Intestinal Blockage - Abdominal Surgery - Goes into Sepsis § Septic Shock

[sherry1414]

12/19/03 my dad age 78 had surgery on sm intestines to remove blockage (started on 12/16).Before he went to hospital, he was walking 3 miles a day, driving & leading a normal life. On no medication except Trizadone for fibromyalgia. After morphine shot for pain after surgery,pulled the NG tube out of nose Tues AM after surgery on previous Friday. Doctor ordered leave NG tube out to see what happened. He got sick violently vomiting Tues night. Family memeber was there & nurse said she did not want to call doctor in middle of night to bother him. He vomited all night & Wed AM about 10 AM, doc said to put tube back down nose. He improved some, doc ordered liquid diet (did not run CT scan to see if stomach could handle) & he began walking around hall by Sat 12/27. Sunday 12/28, wasn't feeling as well.  4:30 12/28,he started complaining with shoulder hurting, said oh my chest 3 times & started breathing fast. Had chill. Nurse gave him morphine shot,told him he was hyperventilating. 1-1/2 hrs later, gave him another morphine shot & told him he was just panicking. He continued breathing very fast through night. Inexperienced nurse on nightshift called doc twice but was not forceful with doctor about seriousness. Doctor ordered bloodwork, Electocardiogram. We were told all tests came back normal. Day shift nurse came in, saw problem & called doc.  Doc started telling her to try something else & she said no, you don't understand. This man is in trouble & needs pulmonary support. So doc said do whatever she thought. Within 15 minutes, she had lung doc who immediately put him on ventilator.  Moved to ICU.  His surgeon did not show up until 9:00 pm Mon night. Was very unstable for 3-4 days.  Got vitals stable, then started leakage through incision. Original surgeon referred to it as a little drainage that would clear up. By Sat 1/3, my dad was in another emergency-doc didn't show 2nd time. CT scan showed bowel leakage in stomach. We fired original surgeon, got new surgeon and he did emergency surgery Sat 1/3 to repair leakage.  Looked like kidney dialysis was inevitable but they began recovering from shock.  Infectous doc doctored him for sepsis & finally got the infections/bacteria cleared. Nuerogoly doctor ran CT scan on brain and said it showed no sighs of stroke, or anything. EEG Xray showed a minor slowing of the brain but nothing major. Hd to have trach due to bleeding. Trach is capped now. PROBLEM:  Took weeks for him to wake up even though no medication given during 2 weeks.  Once awake did not recognize anyone. Now he recognizes us but his mind is gone. He can answer yes/no questions, remember family names, but he talks about things that make no sense. Totally helpless. Slowly gaining strength back but still cannot handle himself. Uses bathroom in bed, on IV feeding-started liquids today, has to be turned, everything. New doctors just say need to wait and see. 61 days in hosp so far. What would you suggest, anything else we can do for him?

[Roger Gould, M.D.]

I don't want to recommend anything because I do not see these kind of patients in my outpatient practice. It is quite common for a man of that age who has functioned well to lose function after all of this medical trauma.  My medical instincts say he will have a full recovery, but I don't know how long that will take, and the best thing you can do is make sure he has no more trauma and gets out of the hospital back to familiar surroundings as quickly as possible.