1. Bittermama

    Bittermama Registered User

    Jun 9, 2012
    27
    Kingston, Surrey
    Hi everyone, mum has been in hospital for 3 weeks now. She was admitted as she had blood in her urine as well as yet another UTI. She has kidney stones which they thought would pass in her urine but they have not. She really needs to have an operation but she is 88 years old and does not have a great quality of life now. We are meeting with the team at the hospital this morning to make decisions about her care and as you can imagine I am quite in a state. I have read that anaesthetic has a effect on the brain and can make dementia worse (that's if they offer an operation)? The other option is where do we go from here if an operation isn't viable ? Has anyone had any experience with this? Has the person you cared for needed surgery and what happened? Just like to add mum is not in any pain, and is eating small amounts and is on fluids. She has also had a blood transfusion. Thanks
     
  2. Linbrusco

    Linbrusco Registered User

    Mar 4, 2013
    1,578
    Female
    Auckland...... New Zealand
    I'm sorry to hear about your Mum.
    My Great Aunt 85yrs does not have dementia, but is in declining health especially mobility (orthostatic tremors) and is in the exact same position.
    Frequent UTI's, one severe that hospitalised her for a week, but not yet in pain with her kidney stones.
    They do not want to operate given my Aunts age. She has had many general anesthetics over the years, but the last one being about 15 yrs ago, but suffered with delirium when she had her UTI with high temperatures.
    They have given her meds to try and dissolve them, hoping she passes them, but are on a wait and see approach, and doing regular urine & blood tests.

    My Mum with AD had surgery 2 yrs ago for bowel cancer, and I will agree that her dementia was slightly worse post op, than beforehand.

    Will watch this post with interest.
     
  3. Bittermama

    Bittermama Registered User

    Jun 9, 2012
    27
    Kingston, Surrey
    Do you know what mess they gave her to try and dissolve the stones?
     
  4. Owly

    Owly Registered User

    Jun 6, 2011
    538
    #4 Owly, Aug 27, 2015
    Last edited: Aug 27, 2015
    Here's a herbal idea, stonebreaker tea - for gallstones and kidney stones

    http://www.amazon.co.uk/gp/product/... piedra tea&qid=1440664228&ref_=sr_1_1&sr=8-1

    Maybe check with doctor first!

    Anaesthetics contain nitrous oxide which can deplete B12 during an operation, and cause permanent worsened memory IF your B12 level was low beforehand. A blood test to check B12 before any op, and supplementing it beforehand, may be the answer if an operation has to happen.

    I found this page that says that if you are already depleted in B12, then you may come off worse from an anaesthetic -

    https://en.wikipedia.org/wiki/Nitrous_oxide

    "Nitrous oxide inactivates the cobalamin form of vitamin B12 by oxidation. Symptoms of vitamin B12 deficiency, including sensory neuropathy, myelopathy, and encephalopathy, can occur within days or weeks of exposure to nitrous oxide anaesthesia in people with subclinical vitamin B12 deficiency. Symptoms are treated with high doses of vitamin B12, but recovery can be slow and incomplete. People with normal vitamin B12 levels have stores to make the effects of nitrous oxide insignificant, unless exposure is repeated and prolonged (nitrous oxide abuse). Vitamin B12 levels should be checked in people with risk factors for vitamin B12 deficiency prior to using nitrous oxide anaesthesia."

    .
     
  5. Beate

    Beate Registered User

    May 21, 2014
    11,713
    Female
    London
    My OH has two small kidney stones. I was told they would avoid an operation as long as possible and just monitor them for now. They are quite small and he's not in any pain. Should they grow too large however or pain him, they would have to try and get them dissolved so they can pass. That operation involves anaesthesia and a short stay in hospital. I hope to god that never happens. If your Mum is not in any pain, I can only assume they are quite large? The doctor would be the one to tell you whether an operation is necessary - sometimes it's unavoidable. Just make sure the doctor is fully aware of her dementia and will factor it in his treatment.
     
  6. Spiro

    Spiro Registered User

    Mar 11, 2012
    522
  7. nita

    nita Registered User

    Dec 30, 2011
    1,802
    Female
    Essex
    I posted recently with a similar problem - my mother has a stone in her bile duct which ideally should be removed. However, the doctor considered her a high risk patient. The procedure involves putting an endoscope down the throat and making a small cut where the stone is. I am not sure if this is the same as in your mother's case. I don't think anaesthetic is given, but a sedative.

    Like yours, my Mum is not in pain and has now been out of hospital for 2 weeks with no recurrence of infection. She is on Ursogal tablets which are supposed to make the stone smaller and I asked the doctor if there is any chance of it passing through - he said "yes". I asked if this would give her any pain and he said "no".

    You might like to look at the replies I had on my thread.

    http://forum.alzheimers.org.uk/show...lderly-Dementia-Patient&p=1150914#post1150914

    I hope all goes well with your Mum and that the doctor can give you good advice.
     
  8. Beate

    Beate Registered User

    May 21, 2014
    11,713
    Female
    London
    If you read the second link closely, it says not all kidney stones can be treated this way and some form of anaesthetics is usually given due to it being painful. The one thing you do not want is the patient moving because of the pain, especially when they don't understand why, so with dementia I am guessing there isn't really much way around some form of anaesthetics to go with this, and if it's only to get them to lie still for an hour.
     
  9. nita

    nita Registered User

    Dec 30, 2011
    1,802
    Female
    Essex
    I should have pointed out that the procedure is different in my Mum's case with the stone obstructing the biliary duct. You will have to be guided by the consultant. I was told that the risks were too high given my Mum's age and frailty.


     
  10. Mrsbusy

    Mrsbusy Registered User

    Aug 15, 2015
    356
    I know of somebody who had Kidney stones zapped by laser to make them smaller and then they were small enough to be passed naturally. Maybe that would be worth suggesting as anaesethic is in the body's system for three months after having it . It's bad enough to recover from it when you understand things so I would avoid it if at all possible.
     
  11. Bittermama

    Bittermama Registered User

    Jun 9, 2012
    27
    Kingston, Surrey
    Just thought I'd update my situation. Docs are not going to operate, too much risk. My mum has stopped bleeding and infections are clear. Her blood test results are very good so they have now decided to discharge her. The doctor thinks she may have passed the stones, although I am not confident. I have asked if they would do an ultrasound just to put my mind at ease, but they have refused. I am worried it will only be a matter of time before she starts bleeding again. Something just doesn't feel right or am being over anxious? Thanks everyone.
     
  12. Bittermama

    Bittermama Registered User

    Jun 9, 2012
    27
    Kingston, Surrey
    Is it time to let her go?

    Mum in hospital for 2 weeks now with another uti. Met bladder doctor and he said he could remove the stone from her bladder in 20 minutes under a light general anasetic. But would need to talk to the stone doctors first. They have not agreed to do this and now want to put her on palliative care? What should I do? I would like to give her the chance of the op and if she dies then, at least I have given her a chance. I cannot stand to see her die slowly at home. Please help
     
  13. Lawson58

    Lawson58 Registered User

    I had a kidney stone removed surgically several years ago . I was not a candidate for lithotripsy because of a congenital deformity and because of the particular shape and location of the stone itself.

    I had been warned that it was an extremely painful procedure and that is exactly what it was and I can't imagine putting an elderly dementia patient through it unless it was a dire emergency. Removal of the drains three days later was also pretty horrible so my advice would be to avoid surgery if possible.
     
  14. Bittermama

    Bittermama Registered User

    Jun 9, 2012
    27
    Kingston, Surrey
    Thank you for the advice.


     

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