As I posted on Facebook the other day, my step son, Michael< and I took Linda into the e.r. because she had a fever, was acting very confused and could hardly walked. She was diagnosed with dehydration and low oxygen in her blood, admitted for the night and later pneumonia was added to the diagnosis. They said in a few days everything would balance out and she would be ok.

Tuesday morning I was there til noon then went to do some errands. when I left she was still kind of confused and weak but doing better. I returned about 3:30 to find her accusing 2 rn's and a cna of trying to run a scam on her. She said they had injected her with illegal drugs while she slept. One RN said she had been injected in the abdomen with heparin and had also received a sedative through her iv. I asked what heparin was and she said it was a blood thinner to keep clots from forming in her legs. I said she wasn't supposed to receive that kind of stuff as she had bleeding ulcers some years back and I would like to talk to the doctor about it.

I then sat with Linda and said there was nobody running a scam and that I would talk to her doctor. She then decided that I was backing "them" up over her and asked why I was trying to kill her. Things very quickly went downhill from there as she came more and more agitated and convinced that we were all trying to kill her and the hospital was going to take away our house. I tried my best to calm her down and convince her that there was no conspiracy but it just kept getting worse as she asked me how dare I do this to her and more along those lines.

By about 8 pm, after she ate a little dinner (convinced that it was drugged) she settled down some and began to drift off to sleep. Exhausted, I decided to go home and have some dinner. I talked to Michael for a while about what had happened and he researched heparin on line and saw that there was a possibility of reaction with nicotine. The same dr who ordered the heparin had also ordered a nicotine patch, which Linda has been using as she tries to quit smoking. So we decided we would talk to her dr about it in the morning. I then took a valium and tried to get some sleep, but about 2:30 am the phone rang and it was the nurse telling me that Linda wanted to talk to me so he switched me over and Linda asked why I was home in bed and not there loving her. I told her I would be right over and Michael and I hurried to the hospital.

When we got to Linda's room, her hands were restrained and she was thrashing and kicking out at people (I later learned that she had kicked a male nurse very close to the groin but that he was ok). She then started yelling at Michael and myself about why were we killing her and actually spit at me and then spit in her son's face. We stayed until about 6am and the situation remained out of control so I thought maybe it would be best if we leave and she might settle down. It also turned out that they had given another injection of heperin so now I was really thinking this is a bit much for a coincidence.

Later Wednesday I went over and she was still glaring at me with hatred and demanded why am I killing her and she was obviously hallucinating now as she thought she saw someone in the hospital killing 1000's of finches and that there were bird droppings dripping from the monitor near her bed. The dr who was treating her is from an eastern European nation and has a very heavy accent and speaks very fast. When I finally got to talk to her on the phone and asked her what the hell is going on and did she think that the heperan had anything to do with it as it seemed that this situation had started soon after that being given. She dismissed it and said it was nothing to do with that or the nicotine patch. She was almost impossible to under stand over the phone so we agreed to meet later in the day when she came on her rounds. When we did meet it was still very difficult communicating with her but she said that what was happening with Linda was common for patients with low oxygen saturation. I said it would have been nice to know that ahead of time and that there had been a number of rn's standing around like they had never seen this before. Communicating with this dr was so difficult that I pretty much gave up in frustration and went and sat with Linda, listening to her ravings until she finally fell asleep.

During that time her nurse came in and tried to give her an anti psychotic pill which she refused to take. Ok, I realize that this is turning into a novel but I really have no one to vent to. Thursday morning the dr called our house and I again asked her about the possibility of a drug reaction and she said she had removed the nicotine patch. I asked if she coudn't have a day off from the heperin as there seemed to me that there was a connection. She said that would be dangerous as Linda might get a blood clot in her leg. I said she hadn't really been bed ridden that long and was moving her legs around quite a bit. Again, I would like to give her a break from this stuff and see if she improves. Michael then asked if he could speak to the dr so I gave him the phone and he basically expressed the same concerns that I just had. She then got rude with him asking about his medical credentials and finished up with "ok I will take her off the drug and she will probably get a blood clot in her leg and die, and it will be your fault".

Well, we headed back to the hospital and told the charge nurse that we wanted another doctor to come see Linda and told her what the current doctor had said on the phone. We went to Linda's room and she was still very agitated and convinced that we were killing. The patient monitor who was keeping an eye on Linda said she had been calmer earlier so we thought our presence might be counter productive and left.

This morning, Friday, we went back to find Linda much calmer. We were hoping to catch the new dr on his rounds but he had already been there. The nurse also said that Linda had finally agreed to take the anti psychotic drug during the night. We met the new dr about noon and he said he had discontinued the heparin and was keeping her on the anti psychotic. Linda was sleeping much of this time so after talking to the dr we came home as Michael has been felling sick and lack of sleep was really getting him down. He's sleeping now and I will soon be headed back to the hospital to see how Linda's doing now.

To anyone who actually managed to read through this whole thing, many thanks and please keep positive thoughts in your heart for Linda.

David,

I am so so very sorry to hear how awful the last few days have been. I can't even imagine how disheartening and frustrating this latest development with Linda has been. Having been thru several rounds of my mother's hospitalizations where communication between her (with some dementia), the nurses and doctors has been terrible, I can tell you it sucks.

Someone needs to get to the bottom of her confusion...it is more than pneumonia for sure and it seems they are stabbing in the dark.

Sending you strength....Deb

I am so sorry to read these events with Linda especially as you both have been through so much already. I have nothing to offer but my love and thoughts. I know that things are different between countries and even states here as it no doubt will be in the US too. Here there are patient liaison people (officers) who are there to look after the patients best interests. Is there not something like that at the hospital that you can talk to? It seems that having a doctor that displays the attitude hers did is really not acceptable. Also due to language/accent difficulties it seems you are not able to communicate properly with this doctor. There must be a higher authority there that can help you with this. My hope is that someone with more knowledge of your hospital system can offer some concrete advice. My thoughts are with you Linda and your son..Love Gabriele

David, I am so sorry to hear what has been going on with Linda. I am very surprised they didnt remove the nicotine patch right away. Im completely shocked at what the doctor said to your son over the phone. As with the fentanyl patch, hot showers or baths, cutting, folding or ripping the patch could make too much medicine be emitted from the patch. I do not know if those type of patches would cause the low oxygen levels. Poor Linda! I hope she recovers quickly and hopefully wont remember any of this awful experience.

Ive spent alot of time hospitalized and know that heprin shots are standard. I hated getting them. Hospitals will also put a patients legs in something like airbags which inflated and deflate by themselves to help avoid blood clots.

It sounds very much like a drug interaction of some sort. You know your wife better than anyone, you saw the correlation and hey should have listened to you from the outset. The same thing happened to my mom, she was always very sensitive to drugs - when she was hospitalized with a bowel perforation. They switched her meds to a palliative pain med (she had brain mets from lung cancer at the time. When we first went in after her abdominal surgery - she was talkative and joking -withing 12 hrs of changing her meds she became almost non responsive - my step dad noticed immediately the change and suggested it might be the new med - they said no, it's usually well tolerated etc.. We went through two days like this. He said it to them again they still didn't listen then he told them I was a nurse so when I finally told them point blank I want her off it! They stopped immediately. And for them not to give her another med unless she was in pain and asking. Sure enough her entire demeanor changed!!! She became far more lucid etc... I was even able to ask her if she was in pain and she could respond and carry on a conversation though at that time she was gravely ill. drs who think they know everything are dangerous - drs who are threatened when you question them are even more dangerous - it means they have trouble admitting they don't know everything and that's a bad thing! what you did was right. Also I am one of the least prejudice people you will ever meet - I do not see colors I judge the person, however if you are in an industry where you are dealing with the public - particularly if you are in a profession like medicine - you should be abl to speak the primary language CLEARLY - IMHO - remember everyone is different! Just because 9 out of 10 people don't have a reaction... Doesn't mean Linda's not the 1 who does - btw .26% of people having heparin - complain of hallucinations... They did a study! hugs and get some sleep!

Dang, David. You sure have your hands full - I pray Linda gets some relief and over the pneumonia. I hate to admit it, but some doctors/nurses haven't a clue as to what they're doing, and I would probably be as bad as Linda was every time they administered anything new without the doctor first telling and explaining to me what was going on. I feal for you and pray you can get some relief.
julieann

David,

I am so sorry for you and your family. This is the last thing you need to add to the list of medical issues.

I often see patients who are hospitalized go from a normal mental state into a psychotic state seemingly overnight.

There are numerous reasons why this may be happening to Linda, but with limited information, it's hard to tell.

I'm assuming that since she is has been dehydrated, they are monitoring her electrolytes, kidney function, and liver function? Any upset in these levels, especially in combination with certain medications can certainly lead to a psychotic break. If you want to send me a PM of the meds she takes and a little more info about her medical history, I might be able to help you...if you want. I don't want to be intrusive. Sometimes it just helps to know what questions to ask the medical staff.

I'm especially sorry that you and Michael were treated so poorly by her attending physician. It was COMPLETELY inappropriate for her to get defensive and subsequently tell you if she dies, it's your fault! There are much more appropriate and effective ways of explaining her rationale for her treatment plan. Blood thinners such as heparin and lovenox are indeed routinely given to patients who are on bed rest or are at a higher risk of developing a life-threatening blood clot. As Christine mentioned, venodyne boots are also used and are quite common. They alternately inflate/deflate around the calf muscles to assist in keep the blood from pooling in the legs and forming a clot that could break free and get lodged in the lung (pulmonary embolus).

I looked online a bit to find drug-drug interactions and medication-induced psychosis. I couldn't find much about the interactions, but there are multiple side effects of any drug and there are many drugs that can induce psychosis, especially in her physical state on admission. The thing that concerns me is that she was showing signs of this episode before you brought her to the ED and it got progressively worse as she stayed there. To me, that's a red flag for an underlying infection (UTI, for example) that needs to be investigated.

I could go on and on...sorry. I just want to help. I'm glad that she has a new attending physician and hopefully they will find the source of her condition so they can devise an effective treatment plan. As soon as they do, it should pass and she'll be back to herself.

Please let me know if there is anything else I can do to help.

Best wishes to you all,
Kerri

Hi,
I' sorry you have had this experience and am mortified that noone took any time to explain things to you and Michael.
You said Linda was admitted with pneumonia. This is a bacterial infection and would have caused a septic reaction in Lindas body. This in itself can cause episodes of gross confusion and hallucinations. Couple this with the fact that the pneumonic process causes a reduction in the amount of oxygen Linda is able to absorb which also contributes to the confusion. This is a double banger - Sepsis causing confusion and low blood oxygen levels due to the pneumonia causing confusion/hallucinations.
I'm sure Linda will have been treated with Intavenous Antibiotics , so by now they should be on top of the infection . It will take time for the pneumonia to resolve and her oxygen levels to get back to normal, but I sincerely hope her confusion and agitation have improved.
I don't think the Heparin is to blame - a red herring.
Hope things are much better by now, take care,
Tammy

A very common cause of confusion which deteriorates to hallucinations is sodium imbalance. I could be way off base here but given that Linda was diagnosed with hydration on admission, then maybe her sodium levels are off. Simple blood test will see.

Also, I didn't know about heparin causing confusion but nicotine patches certainly can, and withdrawal from smoking (even with the patches)can cause irritability which may be manifesting as paranoia and violence. But do one thing at a time so if Linda improves, you will know what has done it, so you know what to avoid in future.

I personally struggle with the idea of giving her an antipsychotic if she isn't psychotic too - but I am not a doctor. Can you get another opinion from elsewhere?

Oh, David - I wish I could add something to what has already been said - You and Linda have been through so much! Just know that my heart is with you and Linda and your son. I hope everything improves very, very soon!