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I’m sorry. This is not a question. I’m sorry, because the only reason I’m writing this is to vent. This means I’m pouring my worries onto you. I’m sorry.


My lovely sister is in hospital. I, her brother, help her. She has good health. We have no other family.


Suddenly an avalanche of problems happened.


-UTI, so she went to ER.


-She doesn’t have sepsis, no organs damaged.


-They treated the infection, but now she might have a bleeding ulcer. (They’re not sure.) I believe it’s from the hospital stay (bleeding ulcers can be caused by strong medicine).


-She suddenly has severe anemia (I believe it’s also from the hospital stay) (bleeding ulcers can create severe anemia). So they gave her a blood transfusion, without consulting family.


-We will stop the blood transfusion tomorrow. Blood transfusions can be good. But they can also create problems.


-Instead we prefer iron supplements, or eating more food that contains iron.


-She’s in hospital. She’s feeling very well. But I worry a lot about the ulcer, etc.


-We will refuse anesthesia, to do testing on the ulcer. Too risky. Sometimes, elderly people are cognitively impaired after. We don’t want invasive testing.


-Some bleeding ulcers heal on their own. Some don’t.


I wish everyone, and my sister and I, luck in overcoming our health problems.

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Hereiam,
The Forum is a wonderful place to vent. But do know, if you write on the Forum and don't want ANY advice, you should likely write in your own diary to vent, instead. Here you have people. People will react, if you see what I mean.
I hope your sister will get better. The two things she is suffering from are extremely common, and can be caused by a multitude of things.
I hope you will put your trust in the doctors who are trained in care. I spent my career as a nurse, and if I have learned one thing it is that "a LITTLE knowledge can be a dangerous thing," as the old adage goes.
Remember, the doctor has many many years of training under his or her belt, and a wealth of experience. That's why you are there.
Is this the first illness your Sister has faced down? Or the first illness serious enough to be hospitalized? Are you her POA for health care, or a person listed as her POA on an advance directive? May I ask how old your sister is? And how old you are?
I was the POA and listed on advance directive for my brother. We were like Hansel and Gretel in the dark forests of life until his death. I understand the deep affection and loyalty you express, and the worry.
Do know that family is not consulted about getting blood unless the sister is incapable of signing for taking it; if she has severe dementia and a health care proxy assigned (is that you?), then you would be consulted. I hope she is currently capable of making her own decisions.
Again, hope your sister does very well, and wish you both the best of luck and health.
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Thank you!!

I do want advice.

I don’t have any question.

I’m stressed.
I agree the doctors are trained. You’re right, “little knowledge” is dangerous.

But doctors also make mistakes.

However, you’re right about your warning. Thanks!!!
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hereiam, That's just great. I hope the docs will take time to talk with you. You can also ask to speak to social worker responsible for your Sister's care and he or she can make a good go between. Docs get busy and tend to do the walk -away too quickly. Also most cases have a nurse manager. If you are Sister's next of kin or health care proxy on her Advance directive then she will discuss everything with you. And if these papers aren't done and sister is competent to answer a few questions this is a great time for the Social Worker to help you get this simple form done.
I sure do wish you the best and hope you will update us.
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Thank you!!
I'm just stressed. I've been crying all day.

I make the decisions. My sister can too.
The doctors are speaking to me. They are very patient, and take time to speak.

Unfortunately, they didn't consult family about the blood transfusion. They admit they should have. It's the kind of decision you normally ask.

Blood transfusions are not always a good idea. And anemia (even severe) can be treated in other ways.

Thanks for your message!!!
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HereIAm, (((((hugs))))) and welcome.

I'm curious, why is your sister not able to speak for herself about what treatments or tests she wants?

Your sister must have consented to the transfusion, right?

When my mother reached the age of 90, had had a stroke, a broken hip and been diagnosed with vascular dementia, we realized that there were no "good" solutions to her increasingly complex medical issues.

Is your sister very elderly and confused about her health? If she is in good health and doesn't have dementia and presents with a possible ulcer and internal blood loss, I would certainly want an endoscopy done (under a local) to see if there is a bleeding ulcer. I'd also want to test for H. Pylori. I'd want a stool sample to test for occult blood.

Sometimes, blood loss like your sister's is life-threatening and there is not the luxury to wait for the patient to take supplements and eat better. A transfusion, absent other contraindications, gives immediately relief and gives the docs time to figure out what is happening.

Please stick around and let us know how you AND you sister are doing tomorrow.
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Thanks for your message!!

I appreciate the support!!

Sister was in good health.

UTI.

Elderly. - Right now - not good she makes decisions. Hospital agreed they should have asked family about blood transfusion.

I decide today. I’ll speak with the doctor, to ask/listen/then decide various topics.

They aren’t sure about ulcer. Correct, they are doing stool testing, etc.

They said local anesthesia not possible. It would have to be total. Sleeping.

Anesthesia very risky.

Blood transfusion - not for possible ulcer. For anemia.
I understand, sometimes necessary. It appears to have been optional.

Today, doctor and I talk again. See situation.

Thanks!!
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The family gets no say in whether she gets blood transfusions or not if she's capable of making her own decisions. Please stop interfering with her treatment.

My mother had severe anemia, diagnosed by her doctor as "she needs to exercise more" 🙄 two hours before he called and told us to get her to the ER because she was bleeding internally. It took five units of blood to get her back up where she needed to be, and iron supplements were not going to be the cure. She could barely eat, so more food with iron isn't a solution either.

Blood loss is no small matter, so again, stop interfering with the doctors. You aren't helping your sister by putting doubt in her mind about their competence with your internet-acquired MD.

I understand you're upset -- anyone would be -- but be supportive of your sister and encourage her that she'll get better. Don't pile extra worries on her about her treatment -- it isn't kind.
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Thanks for warning!!

I appreciate the warning and support!!

Sometimes blood transfusion is necessary. If necessary, we won’t stop.

Sometimes it’s optional.

Hospital agrees sister - right now - shouldn’t decide. Hospital agrees family should have been asked.

No doubts are being given to sister.

I’ll speak to doctor. We’ll see what is necessary/not.

Not upset (in the sense of angry).
I’m very concerned, praying.

Sister looks very good, feels very good. Hospital really helped. UTI down. Pipi color great, clear.

Doctor said:
-anesthesia might be very risky
-might be better not
-might be ok today, not needed (invasive testing for ulcer, anesthesia)

We will see situation today.

Thanks!!
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hugs!!!! praying and wishing everything to be ok for your sister!!
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Thank you!!
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Thanks - a lot - for the support in this very stressful time.

I’ve been crying, praying, awake almost all night.

Really, I thank this forum for support.

I just spoke with my sister. Doing incredibly well. Smiling, looks, feels very well.

They are analyzing results. If ok, they’ll stop blood transfusion (not because I’m concerned about blood transfusion, but because that was their plan anyway).

If absolutely necessary, we’ll continue blood transfusion.
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hug!!!!!
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Wishing everything good for your sister and you!!
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Dear all,

Thank you for your support!!!

I spoke with the doctor.

I hope very much it all goes very well. For my sister!

And for everyone on this forum, facing various challenges! I’ll return to the forum in the future.


The doctor said:

good news:

-UTI much better
-they stopped blood transfusion today (not because of my concerns, but by chance that was their plan anyway)
-anemia much better
-sister can go home tomorrow, if blood result again good tomorrow!!!
-at home: iron pills, etc.


bad news:

-question of “maybe bleeding ulcer”
-doctor agrees: risky to do anesthesia/testing
-doctor says it’s possible the bleeding stops on its own.
-if there is an ulcer, it was there before the hospital. by chance it started bleeding now.


I’m wishing lots of good health to everyone, my sister and I.
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dear here i am,

wishing lots of luck to your sister!!!! i hope it all works out!!!!
sometimes, one is lucky!!! i hope your sister completely recovers.

bundle of joy
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If they are releasing sister with iron supplements consider a mild laxative. Iron can be wicked constipating.
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Good luck to you and your sister. Just do the best that you can, that is all any of us can do. Vent away, this is a great place to do it. It has kept me from "putting my head in the oven" many times. ((((Hugs to both of you))))
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Thanks for the warning (iron), kind words and good luck!!

Wishing you all good luck too!!!

My lovely sister was so well. Really well. We were just smiling/laughing together a few days ago. (It’s like that every day).

And then UTI (ok now) and possibly bleeding ulcer.

I keep crying.
I spoke to her (phone, on purpose without video), so no tears could be seen.

My sister needs to be lucky —
heal the “maybe ulcer” on its own. (There might not be any ulcer). Heal whatever it is, on its own. Stop having black stools.

She looks, feels great today.

I’m sending a lot of love to you all.

Here I Am
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UTIs if not treated can cause sepsis. The person also has Dementia like symptoms. I bet there was some dehydration too. This also will cause Dementia type symptoms.

Alva's the nurse so she will say if I am right or wrong. Anemia and stomach ulcers do not happen because of a couple of days in the hospital. These problems were before her stay and found when she entered the hospital. As explained, if the ulcers were bleeding then your sister was losing blood, the reason for the transfusions. Your sister should have been showing some signs. Like thinking it was stomach upset or heartburn. If she has ulcers she needs to watch her diet. No hot and spicy foods. No foods with high acid content. Before she leaves the hospital ask for a diet plan. If these ulcers don't heal, she will be back in the hospital. Over the counter meds will not help.

You keep saying sister is elderly. I am 72 and do not consider myself elderly. If your sister is passed 80, she may start having health problems she did not have before. The UTI can be kept at bay by using cranberry tablets and a probiotic. Alva swears by D-Mannose. Because she may have ulcers I would check with her doctor if safe to use what I have suggested. She should be drinking plenty of water. When she uses the bathroom she should use wipes to clean herself well after toilet paper. I like Huggies. No soap near the urethra. Cotton panties because they breath.

As long as your sister is competent to make decisions, a doctor does not need to talk to you. Even if you have medical POA, if she is competent doctors don't need to talk to you. She can have you put on HIPPA paperwork or verbally say its OK to talk to you. HIPPA keeps doctors and nurses from being able to say more than "she's comfortable" or "shes had a good day". Patients have a right to privacy when it comes to their health. You as a sister gives you no legal rights. If you do not already have POA, I would get it and have it immediate meaning it starts as soon as your sister signs it. This does not mean you make her decisions if she is competent just means you don't need a declaration of incompetence from a doctor if for any reason she is incompetent. Really, the doctor does not have to discuss anything with family if your sister is competent to make informed decisions. It was a courtesy that he did so.

My daughter is an RN who worked in rehab/NH facilities. She had a Dementia patient that had only a sister who came to visit. Since the patient had Dementia she couldn't sign a HIPPA form. Even so, my daughter would tell the sister how the patient was doing and what was being done until one day when the sister started ranting and raving about a bandaid that had been put on the patients hand for a skin tear. No one had called her. No they wouldn't, because she had no POA or was she on the HIPPA form as a contact. My daughter could not calm her down and eventually had to be curt and tell the woman that she was lucky that my daughter had told her anything. What I am trying to say is just because your family you have no rights to your sisters health information if she is considered competent to make informed decisions. Your opinion is not relevent. You sister has the final say. Its between her and the doctor how her health is handled. Your sister can ask that you be present for any consults. This gives you the opportunity to ask questions. You can talk it over with ur sister but she has the final say. Which is the way it should be.

I will say this won't be the last time your sister will be hospitalized. These stays will be a lot easier if you understand the system. Be glad that a Doctor comes out and talks to you, he doesn't have to.

Hope there r no more hospital visits and her healthcare can be handled by her PCP. Have sister fill out a HIPPA form for any doctor she sees or facility giving permission for you to obtain info on her health and ur an emergency contact.
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Thanks for your warnings, JoAnn!

One tends to summarize, and not all facts are presented.

Here more facts:

I have POA.
I’m the brother.

My sister was in good health.

My sister doesn’t have dementia.

In hospital - right now - not good for her to make decisions. Doctors agreed.

Doctor agreed they should have asked me. (I’m not just family, I’m POA).

It’s not that important to me, that they didn’t ask my permission. I know they did what they think is best:

give blood transfusion.

It appears now, that blood transfusion was necessary. Not optional.

It is possible that 1 of the many reasons my sister feels so well now, is because of the blood transfusion.

——————————

Luckily, there was no sepsis.

Just UTI, not severe.

But suddenly “maybe bleeding ulcer”. Suddenly anemia.

It’s possible the ulcer was already there.

It’s also possible it was caused by stress and strong medications in hospital. Our urologist (he’s not from the hospital) said this now.

It’s also possible there is no ulcer.

We won’t do invasive testing/anesthesia. Too risky. And even if test says ulcer: we won’t operate. Too risky. So no point to test. Our urologist agrees.

Our urologist is very optimistic about my sister:
1. the bleeding stopped today
2. it’s possible it heals on its own at home, calm, no stress

We’ll need luck.

Right now, my sister feels very good.

Tomorrow she comes home!!!

Thanks for everyone’s kind support!

Here I Am
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dear here i am :),

i'm wishing for things to turn around for your sister!!!!
it is possible.
sometimes things work out, the body fights!!!!

hug!!

bundle of joy
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Thank you bundle of joy!!!

Thank you, all of you!!!
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UPDATE

:)
Dear all,

THANK YOU for your support in a very difficult time for me.

You let me vent, and you gave me warnings and support!!

My sister is on her way home now, after about 1 week in hospital!!
:) :) :)

I want to add some details below, in case it helps someone in the future. Of course, every case is different. ——

1. It was a good idea I refused anesthesia. I also refused invasive (stomach) testing. No point. My sister is elderly. Only risky. And even if they discover something, we’ll never operate.

2. Our urologist (not from hospital) (I was in constant contact), was right!! “Maybe stomach ulcer” (hospital doesn’t know if there was an ulcer; we didn’t do the invasive test to check) went away, after calm. Our urologist said: he believes she never had an ulcer before the hospital, and it suddenly appeared after hospitalization (due to stress of hospital, stress from UTI, + strong hospital medicine) (that was my initial instinct too).

Please be careful when you decide whether LO should go to hospital. There are risks. Sometimes, there’s no choice and you must go to the hospital.

We could have gotten our private urologist to see my sister at home, treat at home. (Sometimes possible; depends how bad the situation is).

I didn’t decide to bring my sister to the hospital. I was not home in that moment. The caregiver made the decision. The caregiver is a lovely, competent person. We have agreed however, that from now on, my sister will not go to the hospital again without my consent (caregiver will call me). (Exception: falling, possible broken bones, ok to go to hospital without my consent).

3. My sister has always had some anemia (but every doctor has said it’s OK). It’s possible hospital decided unnecessarily to treat the anemia.

4. I have POA. My sister wants me to make decisions under some circumstances. The hospital doctors know. Next time they’ll always ask my permission.

5. My sister was given blood transfusion against “maybe ulcer bleeding” without my consent. That’ll never happen again. (Day after being hospitalized, she suddenly had bloody, black stools. But then, bleeding stopped some days later.)

6. UTI fine. They fixed it.

7. Blood transfusion:

please be careful before you accept.

Sometimes necessary to save life (then personal choice, or religious, if you want; if your family wants).

Sometimes not necessary (like my sister). It only adds more risk. My sister is full of energy, healthy, very good blood. Be careful before you agree to accept someone else’s blood.

Anemia can be treated in many ways (blood transfusion not always necessary).

Ulcer bleedings can stop on their own (our urologist was right: he knows my sister’s medical history well. He said this is from hospital, stress, medicine, etc. It will stop on its own).

Please do research on blood transfusions: they are often over-used in hospitals (I’m not talking about when you’re in an accident, bleeding).

8. Goooood luck everyone!!!!! My sister is very lucky. She’s OK!!!

9. This is our personal decision: we will never accept blood transfusion for anemia. We will always look for alternative treatment. It’s a personal choice. My sister doesn’t want blood transfusion against anemia (they gave her blood, but she was unfit/unwell to make a decision. She was in a daze/incoherent/confused. Hospital, as said, admits they should have asked me.)

Our bodies create new blood every 4 months. Then the donor blood in my sister’s body will be replaced by her own new blood. Good.

10. My sister is soooo happy to be home. This ended very well.

11. Our private urologist comes to the house tomorrow, to check.

12. Our private cardiologist comes to the house also, to check all the results and try to reduce all the medicines back to how it was before hospital. (My sister only had 1 little pill, 3 times a week).

THANKS FOR YOUR SUPPORT, in a very, very hard time for me (crying, praying) !!!!! :)
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:) Just adding to my update below.

Of course, one should ask a trusted doctor’s opinion, about one’s own case.

Keep in mind, that in hospital, doctors might not warn you about the risks of various things. In a rush. Some don’t care. Some care.

I think it’s very useful to learn from others’ experiences.

For example, it was through this forum that I learned how dangerous anesthesia can be for elderly people. (Many people regret putting their LO through it; after, the LO was not the same, mental decline (sometimes permanently, sometimes temporarily.)

If one is lucky…one should try to avoid…doctors and lawyers.
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Greetings! This is just to thank you all once more!!

Many of you helped me, while I was so worried for my sister. It was very nice for me to have your comforting words.

My sister is doing incredibly well. Recovering very well. Healthy!

Back to her normal mental self too: happy, full of energy, witty.

THANK YOU for your support in the very rough patch some weeks ago.

Enjoy the weekend! Wishing luck for you too, and your families!

Here I Am
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fantastic! what a relief for you, and your sister!!

celebrate, relax, enjoy!

bundle of joy
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Thanks!!!
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Glad to hear this! I am also glad to see you inherited your sister's sense of humor & wit, based on a comment I just saw you leave a poster here on AgingCare.......LOL.
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