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Posted 4/3/2010 5:40 AM (GMT 0)
As some of you may already know, my mom passed March 6 due to septic shock associated with end stage liver disease. After some thinking I just found it odd how quickly my mom's health deteriorated once she was admitted into the hospital so I decided to do a little research of my own.

First and foremost I am NOT a doctor these are just my personal opinions and suggestions. The more I research the more I began to feel like I was cheated out of time with my mother. Yes she had end stage liver disease but transplant was never discussed with the family. I don't know what took place in her private meetings with her doctors. Anyway she was admitted to the hospital on Feb 17 where I believe the first (and fatal) risk was taken by the doctors but was never discussed with us. (It was my mom and myself there) the first mistake was using a urinary catherization tube. They just came into her room and told her she needed a catheter, the risk of catching a UTI from that catheter was NEVER discussed.

Any type of infection for someone with a liver disease can turn fatal. It was from the catheter that she got the Urinary Tract Infection which spread to her blood. That resulted in Sepsis. Sepsis in a person with a strong immune system/liver can be fatal so the mortality rate of one with a bad liver or weakened immune system is scarily high (like 90%).

The sepsis infection caused her to go into septic shock which caused acute liver failure and her kidneys began to fail because of this as well.

I can't say the outcome would have been different but I definitely think the risk of a UTI and complications associated with a UTI should have been thoroughly discussed with us before the catheter was inserted.

Post Edited (Bee83) : 4/3/2010 12:02:16 AM (GMT-6)

Posted 4/3/2010 3:54 PM (GMT 0)

Bee, I really don't think it does any good to second-guess things that were done.  It's always good to question things that are going to be done--to get a good explanation of the reasons--but after the fact you are just going to beat yourself up.  I can only tell you that I have liver disease and have had catheters for all 8 of my major surgeries the past 7 yrs.  One I had for 7 weeks while bed-ridden and did get IV antibiotics during that time.  The others I didn't and never got an infection.  Your mom's body was in a very weakened state.  If a transplant was never discussed, it could be that they didn't think she would survive long enough to go through all the evaluations or that she was not strong enough to go through the surgery--or both.

Please don't beat yourself up for things you didn't do or ask.  As Oprah often says, "When you know better, you do better."  But it may have made no difference in the outcome.

Big hugs,

Connie

Posted 4/3/2010 6:15 PM (GMT 0)
I know people get catheters often with no issues, but even if there was a small chance of complications I just feel like we should have been informed. I guess I'm still looking for answers considering she has never gotten THAT sick before to require hospitalization. Even with all that said I'm coming to terms (still not completely accepting of it obviously) with what has happened. I'm not beating myself up over it either, I know that I did my part as best as I could. With my faith in God and hers I'm content in knowing she's in a better place and things happen the way they do for a reason.

My mom and I have always been close. Her role in me being the woman I am today has been and will continue to be very significant. Of course it's hard for me to deal with and only natural for me to want clarification on why. Bottom line is I just miss her and it most definitely hurts. I know that it'll get easier with time.
Posted 4/3/2010 6:48 PM (GMT 0)
Bee, your questioning everything is normal right now.....wasted energy yes.......but totally normal. 3 years later I occasionally find myself questioning,blaming,or feeling quilty. There's so many feelings that go along with bereavement it isn't funny. And as time goes on the negative feelings pop up less and less. When they do now, I try to think about the happier times and not dwell on the would haves, should haves and could haves. They are not productive for my well being. As with everyone else here I did my best and have nothing to be angry or feel guilty about. It was God's will...just not mine.

But I do happen to agree with you on catheterazation with anybody that is already high risk for infection because of their condition, they need to make sure that the patient and/or family is aware of the risk involved for infection. One of my brothers died in 1979 of septicemia due to a urine track infection caused by his catheter. Now he was a quadriplegic and had a catheter for years. I knew that he could get an infection, he got those plenty of times over the 19 years that he was paralized. I just didn't know that it could kill him. And if he knew, he didn't tell any of us family members.

Take care......thoughts and prayers............
Posted 4/4/2010 3:47 PM (GMT 0)
i think it is very hard when you have a loved one in hopsital seriously ill. You put their lives in the doctors hands. I suppoese thare is that many things that can go on, that doctors do not have the chance to explain to the family thoroughly , why? i do not know. I do know my mums immune system is very low she has had lots of infections including cdif and mrsa, both of which the hospitals played down, they never discussed how serious they could be to a person in her condition.Whe i researched them i got really frightened and I did not understand why the hospital were not informing me of the dangers.Is it becuase they are so busy, understaffed, overworked to discuss these things with the families, again i really do not know. I do know that doctors and nurses most of them do a wonderful job saving lots of people, fighting for their lives doing everything possible they can to save them.But once and a while things do get overlooked or they might get it wrong. It can have tragic circumstances. But i have got to believe that on the whole they do try their best to do good, otherwise you would be questioning every decision doctors make. I assure you Bee I am not making light of your situation, it is terrible to find out that there was something that could have prevented your mum from dying, Maybe if you could have a word with the doctor he/she might give you a valid reason as to why the catheter was used. it is natural for you to want answers these questions. My thoughts are with you right now
Posted 4/4/2010 6:30 PM (GMT 0)

Allie, in answer to your questions, as sterile as hospitals try to keep the environment, they are nonetheless a breeding ground for infections.  A person is much more likely to contract MRSA or pneumonia or any other infection in a hospital than at home.  That's because of the close approximation of sick people, plus visitors who come to the hospital with infections.  Add to that a weakened immune system and it's a wonder more people don't die in hospitals.  I consider myself lucky to never have had an infection at the site of my 8+ incisions.  I was also fortunate to only have contracted pneumonia during one of my hospitalizations (the last one.)  I take a multivitamin and vitamin C daily and eat a healthful diet, which contributes to a good immune system.  But after surgery, the body is in a weakened state.

Doctors and hospitals are absolutely aware of these risks, but don't mention them or stress them due to the possibility of lawsuits.  It's the big elephant in the room.

Hugs,

Connie

Posted 4/5/2010 8:02 AM (GMT 0)
Yes I do understand that the hospitals are a breeding ground for most infections. My mum has been lucky enough to pull through all of hers, without the help of extra vitamins and a good diet. What I do not understand is why when infection is present do nurses and doctors have the same methods to prevent spreading the infection. I thought when mrsa was present that you would have to wear an apron wash your hands before going in and before coming out of the room, some nurses did this others did not. my mum was allowed to wander freely up and down the corridor, yet she had a room of her own supposedly to prevent infection. Why do the hospitals not have the same strict rules then all nurses should know the procedures, then everyone would know where they stand. they give you leaflets mrsa and cdif none of them mention how serious it can be. Surely this cannot be right.
I also was only trying to say that sometimes we have to put our faith in the doctors, for them to make the best decisions for our loved ones. Hopefully if they are to seek advice from elsewhere it will be from someone more experienced than themselves. Good communication throughout themselves and with families is a must.
Posted 4/5/2010 5:19 PM (GMT 0)

Allie, it does sound like the hospital your mum has been in has been very neglectful in regard to sanitary/serile issues.  I must say that Mayo here does an excellent job.  EVERY patient has a private room and rooms are only on one side of the wall, with a nursing station between each room.  Containers of antibacterial foam are attached to the walls and on counter tops everywhere.  Every medical person who came in contact with me washed their hands and/or wore gloves.  In the surgical suites, the sterile instruments come up on one dumbwaiter while the used ones go down on another to prevent cross-contamination.  So I was quite surprised when I developed pneumonia.  But I do believe their incidence of infection is very low and incidents of death from infection even lower.  Other hospitals could learn from them.

Hugs,

Connie

Posted 4/5/2010 8:22 PM (GMT 0)
My mom passed because of septic shock as well. We were in great hands, they did explain all of the infection risks to us. They made us wear gowns and all of that to try and keep it as clean as possible, In fact, the night before mom passed, the doctor believed that she had pulled through the c-diff and was making plans to get mom back to the step down. I was mom's poa, it was my decision that they should not try and treat the septis anymore, mom was in just a vicious cyle of an infection, then c-diff while treating then pulling through then getting another infection. I feel like I did everything I could, what happened with the infection was beyond my control. I would not have proceeded in a differnt manner. I'm not sure I could have asked the hopital or doctors to to any more to prevent it.
Posted 4/6/2010 1:34 AM (GMT 0)
I understand what everyone is saying but the risk of infection was only explained to us after she was infected. The preventative measure were taken once she was put into the ICU. She was in the IMCU for a week that's when she had the first signs of sepsis. Even then she wasn't moved to intensive care right away. She was only moved to intensive care while receiving blood platelets after she began to aspirate and a concerned nurse spoke with her doctor. We only were asked to wear masks and gowns to visit her once she was in the ICU. I too was my mom's point of contact. I had to make the decision to stop all meds aside from morphine drip to keep her comfortable and to remove the ventilator. It was the most difficult decision I've ever had to make in my life and I still get teary eyed when I think about having had to make that decision. She wasn't getting any better after septic shock set in, it was a downward spiral and no need to hold on for my own selfish reasons.

I don't know it just a lot to deal with. For those of you who've lost a parent I'm sure you understand what I'm feeling right now. There was no "preparation" time so to speak. She went into the hospital for a hip fracture and dehydration.

The cirrhosis has been there for a few years, but it'd never caused her any major complications. I just expected this to all be a "regular" hospital visit and then 2 weeks later she was gone.
Posted 4/14/2010 10:04 PM (GMT 0)
I just read a NY Times article that states 100,000 deaths a year are attributed to germs.  (Thanks, David!)  The good news is that the government is going to start sanctioning hospitals with high rates of infection in 2015.
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