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Help! DH's health has declined after surgery. Update 11/13


AbcdeDooDah
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DH had surgery on Feb 21 for a tear in his elbow.  He recovered pretty well and was off codeine after 4-5 days and then just ibuprofen 800. He was eating fine. Maybe a little less of an appetite.  

About 10 days ago he got acid reflux/heartburn so badly that he was just moaning and staying in bed. His chest/esophagus was on fire. For almost a week he only got out of bed to go to the bathroom.  He had water but not much food. He went to the doctor a few days ago for routine bloodwork and the doctor said GERD and told him to take Zantac in addition to the OTC omeprazole he already had. 

In the past few days he has had literally only a few bites of food. He's walking around like an old man and he has lost 16 lbs since the surgery. He just sits and stares or stays in bed. His stomach hurts off and on. Some diarrhea. 

All that to say, is there some illness like this that occurs after surgery? I've never heard of anything but you never know. Or do these symptoms ring a  bell for anything else? It's a little disturbing how he seems to have gone downhill.

ETA:He can't get warm, either, but no fever. 

Edited by AbcdeDooDah
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3 minutes ago, unsinkable said:

Jeepers...I came looking for your thread but I wasn't expecting this...I am so sorry!

Did his bloodwork come back OK?

Are the prescribed meds improving his symptoms at all?

He hasn't heard back. He told the doctor about these symptoms while he was there. 

The acid reflux symptoms have calmed down. 

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37 minutes ago, AbcdeDooDah said:

He hasn't heard back. He told the doctor about these symptoms while he was there. 

The acid reflux symptoms have calmed down. 

 

My instinct is that the surgery isn't related. Based on the space between surgery and onset. And that the problem is systemic, based on the fatigue, no appetite, etc. I would guess the heartburn episode is part of the whole thing, a symptom and not a diagnosis.

But beyond that I don't know.

I'm sorry.

I did think of thyroid problems. Did they check that?

Edited by unsinkable
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23 minutes ago, unsinkable said:

 

My instinct is that the surgery isn't related. Based on the space between surgery and onset. And that the problem is systemic, based on the fatigue, no appetite, etc. I would guess the heartburn episode is part of the whole thing, a symptom and not a diagnosis.

But beyond that I don't know.

I'm sorry.

I did think of thyroid problems. Did they check that?

Thyroid? I don't think so? He's on a newish(2 months)  diabetes med. That might be something  to look at.

Edited by AbcdeDooDah
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You need to follow up with your PCP tomorrow.  The weight loss, lack of appetite, etc. do not point to GERD....but could be Barrett's Esophagus.  

Be the squeaky wheel.  This may or may not be related to his surgery, but in general, I'd be worried about cancer or some sort of infection.  Where? No idea.  That's a PCP's job. 

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Ugh. I just brought up investigating a little more. Asked about his other meds. He gaslighted me about sitting and staring and being tired all the time. "It's esophageal. I'm getting better and that's all I'm gonna say." Voice raised and snappy.

Edited by AbcdeDooDah
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11 minutes ago, AbcdeDooDah said:

Ugh. I just brought up investigating a little more. Asked about his other meds. He gaslighted me about sitting and staring and being tired all the time. "It's esophageal. I'm getting better and that's all I'm gonna say." Voice raised and snappy.

 

So to be clear...he's malingering? He lied to you about the fatigue? 

What about the weight loss? 

Has he been going to work?

are you sure he isn't just trying to put you off and underplaying it bc he is afraid?

I would unleash (verbal) hell on any family member who lies to me about being sick. They know it, too. I went through too much real illness with my parents when I was a kid and too much as a parent to my own kids. I will do anything for my family if they are truly sick. 

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15 minutes ago, unsinkable said:

 

So to be clear...he's malingering? He lied to you about the fatigue? 

What about the weight loss? 

Has he been going to work?

are you sure he isn't just trying to put you off and underplaying it bc he is afraid?

I would unleash (verbal) hell on any family member who lies to me about being sick. They know it, too. I went through too much real illness with my parents when I was a kid and too much as a parent to my own kids. I will do anything for my family if they are truly sick. 

No, he's saying that he's not sitting and staring and that he's out of bed a lot. My kids are seeing the same thing I am. He's not being honest.

I think he's in denial.

ETA: He's off work from the surgery

Edited by AbcdeDooDah
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Wait - this was after going on Ibuprofen 800mg? He may have given himself an ulcer! Ibuprofen can tear up the gut really fast in some people. And if it is bleeding he could be anemic from the blood loss, which would explain the weakness, etc. 

He needs to go to his primary doctor or better yet, a GI specialist ASAP. 

Edited by Ktgrok
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11 minutes ago, AbcdeDooDah said:

No, he's saying that he's not sitting and staring and that he's out of bed a lot. My kids are seeing the same thing I am. He's not being honest.

I think he's in denial.

OK...I was confused about the gaslighting part. I thought it meant he was making you think he was sitting and staring when he wasn't but you mean he WAS doing that but he is trying to make you think he really wasn't. 

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5 minutes ago, Ktgrok said:

Wait - this was after going on Ibuprofen 800mg? He may have given himself an ulcer! Ibuprofen can tear up the gut really fast in some people. And if it is bleeding he could be anemic from the blood loss, which would explain the weakness, etc. 

He needs to go to his primary doctor or better yet, a GI specialist ASAP. 

He took the IB for about as long as the Tylenol 3, less than a week. That fast?

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9 minutes ago, lavender's green said:

Did they check for pancreatitis? My friend first experienced it as extreme heartburn (triggered by gallbladder), and my dad had it triggered by ibuprofen. 

I wouldn't be surprised if it was that. His doctor just seems to be a pill-pusher. 

He's dismissive of my concerns so I'm not sure why I'm even bothering. 

Edited by AbcdeDooDah
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I'm not in a medical field, but that much weight loss so fast sounds drastic and dangerous to me.

I can tell you from observation and experience that ibuprofen can cause the GERD and the runs.  I am surprised that the doctor didn't offer prescription Prilosec instead of the OTC plus Zantac combo--IME heavy doses of prescription Prilosec would be stronger than that combo.  I tend toward GERD, and one natural thing that helps it a LOT is steeping a bunch of sliced fresh ginger in boiling water until it drops to lukewarm, and then drinking it.  I don't mind the flavor but some find it too strong and have to add a little honey.  That is marvelously healing to a damaged stomach and throat.  

But although I would do that in this case, this seems too serious to let go any further.  I think he needs to see another doctor, maybe a GE doctor, pronto.  And I'd be watching for signs of dehydration, do you know the pinch test?  If he is dehydrated, hie thee to urgent care, he might need IV fluids.

Edited by Carol in Cal.
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11 minutes ago, Carol in Cal. said:

I'm not in a medical field, but that much weight loss so fast sounds drastic and dangerous to me.

I can tell you from observation and experience that ibuprofen can cause the GERD and the runs.  I am surprised that the doctor didn't offer prescription Prilosec instead of the OTC plus Zantac combo--IME heavy doses of prescription Prilosec would be stronger than that combo.  I tend toward GERD, and one natural thing that helps it a LOT is steeping a bunch of sliced fresh ginger in boiling water until it drops to lukewarm, and then drinking it.  I don't mind the flavor but some find it too strong and have to add a little honey.  That is marvelously healing to a damaged stomach and throat.  

But although I would do that in this case, this seems too serious to let go any further.  I think he needs to see another doctor, maybe a GE doctor, pronto.  And I'd be watching for signs of dehydration, do you know the pinch test?  If he is dehydrated, hie thee to urgent care, he might need IV fluids.

I just looked on his nightstand and he was prescribed pantaprazole. Now I'm even more concerned.  My mom got c. Diff from that.

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23 minutes ago, AbcdeDooDah said:

I just looked on his nightstand and he was prescribed pantaprazole. Now I'm even more concerned.  My mom got c. Diff from that.

Honestly, I was going to suggest c Diff.  I'm a bit paranoid after taking Microbiology this past fall though.  It might be worth looking into.

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I don’t blame you for being worried!

I think it’s time for a new doctor. NOW. Can you get him an emergency appointment with a good gastroenterologist? And when I say emergency, I mean tomorrow. I wouldn’t wait. It’s not normal to lose that much weight so quickly, and his other symptoms are very worrisome as well. 

I’ll pray for him.

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10 minutes ago, Catwoman said:

I don’t blame you for being worried!

I think it’s time for a new doctor. NOW. Can you get him an emergency appointment with a good gastroenterologist? And when I say emergency, I mean tomorrow. I wouldn’t wait. It’s not normal to lose that much weight so quickly, and his other symptoms are very worrisome as well. 

I’ll pray for him.

Thank you. He pretty much told me to stay out of it and just reiterated it a minute ago because I can't keep my mouth shut.

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2 minutes ago, AbcdeDooDah said:

Thank you. He pretty much told me to stay out of it and just reiterated it a minute ago because I can't keep my mouth shut.

 

Maybe he’s scared to see another doctor because he’s worried they’ll find something wrong with him. Maybe he isn’t thinking clearly because he’s so exhausted from the sudden weight loss. Or maybe he’s just a royal pain who’s too stubborn to do what’s good for him.

Whatever the case, I would call a gastroenterologist and explain what’s going on, and try to get an emergency appointment. If your dh objects, tell him you’re not going to sit around and wait for him to get sicker, and tell him you will gladly apologize if the doctor agrees with him that he’s fine. 

I know it’s hard to force a person to so something they don’t want to do, but I’m afraid if you don’t, he may only get worse. His symptoms sound serious to me. 

I’m so sorry he’s not being more cooperative. I do wonder if maybe he’s not thinking clearly about this. Has he looked in the mirror? He must look pretty gaunt from losing that much weight so quickly. 

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10 minutes ago, StellaM said:

 

When I was in this situation, I pretty much just confined myself to saying something once a day, because more was 'nagging'. 

So, you've said your bit today.

Tomorrow just  say, once, 'You have rapid weight loss, you are not eating and your reactions have slowed down. You need to go see a doctor.' 

And then so on, once each day. 

Eventually he'll either go on his own accord, get better, or get worse.

If he gets worse you can call an ambulance. 

 

The problem is, if she waits until she has to call an ambulance, that could be too late. 😞

I’d keep at him until he was ready to agree to anything, just to get me to shut up. 

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You mentioned a diabetes medication and this sounds very similar to the lactic acidosis my father went through recently caused by metformin.   It was kind of a shitstorm that caused it and he went downhill slowly, then fell off a cliff at the end, so to speak.   He’s fine now, but needed to be dragged into the emergency room.

If he’s not eating or drinking much, it could be dehydration which will exacerbate the problem.  Not to mention that chronic dehydration causes altertered mental status.  And feeling cold.  And weakness.   Honestly, I’d try to convince him to go to emergency, but maybe since she’s so reluctant, you’ll have to, well, hell, I don’t even know.   Drag him in or wait until he’s so weak an ambulance has to take him.

I’m so sorry you’re going through this  

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9 minutes ago, Ailaena said:

You mentioned a diabetes medication and this sounds very similar to the lactic acidosis my father went through recently caused by metformin.   It was kind of a shitstorm that caused it and he went downhill slowly, then fell off a cliff at the end, so to speak.   He’s fine now, but needed to be dragged into the emergency room.

If he’s not eating or drinking much, it could be dehydration which will exacerbate the problem.  Not to mention that chronic dehydration causes altertered mental status.  And feeling cold.  And weakness.   Honestly, I’d try to convince him to go to emergency, but maybe since she’s so reluctant, you’ll have to, well, hell, I don’t even know.   Drag him in or wait until he’s so weak an ambulance has to take him.

I’m so sorry you’re going through this  

Thank you. He's not taking any metformin but maybe the other drugs can cause that?

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A few thoughts.

1. Does he test his blood sugar since he is on a diabetes med. Many of his symptoms can be related to high/low blood sugar.

2. If he is not drinking enough, he could be constipated. It can cause a lack of appetite and that can cause weight loss. Constipation is common in people after surgery. One thing that can cause constipation is a sudden decrease in coffee consumption. If he drinks coffee all day at work and doesn't at home, that can contribute. Also lack of activity being at home can make it worse.  He may not want to discuss it if he is embarrassed. Constipation can lead to hemorrhoids and blood loss can lead to low iron, which can lead to fatigue. OTC miralax can help and is virtually tasteless.  A stimulant laxative or enema may be needed to get things going. 

3. No likely, but any possibly of a trauma to his esophagus during the surgery? That can lead to not wanting to eat.....

Edited by Tap
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1 minute ago, Tap said:

A few thoughts.

1. Does he test his blood sugar since he is on a diabetes med. Many of his symptoms can be related to high/low blood sugar.

2. If he is not drinking enough, he could be constipated. It can cause a lack of appetite and that can cause weight loss. Constipation is common in people after surgery. One thing that can cause constipation is a sudden decrease in coffee consumption. If he drinks coffee all day at work and doesn't at home, that can contribute. Also lack of activity being at home can make it worse.  He may not want to discuss it if he is embarrassed. Constipation can lead to hemorrhoids and blood loss can lead to low iron, which can lead to fatigue. OTC miralax can help and is virtually tasteless.  A stimulant laxative or enema may be needed to get things going. 

3. No likely, but any possibly of a trauma to his esophagus during the surgery? That can lead to not wanting to eat.....

1. He rarely tests. I think the last one on his meter was in February. 

2. He's had diarrhea off and on. I doubt he's drinking much. He doesn't drink coffee but he does drink tea and diet soda.  The doctor told him no more tea. I hope he said the same about soda.  

3. He thought about that, too.

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Just saying my dad did that unusual snapping, and that was literally the only clue I had because he was on the phone with me from out of state. Sent him to the ER and it was pneumonia. Clearly SOMETHING is wrong and clearly that doc didn't get it figured out. 

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Has he been on an antibiotic? And is he taking Florastor or something as well? Even gut out of whack could cause those symptoms, ecoli, something flaring up...

There will be a pharmacy in town that is open, so you could go talk with the pharmacist. Or your insurance should have a nurse line you could call. Calling the nurse line could be good, because they could help you sort out how urgent it is. That's what I would do.

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9 minutes ago, PeterPan said:

Has he been on an antibiotic? And is he taking Florastor or something as well? Even gut out of whack could cause those symptoms, ecoli, something flaring up...

There will be a pharmacy in town that is open, so you could go talk with the pharmacist. Or your insurance should have a nurse line you could call. Calling the nurse line could be good, because they could help you sort out how urgent it is. That's what I would do.

I think they gave a shot of ABC after surgery.  I'm not sure. I remember the nurse mentioned ABC but he never had any pills. We have Florastor. I can remind him about them.

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25 minutes ago, AbcdeDooDah said:

1. He rarely tests. I think the last one on his meter was in February. 

2. He's had diarrhea off and on. I doubt he's drinking much. He doesn't drink coffee but he does drink tea and diet soda.  The doctor told him no more tea. I hope he said the same about soda.  

3. He thought about that, too.

1. have him test a few times over the next few days. Pre and postprandial.

2. Constipation can cause a blockage and diarrhea can slip past. The change in drinking habits can contribute, since caffeine and artificial sugar can be a laxative in some people.  Constipation can mimic GERD. You can use OTC miralax, stool softeners, stimulant laxatives and enemas.  If you suspect constipation, many people here can give you guidelines, or you can google to get a protocol. 

Any results from the blood work?

Edited by Tap
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3 minutes ago, Tap said:

1. have him test a few times over the next few days. Pre and postprandial.

2. Constipation can cause a blockage and diarrhea can slip past. The change in drinking habits can contribute, since caffeine and artificial sugar can be a laxative in some people.  Constipation can mimic GERD. You can use OTC miralax, stool softeners, stimulant laxatives and enemas.  If you suspect constipation, many people here can give you guidelines, or you can google to get a protocol. 

Any results from the blood work?

He can tell his blood sugar just by how he feels. 😶

I'll try to pay attention to his fluid intake tomorrow. He hasn't gotten he results yet. 

 

 

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6 hours ago, Carol in Cal. said:

I'm not in a medical field, but that much weight loss so fast sounds drastic and dangerous to me.

I can tell you from observation and experience that ibuprofen can cause the GERD and the runs.  I am surprised that the doctor didn't offer prescription Prilosec instead of the OTC plus Zantac combo--IME heavy doses of prescription Prilosec would be stronger than that combo.  I tend toward GERD, and one natural thing that helps it a LOT is steeping a bunch of sliced fresh ginger in boiling water until it drops to lukewarm, and then drinking it.  I don't mind the flavor but some find it too strong and have to add a little honey.  That is marvelously healing to a damaged stomach and throat.  

But although I would do that in this case, this seems too serious to let go any further.  I think he needs to see another doctor, maybe a GE doctor, pronto.  And I'd be watching for signs of dehydration, do you know the pinch test?  If he is dehydrated, hie thee to urgent care, he might need IV fluids.

Ginger actually causes GERD in many people, I'd be very careful with that. IT's one of my biggest triggers. 

My other thought is the diabetes...is he still taking his normal dose of medication even though he's not eating much? That could cause low blood sugar and weakness. 

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8 hours ago, AbcdeDooDah said:

He can tell his blood sugar just by how he feels. 😶

I'll try to pay attention to his fluid intake tomorrow. He hasn't gotten he results yet. 

 

 

If he is new to diabetes medication, he could be used to the feeling of his glucose level going high, but the med may be dropping him too low.  It wouldn't hurt to check his number to see where he is at for a day.

Like others, I would get an appointment scheduled with a GI doctor. If the PCP gives you a push back on writing the referral (most specialists want a referral from a PCP) just tell him you want it for a second opinion. It isn't required that a PCP assist you in getting a second opinion, but if he refuses to write the referral, you need to change PCP. Sometimes it takes a while to get a new patient appointment. So, I would start now and that way you can get something on the books. You can cancel later if you need to. 

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4 hours ago, Ktgrok said:

Ginger actually causes GERD in many people, I'd be very careful with that. IT's one of my biggest triggers. 

My other thought is the diabetes...is he still taking his normal dose of medication even though he's not eating much? That could cause low blood sugar and weakness. 

Yes, same dose. Looks like it could be all kinds of things causing a perfect storm.

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5 minutes ago, Tap said:

If he is new to diabetes medication, he could be used to the feeling of his glucose level going high, but the med may be dropping him too low.  It wouldn't hurt to check his number to see where he is at for a day.

Like others, I would get an appointment scheduled with a GI doctor. If the PCP gives you a push back on writing the referral (most specialists want a referral from a PCP) just tell him you want it for a second opinion. It isn't required that a PCP assist you in getting a second opinion, but if he refuses to write the referral, you need to change PCP. Sometimes it takes a while to get a new patient appointment. So, I would start now and that way you can get something on the books. You can cancel later if you need to. 

We don't need referral, so that's good, but Dh doesn't see any need to change anything. He also isn't honest about testing. He absolutely won't if I say he needs to. 

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1 minute ago, AbcdeDooDah said:

We don't need referral, so that's good, but Dh doesn't see any need to change anything. He also isn't honest about testing. He absolutely won't if I say he needs to. 

That is good. I know my insurance doesn't require a referral, but most specialists want one anyways They want one so they can see the PCPs notes on what he has tried so far and what his original diagnosis is. 

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How is he feeling today? Were you able to call and speak with anyone about his symptoms? Will he see another doctor?

Edited to add — Sorry to bombard you with questions!!! I have been worrying about you guys, but I didn’t mean to give you the third degree!!!

Edited by Catwoman
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2 hours ago, Tap said:

That is good. I know my insurance doesn't require a referral, but most specialists want one anyways They want one so they can see the PCPs notes on what he has tried so far and what his original diagnosis is. 

In our area, specialists don't require referrals. It's a good thing, because the GP's in our area have the personalities of dishrags. I avoid GP's at all costs and go to a specialist if there is one for an issue I am having. With the exception of my son's first nephrologist, I've never met a specialist I didn't like. They have all had a good bedside manner and most importantly, they know their stuff. I often tell people they need to find a good GP, but I've personally not been successful at it. The one GP I liked in my 25+ years of living here moved out of the area after a few years.

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