Mid-brain cavernoma

It is not unusual for patients with increased ICP to be thirsty and crave and drink huge amounts of fluids. We often had them on fluid restrictions and shut off the water to their rooms. I would assume that if the doc was concerned he'd have the patient on fluuid restriction and in ICU and on ICP monitoring.

Did you read what was in the doctor's progress notes to see what the medical treatment thinking on this is? This condition cannot always be repaired.

• http://www.avmsurgeon.com/cavernoma/deepcavernomas.html
  
• http://www.medi-fax.com/atlas/brainaneurysms/case29.html
  
• http://www.brainavm.uhnres.utoronto.ca/case_examples/case_Cavernomas_ST.html

I got it. We aren't the doctors though. They are the captain of the ship and often know the patient and what the plan of treatment is. Sometimes they don't disclose it in the chart. All we can do is notify them of our concerns and document that we did so. After that, it's up to karma. I would have started daily weights on this person to monitor the fluid status more closely since I&O on these people isn't always accurate or the patients aren't thinking normally or following directions. Our neuro patients were very creative in how they got their fluid (they would drink mouth wash and the water in flower vases) and how they got rid of it (they pee'd in trash cans, cups and any other kind of container they could find).

one of the hardest lessons i had to learn over the years was that the doctors don't save everyone. sometimes not every patient is savable. not every patient wants to have every medical treatment done to them that can possibly be done. one of my doctors told me recently when i reminded him again that my advanced directives were in my chart and i wanted the plug pulled if i coded that he wanted to be a smoking spot in the bed when he finally died, meaning he wanted everything possible done to keep him alive, and i couldn't stop laughing for days over that. you had to be there to get the humor in it because he's an oncologist and he was quite cheerful when he said this. anyway, the goals of treatment fall into 3 categories, two of which people often forget about:

• improvement of the patient's condition/cure
  
• stabilization of the patient's condition
  
• support for the deterioration of the patient's condition
  

everyone is rooting for a cure, but the fact is that stabilization and deteriorization happen a lot and they are sometimes hard for people to deal with. nursing homes and cancer centers are not popular places to work because of this. end of life care is very different to tolerant emotionally for many people.