Urgent Help and Guidance Needed

[Arpan12]

Hi All,

I am writing this letter to you today as a troubled and worried son, asking help for his father's serious condition, writing from India.

To tell you briefly, my father had an MI on 10th October, 2012, post which Angioplasty was done (I am not a medical person and neither do I have in guidance while I am writing this mail to you - hence please bear with my lack of knowledge)

Post the angioplasty, he suffered a cerebral hemorrhage, because of the side effect of the drug they had given him, post the MI, as a life saving measure.
Due to this hemorrhage, the cardiologist was unable to administer heparin and other anti-coagulants in his blood, post the angioplasty, because I believe, that would have increased the risk of further bleeding inside the brain.

So, what happened was, he was without this drug for about 7 days, post which, he had to undergo a brain decompression surgery to relieve him of the blood that had accumulated in his brain. The surgery went off well and every symptom of the patient including the heart was fine.


Just a day after the surgery (within 24 hrs), he suffered a 2nd attack on his heart and as per the cardiologist, the stent which was placed inside his heart was blocked, because we were not able to administer heparin and anti-coagulants to him, and hence the attack. However, he was responding to drugs, sedatives and was put on ventilation support, since 17th October, 2012.

Now, on, 19th Oct he had a sudden LVF (Left Ventricular Failure), after the doctors tried to bring him out of ventilator support and also reduced the sedatives and stopped the painkillers. In the morning same day, he was very conscious and although unable to speak, he was able to respond the stimulus. But suddenly in the evening at 6pm, he suffered this LVF, post which he has again been put on all support systems, after which I am told, he is responding okayish to it.

But the situation now is that whenever they try to wean him out of ventilator support, he suffers a LVF and the cycle starts again. There is also pulmonary edema which is hampering his progress. The consulting cardiologist is also very less hopeful about the situation here.

My plea to you would be two things :

    Kindly guide me and help me in this situation - I am the only son in the family and being such a non-medical person, I am being unable to take calls on important medical matters and have just the above detail to go by.

    The consulting cardiologist here is trying his best, but now he also has said that it's a matter of chance and luck with medication, which can save him - I understand his position, but I am unable to reconcile to the fact that nothing can be done for my father here.


We are based at Peerless Hospital, E.M Bypass, Kolkata - 700094, West Bengal, India

My contact details are also given below - Kindly consider my request and let me know.

Arpan
[phone] / [phone]

[Paderla Anitha, DNB]

Hello and hope you are doing well.

Good Arpan. Hope your father recovers completely. Now work slowly towards improving his memory. Try ‘brain teasers’, they are known to increase memory functions. Also, see that he gets adequate sleep; it’s supposed to improve cognitive functions.

Hope this helped and do keep us posted.

[Arpan12]

Hi Dr. Anitha,

We have brought him home and he his progressing on his recovery. His BP is at 90/60 and is stable as of now. It's just that his memory functions are a bit reduced now and can't recall most things. Otherwise physically he is starting to walk around and regained his speech. He is on strict dietary restrictions as well.

Regards
Arpan

[Paderla Anitha, DNB]

Hello and hope you are doing well.

Good to see your father is progressing well. Hope he is weaned of dopamine and dobutamine. And keep a check on his blood sugar levels.

Hope this helped and do keep us posted.

[Arpan12]

Hello,

Well, the update today is that he has been moved out of ventilator support. But his BP is low and is on constant IV of Dopamine and Dobutamine to prop up his BP levels. It remains steady at 90/60 however refuses to go up. His GCS is 4 for Voice and between 3 and 4 for Eyes and Motor, which doctors are hopeful that will go up. He was being fed through tubes till yesterday, but since today has started taking oral feeding. His blood sugar count is at 234 and doctors say he requires 72 units of Insulin to keep it at that level.

Let me know the future course of action for this please

[Paderla Anitha, DNB]

Hello and hope you are doing well.

Arpan, I understand your predicament and sympathize with you. But its unfortunate that your fathers clinical course has progressed the way it has. After the angioplasty, patients are initiated on anticoagulants, which has triggered the intracranial bleeding for your father. Could be that the dosage of anticoagulants could have been adjusted based on the PT/INR levels. Now, it appears his heart needs support for the ventricular functioning.

Hope this helped and do keep us posted.