Excessive Bleeding

[dewdrop]

Hi,
I am so worn out I hope this makes some sort of sense. lol I take care of my mom who is 76 and on dialysis for 2 years now. She has also had a stroke and a heart attack. She is on a ton of meds. Anyways, she was hospitalized in March for fluid overload (which we didn't even know could happen). The center she goes to is not very helpful. Well, when she was in the hospital they diagnosed her with AFib and put her on Coumedin. She is also on Plavix and an aspirin so that is a lot of blood thinner but they insisted it would be ok. Well, its not been ok. Ever since then she has been feeling worse and worse. They put her on 32oz of liquid a day and they pull about 2-3 M,W,F. She feels like she is walking in quicksand. Sometimes I think I will have to carry her into the house. The other thing is bleeding. She bleeds after every treatment. Sometimes not bad and sometimes really bad (transfusion bad). Today was another one of those days. I had gotten her comfortable on the sofa and I went to run to the grocery store for a few things. She calls me and says she is bleeding and I need to come home. I said how bad is it? She said really bad. I told her to put pressure on it and I would be there as fast as I could. I called 911 when I hung up with her because I didn't know how bad it really was. When I got home it looked like a crime scene. Still bleeding bad. Put pressure on it and it was coming out the sides. Terrible. EMT got there and took her to the hospital. BP was 87/30. Anyways, she is scheduled for a fistulagram tomorrow. I am at my wits end. I could write a book on all the problems she has had to get through. I feel like she is getting lost in the system. Nobody really seems to listen or hear. Maybe because she is old, I don't know. She is the most wonderful mother I could ever ask for. I want to help her, I just don't know how. Does anyone have any ideas about the bleeding or what we could do to prevent it? She is getting down trying to deal with one thing after another.

[Rerun]

Bleeding after the needles are removed, is a sign of a narrowing in which a fistulagram is the best thing to do.  A fistulagram is when they go in and balloon the narrowing.  The procedure is only about 15 minutes but it takes ALL day it seems.  They have to get her ready and put in an IV and then draw blood for a potassium check on and on and on..... I hate them!

Your clinic could do a little more education.  Yes, if you drink fluid and they don't take enough off (find your dry weight) you will carry too much fluid on and pretty soon you can't breathe. 

[MaryD]

And your mother is not old - she's only six years older than me. 

It does sound as though she might be getting lost in the system.  Do you have a neph who talks your language?  Her problems should be brought up with him/her and their explanations should be worded so that they are understood by you.

I hope things settle down for her, and for you, too.     

[papacat]

For what it is worth, my Cardiologist told me I had to stop Plavix and Aspirin when they put me on Coumadin for A Fib. The reason was because it would cause bleeding.

I  hope you can get the support you need very soon. You do have your hands full!

papacat

[Riki]

i'm not sure if this helps or not, since I'm not on any blood thinners, but I've heard the neph telling other patients to not take their blood thinners or other bp medications until after their treatment on dialysis days

[dewdrop]

Thanks Rerun, she has had many fistulagrams and sometimes there is a narrowing and sometimes nothing. She has several stents in her arm. They did the fistulagram this morning but still no word. Hurry up and wait. I hate it.  Mary, I didn't mean it like it sounds, she is 21 at heart and that is what matters.  Her neph is not very helpful at all. He comes around the center once a month and mom says he barley speaks to her. A nurse practitioner comes every other week and she is a bit better. She has suggested physical therapy for her "walking in quicksand" feeling. Hopefully it will help if she can manage to get through it. Thanks for the hug  Papacat I think they are going to stop her Plavix and see if that helps. I hope it does. She has been through so much with her fistula and now she has "steal syndrome". She doesn't take her Plavix or aspirin on dialysis days but the coumadin is every night. It just frustrates me so much that these doctors get paid the big money and I am here trying to figure out what to do. Medicine has become such a regimented system.   

[MaryD]

Does your mother know what day her neph is due to come around?  Would it be possible for you to go to dialysis that day and do the asking of questions?  If she is not as quick mentally as she used to be, she may not be able to get her act into gear fast enough to corner him.  Or if that's not possible could she take a short list of the most important questions with her.

I know what it's like to be in a 70 year old body and feel like 25 - though I have occasional days when I feel like 85.     

[waltswife]

I don't know if this will help, my hubby is on warfarin and a aspirin.  Which lead to a once a month blood test to check his PT/INR.  You can find what they mean on line, I can;t spell them.  And the number that the doctors look for is 1.5 to 2.5.  When it gets too high, they have to adjust the dosage.  Once my hubby showed up as 7, and they had me get a prescription filled for vitamin K to clean out the blood thinners from his system.  And what the doctor said to me was, for the next few days make sure he doesn;t start bleeding, and if he does get him to an emergency room because he could bleed out. 

It's a real good thing for your Mom that you are watching out for her.  And you can ask about all these blood thinners, and ask what her PT/INR is next time you see a doctor.