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mother in law in hospital Declining
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<blockquote data-quote="Marguerite" data-source="post: 286748" data-attributes="member: 1991"><p>Janet, the only terms I could find were "postural hypotension" which is also sometimes called "orthostatic hypotension". It's basically where your BiPolar (BP) is OK while you're lying down or even maybe sitting (especially semi-reclining) but when you get up, it suddenly drops, often to the point of fainting (or at least feelnig faint). This can happen a bit for most people, especially when getting out of a hot bath, but it becomes a problem where it causes dysfunction. It's a matter of extremes.</p><p></p><p>Treatment can be as simple as taking extra salt on board.</p><p></p><p>DL, a couple of thoughts. On top of what I mentioned above, your mother in law needs to be assured that opening her up is not even necessarily going to be suggested. She can relax a bit there. Because even if doctors want to fix things, there are many ways they can do it without having to open her up. At her age they will want to avoid a general anaesthetic or surgery if they can. But at her age she is still entitled to quality of life, and a sudden change like this indicates a problem that could well have a simple fix.</p><p></p><p>If her carotids have gunged up, they could cause symptoms like this. There could be other causes of course, but Doppler studies on her carotids would be a good start - again, non-invasive. It's just ultrasound over the throat area.</p><p></p><p>If her BiPolar (BP) is normal, I doubt she'd headed for a stroke from a bleed-out. The worst risk I suspect would be a blockage of flow from the carotids plus a clot breaking off and causing a blockage in the brain.</p><p></p><p>Thinking of this scenario - carotids blocked up a lot, plus BiPolar (BP) on the low side plus low salt. SO when she stands up, the blood flow through the carotids, sufficient when lying down, has more to pump against to get through the blockage and so she faints. </p><p></p><p>I need to think about the BiPolar (BP) reading - the low diastolic with normal systolic (ie wide pulse pressure) I think also indicates blockages in major vessels.</p><p></p><p>It depends on a lot of things, but there is a lot they can do to help her without having to cut her open. Diet is a really good start - low fat (especially low trans fat, low saturated fat) and increase in mono oils. Ease back on carbs, introduce more fibre (especially psyllium fibre and other soluble fibre) and more fresh vegetables, as raw as she can stand it. Summer is a great time for salads anyway.</p><p></p><p>Of course, in any kind of institution the quality of food often isn't too good. And a common health problem for older people is poor nutrition especially various vitamin deficiencies. You can get some weird symptoms.</p><p></p><p>Was she ever a smoker? Does she still smoke? That could also be a factor.</p><p></p><p>And if the doctor does insist on surgery, it's still not so risky - I had an elderly female relative who had her cataracts done when she was 95, then had a mastectomy a few months before her 100th birthday. She left the hospital after 3 days, to come back to her retirement hostel. She walked back in as if she'd just been taken for a lovely Sunday afternoon drive.</p><p></p><p>My mother had blocked carotids as well as clots in other places. She began having TIAs when I wasstill in my teens. I wasalmost 40 when a clot moved form her leg and went to her brainstem, causing a blockage (and therefore stroke). She was determined to overcome the handicap. And that was worst case scenario, it took decades to occur.</p><p></p><p>If BiPolar (BP) is up, you risk a blood vessel rupturing. If there are a lot of clots around, you risk one of them moving. If you are low in salt, your blood viscosity is affected and that can cause lower BiPolar (BP). But there are also other factors - there are sensors to Co2 levels and BiPolar (BP) levels in the carotid arch, so depending on where clots are, it can have a strong effect when the danger is not as bad as it at first seems.</p><p></p><p>I suspect the first step will be Doppler studies on both sides. Meanwhile they'll be doing blood chemistry. </p><p></p><p>Keep insisting that this apparent dementia, especially episodic, is very recent and unusual. They don't know her in the hospital and you're right, they may just assume she's a crazy old lady.</p><p></p><p>As for how you deal with her - tell her that something has suddenly gone a bit haywire for her, YOU think it could be something simple that can be easily found and shouldn't be too invasive to fix, but to not let it upset her too much, you are there for her and will make sure the hospital staff treat her with respect.</p><p></p><p>A sudden recent problem is far less likely to be unfixable or nasty. She's OK a lot of the time, she's only confused when she's fainted or similar. So it's not dementia. ANYONE would exhibit confusion under these circumstances. Anxiety could make it worse.</p><p></p><p>Basically - reassure her, but don't pre-empt the doctors, make it clear what you think, rather than second-guess the medicos in case what they tell her is too different. You don't want the doctors' advice undermining yours, not until you get to talk to them!</p><p></p><p>Marg</p></blockquote><p></p>
[QUOTE="Marguerite, post: 286748, member: 1991"] Janet, the only terms I could find were "postural hypotension" which is also sometimes called "orthostatic hypotension". It's basically where your BiPolar (BP) is OK while you're lying down or even maybe sitting (especially semi-reclining) but when you get up, it suddenly drops, often to the point of fainting (or at least feelnig faint). This can happen a bit for most people, especially when getting out of a hot bath, but it becomes a problem where it causes dysfunction. It's a matter of extremes. Treatment can be as simple as taking extra salt on board. DL, a couple of thoughts. On top of what I mentioned above, your mother in law needs to be assured that opening her up is not even necessarily going to be suggested. She can relax a bit there. Because even if doctors want to fix things, there are many ways they can do it without having to open her up. At her age they will want to avoid a general anaesthetic or surgery if they can. But at her age she is still entitled to quality of life, and a sudden change like this indicates a problem that could well have a simple fix. If her carotids have gunged up, they could cause symptoms like this. There could be other causes of course, but Doppler studies on her carotids would be a good start - again, non-invasive. It's just ultrasound over the throat area. If her BiPolar (BP) is normal, I doubt she'd headed for a stroke from a bleed-out. The worst risk I suspect would be a blockage of flow from the carotids plus a clot breaking off and causing a blockage in the brain. Thinking of this scenario - carotids blocked up a lot, plus BiPolar (BP) on the low side plus low salt. SO when she stands up, the blood flow through the carotids, sufficient when lying down, has more to pump against to get through the blockage and so she faints. I need to think about the BiPolar (BP) reading - the low diastolic with normal systolic (ie wide pulse pressure) I think also indicates blockages in major vessels. It depends on a lot of things, but there is a lot they can do to help her without having to cut her open. Diet is a really good start - low fat (especially low trans fat, low saturated fat) and increase in mono oils. Ease back on carbs, introduce more fibre (especially psyllium fibre and other soluble fibre) and more fresh vegetables, as raw as she can stand it. Summer is a great time for salads anyway. Of course, in any kind of institution the quality of food often isn't too good. And a common health problem for older people is poor nutrition especially various vitamin deficiencies. You can get some weird symptoms. Was she ever a smoker? Does she still smoke? That could also be a factor. And if the doctor does insist on surgery, it's still not so risky - I had an elderly female relative who had her cataracts done when she was 95, then had a mastectomy a few months before her 100th birthday. She left the hospital after 3 days, to come back to her retirement hostel. She walked back in as if she'd just been taken for a lovely Sunday afternoon drive. My mother had blocked carotids as well as clots in other places. She began having TIAs when I wasstill in my teens. I wasalmost 40 when a clot moved form her leg and went to her brainstem, causing a blockage (and therefore stroke). She was determined to overcome the handicap. And that was worst case scenario, it took decades to occur. If BiPolar (BP) is up, you risk a blood vessel rupturing. If there are a lot of clots around, you risk one of them moving. If you are low in salt, your blood viscosity is affected and that can cause lower BiPolar (BP). But there are also other factors - there are sensors to Co2 levels and BiPolar (BP) levels in the carotid arch, so depending on where clots are, it can have a strong effect when the danger is not as bad as it at first seems. I suspect the first step will be Doppler studies on both sides. Meanwhile they'll be doing blood chemistry. Keep insisting that this apparent dementia, especially episodic, is very recent and unusual. They don't know her in the hospital and you're right, they may just assume she's a crazy old lady. As for how you deal with her - tell her that something has suddenly gone a bit haywire for her, YOU think it could be something simple that can be easily found and shouldn't be too invasive to fix, but to not let it upset her too much, you are there for her and will make sure the hospital staff treat her with respect. A sudden recent problem is far less likely to be unfixable or nasty. She's OK a lot of the time, she's only confused when she's fainted or similar. So it's not dementia. ANYONE would exhibit confusion under these circumstances. Anxiety could make it worse. Basically - reassure her, but don't pre-empt the doctors, make it clear what you think, rather than second-guess the medicos in case what they tell her is too different. You don't want the doctors' advice undermining yours, not until you get to talk to them! Marg [/QUOTE]
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