My dad, age 73, has Alzheimer's. He has kidney stones which he cannot pass by himself. We have been told that he needs surgery to remove the stones, but it seems that the physicians are reluctant to do the surgery becauase he has Alzheimer's. We were informed that with Alzheimer's patients, physicians don't like to put them to sleep because of the fear of them not coming out of the anesthesia. Does anyone know about this? While waiting for the physicians to make a decision (mainly his urologist) he as developed UTI and was placed on two different antibotics and a pain med. We have been waiting five weeks for a decision to be made while he is in pain and cannot tell us about it, we can only go on his actions and if he happens to run a fever, which he did on Sunday. At that point, the nursing home personnel really started working hard on getting something done and has now mentioned getting a second opinion since the first urologist has taken so long. We feel that a part of the delay has been where Dad has medicare and medicaid and no longer has other insurance. I just wish, if this was the case, the urologist would have been up front with mom in the first place and we could have moved on to someone else five weeks ago. We really are at the end of our rope especially after watching Dad lay in pain on Sunday night. Again, the chance of an Alzheimer's person not waking up after surgery, is it any greater than someone without Alzheimer's? Also, has anyone ever heard of saddle block being used so that the patient doesn't have to be put under the anesthesia completely? This has not been mentioned, but a friend had brought it up to keep dad from being put to sleep. Thanks for reading my LONG notes of concerns!
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Hi, Cathy,
I'm not a medical doctor, but I did do a Google search and found a few medical journal articles that indicate that anesthesia could pose a problem for people with Alzheimer's due to the damage to the person's brain.
With that said, I think you do need to get a second opinion about the surgery. Five weeks is too long for the decision about surgery to be made.
One other thing that I think you need to be ready for if he does have the surgery. There's a possibility that his Alzheimer's will progress more rapidly. I found that in my mom's case, any hospital stay (in her case, due to repiratory infections) resulted in more disorientation and loss of mental state - and she didn't have surgery. Therefore, I don't want you to be surprised if this does happen.
Take care and keep us posted!
Dorian
Hi, Cathy,
You're right - life does throw a lot of curve balls. But what's evident is the underlying love that you and your family have your father. Again, I really know how much deep down he appreciates the care that you're making sure he has.
Keep us apprised of the UTI situation. Like you, I have learned firsthand the challenges of getting some doctors to respond in treating a person with Alzheimer's who has another health issue. That's where being his advocate with both the doctors and the care facility staff who monitor his daily health is so important. In my experience, the level of the family's involvement can be the determining factor on the type of medical care provided. We had an experience where one doctor (who was the on-call doctor for that day) would have let Mom "go" when she was in the early stages of a respiratory infection and laying unconscious in her nursing home room. I was at the nursing home when the nurse made the call to the doctor's office about transporting Mom to the emergency room. Afterwards, she relayed that conversation to me and said that because she told the doctor that "the family is very involved", he agreed to the transport. So please know that you may have to stay on the medical community's case.
With that said, I'd encourage you to keep in the back of your mind the realization that at some point down the road you're going to be need to be ready to say that final goodbye to your dad. In my case, it was the next time that Mom had a respiratory infection (about a year after the situation I described above). She came back from the hospital, was alert for a few days, but increasingly became more non-responsive starting on Sunday. We didn't realize what was going on at first (since we assumed that it was the ups and downs that typically followed Mom's hospital stay). By Thursday, I had a gut feeling that she was not going to make it (although the nursing home staff seemed to still have hope). On Friday morning, while visiting Mom, I mentally told her it was OK for her to "let go" if she felt it was time, that we would be OK, and that we wouldn't ask for medical help. Sure enough, very early Saturday morning she passed away. I tell this story because I found that through all the earlier hospital stays and medical emergencies I had come to grips with the idea that Mom was going to die and was able to let her go on her own terms (instead of seeking medical help to prolong her life once again).
Take care and keep us posted!
Dorian
Hi Dorian, Mom finally received an answer from the doctors on Tuesday morning. They are going to perform the kidney stone surgery on Monday, August 24th at 7:00 a.m. We know that he needs to have the stones removed because he is in pain, but have also been told (by a nurse at the nursing home) that it is harder for a person with Alzheimer's to wake up after have anesthesia. We are really scared, which I know is natural. Mom has been consistant with talking with the doctors. She and I have been with him when he developed pain and fever (which I noticed) from a UTI not long ago, so I know that we have to be his advocate at this time. I had to do the same thing with my grandmother about three years ago that you were talking about doing with your mom and that we letting her go. We all said our "goodbye's" and she passed away after we left with her neice with her. I am sorry for your loss and hope that you are doing OK. I hate to see dad in the state that he is in with the Alzheimer's, but at the same time I am selfish enough (and I know it) that I'm not ready to say "goodbye). That is one goodbye that I won't be able to do or the person that I won't be able to tell that it is OK to leave. I know that it is selfish, but I have a way to go yet. I just hope that we all make it through Monday and the surgery OK. I will keep you posted. Thank again! Cathy
Just a little update about Dad after his kidney stone surgery:
Dad had his surgery on August 24th as scheduled. That night he ran a temp of 102 and the subsequent nights the temp was anywhere from 101 to 99.8. He had a stint (spelling probably wrong) placed in the urether and then removed on Wed. the 26th. I spent the nights of Mon, Tues and Thur with him at the nursing home, while Mom spent Wed and Thur with him. I honestly didn't think that he was going to pull through the entire day on Thursday. He appeared to be in a coma like state. They did a chest x-ray (came back clear) and drew blood (were told levels were elevated, but not enough to be concerned about). They took him off all pain medication and his Xanax. He finally started coming around on Friday. He is now back in his wheelchair. However, he is having trouble swallowing and his food is having to be pureed. I asked if the anesthesia could have moved the alzheimer's into a deeper stage and was told that they didn't think so. He was on a gound meat diet prior to surgery. I am thankful that he is moving around again, but am concerned about his eating habits. He is now eating about 75 percent of his meals, where before he was eating 100 per cent and then whatever we fed him in between during our visits.
Thankful to still have Dad around to enjoy and make memories!
Cathy
Hi Cathy,
I have read your story about our father. I know all these emails were written in August and there is probably more to your story by now. I too, am in a similar situation with my father. He is 85 and in the early stages of Alzheimer's. He still lives at home with my 81 year old mother who is legally blind with macular degeneration. Needless to say, my life is very busy being the caretaker for both of them. My father now has a very large kidney stone that they are trying to disolve with drugs. Then if that doesn't work in two months, they are going to try to "blasting it" to break it up. If that doesn't work, then it is surgery. And that I what I am very worried about. So, I have been searching for all kinds of info on the internet tonight. I came across your story and it touched my heart. I was wondering how your father (and you) are doing now - seven months later.
Blessings,
Debbie
My father-in-law had moderate AD(Alzheimer's Disease) in 2007 when he had hernia operation twice. I am not sure if he was totally put out, but it was a same-day operation. He did it twice in 3 months as the first one failed due to his posture in the bad chair. He was 86 at that time. Now he is 88. But we were never told that he could not have any surgery at all. He was able to be put to sleep to go through this. But he forgot he had the wound and sat down with pain.
I think the bigger problem is that he would take off all the IV lines and bandage in the hospital if he does it now. I would worry how he would cope with the wound afterwards. He would also be agitated and fearful in the hospital. Depending on his stage, he may be paranoid and wants to "escape".
I am not a doctor so I have no idea about how he can be put to sleep, but I would think it is ok to have the minor operation. The problem is how the patient copes with it given Alzheimers. I personally think the minor surgery should be ok and worthwhile. When it comes to a big open surgery, he may not need to go through it because of quality of life.
Take care,
Nina
Thanks for taking the time to address my concern. We are waiting on his urologist to get back in town, which will be late next week. Dad has waited for five weeks to get a surgery date. I just hope that I don't have to see him pain again before the surgery, although I realize I will see him in pain afterwards. I just don't want to see him have any further complications from not being able to pass the kidney stone. However, the concern of being paranoid and wanting to "escape" is something I don't think Mom or I have considered. We went through something like that when he had knee replacement surgery right after he was diagnosed with Alzheimer's. He saw bugs all over the place and thought the police were after him, and this is a man who is very gentle and never been in trouble with the law. So again, thank you for bringing this to my attention.
Bless you,
Cathy
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Thanks Dorian for taking the time to answer my question and especially taking the time to do a Google search on this subject. I tried and came up empty handed. My dad seems to be in a lot of pain and has developed a recent UTI. Since he has been put on antibotics and pain medication (every 4 hours) he didn't seem to be in pain today, but that wasn't the case last Sunday. I witnessed him in a lot of pain, could tell by this facial expression, his moodiness and the way that he was laying in bed with this knees drawn up to his chest. He was running a fever of 102 at that time. We tried to get into see another doctor for a second opinion, but was told that we could not get an appointment for 4 or 5 weeks, so mom decided to just see dads regular doctor sometime in the next week or two. Our fear has always been what damage the anesthesia would do to him due to his Alzheimer's. Needless to say, I hate to see him in pain, it is like when my boys were little and couldn't tell me they were hurting; but, at the same time it scares me to death to think of him being put to sleep. His stage of Alzheimer's at this time is that he cannot feed himself or walk alone, he does talk some but cannot be understood - however he will shake his head to answer questions, whistles, has facial expressions and can still give kisses and hugs. I take advantage of the "can do things" all the time and thank God for them. Mom took care of him as long as she could, however Oct. 31, 2008 we had to place him in a nursing home. He has adjusted well, and you can tell that he considers them "his family." At times, this hurts to the bone, when he will give them the "hugs and kisses" and shuts his eyes or turns his head when I give him a kiss. I do get the occasional hug and kiss with a sneaky smile every once in a while. However, I had to step back from the situation and realize that the staff there have become his family and be thankful that he feels comfortable and loved there. Live throws us some sharp curves and we just have to learn how to cope with them and be thankful for the positive aspects that can be pulled out every visit and/or time spent with our loved one/ones. Thanks again for your time and concern. It helps to have someone to talk this concern over with that isn't closely connected to me. Take care! Cathy