QUERY:
Please help us immediately. My father (77 yrs old) is gravely ill in intensive care. The physicians have yet to determine what type of infection he is suffering from.
Here's the background: He has developed pulmonary fibrosis from the consumption of amiodarone while also taking coumadin,lanoxin and prevacid. In March of 2000 he was diagnosed with amiodarone toxicity and then was switched to the combination of cardizem, prednisone, coumadin, and lanoxin. Last week he felt terrible and was taken to the hospital. He is now on a respirator and has gone into what they call a 'metabolic coma' where he's not responding to stimuli. They are keeping him sedated with morphine, he has a pronounced level of pulmonary fibrosis with a respiratory rate of about 30 (it went to 40 at one point). They've done a bronchoscopy and have take samples where they don't know what is causing the pus in his lungs. His heart rate is down to about 100 from 140, his blood pressure is considered good and so is his oxygen level, due to the respirator. They did a lumbar puncture and the fluid was clear and showed no signs of meningitis, bleeding or stroke. He has some bleeding out of his stomach and they're giving him a drug I forget the name of to treat this. Today he is moving his head and legs and right shoulder and is looking at us with glazed eyes that are unblinking. I fear that unless we find out what is the condition that is causing this then he will soon die. Please help us at your earliest nanosecond.
ANSWER:
Dear S,
I am so sorry you are having to go through this with your father. I can hear the
angst in your letter and know that you are doing everything you can to help him.
Although I am not able to be there with you, and am certainly not as knowledgeable
about the situation as the doctors who are with him there at the hospital, I can tell you
a few things that may help you handle the situation.
Some of this you may already know, but bear with me please. First of all, your
father was already extremely ill before this crisis occurred. He was on some intense
medications, had to be changed to different intense medications, and his system was very
weak. He had a heart arrythmia, some cardiac failure, and possibly a stomach ulcer
or a gastritis. The medications used for the heart arrythmia caused some of the
problem (the amiodorone toxicity) but it was a risk he had to take if he wanted to treat
his heart. By taking him off the amiodarone, they had to protect him from a stroke
caused by the abnormal heart rhythm, so coumadin was used to thin his blood.
Meanwhile, his lungs were fibrosed so they were not working as well as they should,
so he ended up on a respirator and apparently with an infection. Time will tell if
this has been too much for him to handle.
S, with everything they are doing - it sure seems like they are trying everything
appropriate to save your father's life. If I were his doctor, I would be trying hard
to find the specific infection he has, and covering him with all kinds of broad spectrum
antibiotics while I figured out something more specific. Supporting him with the
respirator to give his own body a chance to fight this is appropriate. Some of his numbers
sound pretty good, so I think he has a chance.
It also sounds like you are getting good information and keeping up well with the progress
they are making in trying to help him. You are doing the very best you can. I
can not see any areas where they are lacking in their attempts to save your father.
The best thing you can do to help him now, is to be with him as much as they let you.
Even though he is in a coma, he can sense your presence and you can be supportive
in his efforts to win this fight. You may not be a religious man, but prayer HAS
been shown to help patients in the intensive care unit, so if you can find something to
pray to, it might help. And then you will have done everything in your power.
If everything medically is being done, and you are being kept informed of all the changes,
and you have the emotional support you need, and you use whatever spiritual
reserves you have to call on...then whatever happens - you know you did the most you
could. And that is the most anyone can ask of you.
Good luck to you S and best of luck to your father.