden as she had suffered a major stroke.
He has angina which prevents him from now doing any exercise, so this has caused him to put on weight (he is currently 14st 9 and is approx 5ft 6 tall) He also smokes upto 15 hand rolled ciggies a day and drinks upto 2 cans of beer per night (either guiness or carlsberg)
HAs anyone got any idea of what can be the problem.?
I look at epilespy but his symptoms dont really match that, they are more in common with postural(orthostatic) hypotension. I did suggest to the doctor in a&e about maybe giving him salt tablets but she laughed that off and said that would raise his pressure to much and high pressure is worse than low (I know that is right however if the salt intake was monitored then surely it would be an improvement)
To top it off, my dad is in a ward and some of the people appear to have mental issues (not on a geriatric ward) and this now seems to be affecting him as he is getting confused, forgets names, and when I told him that I wouldnt be able to make it tomorrow and that it would be friday, he said that he will try to stay alive until then. He didnt look like he was joking.
Sorry for the long post but not getting any joy at the hospital so was just wondering if there were any doctors / consultants on here
Cheers for any replies
03 January 2007, 10:48 PM
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Could be too many things to really do justice to here mate. If he is really blacking out then top causes might be
1) Anything brain related ie TIAs(mini strokes)
2) Heart related ie normal rythmn of the heart disturbed for a few moments which cuts of blood supply to brain and so has turn
3) Hypoglycemia ie blood sugar drops and so brain shuts off
4) Related to medicines he is on
But could be so many things. It may not seem as though the hospital is doing much but they will run through all the tests to try and get to the bottom of the cause.
All the best
1) Anything brain related ie TIAs(mini strokes)
2) Heart related ie normal rythmn of the heart disturbed for a few moments which cuts of blood supply to brain and so has turn
3) Hypoglycemia ie blood sugar drops and so brain shuts off
4) Related to medicines he is on
But could be so many things. It may not seem as though the hospital is doing much but they will run through all the tests to try and get to the bottom of the cause.
All the best
04 January 2007, 01:22 PM
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24 hour ECG, echocardiogram and a CT head might be some investigations to ask about given what has been written.
If nothing found, then it comes to practicalities - eg community alarm, home helps etc.
If nothing found, then it comes to practicalities - eg community alarm, home helps etc.
04 January 2007, 03:50 PM
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Originally Posted by john banks
24 hour ECG, echocardiogram and a CT head might be some investigations to ask about given what has been written.
If nothing found, then it comes to practicalities - eg community alarm, home helps etc.
If nothing found, then it comes to practicalities - eg community alarm, home helps etc.
Just got a call this afternoon, they are now appearing to do something, he is booked in for a CT scan tomorrow morning, and they are also doing the 24hr ECG trace. Hopefully that will monitor his ECG all of the time instead of every hour like the 24hr blood pressure test he has had done previously.
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04 January 2007, 03:59 PM
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Yes the 24 hour ECG is continuous electronic monitoring, electrical anomalies (arrhythmias) are relatively common with angina as poor blood supply to the heart muscle can also affect nerve conduction. The suggestion of the echocardiogram was because of the heart murmur that the casualty doc heard - it may just be age related aortic sclerosis (one of the more common murmurs), but my simple GP mind suggests to me that any murmur that is heard in the context of collapsing/blackout episodes should have the pressure gradient across the aortic (or other) valve measured.
05 January 2007, 09:09 PM
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update, he has had the ct scan, and all that shown was some narrow blood vessels but that is "normal" and nothing to worry about. He has currently got the ecg thing attached and that is due to come off tomorrow. Now however he is suffering from very high blood pressure, i didnt get a chance to look at the chart for the exact reading but my sister did and it was over 200! however when he moves it drops right down so they have now confined him to bed. He is also seeing things and his confusion has gotten worse
Is this sounding more like a heart related problem? The nurses on duty didnt seem to know and to be honest didnt seem to care however thats probably because between them they are looking after 3 wards and a few rooms so they are obviously very busy/overworked etc so not having a pop at them.
Is this sounding more like a heart related problem? The nurses on duty didnt seem to know and to be honest didnt seem to care however thats probably because between them they are looking after 3 wards and a few rooms so they are obviously very busy/overworked etc so not having a pop at them.
05 January 2007, 10:17 PM
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Originally Posted by J4CKO
First question I would ask is whats in them 15 hand rolled ciggies ?
Originally Posted by D.K.1
Hope he gets better soon 
Originally Posted by Jonno_johnson
No doctor here but i hope it all works out for your dad mate
thanks
05 January 2007, 10:50 PM
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Confusion may or may not be a part of the original problem. The elderly tend to get confused in hospital anyway due to unfamiliar surroundings, sleep deprivation and disturbance to their usuall quite rigorous routines.
All the best
All the best
05 January 2007, 11:28 PM
#15
I think diagnosis via Scoobynet is very difficult and both John & Singh have covered the obvious causes of collapse and transient episodes of confusion.
My advice of dealing with hospital consultants is get a definiative diagnosis from them, don't be fobbed off with any old rubbish.
The symptoms you describe sound like hypoxia, a lack of oxygen to the brain.
I would consider some form of arrythmia (AF, VT or SVT but self-limiting) and these can normally be treated chemically (medication) or electrically (IED) Otherwise something along the lines of an occulsion, or a reduction in the blood supply to the brain, TIA, PE (unlikely but risk factors) or postural hypotension. Also consider C0 poisoning, but this would not explain the confusion in hospital.
Best bet is to hassle the Medical team looking after him
My advice of dealing with hospital consultants is get a definiative diagnosis from them, don't be fobbed off with any old rubbish.
The symptoms you describe sound like hypoxia, a lack of oxygen to the brain.
I would consider some form of arrythmia (AF, VT or SVT but self-limiting) and these can normally be treated chemically (medication) or electrically (IED) Otherwise something along the lines of an occulsion, or a reduction in the blood supply to the brain, TIA, PE (unlikely but risk factors) or postural hypotension. Also consider C0 poisoning, but this would not explain the confusion in hospital.
Best bet is to hassle the Medical team looking after him
20 January 2007, 10:09 PM
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results have been back from the heart trace thing came back okay (a few moments but they said nothing that would cause his problems and would just be down to his age)
My dad had problems also keeping down food, he has had an endoscopy and they have found a stomach ulcer so they took a biopsy of that at the time. They are still no nearer to finding out the problem with regards to his low blood pressure.
He is now having blackouts on a daily basis when he gets up, not every time but his legs always go weak after a few yards of movement. The hospital are now thinking of putting him into care, but if he goes in he will not get out. His mental condition has also worsened, a few days ago he though he was in a pub and that the visiting bell was last orders.
We can get no joy whatsoever from the consultant (who isnt even based at the same hospital - calls are not returned etc, and the nurses generally say we need to speak with the consultant)
Anyone any ideas on further tests that could be carried out to identify the cause of the low blood pressure problem or what we could do about the current consultant, ie how do we get someone else to look at him etc.
Any help or advice greatly appreciated
My dad had problems also keeping down food, he has had an endoscopy and they have found a stomach ulcer so they took a biopsy of that at the time. They are still no nearer to finding out the problem with regards to his low blood pressure.
He is now having blackouts on a daily basis when he gets up, not every time but his legs always go weak after a few yards of movement. The hospital are now thinking of putting him into care, but if he goes in he will not get out. His mental condition has also worsened, a few days ago he though he was in a pub and that the visiting bell was last orders.
We can get no joy whatsoever from the consultant (who isnt even based at the same hospital - calls are not returned etc, and the nurses generally say we need to speak with the consultant)
Anyone any ideas on further tests that could be carried out to identify the cause of the low blood pressure problem or what we could do about the current consultant, ie how do we get someone else to look at him etc.
Any help or advice greatly appreciated
20 January 2007, 10:23 PM
#17
results have been back from the heart trace thing came back okay (a few moments but they said nothing that would cause his problems and would just be down to his age)
My dad had problems also keeping down food, he has had an endoscopy and they have found a stomach ulcer so they took a biopsy of that at the time. They are still no nearer to finding out the problem with regards to his low blood pressure.
He is now having blackouts on a daily basis when he gets up, not every time but his legs always go weak after a few yards of movement. The hospital are now thinking of putting him into care, but if he goes in he will not get out. His mental condition has also worsened, a few days ago he though he was in a pub and that the visiting bell was last orders.
We can get no joy whatsoever from the consultant (who isnt even based at the same hospital - calls are not returned etc, and the nurses generally say we need to speak with the consultant)
Anyone any ideas on further tests that could be carried out to identify the cause of the low blood pressure problem or what we could do about the current consultant, ie how do we get someone else to look at him etc.
Any help or advice greatly appreciated
My dad had problems also keeping down food, he has had an endoscopy and they have found a stomach ulcer so they took a biopsy of that at the time. They are still no nearer to finding out the problem with regards to his low blood pressure.
He is now having blackouts on a daily basis when he gets up, not every time but his legs always go weak after a few yards of movement. The hospital are now thinking of putting him into care, but if he goes in he will not get out. His mental condition has also worsened, a few days ago he though he was in a pub and that the visiting bell was last orders.
We can get no joy whatsoever from the consultant (who isnt even based at the same hospital - calls are not returned etc, and the nurses generally say we need to speak with the consultant)
Anyone any ideas on further tests that could be carried out to identify the cause of the low blood pressure problem or what we could do about the current consultant, ie how do we get someone else to look at him etc.
Any help or advice greatly appreciated
Hi mate, sorry to hear about all the problems your poor dad is having. From a logical point of view low pressure indicates deficiencies in the pump i.e the heart. As John has already alluded to there will also be narrowing of some arteries given your dad's age. These combined factors are probably the cause of the blackouts. With regard to consultant woes, the only realistic option would be to go private but that won't be cheap.
All the best
20 January 2007, 10:42 PM
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Hi there, sorry to hear of all the problems your Dad is having. I can't help you with what might be causing this but I must say I am disgusted at the behaviour of the consultant.
What I would do if it were my Dad would be to find out where the consultant is based and go there and make sure you see him/her if you get my drift. I know they are busy people and often overstretched, but at the end of the day, despite it being a cliche, we all pay into the NHS and hence deserve something back when the time arises. He/she has no right to ignore your calls repeatedly and I would make him/her very aware that you are not going to be fobbed off and that you want your Dad to be given the best posible treatment etc.
Just my 2 cents worth.
What I would do if it were my Dad would be to find out where the consultant is based and go there and make sure you see him/her if you get my drift. I know they are busy people and often overstretched, but at the end of the day, despite it being a cliche, we all pay into the NHS and hence deserve something back when the time arises. He/she has no right to ignore your calls repeatedly and I would make him/her very aware that you are not going to be fobbed off and that you want your Dad to be given the best posible treatment etc.
Just my 2 cents worth.
20 January 2007, 11:12 PM
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Non-medic completely but I have to repeat what I said in your other thread. My father-in-law had very similar symptons and they fitted a pacemaker which seemed to sort it out completey. But I see he has had a trace..... All the best for him and don't give up asking.
20 January 2007, 11:20 PM
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Again Scoobynet diagnosis is impossible, but it does sounds like he has postural hypotension leaving him with excessive BP when lying/sitting and low BP when standing up. It is a shame that stopping/reducing doses hasn't helped.
Other than drug causes it is good to try to find an underlying reason if it is present.
I think you deserve a discussion with the consultant/team before considering placement. Asking for a case conference with the medical/nursing/physio/OT/social work/you present would be a good way forward?
Other than drug causes it is good to try to find an underlying reason if it is present.
I think you deserve a discussion with the consultant/team before considering placement. Asking for a case conference with the medical/nursing/physio/OT/social work/you present would be a good way forward?
22 February 2007, 02:33 PM
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update
Spoke with ward doctors and they ruled out the care option, saying it would not be safe etc due to my dads condition. A cardioligist has done further tests and also a neuroloigst. Consultant has been hard work when we have met with her. The neroligist on the 2nd scan said that he possibly had epilespy as there was something showing on the brain (first scan shown narrow blood vessels) so they have started medication for epilepsy.
We have been informed today that there are no more tests to run by either cardioligst or neuroligst, and everyone is completely at a loss (medical mystery!)
They also told us that they have started him on new medication that isnt even licensed yet to see if that will sort out his blood pressure. They say this is a last resort. I dont yet have the name of this medication, but it has had clinical trials and is just awaiting a license for use (apparently this can take years), however they said they can use it if 3 doctors/consultants agree that it may be beneficial.
They have told us if it is going to work we will know within 3 weeks. With what they have said about it being a mystery we are hoping this drug works as it appears from what they said that there would be nothing else they could do for him.
My dad in himself is worse, they have now confined him to bed permanently, even if he just sits up he either has a fit or the starting of one (legs and arms trembling) He has had 2 recent falls one requiring stitches next to one of his eyes, and one requiring one of those stitch type plasters on his arm. His confusion is now awful, he thinks he is locked up in a police cell. Still seems to recognize us, but now the majority of the time he is aggressive and has told my sister and brother in law to "p!$$ off" a few times. He has also now lost over 2 stone since being in there, and his legs are like pencils now so probably no strength to support himself if he could stand without having a fit.
We were going to ask for a second opinion, however because so many doctors are/have been involved how would we get this without getting the same answers?
Really at a loss and me and my sister (and family) are dreading it as he is just going downhill.
Spoke with ward doctors and they ruled out the care option, saying it would not be safe etc due to my dads condition. A cardioligist has done further tests and also a neuroloigst. Consultant has been hard work when we have met with her. The neroligist on the 2nd scan said that he possibly had epilespy as there was something showing on the brain (first scan shown narrow blood vessels) so they have started medication for epilepsy.
We have been informed today that there are no more tests to run by either cardioligst or neuroligst, and everyone is completely at a loss (medical mystery!)
They also told us that they have started him on new medication that isnt even licensed yet to see if that will sort out his blood pressure. They say this is a last resort. I dont yet have the name of this medication, but it has had clinical trials and is just awaiting a license for use (apparently this can take years), however they said they can use it if 3 doctors/consultants agree that it may be beneficial.
They have told us if it is going to work we will know within 3 weeks. With what they have said about it being a mystery we are hoping this drug works as it appears from what they said that there would be nothing else they could do for him.
My dad in himself is worse, they have now confined him to bed permanently, even if he just sits up he either has a fit or the starting of one (legs and arms trembling) He has had 2 recent falls one requiring stitches next to one of his eyes, and one requiring one of those stitch type plasters on his arm. His confusion is now awful, he thinks he is locked up in a police cell. Still seems to recognize us, but now the majority of the time he is aggressive and has told my sister and brother in law to "p!$$ off" a few times. He has also now lost over 2 stone since being in there, and his legs are like pencils now so probably no strength to support himself if he could stand without having a fit.
We were going to ask for a second opinion, however because so many doctors are/have been involved how would we get this without getting the same answers?
Really at a loss and me and my sister (and family) are dreading it as he is just going downhill.
22 February 2007, 03:36 PM
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Sorry to hear of your Dad's ongoing trouble.
You may just get the same answers again with further opinions.
It isn't that uncommon that the elderly do deteriorate in this way I'm afraid. That is not meaning to be defeatist and to avoid looking for things that are reversible, but if nothing is found then it comes down to good nursing care and symptom relief. It is not pleasant to watch for a relative or caring professionals.
You may just get the same answers again with further opinions.
It isn't that uncommon that the elderly do deteriorate in this way I'm afraid. That is not meaning to be defeatist and to avoid looking for things that are reversible, but if nothing is found then it comes down to good nursing care and symptom relief. It is not pleasant to watch for a relative or caring professionals.
Last edited by john banks; 22 February 2007 at 03:39 PM.
22 February 2007, 03:48 PM
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sorry to hear about your dad my nan was a bit like this before she died but that was 3 years later. she had slight dementia but she was 84 and was a boarderline diabetic is there any chance he could be diabetic??
i hope everything works out for you and your dad
my nan was a bit like this before she died but that was 3 years later. she had slight dementia but she was 84 and was a boarderline diabetic is there any chance he could be diabetic?? i hope everything works out for you and your dad
22 February 2007, 04:00 PM
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Sorry to hear of your Dad's ongoing trouble.
You may just get the same answers again with further opinions.
It isn't that uncommon that the elderly do deteriorate in this way I'm afraid. That is not meaning to be defeatist and to avoid looking for things that are reversible, but if nothing is found then it comes down to good nursing care and symptom relief. It is not pleasant to watch for a relative or caring professionals.
You may just get the same answers again with further opinions.
It isn't that uncommon that the elderly do deteriorate in this way I'm afraid. That is not meaning to be defeatist and to avoid looking for things that are reversible, but if nothing is found then it comes down to good nursing care and symptom relief. It is not pleasant to watch for a relative or caring professionals.
22 February 2007, 06:36 PM
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Sorry to hear about your dad.
I notice he has seen a neurologist and a cardiologist.
Its difficult to offer advice over the net etc. But I would ask for a tilt test - to try and demonstrate neurally mediated syncope or " inappropriate heart rate with low blood pressure after prolonged standing". I assume he has had an transthoracic echo and a 24hr ECG recording which were normal.
Hope he gets better mate.
Porkerboy.
I notice he has seen a neurologist and a cardiologist.
Its difficult to offer advice over the net etc. But I would ask for a tilt test - to try and demonstrate neurally mediated syncope or " inappropriate heart rate with low blood pressure after prolonged standing". I assume he has had an transthoracic echo and a 24hr ECG recording which were normal.
Hope he gets better mate.
Porkerboy.
05 March 2007, 09:43 AM
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Cheers porkerboy
The medication they are now using is Midodrine and Sando-K, currently it is a low does of the midodrine (2mg) and they will be increasing it over the next few weeks to see what levels will help (if any). The only problem with the drug is it causes an increase in presure whilst stationary as well so if he isnt going to move for a few hours then he needs to be careful on if he takes it or not. As his blood pressure is high already when stationary. From the searching I have done on this medication it appears they are now treating him for Neuro postural hypertension.
In himself, he had another fall and cut his elbow, this then got infected and swelled literally double the size and was secreating lots of white puss. He is now on antibiotics for that (flux something or other) and these appear to be working as the swelling and redness have improved dramatically. His mental state continues to be up and down as well, and he is still confined to the bed.
The medication they are now using is Midodrine and Sando-K, currently it is a low does of the midodrine (2mg) and they will be increasing it over the next few weeks to see what levels will help (if any). The only problem with the drug is it causes an increase in presure whilst stationary as well so if he isnt going to move for a few hours then he needs to be careful on if he takes it or not. As his blood pressure is high already when stationary. From the searching I have done on this medication it appears they are now treating him for Neuro postural hypertension.
In himself, he had another fall and cut his elbow, this then got infected and swelled literally double the size and was secreating lots of white puss. He is now on antibiotics for that (flux something or other) and these appear to be working as the swelling and redness have improved dramatically. His mental state continues to be up and down as well, and he is still confined to the bed.
14 March 2007, 11:57 AM
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new update, Midodrine has been increased to 2.5mg (still a lot less than the 10mg that was used in trials and that is down to high blood pressure when stationary) but still no improvement. He is no longer on the Sando-K.
He had a swab taken from his elbow as it wasnt healing as fast as they had hoped and it turns out he has also got MRSA !! He is now on more antibiotics to treat this. He is now also yellow in appearance.
Doctors have said that if there isnt any improvement by the end of this week then there will be no improvment and that they will be then looking toward getting him discharged, so will probably end up in a home.
Mental state is poor, last night he was thinking he was at school and was waiting to go out on a school trip, but previous nights he has been "arrested for recieving stolen goods and locked up in jail", also though a visitor was his dad before he realised his dad had passed away 18yrs ago.
He had a swab taken from his elbow as it wasnt healing as fast as they had hoped and it turns out he has also got MRSA !! He is now on more antibiotics to treat this. He is now also yellow in appearance.
Doctors have said that if there isnt any improvement by the end of this week then there will be no improvment and that they will be then looking toward getting him discharged, so will probably end up in a home.
Mental state is poor, last night he was thinking he was at school and was waiting to go out on a school trip, but previous nights he has been "arrested for recieving stolen goods and locked up in jail", also though a visitor was his dad before he realised his dad had passed away 18yrs ago.
14 March 2007, 12:05 PM
#28
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Keep strong and don't forget to talk to people when you're feeling stressed, sad or angry........and whatever you do don't bottle it up or put on a brave face.........
DCI
DCI
14 March 2007, 12:24 PM
#29
Bad news Jay
It's not a nice thing to say but I hope it is quick with your father. My grandmother spent a long, painfull 3 year downwards spiral with dementia in a care home which was exhausting on the family and on her savings. When the end came it was such a release.
Best of luck fella
It's not a nice thing to say but I hope it is quick with your father. My grandmother spent a long, painfull 3 year downwards spiral with dementia in a care home which was exhausting on the family and on her savings. When the end came it was such a release.
Best of luck fella
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