Another serious nose bleed

[Jancis]

My uncle had a very serious nose bleed a few weeks before he suffered a massive mental breakdown and was sectioned. The nose bleed caused him much trauma and apparently his house looked as if a murder had been committed - there was so much blood. After this event his mental health went downhill in a matter of months and he was eventually diagnosed with dementia and psychotic depression. This was in Dec 2008. Long story but he is now in a good nursing home. He has had another serious nose bleed today and was taken to hospital and the bleeding has been stopped by cauterisation. He was going to be discharged back to his NH but his blood tests revealed anaemia and so the hospital have kept him in overnight and say he may have to have a transfusion in the morning.

We are very worried. He's 81 and has recently lost 2 of his toes because of complications with diabetes.

My main concern is today's nose bleed and wonder if this is related to his illness (dementia). I hope this does not portend another decline in his health.

Also a blood transfusion sounds quite a dramatic procedure?

Does anyone have any thoughts on this?
Thanks in advance
Jancis

[Sue J]

My uncle had a very serious nose bleed a few weeks before he suffered a massive mental breakdown and was sectioned. The nose bleed caused him much trauma and apparently his house looked as if a murder had been committed - there was so much blood. After this event his mental health went downhill in a matter of months and he was eventually diagnosed with dementia and psychotic depression. This was in Dec 2008. Long story but he is now in a good nursing home. He has had another serious nose bleed today and was taken to hospital and the bleeding has been stopped by cauterisation. He was going to be discharged back to his NH but his blood tests revealed anaemia and so the hospital have kept him in overnight and say he may have to have a transfusion in the morning.

We are very worried. He's 81 and has recently lost 2 of his toes because of complications with diabetes.

My main concern is today's nose bleed and wonder if this is related to his illness (dementia). I hope this does not portend another decline in his health.

Also a blood transfusion sounds quite a dramatic procedure?

Does anyone have any thoughts on this?
Thanks in advance
Jancis

Hi Jancis

Sorry to hear what your Uncle's going through. A blood transfusion in itself is not really a dramatic procedure but may not be perceived as such by your Uncle because of his dementia. I hope it goes Ok and he is not too bothered by it, if he's been suffering with anaemia it may make him feel a lot better, I hope so.

Love
Sue
x

[FifiMo]

Jancis,

You might find that the nose bleed is due to thinning of the blood vessels in general, which of course can also be one of the contributory factors to some dementias. On the other hand I had such a nose bleed a few years back - was watching tv and sneezed and ended up in hospital for 5 days and like you said - the amount of blood loss was phenomenal. So it can happen to any of us really, I think.

So far as the blood transfusion goes it is by far the fastest way to counter the anaemia. Use of things like iron tablets all take time and can have side effects like causing constipation etc. Maybe this is why they are thinking of the transfusion as it will deliver immediate benefits for your uncle.

I hope that he is a lot better tomorrow and gets back home to the NH soon.

Fiona

[Jancis]

Thank you Sue and Fiona for your kind and reassuring comments, whenever something like this happens to him I always expect the worse. The NH has just phoned to give me an update, he's having 2 units of blood this afternoon and hopefully will be discharged tomorrow. The nurse asked if he'd been behaving himself and they told her he was fine so long as they leave him alone! I found some information about transfusions for anaemia and it sounds as if this is a simple way to correct a low blood count. Sounds like he'll have to bear with the cannula in his hand or arm for several hours and he'll be monitored regularly so he won't exactly be left alone - just hope he is able to co-operate. He has his little toy dog with him so am hoping this will bring him luck.
xxx

[Nan2seven]

Dear Jancis,

I hope all goes well with your uncle's blood transfusion this afternoon. Brian used to have them on a fairly regular basis, but those that were needed after the diagnosis of his vascular dementia became more and more problematical. Following one of his major nose-bleeds here at home, his trip to A & E and the decision to give him a transfusion (which turned out to be his last), he had to be given light sedation and a nurse was sent to sit with him for the time it took the two units to go in - because he had been trying to remove the canula.

I hope your uncle will soon be feeling very much better. The transfusions used to render Brian quite "bright-eyed and bushy-tailed."

Love, Nan XXX

[Jancis]

I hope your uncle will soon be feeling very much better. The transfusions used to render Brian quite "bright-eyed and bushy-tailed."

Love, Nan XXX

Thank you Nan. I love that expression, it sums up exactly how my Uncle used to be, before dementia.
Take care, Jancis x

[Mariondb]

My MIL had 3 serious nosebleeds prior to any diagnosis of dementia - each one needing emergency admission to hospital. Like your experience, her flat looked like a murder scene!. She was also transfused because she was anaemic....if you lose blood you will be anaemic, that is par for the course and transfusing is the quickest way of replacing it and it should be done before he returns to his NH to restore his oxygen levels.

I don't feel this is related to dementia but more underlying problems that could cause dementia. In MIL's case it is more likely blood pressure with thinning of the blood vessels...the blood has to go somewhere! Unfortunately she also had a habit of picking her nose absent-mindedly (probably a sign of dementia as she knew very well and was told continually not to do it), which I am sure probably exacerbated the problem.

Since her blood pressure has been managed, she has not suffered another for over six months - despite the fact that I suspect she probably still picks her nose with alacrity!

Nosebleeds are incredibly traumatic for anyone at any age. It may well be this is a blood pressure problem but prior to discharge I would make sure you have a clear diagnosis of cause because also his NH will doubtless need to know.