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Posted

Im not sure where to start with this, but something strange is going on with a friend following Pancreatic Surgery, and the staff say at this point they are unsure of the reason and are running tests.

He is not himself in that he is verbally aggressive and paranoid and delusional. He is on pain medication (not morphine, but similar, i forget the name at this point). He is also an alcoholic and hasnt had a drink for nearly a week. He is also Diabetic. Also elderly.

The staff mentioned something about aggressive/paranoid/delusional behaviours as being a side-effect that sometimes results in older patients following pancreatic surgery. But at this time they are unsure if the after-effects are due to that, or to DT's.

Has anyone ever heard of this kind of thing happening?

Hope this post makes some sense. Just trying to gather some info/ideas/thoughts because i..and his wife, family, and friends..all feel completely helpless at this time until we know whats going on.

Thanks.

Posted

I don't think it will be from the surgery per se.

Possibilities include:

  • DTs
  • Side effects of the pain medication or other medication he is on -- this is very common with elderly people.
  • Lingering effects of the anesthesia
  • What is called "ICU psychosis" -- effects of the sleep deprivation etc that accompany hospitalization, this usually resolves within a few days once home.
  • A medical complication such as hypoxia (lack of oxygen) due to an undetected complication. if he has not already, he needs a careful medical exam that includes measurement of oxygenation. I have many times seen confusion/combativeness in elderly patients brushed off when in fact it was an important danger sign. As he is diabetic, hypo/hyperglycemia also needs to be considered.
  • Any combination of the above.

Would help to know the full list of drugs he is on,. The elderly often have unusual reactions to medications.

If careful medical evaluation including measuring blood oxygenation and checking his electrolytes and blood sugar do not reveal a problem, my suggestions would be:

- get him out of hospital and back home as soon as possible, even if it means hiring in nursing care

- reduce medication to the minimum absolutely necessary

Posted

PS

Forgot to add (atho they should have already done so), liver enzymes (AST/ALT) and kidney function (BUN, creatnine) should be checked.

The anesthetic agents as well as all the medications he is on have to be metabolized by the liver. As an alcoholic odds are that his liver function is at least somewhat impaired so iyt will take longer for his system to clear these out. All them ore reason to minimize medications.

If his liver function worsens -- which coulkd happen from the stress of the anesthetic and other drugs -- that too can cause altered mental status.

Posted

Thanks again Sheryl, im still trying to get the info (its complicated..as i have to make those inquiries through a closer friend of the family... quite frustrating)One thing i know now is that all the test you recommended have already been carried out. The closer friend, armed with your list, was able to talk this over with the hospital. However, he didnt write down what meds our friend is on. He mentioned something about pheninol? But i need confirmation. Ive asked him to get the names for me. Will let you know as soon as i can get hold of this info. Appreciate your advice.

Wish to also say that a member pmed me with his own similar story. Many times i have received kindness, support, and invaluable information from members here..thank you very much all.

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