What treatment would King Charles get

[Notreadyforit]

Got a call a few hours ago from hospital. My dad was at friends for dinner this evening, tripped and fell on way to the car. The scan showed fractures and he has a brain bleed. I was told they’d probably need to operate at another hospital and they sent the scans to another hospital who said they don’t need to operate and monitor him where he is. I assume he probably left the house around 10. A and E is busy, with a 13 hour wait. Hospitals are at capacity. Dr Google says quick action and operation (I know, I know). He can’t speak, can barely move one side, has vomited and was trying to push something out of his mouth which ended up being a blood clot. I’m wondering if the treatment path is right for him - how will I know? What would they say if it was King Charles? My poor dad - I spoke to him earlier today and all was fine. They want to monitor him in resus for another five hours. There is no ventilation, no masks, just vulnerable patients and shitloads of viruses about.

Depending on how weak he is he might not be able to swallow a drink and might aspirate. Do ask the staff though. For some people sips of drinks for comfort are OK and regular mouth care should definitely be offered so that he doesn’t feel dry. Ask staff to show you how to do it if you’d like to.

King charles would have got different treatment. Of course he would. I'm so sorry to read your updates op. Massive hugs to you.

Mil fell and had a bleed that they at first wanted to operate on, but they sent her home. She then had a stroke. So she was back in, then they tried to send her home again when she couldn't walk. That all changed when we complained to pals.

I think until it happens to you or you go into A&E or call 999 people still blindly belive the nhs will come up trumps in a dire emergency. But they can't. It's not they don't want to or the teams and tech are the best. They just can not cope with the volume.

Mil had a totally different pathway after our complaint. Do how was she ever getting the very best care? If she was the complaint would have changed nothing.

Yes if your at deaths door you will be at the top and see the nhs at its finest as I have seen for myself with suspected stroke. But this depends on your postcode, how quite resus is at that exact time and unfortunately that's true. I was in a CT scan within a hour because my ambulance came in 5 minutes and there was 3 people in a 8 bed major trama dept that night.

When we are in the active dying phase, our cells are also not working as optimally as they should. Our cells are full of water. When you drink water in the active dying phase, it can be really painful, and cause extra work for your cells when they don't have the energy, and even prolong death. Not offering water is a cruel to be kind way of easing passing, because the body just won't process that water efficiently.

Morphine should slow breathing down, it regulates the nervous system, and helps stop the physical symptoms of panic which also use a lot of energy.

Have the staff got a palliative care nurse that you can speak to so they can help you understand what comes next? It can be difficult if you see them deprive him of water without really understanding why it's happening but you do deserve a full explanation and some comfort too.

Because we pay for him?

OP, thinking of you and your dad ❤️

King Charles is not responsible for the parlous state of the NHS

@ cityanalyst678-
“the King would be able to afford a private room in an NHS hospital. As would anyone with serious money.”

Private rooms aren’t always available - my DN had booked one before she went into hospital, and then there wasn’t one. You can bet your bottom dollar that they would have found one for the King.

OP, huge commiserations over your DF - what a terrible thing to happen. I know only too well how awful it is when things change so suddenly. Hoping for the best for you and your father.

Jesus, read the room. 🙄

Thinking of you and your dad @Notreadyforit

Double posted

Because a specialist at another hospital has now reviewed the scan and knows more than the general A&E doctor who first saw him.

I’m not sure what the 13 hour A&E wait has to do with him as he’s being treated.

I know you don't meant to be but that's a cruel thing to say particularly as it isn't true. Severe traumatic brain bleeding in a patient on blood thinners is sometimes simply inoperable and unsurvivable. If Charles were in the same circumstance he would face the same fate. If it was possible for wealth to buy health in every circumstance then rich people wouldn't die. Wouldn't die from traumatic brain haemorrhage - and yet they do.

I'm sorry you had a difficult experience with inappropriate discharge for your mother in law following her stroke. I believe it is a mistake to conflate that experience with decisions whether or not to commit to neurosurgery for traumatic brain haemorrhage - which carries enormous, catastrophic risks. Different, completely separate decision makers. These decisions are actually incredibly difficult even for the experts. I think non neurosurgeons tend to overestimate the benefits and underestimate the risks of this type of surgery.

Really sorry for anyone who has to experience this kind of injury for themselves or a loved one.

Room next to my dad has signs all over it about isolation. I left to get a coffee whilst they saw to my bed, have come back and my dad’s door is open and so is the room to the patient who is meant to be in isolation. Why is infection control so utterly shit in hospitals.

If it’s isolation for eg MRSA then it’s not airborne and an open door won’t be a risk. Signs are to make sure staff and visitors wash hands and wear PPE. Highly infectious airborne stuff like open TB or something would be on a special -ve pressure ward in our hospital.

People with money and status will always get fast tracked, so I think it's fine to have named one of the most identifiable celebreties as a case in point. Charles would not require an advocate and he would be able to rely on getting his needs met, above and beyond. I think it's fair to highlight that this disparity isn't fair, that Charles by birth is not more eligible for good care than your father, that you should be able to trust services and not have to advocate in order to trust that he's getting his needs met.

Doors aren’t airtight anyway, they don’t create an impenetrable chamber. If someone needs that they will be in a specialist room.
Sounds like your dad has had excellent care and you’re looking for a reason to be angry at the NHS. I understand why but it won’t help you feel better. Just try and let that go for now and be with your dad and relax into the situation if you can. I know that sounds weird but just try and be with him peacefully with no other agenda, just let yourself sink into it. Let him go with love and joy that he lived, not fuming about petty stuff that doesn’t matter and doesn’t affect either of you.
Blessings to both of you and all the extended family.

I am so sorry to read this OP.
Sending very best wishes to your Dad for a smooth recovery.
💐

I am so sorry for what you and your dad have been through, OP. And of course your emotions are raw.

But if a brain injury is not operable, then it is not operable. An A&E doctor would not be qualified to make that decision, and so your DF's scan was sent to a specialist dept. Whose expert opinion was that an operation would not help your father's condition.

And there is a great deal of medical disagreement over whether anti-seizure medication should be given before a seizure has actually occurred.

If it is any comfort, I believe King Charles would have received the same treatment as your DF in those cases.

My mother had a brain bleed and the A&E docs were talking about transferring her to a neuro unit elsewhere for surgery. They sent her scans over but when the specialist docs from the neuro unit saw it they said surgery not possible. It’s quite a common occurrence.

I've often wondered exactly the same thing.
How's your dad getting on now?

I’m struggling as EOL was agreed upon, but since then dad has spoken again, moved the leg he was unable to etc. I don’t know if the same pathway would have been pushed if they’d seen this earlier. It may have been. It may be that his quality of life would have been too abysmal. I don’t feel he was given a chance to recover from rock bottom, although originally was told may get worse before he gets better. When EOL was chosen, he was put on meds that stopped the seizures and pain managed beyond a paracetamol. Doctors say they can be reached with changes, but that amounts to catching them on their daily round. It took 24 hours to show a video of him communicating. Five minutes after doctor left room he moved his leg yesterday. He’s on a different ward to the one where his medical team (? - not sure if phrasing) are.

It’s a tough call. These things are very unpredictable and there’s not always a lot that Drs can do one way or another to affect the outcome. If he survived but was bedbound in a care home is that what he would want? I suspect a lot of people would not want that but you know him best.

The nursing staff on the ward should be able to bleep/ call a Dr from his team to come to the ward to talk to you although probably not the consultant. Otherwise if you ask who his consultant is and contact their secretary then they may be able to arrange a longer meeting

Have you spoken to the palliative care team? Can you ask to speak to them? They are often far more knowledgeable about what to do at the point you’re at and will be able to talk things through with you. Wish I could give you a hug, my Dad died two years ago now and the end was very hard.

Consultant or a doctor would have been fine. Unfortunately I’ve been through EOL with my grandmother, but it was different as all cases are. This is no water etc because end of life has been chosen.

It can be unchosen if that’s the right thing to do. Sometimes it really seems that a person is dying and then they do get better after all. Not usually for a very long time or to a very good quality of life unfortunately.