Don't Know What To Do!

[horseshoes]

A couple of weeks ago, my 85 y.o. dad had some sort of "fit" - violent shaking, not just trembling but REAL jerking movements! Mum spent AGES trying to get out of hours doctor, and eventually phoned hospital to make sure she had correct number. Anyway, the paramedics came out to him, and in fairness they were wonderful. Dad's BP and heart were OK and they couldn't explain whA was happening and said to Mum they would like him to go to hospital, but they have to speak to Dr first. Dr didn't want to admit him. 3 days later he had another episode, but this time it looked for all the world like he'd had a stroke. Slumped to one side, dribbling, slurring. We rang 999 and first response paramedic came out. Spent ages monitoring him. Again heart and Bp OK. He phoned ambulance to take Dad to hospital. After 7 hours in ambulance and A&E cubicle, he was admitted and next day had a "brain scan". This was Ok and they sent him home. This morning, he's had another "episode". Dr (not ours) came out and didn't know what was wrong. Suggested physiotherapy and perhaps a walking frame. (He can walk perfectly well)!!! He has appt oct 26th at a geriatric hospital. In the meantime, poor Mum is beside herself. Nobody seems to know what to do. Are these episodes common in elderly? If they are, then it won't be so worrying but nobody can tell us anything. I should also mention, that Dad has been on morphine for over 30 years and so other drug that stops him being sick from the morphine. The dr in the hospital last time said he shouldn't be on the other drug and withdrew it. If it was that drug causing this, wouldn't it now be out of his system?

[Sqad]

\\\\ Are these episodes common in elderly? If they are, then it won't be so worrying but nobody can tell us anything.\\\\

Yes...more common than one would imagine and the bottom line is that investigations in these elderly patients reveal no cause as is the case with your Dad.

\\\If it was that drug causing this, wouldn't it now be out of his system?\\\

Yes, depending upon how long was the last time he had taken it.
I can't see that these "seizures" are drug related.

For what reason has he been taking morphine for so long a time?

[RATTER15]

In 12 years of caring for the elderly I have never experienced this except in known epileptics, so a new one on me!

Thats not to say that it is that unusual, most likely something that is age related going on in the brain but I'm no expert.

I hope it gets sorted soon.

[horseshoes]

Thanks for your reply Sqad. He had a very bad accident around 1968, and subsequently underwent many spinal operations at Walton Hospital in Liverpool. He has total fusion of some "C" bones ? at top of his spine, and has some sort of wire from his brain? Spine? into a box in his lower abdomen. He's never been fit and well since that accident, and does have tremors. His father had Parkinson's, but Dad has never had a diagnosis of it. These episodes are frightening him, and distressing my Mum too. Once he stops the jerking motions and "comes round", he's quite lucid. What are these episodes called?

[horseshoes]

Thanks to you too Ratter. That's the problem; it's not getting sorted!. The Dr who came this morning said to my Mum, next time it happens, film it!!

[Sqad]

Jacksonian Epilepsy (focal epilepsy)

Walton has an excellent Neurological and Neurosurgical Unit......he would be in good hands.

Yes, i can see the need for his morphine.

[horseshoes]

Sqad. I'm sure they could. Unfortunately he isn't getting referred anywhere! It's been years since he had his last op there. They said then - no more ops!

[Sqad]

Horseshoes.......going off the track for a moment.
Is your friend with the Endometrial Carcinoma still alive?

[horseshoes]

Yes she is Sqad! She's just completed 8 rounds of chemo and is doing well! She's lost all her hair and is rocking a lovely selection of headscarves and wigs.

[Sqad]

That's good horseshoes.
An afterthought........seizures are not uncommon in patients with Parkinson's Disease, so food for thought.

[horseshoes]

This is a message I had from her after 3. treatments:

Dear Mal,

Just want to share some positive news with you. Went for third chemo session yesterday and the oncologist called me in to see her. After only two treatments, the cancer marker number has dropped from over 200, down to a normal range of 27! (Anything below 35 is normal).

Still have to complete the eight sessions but this has given me an incentive. Won't know if the tumours have shrunk or gone until a scan in October, but they haven't grown, so the chemo is doing it's job and should give me more time.s

Hope you and your family are all well and that your garden is progressing according to plan !

Lots of love Mal and thanks for all your good wishes , thoughts and messages. I really believe your good vibes are of great benefit to me xxx

[Sqad]

:-)

[horseshoes]

Sqad, do you think it appropriate that we ask for a referral to a neurologist, or is it not feasible at age 85, which is what I'm beginning to suspect.

[Sqad]

Right...a problem. If he was a fir 85yr old then i might seek a Neurological opinion. If he was an unfit 85yr old, I might let "sleeping dogs lie."

Difficult. Mention a Neurological opinion referral to the Geriatrician. ....and see what response you get.

Don't expect too much enthusiasm.

[horseshoes]

Will do Sqad. I suspect you're spot on. Thank you so much for your opinion and advice.

[dannyk13]

Sqad. Are you saying that an 85 year old (fit or not) is not entitled to the best quality of life available to him?

[bednobs]

the best quality of life isn't necessarily about getting every single treatment/surgery/medicine that you could hve

[Sqad]

Not at all.
I am saying that a neurological approach with ensuing investigations, is extremely unlikely to offer a diagnosis or therapeutic solution which would lead to an improved quality of life.
It is important not to plant unreasonable expectations which would be in the case that we are discussing.

[dannyk13]

OK, that sounds reasonable.

[horseshoes]

Danny, I understand what Sqad means. Also, I don't think it would be beneficial to put my Dad, through what tests could entail. I just wish someone would say something that would make him feel better or at the very least less scared.

Thanks all.

[anneasquith]

That is the job of his gp surely H..?