2 valve replacements and 1 repar

[Juliev25]

My mum had surgery on Sunday which lasted 7 hrs, mitra valve replacement, aortic valve replacement and a repair or a valve on the right side of her heart. After surgery and shortly after being transferred to intensive care she had a further op in ITU as 2 archerys were bleeding and putting pressure on her lungs. She still in ITU and today they woke her slightly but put her back under sedation and Tom I'm going i to sign content for the tube in her mouth taken out and a tube inserted in her throat put in. She had a valve replacement 13 years ago mechanical, and 2 further surgerys years before that on the same valve. She was extremely ill before surgery and it was an emergency. She's on a mild meds for low BP and kidney machine ans liver suppressed. When should we be looking for signs of improvement

[ed34]

I don't swallow the endocarditis thing. All along they haven't really known what the issue is. The postmortem is carried out by independent Doctors, who are usually related to the court system. They phoned me before looking at my Mum and my Wife to get any important history. I would get some notes ready and it can help them to look in the right place. Did they say that these problems could occur before they did the surgery?

[Juliev25]

Mum is been picked up from kings to the corranors for a postmortem in which we will find out tomorrow if there will be an inquest
Doctor signed Death certificate stating Endocarditis due to rheumatic fever as a child

[Juliev25]

Thank you xxxx

[ed34]

Sepsis would normally be shown in the blood tests with elevated white cells of particular types. I personally think they should have put her on antibiotics a month ago, even if a precaution. I've seen this happen several times in ICU. Six other families had identical news to mine in the same week, and all due to sepsis. It was obvious to me then that antibiotics are given far too late.

[Smiley2000]

Hi Julie,

Oh no!  So sorry to hear about your mum!  She put up a good fight and you were strong and held it all together.  There was nothing more that you could do for her.

She had so many complication after the surgery that she really did not stand a very good chance of making a recovery or making it through.  Sepsis is a rear complication but very nasty and that would explain why all her organs failed and the Docs could not pull her through.

You and your family are in my prayers.  Hugs ()

[ed34]

I'm so very very sorry for your loss :(  Please do a full enquiry because I think this was handled very badly. Again I'm so sorry.

[Juliev25]

My mum died in my arms at 9.08 yesterday morning
Her BP medication was reduced from 4.0 down to 0.8
I have asked for a full enquiry into my mums full care
I fought for my mum right up to the end but not one doc would listen
I want to thank you for giving me guidance x

[ed34]

Oh no, I'm so sorry. This is exactly what happened with my Wife in April, I was told the same thing word for word. They always seem to tell you the bad news on a friday so you can't get in touch with your GP over the weekend.
If she has only just been put on antibiotics, they won't work unless they keep her pressure up. I would call the hospital, insist on speaking to the Doctor in charge and state you want the pressure kept up so the antibiotics can get pumped around properly, otherwise it's pointless giving them and you want them to have a chance. I would also say you will be speaking with your GP on monday because you want an independent study done on your Mothers case, on how she was treated and how an infection could go unnoticed when all the signs were there. You are not a Doctor and it was obvious to you, so a consultant should know for sure.

[Juliev25]

Mum started with the runs a few days ago and the tests still aren't back, I think it's e coli
The infections of sepsis and ecoli that were caught from mayday and even though I asked and asked and they kept on saying no to infection in the six weeks in kings ICU
Anyway the 2 surgeons and liver specialist and head nurse looking after mum sat me down to say she's dying and her liver is failing and now her heart is to.
The medications they've been balancing they have now reduced and they've told me there not going o increase again. Meaning when mums BP pressure drops like it did last night and a lot in the day there not going to treat. They are killing my mum. They won't listen and im going crazy. There saying there is not one chance she's going to make it. They told my brother in austraila that there is a slim chance that she would pull through but they told him she's on the maximum of medication. There lying she's on the minimal shes ever had. They have back tracked to me and said its the maxuim she can cope with. I can't believe there doing this. Please give me advice

[ed34]

I think I've already put my confusions. If it is definitely not infection (sepsis) then it has to really be ischemic. I can't see what else could cause multi organ failure.

[Juliev25]

Called nurse again charge to be my voice on dr round this morning regarding sepsis and blood flow to organs ie ct scan etc
Going in st 1pm to speak to doctors
Any advice or questions or knowledge I need to be armed with could you please let me know
Julie

[Juliev25]

Just called the hospital as I've been checking mums symptoms and it's all pointing to sepsis
I've asked if there is a sepsis specialist and reminded them that mum was diagnosed and treated with antio biotics 2 weeks before her major op 5 weeks ago with e coli and SEPSIS
They've told me they do blood cultures everyday and mums on anti biotics but there is no evidence of an infection in mums blood at the moment
I asked if that makes it certain that mum hasn't got sepsis and the nurse didn't give a clear enough answer
I'm going into hospital Tom to speak to the ICU consultant regarding this and asking if scans are showing why my mums in mulitpule organ failure. I've asked the nurse just to tell the doctors my findings and I need to speak to them regarding this
Julie

[Juliev25]

She is been fed by a tube and I've asked and asked about ct scan or angio but there response is that mum can't be moved from ICU
Her 2 ops since the major heart op have been performed in ICU
What she does have is a history of plume nary hypertension on the right side of her heart

[ed34]

I think they need to establish why her pressure keeps dropping. Are they feeding her nutrition through a tube? Have they done a body ct scan or a ct angio to see if the kidneys/liver are lacking blood supply? If they have ruled out infection then it must surely be ischemic? If low nutrients and only a low oxygen content are reaching organs, they will shut down. I did mention a ct angio on july 27th, and I'm shocked they haven't done one. They are checking the blood flow/pressure situation around the supply arteries in the body, but not actually IN the organs. Excluding infection, an organ should work fine if it's getting enough blood and nutrients. I can't think of anything else.

[Juliev25]

That is the machine obs and list of medication
They've told me today chest drain is being removed as nothing out for two days and liver at 28% and mums only showed slight improvements a few days ago and has remained the same since. They said its multi organ failure and expect the worst and only slim chance of survival. They told me 9 days ago she had only 24 hrs. What's your thoughts
Julie

[Juliev25]

At hosp
Hr 116
Art 105 /60
Cvp 46
Sp0z 97
Etco2 4.4
Rr co2 14

Vol 30% resp

Dialysis
Blood 200 ml/min
Pre blood pump 400ml/h
Daily sate 700 ml/h

Replacement 400 ml/h
Pt fluid removal 150
Effluent 1653
Effluent 37
Anti coagulation standard
Antiic continus 3.4
Bolus vol 0.0
Bolus 6hrs

Noradrenaline
Ms disc mc6
Vasopressin 20/40
Act rapid 50
Flolan 2 mc6
Clonidine 600 m66
Fentanyl 50

[Juliev25]

Just called to check on her night
Mixed night with BP dropping and been up and down, at the moment it's ok and she's sleeping
Going up at 1pm today
Just feel for her as its now 5 weeks in ICU and I just don't know where this is going to take her
Julie

[Juliev25]

Kidneys still nothing ed

[ed34]

They can obviously see if the Liver is improving by blood tests. This is good. If the Liver fails, that's basically it. The key I think is to keep the pressure up. As a matter of interest, what have they said about the kidneys? are they still recovering?

[Juliev25]

No more improvements, just the same
There trying to ween her off the sedation but she still keeps pulling the tubes
Doctor has said they've never had such a complicated case and really don't know if she's going to recover or not so there just taking it day by day
They have said if she does recover then it's going to be a very long time recovering
They've said her liver is slowly recovering
Never know what to expect every day huh

[ed34]

Oh just to add, they normally lightly sedate the patients for a quiet restful night. Did they mention this?

[ed34]

gas improvement is good news. There are two basic ways they check oxygen in the blood in hospitals. They use the finger clip which just tells you how well the red cells have absorbed oxygen. However, it doesn't tell you the saturation, how many red cells there are. It's fine having good oxygen levels in red cells, but if there are not many red cells, you will die. The blood gas measures the concentration of the red cells in the blood and how well they are oxygenated. Improvement means her lungs are improving, and the heart is pumping more oxygen around. As improvements continue, the ventilator can be gradually turned down. So that is really good news. With regards to blood pressure, it could be down to her kidneys still, so it means waiting til they full recover. They can maintain it with meds. It's very common for patients to react that way when woken from sedation with all the tubes etc. It's frightening, and apart from sedation the only other method is straps. I really feel for her :( but try to keep in mind it's for the best. I think if they keep her pressure up, and oxygen continues to improve, her kidneys should recover fully and start handling the pressure on their own again. It's looking better.

[ACerulean]

I really don't know what to say other than that I hope that your mother makes a full recovery.

[Juliev25]

Been told blood gases have slightly improved .. Wat this means I'm unsure
Mums reacting violently when woken and trying to rip tubes out and even the mitten gloves she's ripping off. Two nurses had to hold her down and in the end they've resorted to strapping her to the bed. This is very distressing. She's still needing high doseages of meds for blood pressure etc and looks even more swollen but been told when I questioned her fluid input and out put there coldly balancing it and it's ok
Very unsure as to what's going on
Julie