What do the doctors tell you? And what tests have been done. It is entirely possible to have a stroke during surgery. Many many elders have a profound reaction to anesthesia. Anesthesiologists seem still to deny this, but I saw changes often in the elderly, mostly profound confusion, sometimes a decent into instant severe dementia. In some cases this got better, in some it did not while hospitalized; I wouldn't know the outcome once in rehab. Speak with the doctors about this change. They are your best guides at present. As if a CT or MRI of the brain should be done. Wishing you good luck. You can look up "anesthesia side effects in the elderly" on any search engine.
One word. Anesthesia. With all our knowledge medically it is often over looked. Anesthesia is incredibly hard on a human being... on mammals period. It is hard for our bodies to clear it out completely and when someone is older compromised already it can be devastating. My husnband had encephalopathy from liver disease. his ammonia shot way up and he fell into a coma. his breathing became unstable and inadequate they put him on ventilator. The anesthesia /paralytic required to keep someone on a ventilator is horrific. He has never been the same. He has what presents as dementia he has aphasia pretty badly . He cannot walk anymore though physically the therapist said there was no reason he could not recover from hip surgery ( done right after the first coma.) he gets confused does not know who I am does not recognize our condo . the only ones he remembers solidly from day to day is the dog and cat. He can be aggressive sometimes physical. I talked to the doctors and finally one of them told me that it was the anesthesia. It is too much when they are compromised already. I did a double take when I was reading and i noted you said that wild almost fearful look. I have seen that look on his face . I do not know what to call it but if you have seen it you cannot forget it it is distinctive. Like they are seeing the world as a totally alien place where nothing and no one is recognizeable.
Perhaps your dad may have had a seizure. A neurologist should be able to provide some answers knowing about the incident after the surgery. Take care and God Bless.
Bebovar, I am very sorry for your sudden loss. I am a factual person & would be inclined to look for answers too. Sometimes it is the sum of all those factors together.
A broken hip is hard to heal from when older - sometimes even referred to 'the beginning of the end'. I work on an orthopedic ward as an assistant. Those with Parkinson's have an even harder time getting up & mobile again & even with supervision, fall & fall again collecting even more injuries each time. This can be a long & awful road.
I wish you peace at this hard time. Your father is free of all of that now. Many (((hugs))).
Your description of your dad triggered a memory for me.
Years ago, my mom was in the neuro ICU at a big teaching hospital. There was a man a few beds away, facing my mom. His gaze was fixed, glassy and somewhat terrified looking.
My mom, who was in a somewhat altered mental state due to a UTI and electrolyte imbalance, kept saying "that man is staring at me, make him stop".
I remember saying to mom "that man has had a stroke mom, he can't move". It was a visceral response on my part, not one that came from any specific knowledge, if you know what I mean. I suspect that was true of your dad, that he'd had a stroke.
Bebovar, I am so sorry you are going through this.
First thoughts: delirium...or stroke? Overdosed on opiates? (Are his pupils normal or pinprick?)
Does MRI/CT brain scans show anything?
He would have missed his Parkinson's meds maybe before surgery & now? Can he swallow? Suddenly stopping Parkinson's meds would severely mess with his Parkinson's.
Hi Beatty - Thank you for your kind words and suggestions. We’ve lost him now, so we will never know for certain. But your suggestions have given me peace of mind. I have been looking for someone to blame. It is no one’s fault. I wish you peace, love and comfort.
Bebovar, I'm so sorry for your father's troubles and your family's anguish. The most likely culprits are stroke or reaction to the anesthesia. I'm not sure there is any way to know for sure if it's either of these, but you could ask his surgeon. Parkinsons definitely can complicate things. If it's either of these 2 events, the hospital should not be liable so I'm not sure why they aren't being more helpful...unless he's on Medicaid and further non-essential testing is not covered. I definitely concur with the other commenters that getting him the best care going forward is the focus, but you will have a better understanding of how to gauge his progress if you could know what caused his current condition. I wish you progress in getting to the bottom of it all. May you have peace in your hearts as you help your father.
Thank you for responding. We’ve lost him now so we will never have our answers. It was just so odd that he could breath on his own and open and close his eyes yet he could not speak, eat or move. I wish you peace and comfort.
Is he on a respirator or any sort of machine that is helping him breathe? If not, I don't think he could be "brain dead" because breathing requires the brainstem for that function.
Have you asked what their prognosis is? (in those words?)
Is PT coming in to stretch him while in bed?
Have you asked if Hospice is the appropriate thing at this time?
Thank you for responding. PT did come every day and move his arms and legs. He never responded. He was breathing on his own. His heartbeat was strong. He could not eat or move. He could only open his eyes and look around. What is that called? So strange. Unfortunately we lost him. It haunts me. But I know that he knew he was loved very much. I wish you peace and comfort.
Bebovar; I'm so sorry to hear about your dad's condition.
Is he currently in rehab?
You say you have asked his doctors questions and they have no answers. May I suggest that you ask "if this was your father, tell us how you would proceed?"
I discovered quite by accident that this question got me the best answers.
Quite frankly, it may not matter WHY he is in the state he is in; what matters is what is the best course going forward.
This is so hard and such uncharted territory; I feel your pain.
Thank you Barb. I appreciate your kind words. I agree that what matters is how we care for him moving forward. I just don’t understand why the doctors cannot tell us if he had a stroke and if he is brain dead. Instead we look at him every day. He stares back. He cannot speak, he cannot move any body parts. We worry he’s trapped in his body and is coherent. We want to help him escape. Or is it he has no idea what’s going on. Why can’t his doctors answer our questions. They’ve begun to stop by less and less and check on him. He is breathing on his own. His heart continues to beat strongly. Why can’t they just tell us if he is brain dead or not.
Did he have the stroke before or after his surgery? Hip surgery is very serious. Its a shock to the system and anesthesia can cause a decline especially if Dad suffered from Dementia. It may take a while to get the anesthesia out of his system.
Thank you JoAnn. He was in pain when we rushed him to the hospital ER but he was coherent, talking, had a good memory. After he awoke from surgery that is when he had an episode in bed where he had a strange wild look in his eyes, he whaled loudly, shook, arms stiff, has never spoken or moved since. He stares, he breaths on his own, his heart is strong. The only reason they are keeping him at the hospital is because he has a fever which means infection. We just do not understand why his 3 different doctors cannot tell us if he is brain dead or trapped inside a body that will not move. It is torture.
Have you asked his doctor or multiple doctors if he has more than one specialist involved? It’s impossible for anyone who isn’t there to say based on your post but I could speculate perhaps he had a stroke or TIA or something around surgery or it could just be that something around the surgery simply sped up his Parkinson's. Don’t be scared or deflated by these possibilities though, it doesn’t necessarily mean these affects will last and aren’t something he can work through with rehab, again that is all important stuff to discuss with the professionals treating him, it is really important, especially if he doesn’t have a doctor that knows him involved, that you tell every heath care provider working with him right now what is and isn’t baseline for him. One of the problems with elderly patients, especially ones with pre-existing conditions, in this type of situation is that it’s easy for the people caring for them to write off symptoms or deficits as “normal” because they weren’t exposed to the patient pre-event and don’t know how advanced his Parkinson’s or her Alzheimer’s is and how it presents normally. They need your eyes, ears and input to be on top of various events.
Thank you for your reply. We have asked his doctors over and over. We have been worried they have him too much morphine or he was allergic and it caused a reaction. Or he simply had a stroke. He is bed-ridden and does not respond to rehab. He just stares. We’ve asked over and over is he brain dead, can he hear us, they have no answers whatsoever. Feel like they just don’t care because he is old and just taking up their hospital bed.
Anesthesia. With all our knowledge medically it is often over looked. Anesthesia is incredibly hard on a human being... on mammals period. It is hard for our bodies to clear it out completely and when someone is older compromised already it can be devastating.
My husnband had encephalopathy from liver disease. his ammonia shot way up and he fell into a coma. his breathing became unstable and inadequate they put him on ventilator. The anesthesia /paralytic required to keep someone on a ventilator is horrific. He has never been the same. He has what presents as dementia he has aphasia pretty badly . He cannot walk anymore though physically the therapist said there was no reason he could not recover from hip surgery ( done right after the first coma.) he gets confused does not know who I am does not recognize our condo . the only ones he remembers solidly from day to day is the dog and cat.
He can be aggressive sometimes physical. I talked to the doctors and finally one of them told me that it was the anesthesia. It is too much when they are compromised already. I did a double take when I was reading and i noted you said that wild almost fearful look. I have seen that look on his face . I do not know what to call it but if you have seen it you cannot forget it it is distinctive.
Like they are seeing the world as a totally alien place where nothing and no one is recognizeable.
A broken hip is hard to heal from when older - sometimes even referred to 'the beginning of the end'. I work on an orthopedic ward as an assistant. Those with Parkinson's have an even harder time getting up & mobile again & even with supervision, fall & fall again collecting even more injuries each time. This can be a long & awful road.
I wish you peace at this hard time. Your father is free of all of that now. Many (((hugs))).
Your description of your dad triggered a memory for me.
Years ago, my mom was in the neuro ICU at a big teaching hospital. There was a man a few beds away, facing my mom. His gaze was fixed, glassy and somewhat terrified looking.
My mom, who was in a somewhat altered mental state due to a UTI and electrolyte imbalance, kept saying "that man is staring at me, make him stop".
I remember saying to mom "that man has had a stroke mom, he can't move". It was a visceral response on my part, not one that came from any specific knowledge, if you know what I mean. I suspect that was true of your dad, that he'd had a stroke.
I'm so glad your dad is at peace. (((((HUGS)))))
First thoughts: delirium...or stroke? Overdosed on opiates? (Are his pupils normal or pinprick?)
Does MRI/CT brain scans show anything?
He would have missed his Parkinson's meds maybe before surgery & now? Can he swallow? Suddenly stopping Parkinson's meds would severely mess with his Parkinson's.
I am also thinking some type of seizure?
I think you need a Parkinson's expert.
Is he on a respirator or any sort of machine that is helping him breathe? If not, I don't think he could be "brain dead" because breathing requires the brainstem for that function.
Have you asked what their prognosis is? (in those words?)
Is PT coming in to stretch him while in bed?
Have you asked if Hospice is the appropriate thing at this time?
Is he currently in rehab?
You say you have asked his doctors questions and they have no answers. May I suggest that you ask "if this was your father, tell us how you would proceed?"
I discovered quite by accident that this question got me the best answers.
Quite frankly, it may not matter WHY he is in the state he is in; what matters is what is the best course going forward.
This is so hard and such uncharted territory; I feel your pain.
(((((hugs))))))))
Hip surgery is very serious. Its a shock to the system and anesthesia can cause a decline especially if Dad suffered from Dementia. It may take a while to get the anesthesia out of his system.