Ruptured cerebral aneurysm

[krp8128]

Anyone dealt with a ruptured aneurism?

Mom had one 4/2, been a rough month. Tried typing details and broke down again. Bottom line it looks like the emergency is over, not sure what to expect next.

Today was a rough day again and I'm 4hrs away from everyone.

[John_B]

My FIL had one 11 years ago. I can't recall specific details of his but he wound up with short term memory issues but otherwise is doing alright. He spent 20 days in the ICU as they monitored the pressure inside his skull then a week of in patient OT before being sent home. Super fucking scary but all in all it worked out pretty well for him. Shoot me a PM if you need to vent. Otherwise good luck to you and yours.

[krp8128]

Day 1 they got a drain installed to reduce the pressure, that was in and open for about 20 days. Day 2 she got a platinum coil to repair the rupture.

Yesterday, after almost 48hrs of stable ICP, they pulled the drain.

I understand there may be some long term memory issues. What scares the hell out of me was the confusion and gibberish talk that kept getting worse.

Dad seems to take everything the Doctors say, i.e. this is normal, as the final ruling and he is resigned to basically giving up. With the visiting restrictions he's been there the most, on the days that I've visited I've had to pull the staff aside and voice concerns that something isn't right. Each time they have run tests, CT scanned, found something and made adjustments. Everyone just seemed to ignore it until I pointed it out that hey, this shit isn't normal and has only gotten worse!

Last night they moved her out of the Nuero ward, which should have been good for her mental health (they are telling Dad she is irritable and forgetful from so long in ICU).

Today she is completely delusional, started at 3am when she texted everyone that she was in Jail. After 9am things looked OK, but apparently got combative with Dad around lunch. She called me early afternoon and the best way to describe the conversations was schizophrenic paranoia. Just devastating to hear her talk about them poisoning her food, kicking her out, not letting her leave, feeling unsafe because someone could come in and rape her. She had no idea where she was, and tried to tell me that "they" we're doing all sorts of things that aren't even possible. Had a whole conversation about discharge papers and proxy paperwork that doesn't even exist, brought to her by family she hasn't seen in months.

Since this was so bad I talked to my sister, who went in around 5, and Neuro did an evaluation and finally she was able to get a push for a psych consult immediately. That Dr. Adjusted some meds, but didn't give a clear explanation of what the next step is. Eventually dad and sister left for the night, still no clear path for the next day.

I haven't been up in a week, as she was improving, but certainly feeling like I need to go back home tomorrow to give Dad a break and see what is really going on.

[krp8128]

One if the things I had no knowledge of until this afternoon was some of the meds she's been in the past few days for the supposed "ICU delirium". Tonight the switched them up.

Frustrates me that it seems each new Dr has their own preferred treatment and they keep changing things every few days.

Right now I'd like to see how she is acting without the drugs. Some depression and anger from being stuck there is understandable, the conversations I had today are not. Cure seems worse then the disease so to speak.

[old goat]

How old is your mom? What was her thinking, etc, like before the aneurysm ruptured? Does she have movement of her arms and legs, good use of her fingers? Has she been up in a chair, walking, getting any PT?

[krp8128]

How old is your mom? What was her thinking, etc, like before the aneurysm ruptured? Does she have movement of her arms and legs, good use of her fingers?

57.

No mental deficiency that I was aware of before.

Full motor control.

[krp8128]

Almost forgot, there is a 2nd aneurysm that hasn't ruptured that needs to be addressed at some point.

[old goat]

Sorry, edited my post after you responded to it. Has she been up in a chair, walking, getting PT.

At 57 I would expect ICU delirium to pretty much resolve by the time she is recovered enough to be out of the ICU, with the caveat that my experience is not with stroke patients. I don't find that drugs help much with delirium, with the same caveat. The doctor I would be listening to as far as what is going on with her mental condition is the neurologist . I wouldn't expect psych to have much to offer.

When people are delusional in the hospital, paranoia--the idea that people are trying to hurt them or kill them is the most common delusion. Given what is done to people in the hospital that's not surprising. The fact that she is able to have an understandable conversation, however delusional it is, is a good sign, it seems to me.

Being OOB and walking can help a lot if she can do that with safety, and assistance of course.

I would assume she's been checked for infections--urinary infection, pneumonia--common in ICU patients. At her age I would expect her to have a fever and elevated white blood cell count if she had an infection, but sometimes the only evidence of infection is delirium.

My best wishes for her and for you and your family. Sometimes it's a question of waiting it out.

[krp8128]

OG, she's been in a chair quite a bit the past few days and outside a few times. When I was there last week she was quite able to get up, to use the restroom for example, but the cranial drain made that an involved process.

interesting you bring up infection, kind of what I was wondering today No cath since week 1, no reason to think UTI.

She was spiking a fever end of the first week and had something showing in her lungs. Bloodwork showed staph, I told the Dr. She was prone to MRSA infection but they explained it was different and the issue went away after a few days of antibiotics. As far as I know no fever since, not sure what bloodwork they are taking now (I also asked family about magnesium and potassium and no one knew).

I think with the waiting yesterday mom got fidgety with the drain, hope nothing happened there when they finally pulled it. Also surprised they didn't do any scan this afternoon to see, with the drain out and ICP monitor off we've lost all visibility to why's going on up there.

[krp8128]

The doctor I would be listening to as far as what is going on with her mental condition is the neurologist . I wouldn't expect psych to have much to offer.

Quoting this s it stuck out to me when I read your post again.

Neurologist pretty much ignored her yesterday, I think they stopped by for 5 minutes. Several hours later they finally gave approval to pull the drain, then at 8pm she was out of the Neuro wing.

Not sure how much time the spent this afternoon, didn't sound like much. They basically said not a neuro issue, call psych.

[old goat]

You're right to ask about the blood chemistry--especially sodium. People with brain trauma can develop problems properly processing the water and salts in their blood. Very unlikely that the docs wouldn't notice that if she had it..
Sorry to hear that neuro isn't more involved but things have changed since my day--she would have had surgery instead of coiling and the neurosurgeon would have followed her. Sounds like the neurologist is leaving things to the medical doctor(s). As a group neurologists do tend to not get involved in the daily management of patients in the hospital.
Glad to hear she's up and about..

[Shredhead]

My FIL had one flying a private plane over Pittsburgh in 1978. Thru a lot of luck and some skill, he landed safely.

We’re going to his 92nd birthday Friday.
Hope your Mom’s turns out as well.

[krp8128]

Up with her right now. Today is so far so good.

Still pushing the ICU delirium angle, but seem to have a better handle on the meds today.

[Peruvian]

I know nothing about the medicine but wanted to let you know that you are in my thoughts, K.

[krp8128]

I know nothing about the medicine but wanted to let you know that you are in my thoughts, K.

Thanks. Been a rough month.

Sunday night was a shitshow, but it really got the attention she needed Monday as a result. One of the ICU PA's came down and really helped us square some things up (and made mom feel more comfortable) Having my sister and I there gave Dad a break and for once her and I were on same page and pushed for some specific things over the past 2 days.

Hospital let dad stay with Mom last night, went well. She was up 1x and went right back to sleep. Based on that they released her today, been "home" since noon. Hopefully tonight goes well and the mental state continues to improve outside of the hospital over the next few days.

She's ready to go home for real, but being 2hrs away from a meaningful hospital is not in the cards for a bit.

[old goat]

Hey, it's great to hear she's doing better. Getting out of the hospital hopefully will help a lot.
Just the sleep deprivation people get in the hospital is enough to drive healthy people mad. (And some of those sleep deprived people are doctors.)