She's dying isn't she?

[McSteamyorMcdreamy]

Mum discharged herself from hospital today.

Hiatus hernia. She can't eat or drink anything. Literally throws it straight back up.

Can't walk because her lower back is buggered.

UTI in blood. Been given antibiotics but nothing seems to be giving her a boost.

Sat in a sodding chair for 36 hours at A&E. Not slept for at least 48. Said she just wanted to go home.

I'm really scared 😭

MNHQ EDIT to gently suggest that MNers new to this thread take the time to read through all of the OP's posts before answering

Is there another hospital she could go to that might be quicker? I have 2 hospitals nearby both about half an hour away in opposite directions and 1 always has far shorter waiting times in A&E than the other.

Can you at least help the hiatus hernia pain by giving her some bicarb of soda? I have tremendous pain from mine (waiting for an op) but bicarb really helps (and shouldn't make anything else any worse).

Yes! I thought my mum had severe dementia literally overnight!

I could not believe the change in her or the change back when she was better.

Try calling 111 and report it..and see if you can get them to refer her back to A and E or give you any advice on how to help her at home. it might speed things up and in any case it will put it on the record how long its been going on.

It's delirium. Awful.

Unlike dementia it can (often, not always, and after varying lengths of time) be (fully) reversible back to a normal state of mind.

UTI, dehydration with high sodium / low potassium, lack of sleep these are all common triggers for delirium.

Have a look online to see if your area has an intensive home support service.

Your mum sounds like mine at the moment although mine is much older. She was so confused yesterday that she apparently told her GP she was fine. She wasn't, thankfully I managed to get through and they put her on a at home face to face. The Dr that can was fab, she listened and gave her some antibiotics, and some other stuff to get her through as she's under investigation for cancer. My mum hasn't eaten a full meal since mid August

As hard as it is, shift your focus on to something positive. Uti's do strange things townspeople but most respond well and quickly to treatment.

1 day after starting a 3 day course my mum is taking normally again already.

My dad was recently admitted to hospital with sepsis. He has a hernia which has pushed all his bladder etc plumbing out of place and it turned into a UTI. He went to the doctor that week who gave him diazepam to relax the muscles. He was confused but they put that down to the diazepam and he gradually stopped taking it. Later that week he was admitted to hospital with the sepsis and was in itu for about a week, being pumped with hardcore iv antibiotics. I think the hernia pushing everything out of its usual place meant he was retaining wee, which must have then became infectious. He had a catheter put in and they were doing regular cultures to identify the bug. They changed the antibiotics he was on as the ones they used initially weren't working

He was very confused for the first few days, due to the UTI and combination of drugs. He also hadn't been eating prior to being admitted as of course, everything was uncomfortable due to the hernia

Hes back home but with another infection and the catheter is tricky as his plumbing is all out of place, hes awaiting an op for his hernia - hopefully the fact he was in ITU might make his case for a slot a bit more urgent, its a bit of a vicious cycle as the hernia is causing all these problems, but hes probably not well enough for an op due to the infections

Can you advocate for your mum and push them to run some tests, and ask if they can test for sepsis. If shes admitted due to needing Iv antibiotics hopefully they can give her some fluids, by iv if needed as shes probably lost a lot of strength due to not being able to eat

If she is just given tablets and sent home, could you get her some complan or similar - she can then sip these and have them in small doses to make it easier for her to stomach, but will mean shes getting some nutrients into her

Its so scary when a parent is ill, have you got someone who can support you?

Id be inclined to call an ambulance it might hasten her route into potentially being admitted, especially if theres a risk of sepsis

Can you advocate for your mum and push them to run some tests, and ask if they can test for sepsis.

Who is she going to ask?

Her mum is at home.

Coming in by ambulance does NOT get you seen quicker
In fact you may have to wait even longer as ambulance crew has to wait with patient until they can handover and then be triage in a&e.
The OPs mother would have been triage d when she was in hospital and a priority code given with nurses monitoring routinely and escalating concerns

Calling 111. They should, if they are on point, be able to fast track a call to emergency services. They might send an in call doctor out as an advance

Different hernia, hiatuses go up through the diaphragm not down. The OP's mum has enough going on without leaping to thoughts of sepsis.

She needs to go back to hospital.

I don’t know why people are saying ‘demand’ or ‘push for’ this or that (also no idea what the ‘test for sepsis’ might be……..) when she’s discharged herself.

Take her back. It’s true a UTI alone could make her delirious -gram negative bacteraemia (that can result one of the most common UTI bugs, e Coli) also makes people feel absolutely miserable and as though they are dying but is readily treatable.

She may well die if you do nothing,

OP, I'm so sorry that your mum is so ill and that you're this worried. Maybe call 111?

I thnk that calling 111 is a sensible step. In our area, 111 would be able to get a GP to call your mum back, and/or arrange an urgent GP appointment for Saturday morning. Sometimes, intervention by an on call GP can be very helpful in moving things forward.

The plan suggested by a PP of going back to A and E at 6am is another possibility. if for any reason you don't get very far with 111. But it does depend a bit on what your mum feels able to agree to, right now.

Call 111 there might be an out of hours GP appointment she could get.

Calling an ambulance will be slower and won’t make a difference once she is there.

OP, can she keep down the antibotics?

Please take your mum back to A&E in the morning. I suspect she was on the cusp of getting her bed and being admitted. This is where she needs to be.

To those suggesting 111 and an out of hours GP appointment etc, she was already on the other side of those when she self-discharged. She was in the right place and the hospital had assessed that she needed a to be admitted to a bed. She was in a safe place. It's shit she didn't have a bed but she needed to stay where she was so she got the next one. She just needs to go back. There is no fast track.

Also there is no admitting straight to a ward anymore. A GP can have the longest chat with a specialty doctor, both of them agreeing she needs to be seen, before sending a patient to hospital, but that will always be to a place where she can be assessed in person by that specialty first, which is A&E.

I'm so sorry this is all so shit. UTIs are a real behaviour changer - but she can get better from this. Please take your mum back to A&E in the morning - early doors!

You need to take her back asap. A hiatus hernia can be fatal; if strangulation of the hernia happens/if it twist the stomach & can lead to cardiac compression.
As my mother found out a few years ago & was rushed in Xmas day for an operation that saved her life.

My hiatus hernia caused a flipped stomach (gastric voluvus). At ER triage, I was told it was probably flu and sat in the waiting area for hours in extreme pain. It wasn't. I ended up in critical condition. Spent three weeks in hospital, two of them in a medically induced coma.

Fixing a hiatus hernia in a routine op. She just needs a good sleep and she'll eat when she's hungry.

She may have something else going on, and she needs a full work-up in A&E. If she will not go back to that one, if she were my mum, I would get her in the car after a night's sleep (hopefully) and drive her to another hospital, even if it means a couple of hours' drive.

Then stay there. Chair or not, if she is in so much pain, she needs to get assessed by a hospital doctor. Are you certain she has a hiatus hernia, and what is this based on?

I ask because the frequent vomiting and pain level sound more extreme than with this hernia type, but I know that a minority can be really bad. She needs the UTI monitoring and also her temperature. She must not discharge herself again and you need to ensure she doesn't, because these things will not get better on their own.

The way I think of it also is that it isn't the doctors' and nurses' fault their A&E is in crisis, but they will do their best when they finally get to treat her.

Remember too, you can go to see any GP! Every person has a right to go into a different practice if they are outside their own area, so drive her an hour away and ask to be seen as an emergency in a practice with good reviews. They will usually see the patient the same day as a one-off.

You’ll have to take her back to hospital. Is there another hospital slightly further away with shorter waiting times? We have two about an hour away in different directions.

Take her to another hospital.

You need to take her back to A and E and wait OP as awful as it is. I don't know what people are on about telling you to 'demand' things. It sounds like the hospital staff were concerned and organising tests, treatments and admission but mum chose to leave against their advice. You don't need to demand anything she just needs to wait her turn.

There will be very little that a GP can do to bridge this gap. They are not an acute response service. They cannot administer IV antibiotics/fluid/oxygen, they cannot organise tests as quickly and they cannot monitor her continuously.

It doesn't sound like she's dying as such but it sounds like she is very ill due to likely reversible causes and she may well become gravely ill or die if she doesn't follow medical advice. Flip this on its head and ask yourself if the hospital are so overwhelmed that they can't find a really sick person a bed for over a day do you really think they'd keep her in if it wasn't 100% necessary? do you think if there was anything a GP could do right now that they wouldn't send her home themselves and ask the GP to do it?

Your mum likely has many years ahead of her. If you really care about her then take her back to A and E where they can treat her illness before it's too late rather than taking her home where she isn't safe and isn't receiving treatment then bleating that she's dying in such a defeatest way when she's chosen to refuse treatment. It's horrible I know but the staff will be doing their best and A and E is where she needs to be like it or not.