My 79 Year Old Mom.Crohns BP and other ??'s

This is my first post, so I'm a newbie. My 79 year old mother was diagnosised with Crohn's in March of 2004. She was diagnosised and hospitalized for 1 month following a colectomy with colostomy and other complications. After being released from the hospital, she continued to get weaker, short of air, and not progressing well. 4 months later they discovered a abcess from the surgery that had tunneled to her back side. She spent another week in the hospital for IV antibiotics and drains were placed. After this episode she began to recover much faster and was able to maintain some of her activities. In May of 2005, she went back for a reversal of her colostomy and repair of 2 hernias. She slowly recovered and was doing well, without meds for her Crohn's. She had some trouble with diarrhea but the surgeon the the GI doc said that was expected because she didnt have alot of colon left and she would have "short bowel" syndrome. Her diarrhea was controllable and she didnt have many other symptoms. In January of 2006, she developed an abcess at her old colostomy site, she eventually had a one day surgery for this, it was not related to her Crohn's but to the sutures they used to repair the hernia had waded into a ball and caused infection. Since April of 2006, she did very well until about 1 week before Christmas of 2007. She began to complain about being tired and then on Christmas Eve 2007, she starting have alot of abdominal pain, diarrhea, back pain and major fatigue. Of coarse, its a holiday and none of her regular docs are available, but one of their partners did subscribe Levabid. The day after Christmas her symptoms grew worse and she went to the local urgent care clinic. They examined her, did lab, and a CAT scan. All her lab was normal. Her CAT scan didnt show any abcesses or anything that different. Her GI doc in out of the country until Jan 21. We went to his office and saw the nurse practionier and she prescribed Pentasa. That was 2 weeks ago. Her diarrhea has calmed down, but she has waves of nausea and occasional vomitting, her pain is "all over" Not just abdomin, but also in back, neck and joints. The pain is worse at night. She has sores in her mouth and around her rectal area. She also has some sores that broke out on her abdomen. She complains of terrible fatigue, dizziness, and weakness. No appetite. Her blood pressure is low. (90/60) I take it daily, I'm a nurse. She has stopped taking her daily BP meds. I have encouraged her to drink plenty of fluids and have gotten her a bunch of Gatorade. She is not on any pain meds except Tylenol. She does take Xanax at night to help her rest and she takes a daily dose of Zoloft. She takes Potassium and Magnesium. The nurse practionier put her on Entocort today along with the Pentasa. I read many posts on this site and feel that alot of her symptoms are like many of yours. My questions are: Has anyone suffered from low blood pressure? Will the fatigue and weakness ever improve? What can we do about her pain? Any suggestions or ideas or anything will be welcomed. I have a list of questions for the GI doc when we see him on Jan 22, like Vit B12, probiotics, pain pills, iron supplements and etc. Thanks you in advance for any ideas.

** I added a title to your thread this way you should get more replies to your post ....**IF it is not what you would like there then by all mean do put your own topic in.WELCOME to HW...........LYN 

Post Edited By Moderator (Howlyncat) : 1/12/2008 7:45:39 AM (GMT-7)

Hello and glad to have you on this forum! Its wonderful that you care so much for your Mom! I am sure she deeply appreciates you.

Jan 22 seems like a long time away. The sores you mentioned are worrisome, as is the low blood pressure. I am concerned there may be infection. She may be having a reaction to a drug, and suddenly going off the BP meds can be a problem. I would keep in frequent contact with the nurse practioner. They often are compassionate people who are willing to take the time to care for you. Doesn't your Dr have someone sitting in for him/her while he is on vacation? If her symptoms aren't getting better, I would consider going to the ER.

I really feel for her! Getting such a strong dose of this disease at her age can't be pleasant. Please let us know how she is doing!

Gosh, I am so sorry for your mom's suffering. I haven't experienced the surgeries, but I do have the low blood pressure. Mine is normally 80/50-ish range. Sometimes it goes as low as 50/30 which I know sounds like I'd be dead. I have had low blood pressure all my life, so maybe I am used to it by now. What I do know from my experience with Crohn's is that I have gone through times of extreme fatigue where I could barely get out of bed, pain that seems like it is all over (many of us have lots of joint pain along with the intestinal pain), not having an appetite at all and frankly just feeling horrible. Yes, it can certainly get better and I hope it will soon for your mom. She obviously needs more help with her multiple issues. Is there any other GI doctor that you can consult in the meantime? Please keep us updated on her progress. We all care.

I'd like to extend a warm welcome to you on your first visit to Healing Well! To help you get the most out of the Crohn's Forum please feel comfortable asking questions or email if you would like too. I am Kitt and I am a nurse too.

I am so sorry about your dear Mom. I am wondering if perhaps she has been through so much and because of her age she is showing more signs of fatigue.  It certainly sounds like she needs to be seen by her GI. Also the low pressure.........what does she normally run? Is she dehydrated, I know you mentioned gatorade for lytes but she could be volume depleted.  Just tossing out some thoughts.

Any cardiac problems...............?? I hope she is feeling better soon and please keep posting. Gentle Hugs to you and Mom.

 

Thank you everyone for your responses. Unfortunately, the GI doctors partners will not see her in the office, if she is hospitalized, they would care for her there, but for office visits you have to see your regular GI doc or see the NP. It sounded silly to me, but I guess they are afraid of losing pts to each other?? The NP has been good about helping us out. I think my Mom's low BP is partially related to her volume intake. I have been making sure she drinks plenty. She has experienced some low BPs in the past when she was very ill. She does not have any heart problems that are current. During her month long stay at the hospital the first time, she did experience some irregularites that resolved on their own and the cardiologist's opinion was that she so sick for 2 weeks prior to her surgery that her heart problems were transient. During her 2nd surgery, the surgeon said she did have a little irregularities and had the cardiologist see her again, but since they resolved on their own, he felt that anytime they mess with her gut her heart reacts. Those were the only 2 times she had problems and they resolved on their own and never showed up again in the hospital after either surgery and she was on a heart moniter the whole time. When I check her BP, I also listen to her heart and I dont hear any problems. (I work a cardiac floor, so I'm used to hearing hearts) I definately think she would benefit from B12 and other supplements. Its at the top of list for the GI doc. We have tried nutrional supplements, like Boost and Ensure, I even had her try energy bars and the like, but she absolutely does not like them. The only thing she did try and would eat was the high protein jello they gave her at the hospital. Do you know if I can buy a protein powder and put it in jello if that would work? I have printed several things off this site and given her to read. I think this helps because she can relate and feels like she is not alone. Was able to wash her hair and shower on Saturday, so that was a plus. I worry about getting her to the doctor, but if I have too, I will go rent a wheelchair and take her that way, we did it before, we can do it again. Again, thank you for all your suggestions, it helps me to read this site, and I feel that I can help her.

I would take her to the ER and get her admitted. I am also a nurse (old ER/ICU nurse) and there needs to be some serious testing done. Just with her Hx of abscess formation along with pain esp in the back with low BP really concerns me. If it were me, I would be there. My mom died from complications of hypotension, she was in her 90's. She should def be on B12, try SL until ordered. Also older folks don't feel pain as much as younger people do. It is terrible that covering docs won't see pts, nevermind hardly call them back. I had to be pushy about getting a blood test done when my doc was away for a month. Please don't trust NP's or CT scans totally. Could she have a yeast inf causing the sores and/or an inflammatory arthritis from the crohn's. Good luck and welcome to the forum.