Advice please about mum

Discussion in 'ARCHIVE FORUM: Support discussions' started by barmby, Nov 15, 2006.

  1. barmby

    barmby Registered User

    Nov 6, 2006
    29
    Hi..My mum lives in a residential home and she has been having diarroea for some weeks,also has constipation and she is on Movical...But today I saw her and she has lost 4lbs in a week..She looks awful and is not drinking alot...I was reasurred last week that she was not impacted as the district nurses said so but would an abdominal scan allow us to see that,rather than just a rectal examination...So now the GP is coming out to decide whether she should be admitted to hospital...Should it be taking this amount of time to sort out her diarrhoea..They just keep saying well she is not impacted.......Any advice would be good....Thanks
     
  2. jenniferpa

    jenniferpa Volunteer Moderator

    Jun 27, 2006
    39,438
    I'm not quite sure what you mean - how can she have diarrhea AND constipation? Surely they are mutually exclusive?

    Jennifer
     
  3. barmby

    barmby Registered User

    Nov 6, 2006
    29
    Mum

    She had constipation for some time and that was why the district nurses came to do rectal examinations but then over the last few weeks she has had episodes of diarrhoea which we thought was because of the laxatives she was on to treat the constipation...It was mentioned that she could be having overflow and that the impaction if apparent was high up....But it needs sorting out ....
     
  4. jenniferpa

    jenniferpa Volunteer Moderator

    Jun 27, 2006
    39,438
    Ah I see. Having done some research on this I see that (and I apologise in advance for the somewhat graphic nature of this post) liquid stool can leak out round the obstruction. From what I've read the SOP in order is digital rectal exam (which has been done) then a flat plate xray if the suspicion is that the blockage is further up. It CAN be further up, in a position which is not delectable with a rectal exam. If your mother is losing weight that fast I would ask them for some guarantee that it is not an impaction in the colon. I think you need to be pushy about this - rapid weight loss is always a sign that something is wrong, and it's up to them to work out what it is.

    Jennifer
     
  5. TinaT

    TinaT Registered User

    Sep 27, 2006
    7,095
    Bolton
    Amusing thought

    What wonderful typing errors we all make!! Couldn't help but smile at the 'not delectable with a rectal exam'. It is nice to have a smile (albeit inadvertently given) in the middle of all the upset, confusion, worries and difficulties of caring for our loved ones. And Jeniferpa you certainly tackled a complicated explanation far better than I could:)

    Hugs to all xx TinaT
     
  6. jenniferpa

    jenniferpa Volunteer Moderator

    Jun 27, 2006
    39,438
    woops!! I think I'll let it stand - it improves the whole flavour of the explanation.
     
  7. Nell

    Nell Registered User

    Aug 9, 2005
    1,170
    Australia


    Oh Jennifer! I couldn't stop laughing! You've missed your calling - you should be a comedian!
     
  8. MJK

    MJK Registered User

    Oct 22, 2004
    54
    Hi,

    I would have thought that further investigtions were definitely needed in order to rule out more serious problems such as bowel cancer. I'm not suggesting that that is what it is, but I thought that any change in bowel pattern (especially in an elderly person) was usually checked out for this.

    mjk

    P.S. It's probably nothing of the sort but my Dad died of it so it's always something I think of.
     
  9. barmby

    barmby Registered User

    Nov 6, 2006
    29
    Mum

    Thanks for the advice..The doctor is sopposed to be contacting the home this morning...If it is not fecal impaction then what other reasons could there be for mum having this diarrhoea..Its a very fluid like diarrhoea and one carer described it like tobacco like fluid.....Thanks
     
  10. jenniferpa

    jenniferpa Volunteer Moderator

    Jun 27, 2006
    39,438
    #10 jenniferpa, Nov 16, 2006
    Last edited: Nov 16, 2006
    I must say, it certainly sounds like fecal impaction. Assuming she doesn't have any other symptoms such as cramping or fever (both of which would make me wonder about an infection) I would also find out exactly how much and how long they have been giving her the Movical. If it was "regular" diarrhea, you would expect to see very frequent, almost explosive bowel movements. Also, if it was related to some form of food intolerance or allergy (another possibility) the fast passage of the food eaten through the intestine would mean that a) it would be very foul smelling and b) undigested food would be present in the stool (although that would also be the case if she had an infection). The other main casue of diarrhea is a parasite - not what you would expect in the UK, but it happens.

    Hopefully by now the doctor will have been and put a plan into action. If he's inclined to take a wait and see approach, be pushy. Ask him for a specific plan, and what will happen if she has a seizure before that point (a not unexpected result if she's dehydrated). Sometimes, pointing out that you are aware of potential dangers is enough to push them to be a trifle proactive.

    Jennifer
     
  11. barmby

    barmby Registered User

    Nov 6, 2006
    29
    Mum

    The GP was soppossed to come out this afternoon to see mum but he has faxed the home and said he will refer her to the Geriatrician who is sopposed to come tomorrow or Monday...We will see!This site has been so helpful recently when there has been queries so thanks for that..The place where mum is is a very good home but I feel they have just hoped that it would sort it self out and the GP I would of thought would of referred her earlier...Instead they have been treating the constipation one way or another,,,Even the Specialist who deals with mums Alziemers said a week ago that the diarrhoea should be sorted out and was genearlly concerned....She is also on a liquidised diet and some solids,reluctant to take fluids but the home insisits she is not dehydrated...It is a residential home..I just feel that something isnt right....
     
  12. barmby

    barmby Registered User

    Nov 6, 2006
    29
    Mum

    HI....My concern for mum still stands as she will now see the Geritrician on Monday so she has to endure another two or three days of diarhoea before something is done...Mum cannot tell us how she feels,if in pain...She is taking diet and some fluids but like we have pointed out is she getting enough nourishment...The Doctor says this can happen to Dementia patients and is happy to wait till Monday despite the fact it could be fecal impaction...So a member of my family has said that if they see her tonight and she is unwell,still with bad diarhoea then they will take her themselves to the hospital....
     
  13. Amy

    Amy Registered User

    Jan 4, 2006
    3,453
    Let us know how things go Barmby.
    It does seem too long to wait until Monday.
    Love Helen
     
  14. barmby

    barmby Registered User

    Nov 6, 2006
    29
    mum

    Isnt that amazing...since my family member has spoken to the doctor he has gone straight to the home,examined my mum and sent for an ambulance as her stomach is distended.....Why didnt he do this earlier?We are going to meet her at the hospital but I just needed to tell you this....
     
  15. jenniferpa

    jenniferpa Volunteer Moderator

    Jun 27, 2006
    39,438
    I'm very glad you've got progress but good grief - why did it take this long?!?

    Let us know how you (and she) get on.

    Jennifer
     
  16. barmby

    barmby Registered User

    Nov 6, 2006
    29
    Mum

    Hi...Well mum is now settled on a surgical ward..She is waiting for a sigmoidoscopy,they didi try to do one on sat but she was too frightened so hopefully today she will have it as I will be allowed in to be with her...It is a bowel obstruction but unsure what it is as yet..It is very worrying as poor mum cant really tell us if she is in pain..She looks so frightenend...I am pleasently surprised at the care the staff are giving mum...They are treating her with dignity and giving her good care..They do know she was once a Nurse!Will keep you posted.....x
     
  17. MJK

    MJK Registered User

    Oct 22, 2004
    54
    Glad the problem is finally being investigated. I always find not knowing the full story more stressful than anything else.

    Hope the procedure goes ok today, good luck.

    mjk
     
  18. Grannie G

    Grannie G Volunteer Moderator

    Apr 3, 2006
    69,903
    Kent
    I`m pleased she is finally being treated with some respect. It`s not before time. I hope they get to the root of her trouble and it isn`t too serious.
     
  19. barmby

    barmby Registered User

    Nov 6, 2006
    29
    mum

    Just to say first thankyou for your replies back about mum..It does help to talk about whats happening..
    Well I visited mum on ther ward to be told by a Nurse that she was going back to the "Nursing Home" today...!!! She lives in a residential home....I was so shocked because the reason she is going back home is because they could not do the sigmoidoscopy because she was too rigid...So I said has the diarrhoea stopped.."No" she replied,"she is still having it".....I looked shocked again..So I asked why was she being sent home when they had not made a diagnosis...She was not sure..........Well I was so annoyed and spoke to the houseofficer who was very nice and said he wasnt sure why mum was being discharged but the Registrar had made that decision...To cut a long story short because I said something she is now staying in and the Consultant is doing a CT scan on her....If my mum had no family she would of been discharged,to what the staff thought was a Nursing Home,Big error,and she would of been readmitted no doubt in the next 24hrs..How cruel would that of been for my mum...Would they have done that if that patient had been a 41year old lady.....And sadly even the Nurse didnt really understand why mum was going back home,so why on earth did she not speak up and why did she make the error of assuming it was nursing home......
     
  20. jenniferpa

    jenniferpa Volunteer Moderator

    Jun 27, 2006
    39,438
    What a roller coaster you are on. I was just going to post that I was glad they were finally sorting this out and then you repost with this. Nursing home or residential home - I don't think it would make any difference. If your mother has a bowel obstruction they need to find out what it is is, and no nursing home has the facilities to do that. Don't rest on your laurels though - we went through she will have a scan, she won't have a scan saga last time my mother was hospitalized. One person can countermand another person's order so you need to keep on top of it.

    Jennifer
     

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