BIL with diabetes rushed into hospital

[Jux]

SIL rang on Sunday. Apparently they told her he wouldn't be coming out. DH rushed off to London (150 miles) to be with her and we were all expecting the worst. However, yesterday the news is that he will be in there 'a long time'. He is mainly unconscious, on a drip. Other than that, we know nothing. He'd had multiple strokes over the years and was confined to a wheelchair too, if that's relevant. Very proud and refused to go out as he didn't want people who knew him to see him in the chair. In his late 60s.

SIL fell foul of something bad she ate and was already confined to bed by the time dh got there so he has spent the time looking after her, cleaning her kitchen/bathroom etc. Apparently BIL had been rather incontinent and the sofa and much of the carpetting needed sorting too. He's done that. Later today he will go to the hospital and try to get a bit more info about BIL's condition/prognosis, but I'd be really grateful if someone could give me some idea of what might be going on.

[CMOTdibbler]

I'm really sorry to hear that Jux. I guess he's probably had another stroke, but I'm sure your dh will find out more at the hospital.
Has sil not been coping before ? It might be that ss need to get involved to get a care package in place ?

[Jux]

Hi CMOT, you helped me with my mum a couple of years ago.

One outcome I am hoping for is that SS do get involved. SIL has been looking afterBIL for about 5 years and more recently been dashing off to shop, clean etc for her mum (my mil) and sfil. Mil is completely senile and sfil has suddenly become v frail and they haven't been washing up, cooking, washing clothes etc etc.

Had a long chat with SIL a month or so ago and suggested she get SS involved, first to help her with BIL, and also to help sort out the old folk. Last week we heard that SS were now going to be visiting the old folk on a regular basis. SIL has been running herself ragged, doesn't drive and has an hour's trip to get to her mum's. When she gets home, BIL will 'punish' her for being away by not eating the meal she'll have left for him, not taking the medication left for him, refusing to eat or take medication in the evening as well.

SIL needs carers allowance and some respite. She's messed up her own system by alcoholism, but has actually been on the wagon for the last few years, and before that short fall off the wagon, was dry for about 12 years.

I hadn't thought it could be another stroke. I assumed it was diabetes related because that's what dh said. He's just as likely to have decided that himself because it somehow accords with his expectations, though. If it came from SIL, she does know what she's talking about generally, particularly vis a vis BIL's condition. I'd been thinking diabetic coma.

DH has decided he himself is coming home tonight, so I'll find out something tomorrow, at any rate.

I suppose if it is another stroke, and BIL's been in most of the week and most of that unconscious, then the prognosis is bad.

[lilyliz]

what a worry for you andDH,apart from that don't know what to say except I hope it goes well for your SIL

[Jux]

The good news is that BIL is definitely not about to die. DH saw him yesterday briefly. There were no doctors or nurses free, but he spoke to a physio, who kindly read all the notes and told dh that BIL will certainly be in there for some time yet.

It wasn't a stroke; his diabetes insulin/sugar levels just went out of control, no idea why, but he fell into a coma from which he has 'recovered' (?) but is still mainly asleep. They are giving him masses of insulin and yesterday were about to give him masses of heavy duty anti-biotics.

It seems likely that when he does eventually come out, he will have to go into a care home as his medical needs will be too much for SIL.

I still have no real idea of what happened, how it happened, what sort of care/medical attention etc he is likely to need in the future, how such an event could be avoided in the future and so on.

I really, really need information, knowledge. None of these decisions will be down to me, but if I understand as much as I can, then I can help SIL and DH when the time comes.

[oldraver]

If he has (stupidly) been refusing to eat and take his medications then this will have an effect on his insulin/glucose levels. If he has been taking Insulin and not eating this isnt good, nor is eating and not taking Insulin and other Diabatic medication. If his glucose levels are not controlled it will make him prone to infections, possible cause for the doses of ant-biotics maybe?. Maybe someone more knowlegable will be along to fully explain the whole balance that needs to be in place to deal with Diabetes.

FWIW it does sound as though he needs help with his care but if he wants to refuse treatment/food when it suits him I dont know what can be done about this

[HerdOfTinyElephants]

I know someone who died from diabetes-related complications recently, even though he had always been extremely careful with food and insulin. An infection set in in his foot (he was sensible and went straight to GP and it was being monitored), that seemed to cause his blood sugar levels to spiral way out of control (they took him into hospital to try to stabilise blood sugar but even there couldn't do it) and that led to kidney failure and multiple heart attacks. All this was spread out over a couple of months

[Jux]

HerdOfTinyElephants, I'm so sorry, that was ghastly.

BIL has stopped being stupid, but only in the last month or so. He was like that whenever SIL went to help out the old folks - once or twice a week; that was why she couldnt' do that much for them when she was there because it was a 2 hour round trip and if she was out more than 3 hours he'd probably have peed on the sofa as well as everything else. Poor woman. She has been valiant with very little support.

I haven't heard anything further, so am hoping no news is good news.

[Jux]

I know, holyShmoley, the thought has crossed my mind. No one else will see it like that though, he is the one who got her to stop drinking.

[Neverlandpirate]

Hi, it sounds to me like your bil has ketoacidosis where the levels of ketones in the body get very high due to either infection, or not taking correct insulin/ tablets. The ketoacidosis can make someone go into a coma and need massive doses of intravenous fluids and insulin to get the acidic blood to be normalised.

This condition can for some be life threatening, especially if they have any other underlying conditions, but for most it can be reversed with a lot of medical treatment.

It also sounds like the strokes that he has had have possibly caused some degree of personality change in him which will have caused him to act differently than he used to. For some people strokes, particularly if they have had a few can make people develop a degree of dementia, or to a lesser extent mood swings etc.

I am speaking here as a nurse, but also someone who nursed a relative after she had had a few strokes. Her personality completely changed, and she would have terrible tantrums where before she was the nicest calmest person I knew. She used to hit out a lot due to frustration of her body not doing what she used to do. She became impossible to care for at home and reluctantly we had to get her into a nursing home where they diagnosed her as having vascular dementia (the strokes had killed off some of her brain and the brain didnt recover).

I just wanted you to know that following a stroke some people are never the same again, and it helped me to know that my gran wasn't deliberately being horrible, but she couldn't help it as she had suffered brain damage. This might be the same with your BIL? Maybe the time has come for him to get more professional help outside of his home, where your SIL can visit him every day but doesn't have to take charge of his general care?

It is a horrible situation your family is in and you all have my sympathises. Take it a day at a time.

[Jux]

Neverlandpirate, thank you thank you thank you. I could hug you for that post.

He's always been described to me as a really lovely bloke, and dh's family love him. I've generally found him to be pretty bad tempered and difficult, but he'd already had some strokes when dh and I met, so that could explain that. I knew that could happen with Alzheimer's, and just didn't think about the impact of the strokes possibly being the same (and I had a place to study Neuroscience! you'd never believe it).

I think he will have to go into a nursing home, which will upset everyone, but will allow SIL to actually have some time for herself; almost certainly it will be the best solution. I know DH thinks that's what should happen.

Once again, thank you.

[Neverlandpirate]

Oh I'm glad to have helped :)

I had never realised myself at the time of my gran being ill that the strokes had changed her, and I just wish someone had told me at the time, as I found it really hard to like her at times as I thought she was acting like a spoiled child. If I had known then how a stroke can cause personality changes it would have been much easier for me to cope with as I wouldn't have been so cross with her as it wasn't her fault...she wasn't intentionally being difficult, she couldn't help it.

My mother had a stroke then 15 years ago, and thankfully had very little physical change in her mobility, but she also has had a slight personality change too, but at least this time I understand it more and can be morer sympathetic to it rather than angry at her.

Hope this helps.

Having your BIL placed in the care of professionals will be hard for everyone concerned, but hopefully in the long term after all the upheaval your SIL will get some of the rest she needs, and he will get the care he needs.