To think the hospital just let him die?

[sadaboutlife]

My uncle was 73.
He was taken into hospital last Thursday with severe stomach pains and vomiting.
They gave him a scan and found out he had a perforated stomach ulcer.
Now they said normal treatment would be a operation but they said they didn't think he would survive the operation so refused to do it.
They gave him antibiotics and fluids and 3 days later told us he was dying.
He died yesterday.
I'm angry.
Why wouldn't they just try the Op?
They knew he would die anyway so why not at least give him a chance to live.
I'm so upset.
This time last week he was watching tele happy and now his gone
I just don't understand

Before you start contacting PALS or trying to have lengthy discussions with the hospital staff, I suggest you read ‘This is Going to Hurt’ by Adam Kay. That will give you an idea of just how much pressure the staff are under and how much they do not need their professional opinion to be second guessed.

It is sad when people die (and I speak as one who has few close surviving relatives) but I’m not sure channeling your grief at the hospital staff is the way forwards. I found the book ‘With the End in Mind’ by Kathryn Mannix very helpful in coping with my own grief.

My dh had a perforated abscess about 8 years ago. His appendix had burst and he had perotinitus by the time we knew anything was wrong.

He was admitted early hours of Saturday morning and operated on Saturday morning. He was a very strong, very fit 45 year old. It was touch and go for a week, then a very long recovery. 2 weeks in hospital, and 4 weeks off work before returning part time on light duties.

The only thing that saved his life was his previous fitness and his age. And his recovery was horrendous.

I am very sorry for your loss, but it was likely unavoidable. I heard a quote of 90% of patients with no previous complications die from a perforated bowel, no matter what caused it. Add to that your uncles age and existing health conditions and I would think they did the right thing by not operating. My dh was as strong as an ox, fit and well and still spent a week in ITU. .

I don't understand why they would say he would have a poor quality of life after the op. My husband had the same thing and although the op was a major one and he took a good few weeks to feel ok again, he has been fine since but has to take acid reducing medication for life now. I would also be upset in your situation, surely it's better to try and save someone.

By the sounds of it he was not going to survive whether he had surgery or not.
He had big risk factors..poor skin integrity and comprimised circulation, and whatever caused the perforation.
If they had operated he would have died on the operating table, or days or afterwards with no dignity .
While this type of event is shocking to you as family, the decision not to operate would not have been taken lightly .
Condolences to all your family

My father had surgery (possibly due to SM's pressure) when he should have been put on end of life. It meant his death was far more drawn out and painful than it should have been. Painful now OP, but probably was for the best. xxx

I'm absolutely not trying to say your family member and the life of an animal are of similar importance but if you had a much loved family pet and the vet said there was a 95% chance they wouldnt survive the operation and if they did they would have no quality of life what would you decide to do? Unfortunately these are the decisions Doctors have to make on a daily basis.

OP, if you feel you can I think you should talk to your cousin who was NOK (at least that is my understanding of what you have said)- it is possible that as NOK he was party to conversations with the team looking after your uncle that you were not? Maybe he has information that he has not passed on, maybe he asked the questions you are currently asking and was given the answers?

With regards speaking to PALS, as you were not NOK they won’t be able to pass on information without the permission of the NOK- again, if you really need answers I think you need to speak to your cousin (if you haven’t already- I’m not sure if your concerns are solely yours or shared by the wider family including the MOK).

Sorry for your loss...

Going through something similar with my Mom at the moment.. an extremely rare progressive stomach disease this is only the 2nd time her specialist has seen it in his career. The only way to cure it is to remove her stomach completely.

They won't risk operating because of her age health issues etc because if she did survive the operation her quality of life would be a lot worse than it is now. She is now in palliative care for the rest of her life, will be in a nursing home for the rest of her life etc.

In my Mom's opinion they have made the right decision for her..

Drs etc will make the decision that is right for the patient wherever they possibly can.

But surely the patient (or those closest to them, if they're not well enough) should be the one(s) to decide when to give up on active treatment, not the hospital?

It sounds like the OP’s uncle had children, who accepted the doctors’ decision.

As OP is not the next of kin, her wishes would not be considered relevant.

Having seen a relative have poor quality of life post surgery it has really made me think about when the system should stop treating. Sometimes death really is a blessing and life at all costs isn’t always worth it. I am sorry for your loss. It must be hard if you have some ‘what ifs’ but the Drs decision most likely was a kindness.

surely it's better to try and save someone.

Not always, no. Trying to save someone can actually be quite violent and invasive. Sadly the choice often isn't whether to save or not to save. It's whether to allow someone to die with dignity or whether to carry out invasive procedures which in all likelihood won't work but which will in some way traumatise the patient and mean they still die, but in worse circumstances.

It's a horrible decision to have to make and a dreadful realisation. But we can't always save someone and sometimes trying to is not the right thing.

I don't understand why they would say he would have a poor quality of life after the op. My husband had the same thing and although the op was a major one and he took a good few weeks to feel ok again, he has been fine since but has to take acid reducing medication for life now. I would also be upset in your situation, surely it's better to try and save someone.

With respect, it’s not as simple as that.

It may be the same operation, but the OP’s uncle and your husband are not the same patient. So the implications are extremely different.

The OP has said that her uncle had lots of health problems, including blocked arteries in his legs. That means there would be a very large risk of him having a heart attack or stroke during surgery, which, if he survived it, would leave him brain damaged and dependent on others/machines for the rest of his life.

Sometimes similar happened with my gran. Turned out she already had cancer and had kept it from us, it was her friend who confided in us. That’s why they didn’t perform but they couldn’t just tell us that

Sorry for your loss though it’s hard

Posters need to stop telling OP to contact PALS.

She’s almost certainly not the next of kin, so they won’t speak to her about her uncle’s medical details.

She could only contact PALS if she had the consent of her cousin, but asking for that - and implying that she thinks the hospital let her uncle die (a decision her cousin accepted) - could be really upsetting for him. He’s already lost his father, after all.

I'm sorry to hear this. DH had the same with his uncle last year, he had underlying serious health problems and a perforated bowel. In his case they said similar but left family to decide which was awful. They decided against and he died peacefully a week or so later. these surgeries can leave a lot of internal scarring causing pain and problems eating, as well as sepsis which he might have already had, which can cause organ damage.

Actually @Notthetoothfairy many clinicians would be more than happy to speak with a patient or bereaved family via PALS. We understand that dealing with illness, especially unexpected serious illness or death is very stressful. People frequently don't remember what they have been told or can't fully process information during periods of intense stress and are left with unanswered questions later. If any of my patients or their family was left feeling like the OP does after I had looked after them then I would want to know about it, as would most of my colleagues. In the vast majority of such situations, misunderstandings can be resolved by good communication. PALS generally do a brilliant job liasing between patients/families and clinical teams to the benefit of both "sides." Running straight to a solicitor would be unreasonable in this case, but going to PALS is very reasonable indeed - it is what they are there for.

The exact same thing happened to my MIL.

A perforated ulcer rapidly caused overwhelming peritonitis. Surgery would not have helped as you cannot repair a massive hole that has been swimming in infected material.

She died 48 hours later before many family could arrive from overseas

I am very sorry but I do believe, from what you have said, your relative received appropriate care

A friend of mine is recovering from major abdominal surgery. She is twenty years younger than your uncle, but generally fit and healthy.

The physical toll on her has been enormous, do not underestimate how hugely traumatic an operation would have been for your uncle in his final hours.

Just because the hospital decided not to operate does not mean that they did not have his best interests in mind. As you yourself admit, you would have lost him anyway. Sadly, sometimes this is a result of men's reluctance to go to a doctor even when there is something wrong.

They didnt give up on him OP.
They gave him the chance of a gentle and peaceful death.
We had the exact opposite.
My poor sister being told to perform CPR on our DF who was probably already dead.
Then the ambulance arriving and shocking him.
Hearing his ribs crack as they fractured.
My sister totally traumatised because she thought she had failed.
I know which I would prefer.
We all have to go sometimes and FWIW I think the NHS is more guilty of trying to keep people alive far beyond what is kind.

@RosieLynn several people have already told the OP that she needs to speak with her cousin first.

My neighbour went to GP with indigestion, was given meds. came home that night he collapsed and was dead before the ambulance arrived. He was in his forties with two children under 5. No-one knew about a duodenal ulcer until his autopsy

It’s impossible to stop horrendous things like this happening.

The vast majority of the time, someone going to the GP with indigestion symptoms will have indigestion.

A GP doesn’t have in-house access to MRI/CT scans. They have no way of knowing whether it’s one of the tiny minority of cases that’s something more serious.

@tttigress that is simultaneously the most pointless and most callous post I think I have ever read on here. You have absolutely no idea of the background or circumstances, and all your post could possibly achieve is to make the OP feel even shittier than she already does. Am genuinely baffled as to why you thought it was appropriate to post that.

OP- really am so sorry for your loss.

The GPs can test for a bacteria associated with it or order a endoscopy though. Although sometimes symptoms might be not very painful (from NHS online)...

Sorry that was in reply to the GP not having access to tests etc.

Sorry for your loss. The surgeons are extremely experienced and will have based their decision on this experience along with how your uncle was. 72 is old to put someone through a general anaesthetic. I’m sure if they thought he would have survived then they would have done the op. You say they knew he was going to die anyway so it would have been pointless to do the op. I think it’s perfectly normal that we would try absolutely anything to save our loved ones. That’s why the consultants are best placed to make these decisions rather than family. They are objective rather than being emotional. Your feelings are part of the grieving process 💐