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Medical question, but not Alt. Med.
Posted: 27 April 2007 03:00 AM   [ Ignore ]
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OK my aunt is in the hospital for bleeding ulcers.  It’s pretty bad, but I won’t get into graphic details about it for I know some people have weak stomachs.  Let’s just say she needed 3 rounds of blood through the jugglar and leave it at that.  She is now on fluids IV because even liquids give her problems.

She’s stable now, BUT they immediately took her off her anti-blood clotting meds which help prevent another stroke for her.  They are going to leave her off the med so that they can do surgery on her in the next few days- the med has to wash out of her system first.

While I understand why they have d/c her medicine, I’m worried what risk it poses to her in the meantime concerning another stroke.  Is she at risk for that too in the meantime?  What measures should they be taking to help prevent that given her situation?  Or are there none?

They aren’t going to release her anytime soon and they are monitoring every possible thing about her including the IV, which is now in her chest (PICT), which is very good, but I worry about the potential of her having a stroke even while on the operating table.  I realize it’s a risk they have to take given the situation, but I’m wondering the other risks she now faces.  :(  I gave her questions to ask her dr that she didn’t think of, but I’m sure there are some I didn’t think of and some I didn’t suggest because I didn’t want to worry her needlessly.

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Mriana
“Sometimes in order to see the light, you have to risk the dark.” ~ Iris Hineman (Lois Smith) The Minority Report

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Posted: 27 April 2007 03:00 AM   [ Ignore ]   [ # 1 ]
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Medical question, but not Alt. Med.

OK my aunt is in the hospital for bleeding ulcers.  It’s pretty bad, but I won’t get into graphic details about it for I know some people have weak stomachs.  Let’s just say she needed 3 rounds of blood through the jugglar and leave it at that.  She is now on fluids IV because even liquids give her problems.

She’s stable now, BUT they immediately took her off her anti-blood clotting meds which help prevent another stroke for her.  They are going to leave her off the med so that they can do surgery on her in the next few days- the med has to wash out of her system first.

While I understand why they have d/c her medicine, I’m worried what risk it poses to her in the meantime concerning another stroke.  Is she at risk for that too in the meantime?  What measures should they be taking to help prevent that given her situation?  Or are there none?

They aren’t going to release her anytime soon and they are monitoring every possible thing about her including the IV, which is now in her chest (PICT), which is very good, but I worry about the potential of her having a stroke even while on the operating table.  I realize it’s a risk they have to take given the situation, but I’m wondering the other risks she now faces.  :(  I gave her questions to ask her dr that she didn’t think of, but I’m sure there are some I didn’t think of and some I didn’t suggest because I didn’t want to worry her needlessly.

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“Sometimes in order to see the light, you have to risk the dark.” ~ Iris Hineman (Lois Smith) The Minority Report

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Posted: 27 April 2007 03:29 AM   [ Ignore ]   [ # 2 ]
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Mriana,

I’m sorry that you and your aunt are having to go through this. Obviously, I can’t give any medical advice, but I will say that doing surgery when a patient is on anti-coagulants is not an option, so it’s certainly sounds loke what they’re doing is necessary. And unfortunately, sometimes there are no perfect options when balancing different conditions that require opposing treatment. I would expect the strike risk to be a longer-term thing that the immediate concern about bleeding, so hoepfully she’ll be ok until things have healed and it’s safe to put her back on her maintenance meds. Difficult as it is for us intelligent, questioning freethinkers, sometimes all we can do is try to trust in the judgement of the people caring for us. Even with my background, I find myself having to do that with my daughter’s care providers all the time. I hope all goes well for her.

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Posted: 27 April 2007 03:59 AM   [ Ignore ]   [ # 3 ]
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George,

That was uncharacteristically snide and meanspirited of you. While there is room for discussion about whether Mriana’s and Occam’s remarks in Cory’s thread were politically correct or offensive to some, the place for that debate is in that thread. Responding as you did here, where she is asking for help about a family member’s ongoing medical condition is unkind and clearly inappropriate. Please confine you discussion of Cory’s question to the thread in which it was asked.[

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Posted: 27 April 2007 06:39 AM   [ Ignore ]   [ # 4 ]
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[quote author=“George”]Frankly, Mriana, I am surprised that you posted this before responding to Cory’s question . Why are bleeding ulcers “pretty bad” and Multiple Personality Disorder “funny”?

George, bleeding ulcers are VERY real, while there are questions about the authenticity of MPD.  If you do not think bleeding ulcers are real, then you can go help clean up the mess that left her unconcious and near dead because she lost so many fluids. She almost died that night.  Bleeding ulcers are not “pretty bad” they can be life threatening, like in my aunt’s case. She can’t even do liquids.  No one has ever died from MPD, fiction or not.  My aunt did almost die and according to the Medic that air-vac her, if my cousin had not found her when he did, she would have died.

Ulcers are NOT fiction.  Read up on them and you might learn something.  Then throw in the concerns about stroke and it’s no fun worrying about her.

Sorry, Brennon.  Thanks.  Yes, I know taking her off is the right thing to do, so that she will stop bleeding and all- that and you don’t want a bleeder in surgery.  I’m still wondering what risk that poses though to her having another stroke and how they help prevent one in the meantime- is montoring her vitals and alike enough to catch such a thing in time?

Maybe there is no answer.

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“Sometimes in order to see the light, you have to risk the dark.” ~ Iris Hineman (Lois Smith) The Minority Report

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Posted: 27 April 2007 07:09 AM   [ Ignore ]   [ # 5 ]
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Posted: 27 April 2007 07:14 AM   [ Ignore ]   [ # 6 ]
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George, I’m sorry if you took offense to my MPD remark, but if I remember correctly that thread did not start with that nor was it life threatening.

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Mriana
“Sometimes in order to see the light, you have to risk the dark.” ~ Iris Hineman (Lois Smith) The Minority Report

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Posted: 27 April 2007 07:16 AM   [ Ignore ]   [ # 7 ]
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Mriana,

I’m sure there are at least guidelines or principles the doctors use to manage situations like this, which probably aren’t unusual since so many people are on anti-coagulants and they are bound to need surgery sometimes. I, of course, don’t know the details since it’s out of my field. But I do know that communication is a huge part of medicine, so while you eventually have to trust the judgement of the doctors in situations where you don’t have the expertise yourself, you absolutely have a right to ask for and get as much information as you need to feel comfortable with the situation. If your aunt can’t ask these questions herself, you or someone else can certainly take on that job with the doctors. As you say, sometimes there is no perfect answer, but patients are entitled to all the information they need since ultimately they need to make the important decisions.

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Posted: 27 April 2007 07:21 AM   [ Ignore ]   [ # 8 ]
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Posted: 27 April 2007 07:27 AM   [ Ignore ]   [ # 9 ]
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George, let’s try to keep this thread on topic here.

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Posted: 27 April 2007 07:34 AM   [ Ignore ]   [ # 10 ]
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[quote author=“mckenzievmd”]Mriana,

If your aunt can’t ask these questions herself, you or someone else can certainly take on that job with the doctors. As you say, sometimes there is no perfect answer, but patients are entitled to all the information they need since ultimately they need to make the important decisions.

She’s having a hard time thinking- she’s still drained from everything that happened.  So, yes, I try to go there of an afternoon and ask questions then. That maybe the only way to get the answers- write them all down, take them with me as I’ve been doing, and ask them all then.  My aunt is glad I think of them, which is good, I just think of more after I leave.

George, an amputee has nothing to do with bleeding ulcers, strokes, and anti-coagulants.

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Posted: 27 April 2007 03:04 PM   [ Ignore ]   [ # 11 ]
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Mriana, Brennen gave an excellent answer. 

To follow up with a personal example:  I am on aspirin and Plavix to help protect me from further cardiac damage.  However, because of permanent tissue weakening from prostate radiation I am prone to start bleeding and it continues at a low level.  The only way I can stop it is to go off of the Plavix for a week and sometimes even the aspirin for a few days.  I have to balance the problems.  I can keep protecting my heart and continue bleeding or I can take a small cardiac risk for a few days until I can heal.  I don’t like being forced to make a choice, but sometimes we have to.

Occam

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Posted: 27 April 2007 04:55 PM   [ Ignore ]   [ # 12 ]
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Sorry, I missed that.  Plavix is what she was on, but I’m not sure if that was the answer to my question.  Maybe I should rephrase it:  How does a hospital watch for signs of trouble?  Do all the monitors tell them everything they need to know? I guess her her b.p. goes up, then that would tell them something, but what can they do about it if the thing that would help contributes to the problems with her ulcers?

I guess like Brennen mentioned, it’s a catch 22.

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Posted: 27 April 2007 05:49 PM   [ Ignore ]   [ # 13 ]
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Well, as far as watching for a stroke, I believe there isn’t anything to monitor except signs that one has already happened, and what those are depends on the organ system involved. Obviously the worst are in the central nervous system or the heart. But as far as watching for signs that one is imminent, I don’t know of any way to do that, though of course what can be done for people is generally more advanced than what is available in my field. I do know that if a stroke (more properly a thromboembolism) occurs, it can be treated quite effectively w/ agents to dissolve the blot clot if caught early, which is quite likley with a hopsitalized patient. The hard part is, given her ulcers, I dont know whether the risks of using such agents would outweigh the potential benefits. There, again, is where you get stuck trusting the judgement of her doctors, despite the facts that they may not really know either. There are no large scale, placebo-controlled, multicenter trials for every decision doctors have to make. Sadly, medicine is a victim of its own successes. As many marvels as we have witnessed in the last century, there is still more we don’t know than we do know, and the complexity of a living biological system great to the point of being “chaotic” in the sense of Chaos Theory and non-linear mathematics. Ultimately, some things are unpredictable in practice even if they are predictable in theory. Anyway, those of us who have given up asking God to fix things for us still have to find peace with our limitations, and sometimes our helplessness. With the limits of what rational intellect can acheive and control, even when it really matters to us. I hope you find some level of comfort with the necessary uncertainties of your aunt’s experience, and I hope it all goes well for her.

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Posted: 28 April 2007 03:16 AM   [ Ignore ]   [ # 14 ]
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Thanks, Brennon.  I guess it’s just a wait and see what happens.  Hopefully all turns out well.

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Mriana
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Posted: 28 April 2007 10:26 AM   [ Ignore ]   [ # 15 ]
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What I was badly trying to say was that the cardiac and possible stroke problems are chronic so there’s not too high a level of risk during any short period, say a week.  However, the bleeding ulcer is an accute problem that has to be dealt with immediately.  Taking her off of the cardiac medications for a short time seems less risky than leaving her on and allowing her ulcer or her surgery to bleed.

Occam

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