Begging For Help!!

Specialties MICU

Published

Thank you to anyone in advance that may have some insight on this situation.

My mother had total knee replacement on last monday 3/12/2012. Sugery went well, and was eating a meal 4 hours later.

Day 2, still doing well, sitting in a chair and eating a much larger meal.

Day 3, got a call saying she was unresponsive and being taken to the ICU.

She developed some ticks, tremors, confusion and speech issues. All meds stopped at 1AM. Initial thought was sarotonin syndrome and or delirium.

Day 4 and 5 condition the same, but not immediate recognizing of me or surrounding. Some strange dreams/hallucinations. Increased agitation Only given IV fluids

Day 6 I got a call saying they had to restrain and intubate her. extreme agitation. They started to give her Ativan after flushing her system

Day 7 condition the same, but less responsive. Switched from ativan to precedex. They also started her on propofol to allow quicker mental assessments.

Day 8 still very agitated. Nurses describe her as an alligator wrestling prey. Precedex and Haldol being administered with the propofol. still a lot of ticks and twitches and aggravation

Day 9 same course, but when brought out of sedation, there was 10-15 minutes of calmness and able to nod yes to a question or 2.

Day 10 same again, but got an hour of calm awake time.

Day 11Today when they lowered her sedation, the DR. did not get her to follow commands too well, and not able to track with her vision. This was in the AM. This afternoon when I went to see her, she was tracking well, and following basic commands. She recalled her brother visiting. This lasted about 3 hours, but then got right back into her uncontrolled ticks of moving er legs, arching her back and shaking her head no continuously. All tests and scans have come back with no answers thus far and everyone is baffled. The only meds I can think of her taking that could be in question would be Paxil and Topomax. She is only a social drinker with her group she plays cards with, so I dont think alcohol is in question.

Please ask any questions you have and I will answer them to the best I can. There is something that is being overlooked somewhere. At this point, they are leaning towards transferring her to Hopkins or University Medical Center here in Baltimore.

I am only seeking a broad spectrum of thoughts and opinions and nothing more. I am just looking for any more possible questions that I could ask the doctor that have not been asked yet or ideas that have not been investigated. What better place to try to gather information other than the people that spend the most time with the patients.

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Specializes in LTC, assisted living, med-surg, psych.

I'm sorry your mom is going through such a rough time. :hug: Sometimes with older people, it takes time for the anesthetics used during surgery to work their way through the body systems, and the intervening days can be very trying for all concerned.

Unfortunately, however, it is beyond our scope of practice as nurses and nursing students to offer medical advice. The people best qualified to answer your questions are the doctors who are in charge of your mom's care; please feel free to share your concerns with them and ask them what they think could be going on.

Sending you both good wishes for a swift stabilization and recovery. :)

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Believe me, I have asked tons of questions, but have gotten nowhere. The neurologist is stumped as well. The rest of her body is in good health, even during this situation. I was only posting here in hopes that somebody may have seen something similar to this, or at least seen some better results this many days into the ICU stay. I know serotonin and delirium can last up to a few weeks if thats what it really is. I have really been trying to read up on the meds she is being given. Can anyone tell me their true feelings on the precedex and propofol being used for extended periods? Her max on precedex is .7mcg and the propofol has been up to 60mcg, but they are trying to wean her off of it. When I left tonight, she was at 20mcg. However, when she was in a better frame of mind for the 3 hours today, the propofol was at 5, and the precidex was at .5. Could these meds add to her agitation, and are they safe for exteneded use? I trust the staff tending to her, but I still like to reassure myself. I would trade places with her if I could. I know she is scared being hooked to these machines right now.

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Specializes in RETIRED Cath Lab/Cardiology/Radiology.

Sometimes all you can do is try one thing and another, and/or apply some tincture of time . . .

So sorry this is not cut-and-dried, how frustrating for you all!

I hope the staff can sort out what's going on, and that your mom improves.

Per the Terms of Service, and for your protection, no one on this site is able to offer any medical advice or speculate about what may be going on.

Therefore, this thread is being closed for now.

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