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

Its not about money .its about quality of life an operation would have caused him unecessary pain and suffering

I'm sorry for your loss. Anger is a completely normal part of grief as is asking all those what if questions, I would give yourself time to deal with your loss. I would gently speak to your cousins about what the doctors discussed with them.

I lost my dad as a child, he was 36, because his condition wasn't noticed soon enough. I couldn't go near a medical professional for years afterward as I was so angry that (i thought) they didn't try hard enough to save him.

I later found out that his smoking was partially at fault for the late diagnosis and that he had a rare genetic condition and i had made a judgement against the NHS because I didn't have all the information (my family only told me when they were told i could have that same condition).

Having witnessed my grandad after being resuscitated after a heart attack at 74 when he had terminal lung cancer (there was no one stopping the paramedics) having a horrendous quality of life for his last six months, i wished at the time i'd been there to tell them to let him go at home.
When you're grieving it's difficult not to wish they kept them alive even if maybe they shouldn't.

I'm sorry for your loss.

You said though that his chances of survival if he had the op were just 5%. I think that really means his condition was basically inoperable. The decisions made were about choosing the care that would give him the most peaceful and kindest end.

Understandably you are still shocked and trying to make sense of an unexpected death. That will take a bit of time.

My DFather suffered a perforated ulcer when I was a child. He wasn't even 40, fit and healthy. He didn't know he had an ulcer until it perforated and he was doubled over in pain and crying. I don't remember much but I do know that the operation was invasive and recovery was brutal.

If your cousin isn't able to answer your questions then it's worth speaking to PALS and request a debrief relating to your Uncle's care. I had cause to request this once; PALS arranged for me to meet with the consultant and senior nurses responsible for my relative's care. They answered my questions honestly and patiently as they understand that in the midst of an emotional crisis it is hard to take in information or ask questions.

I am 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)...

And that is what they do, but a perforated one is obviously going to become an acute situation and not wait for the results from the test or for the endoscope.

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

Do you think there are the resources to conduct those tests on every single patient who walks into a GP with indigestion-like symptoms? When 99 times out of 100 it’s indigestion?

Besides, in the case of the pp’s neighbour, it doesn’t sound like it would have been quick enough. He died that afternoon.

No bacterial test result would have been back that quickly, and there’s no way you’d get an endoscopy quickly enough either.

It’s not like there are gastroenterologists on standby to do an endoscopy on anyone who goes to their GP with indigestion.

It’s simply impossible to save some people, however sad that is.

I'm so sorry for your loss. Unfortunately there are times when surgery is not the best option - it's extra pain and distress for the patient with little or no likelihood of recovery so it may be kinder to give pain relief/sedation and let the person go.

I just honestly can't believe he has gone.
I know that sounds stupid but that's it he is gone.
Il never talk to him again or see him again.
I shouldn't be feeling like this as I lost my mum when I was 14 so I know what it's like but it was just so unexpected.
I seen him the other day and spoke to him and he was ok.

Please stop suggesting PALS. So sorry for your loss, OP but they won’t talk to you unless you’re next of kin. They sad they wouldn’t talk to me about my dad unless he authorised access to his notes, unfortunately he was unable to do that as he’d died a couple of weeks before. If your cousin is content, you need to leave this alone.

I am sorry for your loss. I had lots of questions when my father died. I wasn't next of kin and so couldn't ask and wasn't given any answers. It's a bit of an open wound that I manage to look away from most of the time. I believe the medical professionals acted in his best interests - I have to believe that. But it is difficult when you want (need) answers and aren't entitled to any.

@sadaboutlife how you're feeling is perfectly valid. I've lost a parent as a child too but the deaths after that have still felt absolutely awful, whether it's been unexpected or not.
my grandad is dying of cancer at the moment, i've had 13 months to prepare myself for this, i'm still feeling horrendous on and off.

sometimes it's been comforting as i know if i got through losing my dad, i know i can (in time) get through anything else but on the other hand it can open old wounds from losing your parent which doesn't help.

I’m sorry for your loss.

With respect though there is such a thing as a ‘good death’ and it appears that your uncle has been given this.

@sadaboutlife

It will take time to come to terms with it. I don’t know if you are familiar with the Kubler Ross stages of grief (actually stages in accepting your own fate really but hugely useful in understanding that your grief will have stages).

Denial -it can’t be true, behaving as though it hasn’t happened, thinking about what you might say when you see them next
Anger -outrage, it shouldn’t have happened, there must have been a mistake
Bargaining -maybe if I do this, that, the other (complain, question, pray) it might change
Despair -sorrow, sadness, crying, fatigue
Acceptance -coming to terms with your grief

It has become very clichéd and there’ll no doubt be someone along to criticise the generalisation, but as a NHS clinician, I have found it very useful in watching people come to terms with grief and moving through these stages (not necessarily in that order and sometimes cycling through 1 or 2 for a while) is remarkably universal. I also think that Anger and Bargaining are poorly acknowledged as a source of NHS complaints, despite the impact on staff.

Give yourself a breather and allow yourself to feel what you need to. Hope you have family around you.

Sadaboutlife sorry for your loss. If he had a 5% chance of survival but if surviving would have no quality of life, do you think he'd want to live? Is it not kinder on him to let him pass?

Sorry for your loss. It won’t make any sense right now. ...
But Surgeons are people who often don’t care all that much about how much an op costs. They do care if some one dies in their hands on the operating table.

I’m so sorry for your loss.

I just wanted to share with you what happened to my DGM. She had a perforated ulcer and in her case they did decide to operate. She never made out of intensive care as her heart failed. Sometimes there is just nothing that can be done except to ease a persons suffering.

The surgery wasn’t even successful as the doctor explained to us the ulcer was so big there was simply nothing left to repair.

Sorry for your loss OP

My MIL died of similar, also perforated stomach ulcer but she had recently had breast cancer and due to the affects of the chemotherapy they said she wasn't strong enough for the operation. It was such a shame as she had beaten the cancer.

I wonder though if there is a 'right ' time to die? Some times people go younger than expected, maybe after a short illness and it is a real shock to those left behind. Other times a person passes from advanced dementia or terminal cancer and the sadness can be mixed with relief that they are free from suffering.

73 is not old in today's terms for having an operation, unless there are other underlying conditions that make it more risky for example obesity, high blood pressure, diabetes, a heart condition, compromised lung efficiency etc. You don,t say in your first post if your uncle had other health issues, so I assuming that he possibly did which is why the prognosis for a successful operation was so poor.

Sorry for your loss, your uncle clearly had a special place in your heart.

Decisions are made very carefully and thoroughly. Many areas have moved to using 'Respect' forms rather than 'Do not attempt resuscitation' forms and they are incredibly detailed. For example, a form could say 'CPR attempts not recommended, but for intubation and ventilation, central inotropes, filter, if required.' In other words 'try anything, try everything, but if the patient arrests, let them go.' Another form may say 'CPR attempts not recommended. Due to the likelihood that it would be impossible to wean from ventilation, intubation and ventilation not recommended. Non-invasive ventilation recommended.'

So each patient has their circumstances weighed up before clear recommendations are made, so that they get the right treatment.

It's so hard to believe that they haven't taken the easy way out, but it's just a sad reality that not everyone can be saved and being saved can be worse that dying, if it leaves you so disabled that you aren't able to be you anymore.

I just honestly can't believe he has gone.
I know that sounds stupid but that's it he is gone.
Il never talk to him again or see him again.
I shouldn't be feeling like this as I lost my mum when I was 14 so I know what it's like but it was just so unexpected.
I seen him the other day and spoke to him and he was ok.

When you were 14 you had a very different ability to deal with the reality of death, even your own Mums.

I suspect this is the first time that the true nature of what death means has hit you for six. You are now mature enough to realise the full awfulness of it. Perhaps you are not just grieving for your Uncle, but also for your Mum in retrospect?

Your anger is a natural process of grief, you think someone, somewhere must be held accountable? I think the truth is that your Uncle was sadly just too unwell to undergo surgery. His prognosis was equally bad, so surgery would mean pain and indignity extended with the same end result.

I seen him the other day and spoke to him and he was ok.

Externally maybe but internally, he wasn’t ok. and that’s what you’re struggling to reconcile. He wasn’t well enough to survive the operation and if he did, he would be in such a weakened state that his other ailments would have decreased his chances of survival even further.

My neighbor had this and they found it two weeks before he died but still did nothing.
They were told it was a unstable structure with an excellent blood supply. It would take very little to set it off, even the anesthesia could do it,maybe taking BP was risky.
He died very quickly in hospital where they could manage the pain etc

Sorry for your loss

There was something in the newspapers years ago about surgeons and their surgery mortality rates and how they would often refuse to do surgeries where they knew a patient didnt have much chance as it made their mortality status look bad.

@Sunshineonthesilverlining
That’s a very cynical view from the newspapers. Totally unsurprising.

It is true in cold hard factual terms that mortality rates would go up. The human cost behind that is the real story, the trauma to the patients and their loved ones. And let’s not forget the anaesthetists, surgeons, nurses etc, who would have to go through the trauma of having patient after patient dying under their care and as a direct result of their actions. No one would or should be expected to put up with the strain.

Then of course there’s future patients. Who would want to be operated by a surgeon, who’d lost 20% of their patients on the table?

Because of these measured and reasoned decisions, some idiot journalist decided to twist these facts to write an article about surgeons wanting to play god with peoples lives.

I'm sorry OP but your grief and your ignorance of his medical conditions are clouding your judgement. The Dr's and nurses do an incredibly tough job please give them some credit instead of bashing them and second guessing their decisions.