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Sick mother - hallucinations. Help!

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truthsetmefree posted 12/30/2013 20:46 PM

My mother went into the ER a little over two weeks ago, thinking she was having a gallbladder attack due to pain. She is 73 and relatively healthy/active though she was fairly recently diagnosed with Crohns.

Fast forward about 5 days and a multitude of tests and the doctors can find nothing wrong - despite the pain not subsiding. Ultrasounds, cat scans, bloodwork - nothing. No fever, nothing to suggest inflammation - though they did find an aneurism leading to her heart - but nothing they consider to be the cause or even urgent. They sent her home with hydrocodone.

She's no better - according to her.

She will not eat. Hasn't for two weeks.

The pain radiates all throughout her digestive. Never in one spot.

She's not a good patient. She has a low threshold for pain.

My dad has tried to manage her pain by giving her the hydrocodone as well as her Xanax. But she has become extremely weak in the last two weeks as well as frequently dizzy. Add to that delirium, confusion, and hallucinations - and he is not well enough to manage her (nor is she very compliant even on a good day).

So last night she gets up without help - and we are back in the hospital with a broken wrist now.

I had made up my mind last night that the pain med/Xanax concoction had to go - hell or high water.

Now I don't know. But ironically she's not complaining with wrist pain. It's still the stomach - though now it's even the legs. (???). My gut is still saying basically two things - too much meds, not enough food. But I'm not a doctor. the main point - the hallucinations. OMG. Out of her head - hands me stuff though there's nothing there, seeing things, asking nonsensical questions, cannot comprehend the broken wrist/pulling wrap off, fidgeting - wanting up, etc.

Is this detox from meds?

Is this a pain response - and I'm making it worse by holding off meds?

This is like sugar to shit in no time - and I am completely bewildered. I have no idea what to do but I can say we are definitely headed in the wrong direction.

ANY help is appreciated.

nowiknow23 posted 12/30/2013 20:52 PM

Is she impacted, truth? I ask because years ago my mom had the EXACT same symptoms. Turned out she was seriously impacted.

nowiknow23 posted 12/30/2013 20:59 PM

A bit about impaction that might help. I bolded some parts that stuck out to me given what you wrote about your mom's condition:

What are the symptoms of fecal impaction?

Symptoms of fecal impaction are similar to those of constipation, but are complicated when the impacted stool presses on other tissues. Solid stool and other materials can back up in the colon, while liquid stools moving past the impaction can cause diarrhea or uncontrolled leakage of stool.
Common symptoms of fecal impaction

Common symptoms of fecal impaction include:

Abdominal pain or cramping
Abdominal swelling, distension or bloating
Back pain
Blood-streaked stools
Change in bowel habits
Diarrhea (can be explosive)
Difficulty urinating
Fecal incontinence (inability to control stools)
Feeling of incomplete emptying of the rectum
Loss of bowel control
Small or thin, semi-formed stools

Serious symptoms that might indicate a life-threatening condition

In some cases, fecal impaction can be life threatening. Seek immediate medical care (call 911) if you, or someone you are with, have any of these life-threatening symptoms including:

Change in level of consciousness or alertness, such as passing out or unresponsiveness
Change in mental status or sudden behavior change, such as confusion, delirium, lethargy, hallucinations or delusions
Greatly reduced or no urine output
Inability to pass stool or gas
Rigidity of the abdomen
Severe abdominal pain
Severe vomiting
Vomiting blood, major rectal bleeding, or bloody stool

metamorphisis posted 12/30/2013 21:00 PM

That or a bladder infection? Have the tested for urinary tract issues? I know in the elderly they can cause hallucinations and what would appear to be dementia.

metamorphisis posted 12/30/2013 21:01 PM

Also, with what NIK is saying, the pain meds could really be constipating her which would just make it worse and worse and she wouldn't want to eat either. Is she drinking or eating ok?

unfound posted 12/30/2013 21:08 PM

Is she impacted?

My first thought when I saw the symptoms plus pain meds.

She needs to be seen by a physician so they can see this reaction/action first hand. Whether it be mental or due to an illness.

Scary stuff


metamorphisis posted 12/30/2013 21:19 PM

Bleh.. sorry tsmf, I see where you just said she wasn't eating. I think unfound and nik are on to something here. Sending mojo and love to you both. My grandma is staying with my parents and is falling all the time just recently too. I know how scary and sad it is. I hope you get this figured out quickly.

truthsetmefree posted 12/30/2013 21:26 PM

Thank you all for the quick replies. Theyre comforting because, right now, I feel like there is nothing I can do.

Impacted - they did upper and lower GI in the original tests two weeks ago. Would they have found that then? She hasnt eaten since then - very, very little, anyway.

She does have a UTI. Had a minor one two weeks ago - given antibiotics - but still has it now. They also found fluid on one lung that had increased this time - almost a liter - which they removed this afternoon.

Shes just recently slept some - and seems to be mostly easy though shes still having full conversations. But the moment shes awake, shes asking for pain pills and her xanax.

I just wish I could know if holding off on giving her those is the right thing to do. (She can be a bit of a "baby" so its hard to judge.) She has definitely gotten worse since starting all the meds (weak, not eating/drinking, hallucinations). She had NO symptoms the day before going to the hospital.

lemony.2008 posted 12/30/2013 21:27 PM

So sorry to hear that truth, it must be so distressing!

Sending your mother healing thoughts and keeping you all in my prayers.


Mama_of_3_Kids posted 12/30/2013 21:38 PM

UTI's will cause these types of symptoms, in the elderly. A few other things come to mind, as well...impaction, as previously mentioned. She could have become impacted, as a result of the meds, even if she's not eating much. Additionally, did they do any type of pancreatic enzymes?

jo2love posted 12/30/2013 21:47 PM

(((truth & mom)))

truthsetmefree posted 12/30/2013 22:14 PM

Pancreatic enzymes - yes. According to hospital values, they were fine. According to her PCP, they were slightly elevated. We withheld food for a couple days then modified for several more...but nothing has eased the pain itself.

Any opinions on withholding the hydrocodone and xanax? The dr has ok'd valium for the hallucinations. Is that a better option? I absolutely do not want her to hurt....but im also really bothered by how much worse she seems to be getting since "treatment".

gonnabe2016 posted 12/30/2013 22:15 PM


ItHappened2Me2 posted 12/30/2013 22:32 PM

I have Crohn's Disease. During flare-ups it can be VERY painful and I don't like to eat either -- whenever I eat, I have pain. And the "tests" didn't necessarily show signs of inflammation.

If she successfully had an Upper GI and Lower GI, then she was NOT impacted at the time. If she has had little to eat (especially roughage -- like popcorn, apples - with skins, stuff like that) then I would say it probably isn't that.

One of the problems I've had is blockages (I've had partial and full) If it's a full blockage, she would probably be throwing up. Partial blockages are EXTREMELY PAINFUL. My blockages are usually cause by a combination of inflammation and what I eat (see above).

Is she seeing her GI? Sometimes the docs are conservative when it comes to hydrocodone because it can slow down the digestive track. So, that could be a contributing factor.

I'm sorry I don't have a lot of help on the hallucinations. Could dehydration cause that. I also tend to get VERY dehydrated when I have my Crohn's problems.

Sorry to be so long winded -- I've had Crohn's since I was 17 years old and had a full ileostomy when I turned 36. PM me if you'd like more info.

truthsetmefree posted 12/30/2013 22:47 PM

She has been seen by her GI dr, a heart doctor, and then her PCP. No one seems to have any idea whats wrong - and worse, what to even test next. This whole system here is now so screwy because they have what I think is like a hospice (?) type doctor that is suppose to manage all the care while in the hospital (eyes & ears type of thing that keeps doctors from having to make rounds I guess). There seems to be lacking any follow-up/sense of responsibility that wwould come from having a doctor involved directly in your care. When she was sent home after the first 5 days, we were all like - What are we suppose to do now?

When I met the dr on duty today and asked him questions in relation to the last time she was in the hospital, he basically told me that the brroken wrist had no connection to the issue from last week. I almost punched him.

jadedangel posted 12/30/2013 23:04 PM

I would have thought of impaction too. You would be surprised how a good BM helps the older folks. It makes their blood pressure rise, increased temp, heartrate and confusion. (Slight T/J My bro in law Crohn's disease and it seems like a pretty tricky disease to deal with...his joints in his fingers had inflamed...and it was finally determined that it was Crohn's related.)

Anyway, Narcotic medications can metabolize differently in geriatrics. And with her having an UTI, then she is not flushing her kidneys like she should which would let a build up of those medications in her system. I work as a RN supervisor/MDS in a nursing home. I see it a lot.

Encourage her to drink! At least while in the hospital, she has the IV to help pump her with the fluids.

purplejacket4 posted 12/30/2013 23:08 PM

One thing to consider is mesenteric ischemia. That's a fancy way of saying your guts hurt when you try to eat. It's the equivalent of chest pain from coronary artery disease or stroke symptoms from small vessel disease of the brain. Doctors miss it a lot because although it's the bowels causing pain they look normal in imaging pictures and camera studies. You have to order special tests for it.

truthsetmefree posted 12/30/2013 23:30 PM

Purplejacket - Would the pain move with this condition? Its largely across what would be the area in her upper stomach but then it moves lower, to her navel, etc. I do know that there is a 4 mm (?) aneurysm in her aorta but they said it wasnt a concern until it got to be at least 6. Related?

Would they catch this in a ct looking at digestive, etc? Shes had two scans.

ItHappened2Me2 posted 12/30/2013 23:45 PM

UGH -- I hate it when they have all sorts of docs and they don't seem to talk to each other! BTDT! I won't bore you with the scary details of some of my issues with multiple docs. I actually did have some luck with a hospitalist while in the hospital -- but the follow-up afterwards left a lot to be desired.

I get why they have set ups like that -- it's not a knock on the docs -- it can just be hard to deal with when there are multiple specialties.

I second the advice on drinking lots of fluids. Especially if she has a UTI.

Does she tolerate drinks like Ensure?

Sad in AZ posted 12/31/2013 00:17 AM

My mom had a raging kidney infection that resulted in a lot of pain and dementia. Did they test her creatinine (sp?) levels? Turns out she had kidney stones over 1 cm in size--too huge to pass. She had to have lithotrypsy (sp? again )

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