OT - My mother, hypertension or mental health?

[supermum_ms]

Hey knowledgeable people,

I'd like to pick your collective brains if I may, and possibly help my mother. Some of you may remember, she 'was' physically very healthy for her age (early 70's), apart from 20+ yrs dx bipolar, she'd had the odd medical issues that over the years had been dismissed as psychological (all resolved when the physical cause dealt with) but she always had normal blood pressure and was tootling along perfectly.......UNTIL a routine colonoscopy (sp) went horribly wrong. Note: she only had the colonoscopy (sp) after her Dr talked her into it, it was free and even though she didn't have any medical issues to warrant it, her Dr thought it a good idea because of her age alone, looking for early evidence of deviculitus (sp), cancer etc.  

They ruptured her bowel during the procedure, she ended up in ICU, in a coma for 3 days, they ruptured her spleen whilst fixing her bowel and she ended up with a huge scar from breast bone to pubic bone. As you can imagine she was extremely upset and angry to wake up with such a huge scar, after they had told her it would be key hole. For some reason they didn't give her any of her bipolar meds and by day 5, I spoke to the head nurse because it wasn't ok for her to be still off them. As it was her blood pressure went up every time she had a visit from a Dr, she wanted/needed someone to say "I'm sorry" and just seeing any Dr set her off......um pissed off doesn't come close to how upset she was.

This is the first time in her life her blood pressure was abnormal, she was put on meds for hypertension and ever since she's been having dizzy spells, falling, spacing out, seeing stars etc she even woke up in the middle of the night giggling, she had no idea why she was giggling but it woke her up. My red flag radar is flapping in the wind about the hypertension meds, are they dropping her blood pressure too low? She goes to see her GP because she's developed an orange sized lump, bulging out from under her ribcage and its getting quite painful, she called it her third boob lol.......turns out she's got a hernia from the opp, and needs further surgery to improve the problem, they have to put in the mesh support and she's told it probably won't happen again.

Well if you guessed her third boob is back, well you'd be right the hernia has returned and she has to go back for more surgery to fix it, or try too. She brings up the hypertension medication and when they test her blood pressure is through the roof, i'm not surprised actually, she is still very very angry and still suffering because of a medical mistake, totally understandable for her to be upset when its changed her life. She had an ECG and they have doubled her hypertension medication but i am concerned about all the times when her blood pressure has obviously been too low!

Now she has become light sensitive and is suffering migraine headaches, which are both new for her, her anxiety for the future and despondent mood is indicating her depression has settled in and its going to be a battle for her to pull out of it, so not good for her.

If your still with me, the questions I have are... 1)can hypertension be situation specific? 2)Can it be high when she's seeing the Dr because she's anxious and very angry at them for what they've done to her but then normal when she's at home and its dropping too low because of the hypertension meds? That makes sense to me because i know my mother and her medical history, seriously it was only a week or so prior to this entire fiasco that she was on a holt monitor and it was normal so how can she end up with hypertension in so short a time frame.

I maybe totally wrong but i simply dont understand why this time, they are focusing only on hypertension, when i do think this time, it is highly possible that it's psychological. 3) If she is already having 'turns' because we suspect her blood pressure is dropping too low, what should we be aware of now she's on double the meds?

Hope this made sense and you maybe able to offer some insight to us :o)

Thank you in advance.........JJ  

[supermum_ms]

Every family member we've lost, on both sides of the gene pool, has actually been due to cancer. All different cancers though, Dad was the youngest with bowel cancer, they thought they'd caught it early but during his op they discovered it was was at stage 4 and they had to remove his bowel, it had already spread to his liver, no signs or warnings prior to getting constipated.

My brother's and I, are very aware of our increased risk for bowel cancer but i've never lived in fear of it or anything, it happen to my health conscience dad (mind, body and sole) so it can happen to anyone! Being proactive, know your diet and trying to catch it early is the right thing to do, no matter your family history!

Mum's going for more tests today, she's been fasting and all she knows is they are testing her for "TSH, U and E, lipids, and fasting FBS" and running another EKG, she finds out next week what it all means. I will remind her to ask if she can do the holter monitor again, I think they need to see for them selves how low her blood pressure drops now she's on Micardis, especially when she's at home and away from Dr's.

Thanks again.......JJ

btw  No one will ever be able to convince her to do it again, it was unfortunate it happened in the first place but its the continual complications that have been more difficult to live with and so far haven't ended yet.
  

[essdipity]

Wow, JJ. Anyone with colon cancer in the family should *really* get tested promptly and regularly. Just make sure the doctor is competent. Mine is great.

That's good because I have to have another colonoscopy before 2013 is out. In '09 they removed 2 polyps, not cancerous but possibly could turn into that. Much as I dislike the whole deal, as everyone does, much better safe than sorry.

ess

[SarahL2491]

I'm sorry all of this happened to your mom but this reinforced why I won't have one! I know of 2 nurses who had ruptured bowels during this procedure

I'll pass, at my age am probably going to die of something!

[supermum_ms]

Hey and thanks!

I think you've both got some good points, i actually think the hospital must have a note attached to her file because the surgeon gave her his private number for her to call if she ever had a problem - thats pretty unusual i'd think. When the surgery related hernia first turned up, her GP told her the wait could be a couple of years but i got her to call the surgeon and it took less than a week, i'm going to be pushing for this surgeon to get involved again, if she's going on the waiting list this time.

I strongly believe there is a connection, not sure if its white coat syndrome  but her BP is definitely higher whilst she's dealing with this mess, 169/108 which is higher than before she was put on Micardis. Hmmmmm during ICU time, they kept telling us they had trouble stabilising her but no details on exactly what that meant. When she got into the general ward, she was in a lot of pain but mum being mum, she wouldn't take anything (women are tough in our family). She'd also been off her bipolar meds for almost a week, so derrrrrrr no wonder it was high.

Honestly dont know how i'm going to get to her this time, she needs an advocate because she's so down, she'd rather not talk about it, deal with it etc. She wants to see me but doesn't think she could handle seeing me like i am at the moment, I get it but sheeeesh I need to see her no matter if i can talk or not.........so bugger!

I have to agree with the importance of getting tested, lost my Dad to bowel cancer dx at 50 and he was healthy and in his prime, so yeah I get the need but would I do it after seeing what has happened to my mum, errrr can't say 'i' would just now but maybe in another 20 years ;D

ROFL i know we do things upside down over here but we have the same drugs you have, i actually think they are afraid to blame it on mental health but i really wish they would consider the possibility, she's often black and blue from all the falls she's been having, somethings got to change and soon!

Thanks again, you've given me some food for thought and your imput is very much appreciated!

Hugs.........JJ  

[PastorDan]

Yes, JJ, BP is very often influenced by the immediate.  However, that works both ways; remove the stimulus from the thought loop, and the pressure should return to normal.

I am so sorry your mother had to go through this terrible ordeal.  For any of us, it would be very distressing.  For a person with possible bipolar disorder, it could be terrifying and/or infuriating.  For heaven's sake, it's infuriating for many of us just reading about it!

As usual, essie is right.  White Coat Syndrome is a well-documented phenomenon, I think.  You might Google it.

In addition, she's right that a routine scoping is advisable for anyone over 50; after the first time, they'll often tell the patient that they needn't worry about a thing for five years or more afterward.  However, if there is anything about which to be concerned, you want it caught early.  Lost my Dad to cancer that began that way; don't know how much might've been different had he gotten in there any sooner, but I know it's been over 30 years and I miss him terribly still.  He was 61 when we lost him.

Whatever you do, keep advocating for your mother's care, and yes, get those meds back on track.  Check for possible drug interactions, but there's got to be stuff that they can use for BP and BP together, even "over there," right? ;-)

[essdipity]

Hi, JJ. This is way beyond my medical knowledge, but I can offer a few comments based on my own experiences.

About 2 1/2 years ago, when I suffered a trimalleolar fracture of my right ankle, I had surgery and was in the hospital for a week. While there, my BP was sky high for me and unacceptably high for anyone--183/105. My usual BP was and is now in the low-normal range. The doctors and nurses attributed this to pain (which was fierce) and weren't much concerned. They even discharged me at that level. I learned that lots of situations other than typical diseases can affect blood pressure. I was never put on meds for that.

As I recovered, things got back to normal. But I didn't have anxiety, which is an on-going thing, and possibly kept your mother in an agitated state over a period long enough to cause her problems. She was fearful, and with good reason, obviously. I have heard of a condition called white coat syndrome, or something like that, meaning that just visiting a doctor's office can cause a reaction including spiking BP that is not consistent with the patient's health overall. If they are medicated for that observed condition rather than for the 'everyday' one, I can see how problems can result.

The only thing I can suggest is to get her primary doc to order a monitor to be used for as long as it takes to establish what her true blood pressure is. If she's done that, she needs to do it again, this time with a doctor actually paying attention.

But as to the ultimate cause of this, the colonoscopy, I'm all in favor of that. Older people do need it as a screening tool. (Have had 2 myself.) Of course it should be done without a comedy of errors, but that's another subject.

ess