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My grandmother is 80 years old and a few years ago she was diagnosed with Glaucoma in her left eye. They government hospital gave her treatment which actually caused her to go blind in that eye.


After that she was scared to go to any government hospital and we can't afford private hospitals.


Last year her right eye started getting blurry and we had no choice but to go to a different government hosp.


They said she had cataract and needed surgery. So in January this year they did an op but a week later realised they didn't remove all so they did another op, then two weeks after she still could see properly and they did a laser on her.


Basically in 3 weeks she had 3 procedures on her right eye.


Since then they have placed her on meds that make her sleep most of the day and she has lost at least 50% of her body weight. She weighs less than 50kgs


It's has been 5-6 months roughly since all the procedures and she is still on the meds, in the past few months her eye has gotten gradually worse, she says she sees black and white- light and dark and now can barely see anything.


We have to take her to the toilet in the night because she has already fallen because on not being able to see. She also has to be assisted to bath.


I'm not sure what to do as I have phoned the hospital and they say she will have to come in to get a check up but she is so weak and at our hospital you can sit from 6:30 in the morning and only get seen to at 4pm if you are lucky.


Has anyone had this experience or can anyone offer some insight into what is going on.


We are so worried because if this eye doesn't get better she will be completely blind

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I notice from your profile that your grandmother is diabetic. Diabetes can damage and eventually destroy part of your eye, the retina, so I'm wondering if this is an additional complication that has made her difficult to treat. I'm very sorry that she's had so many problems and has had to undergo so much treatment, but has anyone that she's seen explained everything to you thoroughly and answered all the questions that you must have?

Do you literally mean that she has lost half of her body weight in six months?

It seems unlikely that the hospital would keep somebody as frail and possibly ill as your grandmother waiting all day for attention, because it would be so unkind, but she really does need to be examined by a doctor. Perhaps the best thing to do would be to pack cushions and a warm quilt so that you can keep her as comfortable as possible, and take her to the hospital along with everything you need in case you are kept waiting a long time.
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FarrenG Sep 2019
Hi,
Thank you so much for your response.
1. The diabetes is something I'm not really sure about, they told her many years ago that she had diabetes through a urine sample ( another doctor) but this hospital never did any test to verify this on their own. They just gave her metformin for it.

2. They haven't answered any questions. The government hospitals here are know for terrible service and most of the staff have an attitude or don't like working there so when you ask they either are rude or just have a don't care attitude.
When they first gave her the meds and we raised concerns about her sleeping constantly, lose in appetite etc. The nurse just said it was normal and there's nothing they can do.
South Africa is known for terrible state hospitals and there are many cases of mistreatment of patients.

3. Yes she really has lose that much body weight, she is so thin that she can't even stand up on her own for too long.

I'm just so worried because the government hospital goes through hundreds of patients a day, they try to go from one patient to the other as quick as possible.
What if they damaged her eye with the 3 procedures
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Hi Everyone :-)

So sorry for not replying sooner, had the flu for a few days.
An update on my grandmother's condition:

So remember I said in the beginning I was a bit sceptical about the meds the hospital had given her?
Even though they said it was perfectly normal, I decided to do some more research as my gut was telling something was wrong.

The main tablet they have been giving her from December is Azomid 250mg 4 times a day that's 1000mg

Azomid aka Acetazolamide is a "water pill" (diuretic) used to prevent and reduce the symptoms of altitude sickness. Acetazolamide is also used with other medications to treat a certain type of eye problem (open-angle glaucoma)

They were using it as a main tablet not used with any other tablet.

Side Effects:
dizziness - Yes
Light-headedness - Yes
an increased amount of urine - Yes
Blurred vision - Yes
dry mouth - Yes
drowsiness - Yes
loss of appetite - Definitely Yes
changes in the sense of taste - Yes
stomach upset - Yes
Nausea - Yes
vomiting
diarrhea- at times
Headache - Yes
tingling feeling -Yes
ringing in the ears
Confusion - Yes
Unusual tiredness - Yes


It also causes loss of potassium etc.

After reading all these and seeing that my grandmother had 18 out of 20 side effects I was shocked. I couldn't believe that it would be normal for a person to have so many side effects.

Knowing that the hospital would do nothing I decided to drop her Azomid from 4 a day to just 2 a day. One in the morning and one in the evening.

It has been just a few days but there is such an improvement in my grandmother.
She is awake 60% of the day, she actually tells me what's going on in the TV soaps now lol.
She can stand by the window for a few minutes at a time without help.
She can look down from our apartment building to the house across from us and actually see it!
She can see the buildings and cars - not very clearly but progress and she can see the tiles on our floor!
She even told me she can see the navy t shirt I was wearing today :-)

She still needs help to go to the bathroom as she has become so reliant on feeling her way around that we have to remind her to open her eyes or to look for what she needs but I'm sure that will all be fine soon.

She even has a better appetite and every time I ask her if she would like to eat she says Yes no more fighting with her to eat.

I just hope all goes well and she can get back to the active person she was a few months ago before the op.

I thank all of you guys that have listened to me and also given your advice, I really appreciate each and everyone of you.
I will keep you posted on how she is getting on in time to come.
Goodnight wonderful people,
God Bless.
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I'm so sorry, Farren.

I hadn't realised you were in South Africa, home to one of the world's most technologically advanced healthcare systems but - I'm sure you don't need me to tell you - perhaps not with the administrative structure to do it justice.

Thinking, thinking.

Are you anywhere near a teaching hospital? Where in South Africa are you?

I'm not even going to try to guess at what is going on with any aspect of your 80 year old grandmother's health - or not again, anyway! Some forum members do have professional care and/or health qualifications but most of us (including me) are just family caregivers, and it wouldn't be helpful to you if we start trying to figure out what could be happening.

I'm wondering if a major teaching hospital might have a geriatrics department which would be prepared to take your grandmother as an outpatient and do a holistic review of her needs, that's all.

Many medications can slow a progressive disease, or reduce its effects, but not cure it and not stop it indefinitely. Does your family have any support at all with caring for your grandmother?
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I believe you are looking at legal blindness here. The one eye was gone. Glaucoma is a tough one and treatment often doesn't help. The cataract is another thing. TWO procedures is quite common. The removal, and then a sort of laser procedure on some of the scaring and stuff. People call it a second cataract growing but that's not what it is. The THREE you mention is not so common. But whatever has happened it is going to need to be assessed in an office with the special equipment now, just how much vision she has left.
The weight of course is not related. And you are looking her at two different things. It sounds as though your grandmother is failing and in need of a complete physical. At some point the best course of option is going to be ambulance called and a move to the hospital for complete check on EVERYTHING going on here. Sooner is better than later, so the slightest "fall" and in she goes.
I do think you are looking at legally blind. Means she will see shadows, light, perhaps large objects, and not a lot more. But there are other things happening that are worrisome and unrelated I think to the eye. That much weight loss is indicative of disease, and not in the eye.
Because of the medical care system you may not get the care you need without emergency admission. I know nothing of the So African system. I am wishing you good luck.
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cwillie Sep 2019
I think your interpretation of legal blindness is overly narrow and pessimistic (my mother lived independently as "legally blind" for 15 years) however it may be accurate in the OP's case. I do agree that there seems to be a lot more going wrong with this poor woman than vision problems.
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Has she been treating the glaucoma consistently? I'm afraid that is the more likely reason for her continuing vision loss and unfortunately it is irreversible. What do her doctors say? Ask them to write down what her diagnosis is so that you can look everything up. 50 years ago my grandmother went to doctors repeatedly for her decreasing vision and was finally given a pat on the hand and told not to come back, it wasn't until 25 years later that I finally was able to put a name to her eye disease - that kind of thing just isn't acceptable today when we have a world of information at our finger tips.

In the mean time do what you can to make her world as safe and accessible as possible with the vision she has now. Simplify her home so that she can confidently navigate without her eyes - put a commode beside her bed at night. Get some help from your institute for the blind.

I think you should also investigate what each of her medications is for and what their side effects are, her dramatic weight loss and stupor are no doubt contributing to her falls.
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FarrenG Sep 2019
Hi,
Thank you for your response. She is at the hospital now with my aunt, I just hope all goes well and we will have some answers soon
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FarrenG, you mentioned "they" had placed Grandmother on meds that make her sleep most of the day. May I ask who is "they"? I can't imagine an eye doctor doing this.

Was Grandmother able to put all the eye drops that are required in her right eye after cataract surgery? It is very important such drops are used in the right order.

As for the Glaucoma, is Grandmother using prescribed eye drops for her left eye? My sig other, and even my elderly cat that had glaucoma, were using such eye drops. Sig other was able to have a new surgery for glaucoma that was successful thus no need for those eye drops that sting when placed in the eye. .

Not is not uncommon after cataract surgery that one has go back for a second surgery, usually it isn't the norm.
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FarrenG Sep 2019
Hi,
Thanks for your reply, yes the eye hospital did put her on meds that make her sleep most of the time.

After the 3 procedures, they hospital gave her:

Eye Drops:
Duotrav for the morn for both eyes.
Alphagan Purite for both eyes morn and night.
Pred Forte for both eyes every 1 hour

Medication:
Azomid 250mg 4 times a day
6-8 prednisone tabs a day at once
And she was also taking her normal meds for pressure etc.

Also she did take it on time as we administered it to her.
She still takes all these meds except for the Peed Forte drops and the prednisone tabs
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Farren, I don't wish to embarrass you or put you on the spot, but I'm wondering what a "government" hospital is, but assume it has something to do getting Medicaid assistance.   Is this correct?

Are you able to take your GM to a private ophthalmologist?
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FarrenG Sep 2019
Hi There,

No problem at all, a government hospital is a hospital set up in different areas for people who can't afford private hospitals.
They are free and most of the country uses them. Even middle income families.

Unfortunately, due to it being owned by the government they are often run down, overcrowded and most of the staff are not efficent and we'll trained as private hospitals.

I personally hate government hospitals and always tell my husband that I would rather die than go to a government hospital. My aunty actually did pass away due the poor government hospital service.

In my family(including my grandmother) we all go to a private GP when we are sick as we can afford it but private eye hospitals or ophthalmologists are really expensive.
My grandmother's eye surgery would have cost a min of R40 000 for one eye!
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Once the damage is done it is usually irreversible so it could be that there is nothing more that can be done at this point, but I'm including a link on laser surgery:

https://www.glaucoma.org/treatment/laser-surgery.php
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Yes. Yes it can. There's dangers to all surgeries. That's why cataract surgery is done one eye at a time. Just in case it does go badly. You still have one eye left.
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Farren she could have significant vision loss from the glaucoma, has she ever had any visual field testing? My mom had macular degeneration which is kind of the opposite effect, but many people in our community could never understand or accept the fact that although she had some vision she was legally blind. Mom also found it painful to keep her eyes open on bright days and often wore tinted glasses in the house.
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