Questions in the Gastroenterology and Liver Diseases Forum have been answered by Dr. Kevin Pho who is board certified in Internal Medicine and by doctors from Henry Ford Health System.

Question Title: Please someone help

Forum: The Gastroenterology and Liver Diseases Forum
Topic: Digestive


Hello,
> My name is Dorothy Turansky. My Mother is Pauline Turansky 73 yrs old and has
> been in North Shore University Hospital in Long Island New York for 8 weeks
> now. Her history is this.
> Diagnosed with Colon Cancer last summer a tumor was removed from her Large
> intestine very successful surgery Doctors felt no Chemo necessary. Her last
> test showed a reoccurring mass in the back tissue no larger then a quarter.
> did not show in lymph nodes and did not metastissized. surgery was not an
> option so the started Chemo once a week and third week radiation therapy every
> day. they combined the two in one day and she became very ill. admitted to
> hospital for
> dehydration.. while in the hospital she passed clots and her bowel became
> gangreous.. emergency surgery saved her life..she has a little over 5 feet of
> bowel left and some digestion issues, recovered great from that and was
> transfered out to regular floor. Nursing was over stressed not much attention
> and she> got infections. went back to ICU and re intebated.. she seem to clear
> infections but needed TPN and tube feeds can't be tolarated over 25 cc's per hour without massive diarrhea.
> but started to lose faith she would ever leave the hospital alive..
> transferred to RCU
> were they specialize in getting people of the vent..Well she really kept
> getting ill and would cry and tell her family she never wanted any of this..
> she trusted no one.
> it's taking a long time for her to get to the place were she was on SICU.
> believe me i'm sure you now that some caregivers are better then others some
> get a good response from her while others report negitivity. She gets upset
> alot and then they would sedate her. I know she responds best when she is
> talked to but sometimes i feel like the I'm only one who acknowledge these
> things. I believe my mom is depressed and traumatized.
> (all the MEDS maybe) I've spoken with the psyciatrist about treatment but they
> are not willing to treat. eeg test show some slowing however her cat scan
> showed nothing..I think she is just sick of it all.. My Mom has always been a
> fighter and always recovered from anything well ( heart surgery, colon
> surgery, hysterectomy,
> major illnesses in her youth. I think modern medicine is missing something.
> HER EMOTIONAL STATE!!
> I bought some psycho acuostics tape with mild meditation and music on it.
> and I talk to her alot even when she is sleeping. and I would pray with her
> and read the bible. Today she was on the trach collar for 9 hours and she spoke
> for the first time in weeks I heard her voice and was thrilled.. I'm just
> affraid of back slid again. this happens alot.
> we want to know our options but the doctor said some things are to soon to
> tell. We feel so hopeless
> What do you suggest?? We don't know what we are looking at here..
> sorry so long of a letter. please advise!! Thank you anyone..
>
> Sincerely,
> Dorothy Turansky
> dott77@aol.com
>

___
Dear Dorothy Turansky,
I can appreciate the difficult time that you have had during the past few weeks. It is hard to provide you with specific recommendations because of the complexity of the illness and the lack of specific details regarding the surgeries, but I will try to provide a general sense aty to what the physicians will try to do. Obviously, the first stepo is to cure all infections. Concurrently, your mother must be given sufficient calories and protein to allow her to regain hger strength. One reason why she may be hving trouble being weaned form the ventilator is malnitrition, she does not have enough strength to breathe on her own without the machine.

The best way to provide nutrition is via the gut. Your mothers absorptive capabilities may be diminished by the gastrointestinal surgeries. Until it is evident that she can take enough nutrition orally or through a feeding tube, she should remain on the TPN.

This information is presented for educational purposes only. Always ask specific questions to your personal physician.

HFHSM.D.-rf
*keywords: malnutrition
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