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Massive weight gain from fluids in the hospital
Old 07-21-2014, 05:22 PM   #1
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Massive weight gain from fluids in the hospital

My 78 y.o. mom is currently in a rehab facility. To make an incredibly long story short(er), she:

1) Fell and broke her hip (second one)
2) Went to the hospital and got it pinned back together
3) went through rehab and went home
4) the pin ripped out of her osteoporotic bone
5) went back into the hospital for a full hip replacement
6) went back into rehab
7) ended up in the emergency room with dementia that was diagnosed as a sodium deficiency. She's back in her right mind now.
8) got MRSA in her hip
9) had the hip replacement removed and an antibiotic hip spacer inserted
10) she's now back in skilled care/isolation for 6 weeks while she gets rid of the MRSA

However, all of that isn't why I started this thread. In the process of her being treated for the sodium deficiency and MRSA she was given a lot of IVs, both regular and antibiotic. In the 2 weeks since step 7 her weight has gone from 112 lbs to 175 lbs. She's incredibly bloated and swollen in her arms, legs, and abdomen. It's to the extent that her breathing is affected due to her belly and chest being so swollen.

Have any of you (especially the medically trained) seen or heard of something like this before? We keep getting promised it will work it's way out, but she's been off most of the IVs for over a week now, and there's been very little change. Is this something else to worry about? Or is it, if not normal, at least not that unusual? Any information would be appreciated.

Harley
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Old 07-21-2014, 05:30 PM   #2
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When my mom was in the hospital, it was easy to talk to the hospiltalist about fluid retention, IVs, medications, etc. It seems to me you should have frank conversations with all the health care providers involved in your mom's treatments.

A question I would ask would be "How many patients contacted MRSA in this facility in the past 6 months and what happened to them?" Do not be surprised if they do not answer in a straightforward way.

Be prepared mentally for the worst. It is what it is.
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Old 07-21-2014, 05:30 PM   #3
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I'm no medical professional, but if her weight has gone up over 50%, I'd think that is a real concern. Does she have any heart condition? I know congestive heart failure can cause fluid retention. Putting on that much weight so soon can't be good for the heart. Make sure they are checking her heart. But again, I'm not a medical professional. Just my thoughts.
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Old 07-21-2014, 05:39 PM   #4
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She has been through a lot. Multiple contributing factors are probably contributing to this fluid retention, including:

1. Sepsis (a common response of the body to infection, due to leaky capillaries)
2. Iatrogenic (too much IV fluid)
3. Poor renal (kidney) function, making it difficult for her to excrete the fluid she has received
4. Cardiac (heart) failure, which may only now be coming to light
5. Hyperaldosteronism (too much fluid retaining hormone) which can be due to several underlying causes including liver problems
6. Side effects of medications (for example nonsteroidal antiinflammatory drugs such as indomethacin)

This needs an internist to sort it out.

PS. I am a retired medical professional.
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Old 07-21-2014, 06:00 PM   #5
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She has been through a lot. Multiple contributing factors are probably contributing to this fluid retention, including:

1. Sepsis (a common response of the body to infection, due to leaky capillaries)
2. Iatrogenic (too much IV fluid)
3. Poor renal (kidney) function, making it difficult for her to excrete the fluid she has received
4. Cardiac (heart) failure, which may only now be coming to light
5. Hyperaldosteronism (too much fluid retaining hormone) which can be due to several underlying causes including liver problems
6. Side effects of medications (for example nonsteroidal antiinflammatory drugs such as indomethacin)

This needs an internist to sort it out.

PS. I am a retired medical professional.

I agree and I'm a not yet retired medical professional, though a pediatrician. She needs a good internist to sort it out, and treat the problem or problems. I suspect there was excess IV fluids all along the way unmasking one or more of the above problems. But the excess fluid is in itself a problem, especially if it is also in the lungs. This needs urgent attention.


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Old 07-21-2014, 08:09 PM   #6
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Am not a doctor...
look up MRSA for prognosis
and prednisone side effects

very sorry for your difficult situation.
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Old 07-21-2014, 08:42 PM   #7
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Have no medical background.
This sounds like what my neighbor has, I think it's called Edema. You have to look it up or ask at the hospital/rehab. My neighbor developed it after hip surgery and I'm pretty sure there was a problem with too much sodium in her system and she had an infection in her hip. She's going to a wound center (not sure of the exact name) where they put compression stockings on her and hook her up to something that sounds like a vacuum machine. My neighbor is very short and half of her body is bloated.
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Old 07-21-2014, 08:59 PM   #8
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My mom is being seen by half a dozen doctors (surgeon, Infectious Disease, various staff docs), and nobody seems worried about the fluid issue. Or at least they aren't telling us anything. Her regular GP is coming back from a long vacation on Wed, so maybe he'll tell us more. She does have a pacemaker, so the heart is an issue. They have checked her lungs, no fluid in them, just pressing around them. Meadbh's list sounds pretty likely, especially 1 - 4.

She does have a wound vac on her hip, but that's just draining the wound. It's not pulling any significant fluid out of her. And I don't think she's on Prednisone this time.

I'm heading back to see her tomorrow, so I'll check her progress and press the issue if it hasn't changed. With all the other problems she's had it seems less important, but I don't want to have anything major slip past us. Thanks for the info so far.
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Old 07-21-2014, 09:05 PM   #9
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I forgot #7. Lack of mobility. Presumably that's a problem right now.

Edema is a Greek word that means "swelling". She certainly has edema. Edema is a symptom. Unfortunately the word does not tell us the cause.

Sounds like your mom has her hands full with all that's going on. My very best wishes to her for a full recovery.
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Old 07-21-2014, 09:16 PM   #10
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Originally Posted by harley View Post
My mom is being seen by half a dozen doctors (surgeon, Infectious Disease, various staff docs), and nobody seems worried about the fluid issue. Or at least they aren't telling us anything.
Are you asking? If you don't ask, then my experience is they ain't gonna say much. Also, keep asking until you understand. BTW, they are physicians, they are not supposed to worry. That's what family does.

In other news, my mom had a pacemaker. But in the end, she had it turned off. She did not want to be shocked repeatedly when it was time to go.

http://newoldage.blogs.nytimes.com/2...eart-quandary/ and the link to Katy Butler's family story: http://www.nytimes.com/2010/06/20/ma...cemaker-t.html
and more recently
http://newoldage.blogs.nytimes.com/2...the-pacemaker/
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Old 07-21-2014, 09:24 PM   #11
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Are you asking? If you don't ask, they my experience is they ain't gonna say much. Also, keep asking until you understand. BTW, they are physicians, they are not supposed to worry. That's what family does.

In other news, my mom had a pacemaker. But in the end, she had it turned off. She did not want to be shocked repeatedly when it was time to go.
Yep, that and a "do not resuscitate" order. Mom and Dad both preferred it that way.
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Old 07-21-2014, 09:28 PM   #12
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Quote:
Originally Posted by LOL! View Post
Are you asking? If you don't ask, then my experience is they ain't gonna say much. Also, keep asking until you understand. BTW, they are physicians, they are not supposed to worry. That's what family does.

In other news, my mom had a pacemaker. But in the end, she had it turned off. She did not want to be shocked repeatedly when it was time to go.

http://newoldage.blogs.nytimes.com/2...eart-quandary/ and the link to Katy Butler's family story: http://www.nytimes.com/2010/06/20/ma...cemaker-t.html
and more recently
http://newoldage.blogs.nytimes.com/2...the-pacemaker/
I've been asking. Repeatedly. And I'll continue to, unless things get better.

My mom has a DNR, but I'm not sure how that relates to having a pacemaker. Hopefully it's not time to find out.
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