Medical Opinion

[toltol]

My Father had a second stroke about 12 days ago my concerns are around the care he"s receiving in hospital. This time he was not put on any water (drip) for three days, he's now receiving water but intermittent. Yesterday he was on 83 mlph, today he got nothing until this evening, family were asking for it all day but it took them until tonight to put the cannula back in.
The stroke was 11 days ago and he's not yet been given any food, he's getting weak and we are really concerned. The doctor came on Friday morning and said an NG tube should be fitted but this has not happened as apparently the dietician did not stipulate how much food should go in so the staff are powerless to act until he/she returns and gives direction. It all just seems totally inept and we are very worried about him. Last time this happened (six years ago) it took them five days to give him water and about four weeks to give him any food (NG tube).

[toltol]

Good stuff Ann, you were right.
It's pretty much what we had to do with this hospital last time but well worth it. I just never imagined I'd have to protect my family in a hospital but we'll do it again if we have to.

[Rosetta]

headwreck, bad care is bad care wherever it happens. What I wanted to point out was that the LPW is a Uk initiate, as discussed in a previous post on here, and not applicable to S Ireland as far as I am aware

[toltol]

Will do Headwreck, thanks for your help...I see you too have experienced Ardkeen, fun eh?

[gness]

Toltol....you and your family must do what you feel is right...and it is what you feel that matters...Doctors and nurses are not always right and dietitians were useless in my long experience.
I once hauled my husband out of a bed, into a wheelchair and took him into the hospital garden, refusing to return til they had sorted what was wrong.
I have used the threat of solicitors and press...and I am not a confrontational person...just want things to be right....x

[Sqad]

Are we getting the whole story here?

On the face of it, it looks a poor standard of health care.........on the face of it.

6yrs ago he had his first "stroke"......that could mean many things.....
did it affect his face, speech swallowing, arms or paralysis of his legs?
Has he any underlying conditions...diabetes, high blood pressure, blood disorders, dementure.........?

How did his "second stroke" make the results, if any, of his first stroke worse?

How old is he?

The whole picture needs taking into consideration.

[toltol]

Sqad: The whole story is a long one but six years ago my father's stroke was diagnosed as so severe that he would never walk or talk again...that he would have little understanding of the world and we should think about withdrawing care but we saw signs in him (because we know him) that said to us he wasn't all gone and asked that he be given a chance. Over the coming weeks we had to ask for the 'No Resusitation" to be taken off his notes several times, they kept adding it back. Water was not given to him for five days and food was not forthcoming for several weeks (memory says over four). One morning I loooked at his notes to see that a medication had been administered it had then been crossed out and someone (I presume a doctor) had written 'wrong patient'. Then in big letters across the entire document 'Rewrite these notes'. As I previously explained physio was not given for the entire seven weeks he was in the hospital as he would not sit up straight. Yes, my father is old (he's now 74) and he did lose the use of his arm but once he had been given some rehab he learned to walk again and he was fully aware of his surroundings and could hold conversations with his friends and family...Two weeks ago he cut down a tree in the back garden. He ate well and enjoyed his life. As far as this stroke goes we've yet to see what he can do but have been told that he's out of the acute stage and he's showing signs of recovery, he's moved the arm and leg on his good side, understands what we're saying (following commands appropriately) and has spoken a few words.

We are just trying to work out why it seems to be taking days to feed him (in any way) or give him a consistent amount of water Yesterday his cannula had come out in the morning and was not fitted again until today. in the meantime (and after many requests) he was, last night, finally given water subcutaneously at a very low rate which we were told many days ago was just enough to keep him comfortable not enough to fully hydrate him.

We realise that he may not pull through, all we are asking for is for him to be given a chance to see if he can.

This, along with the other posts I have written doesn't look like good or consistent care to us and that is what I would someone to answer, is it or are we expecting too much of the medical staff?

[toltol]

Hi Headwreck,
Mum was there today and did manage to speak to the doctor who said he would like him to start eating but again and recommended that he should be on about 2000 cals a day but he went away and never came back.

We have another relative flying out as we speak and he'll be going with her to the hospital in the morning. We also made enquiries into solicitors, press and external medical staff, waiting to hear back from all three but will hopefully have some news in the morning.

[toltol]

Thank you for your concern, very kind of you.

Will let you know how we go.

[Sqad]

toltol...thank you for taking the time to give a full account of the situation.

In the "old days" of the NHS, your Consultant would be in charge of the medical management of the patient, Matron, the nursing aspect and at the end of evening visiting the House Surgeon ( junior doctor) would be available in Sister"s office to answer any queries from the relatives.

This seems to have disappeared and doesn't help you at the moment.

Please don' t go ranting and raving to anybody.....it is usually counter productive in the long run.

If he cannot swallow, this would pose quite a problem in the long term especially with someone who may well be immobile and unco-operative.....IF this is the case. Long term feeding by a stomach tube has it's problems.

I would ring the secretary of the Consultant and ask for an interview to be arranged to explain the medical management and also to pose your concerns.

Keep us informed.

[toltol]

Update:

He's still alive!
He's been on a thousand calories a day and listless until two days ago when they upped the food to fifteen hundred a day. Back to being alert, smiled a few times, spoke a few words noded in the right places and lifted both his arms... odd as he could only lift one before....amazing what a bit of food can do! Plan is to sit him up tomorrow, it was supposed to happen today but I think that was probably an efficiency too far!

[pixie373]

Brilliant. So glad he's on the mend x

[marval]

It sounds good, I am very pleased for you all.