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We received call from NH saying MIL hemoglobin *(red blood cells) was critically low & that they called for ambulance. My huband and SIL went to ER to meet it.

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the transfusion were probably lifesaving in themselves at the time. I assume there is not a DNR in place. Do you really want these interventions in someone this age with dementia. I would not. Is there any evidence that she is bleeding from anywhere? Are they sure she has not done something like fracture a hip? It would not necessarily be obvious and you can loose a great deal of blood into the tissues when that happens. To me this is screaming Palliative/Hospice care. maybe she fell and ruptured her spleen. There are so many unknowns here and in the elderly the perception of pain is likely to change. Take your time.
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Two things to think about for Monday:

1. What is MD looking for?
2. What does he plan to do about it if he finds it?

Unless there are clear answers to those questions, leading to likely, demonstrable benefit, putting a frail lady with dementia through a colonoscopy is not ideal. Don't be afraid to say enough.
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Utzie50, I am sending prayers that you find useful answers. Keep the faith.
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Utzie, if it turns out she's not making enough RBC's, then they can give her a medication to help stimulate the marrow to make more. It could work if that is what your choose. Is her B12 and other nutrients okay? (I know it's too late to check now, since she received blood. Maybe they ran a panel first?)
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Don't be (openly!) annoyed with DH: I'm sure he'd rather just not think about it, let alone discuss it. When we had a similar dilemma, I canvassed views from all close family members (didn't help - twelve people, fourteen opinions), and the one best qualified to give a clinically informed reply came back with "oh, poor Granny!"

Hope you get some sensible answers via SIL, and that meanwhile MIL is more comfortable now that she has a measurable red cell count :) Thanks for updating.
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Yes they are tough decisions but a family meeting might be helpful with listing pros and cons of her desire for treatment/ wishes. Dementia is increased by lack of oxygen to the brain and that can be caused by low hemoglobin. Something to take into account .... Hope all works out
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I appreciate everyone's thoughtfulness and knowledge. Hopefully, we will know more tomorrow.
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Utzie, thinking about you and your family today.
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Thanks for the update. Will they be able to remove the polyp during the colonoscopy, or will there have to be a second procedure? I understand that you are not sriving this bus, but with a person of that age who is frail I worry about the electrolyte imbalance/ that might be caused by the prep.
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I am just throwing up my hands in horror here. Why find out if the bleeding is coming from the colon if everyone agrees that M/L is too frail for surgery/chemo.
If that much blood has been lost and it is coming from the colon it would be pouring out of her rear end! What do they plan on doing stuffing her up with Tampax. This borders on elder abuse. They plan on force feeding her a gallon of noxious fluid tonight, letting her suffer the inevitable diarrhea and then in the morning subjecting her to the actual colonoscopy which hopefully won't be too uncomfortable. However given her age and condition they will most likely be pretty sparing with the sedation because of the risks involved.
The POA and the rest of the family need to be lined up and given a gallon of the prep,then made to stand in line for ONE toilet.
I can't write anymore I am so incensed.
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