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Ask A. Schuyler, NP Your Own Question
A. Schuyler, NP
A. Schuyler, NP, Nurse Practitioner
Category: Health
Satisfied Customers: 15944
Experience:  Board Certified NP, MS, RN. 25 years private practice & hospitalist
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serious restlessness, back pain, stomach pain, chest pain..extreme

Customer Question

could either of the two be causes of serious restlessness, back pain, stomach pain, chest pain, extreme tired and fatigue, nausea, constipation, low sodium - effects of propofol or narcotics morphine, vicodine, dilaudin?(my mom is diabetic takes insulin shots hospitalized for pneumonia ended up having open heart surg, pnemonia ha returned3times& she hasbeen intubated 5 times, includ the op heart shehas had thoracentesis, thorendectomy, kidney procedure 2pump out fluid buildup in legs &stomache,in 2 days a tracheotamy and possible feed tube in stomach if the tube in her nose does not work)she does have gallstones, sodium extremely low, goes up then down again, possible liver problems, that seems to show up then be fine the next time it is checked. she was doing ok two days after breathing tubetaken out after thorendectomy, was still able to walk and pain was not so sever, after 2days painincreased rapidly, got to where she was too much pain to do anything!
Submitted: 6 years ago.
Category: Health
Expert:  CamilleRN replied 6 years ago.
Hi and thank you for your question. While she has certainly been through alot, restlessness is not uncommon, given the many problems she has had, but If you feel that your mother is over medicated, you need to make an appointment to speak with her Primary Care Phsycian as soon as popssible ( assuming you are authorized to speak onher behalf)
Customer: replied 6 years ago.
Camille- You did not answer my question at all- ther were many other symptoms shew a having
Expert:  CamilleRN replied 6 years ago.
I am not sure what your question is..I understood you to ask if her symptoms can cause restlessness. ...and that you have concernes that she is overmedicated. Please tell me what is the question and I will be happy to help you:-) I will check back for your response and answer to the best of my ability.
Customer: replied 6 years ago.
my questrin was could those symptoms be the EFFECTS of propofol from numerous intubatins OR the narcotics- morphine, vicodine, dilaudin OR what do youthink would cause those symptoms?
Expert:  A. Schuyler, NP replied 6 years ago.

When you opt out an expert, it isn't possible to ask them a follow-up question.


I am also having difficulty reading your question and trying to determine what you are asking, but let me try to see if I can help with some of the answers.


Propofol is usually competely out of the body within 24-48 hours, leaving no after-effects.


Narcotics can cause constipation, and both narcotics and propofol can cause restlessness, nausea, and fatigue. Neither causes pain.


Low sodium (hyponatremia) is not a consequence of using any of the drugs you mentioned. Its symptoms are primarily neurological, and may be responsible for some (or even all) of the restlessness. Sodium levels vary for a lot of different reasons. Among them are 1) reduced intake from food; 2) increased loss from urine, diarrhea, sweating; and 3) dilution due to chronic renal problems (renal insufficiency, nephrotic syndrome, or SIADH.


Another possible problem is pseudohyponatremia (it looks like hyponatremia but isn't). This is caused often by high triglycerides or less often by high levels of serum proteins.

No treatment is generally necessary for pseudohyponatremia. If aggressive treatment for hyponatremia is given, it often causes rebound hypernatremia (high sodium). Any additional sodium must be given very judiciously while the cause of the pseudohyponatremia is investigated.


Please let me know if you have other questions.





Customer: replied 6 years ago.
Ok can you tell me this- what can be done if kidney problems occurred, retaining a lot of fluid in legs and stomach, they are now being filtrated and fluid has been removed. Now Liver enymes are high, they have been up and down is what I have been told. SHould a kidny or liver specialist be consulted? What can be done and what should be expected?
Expert:  A. Schuyler, NP replied 6 years ago.

High liver enzymes can also raise restlessness and hepatic encephalopathy which can resemble psychosis, if they are high enough. Certainly both a hepatologist (liver specialist) and nephrologist (kidney specialist) can be consulted (if they haven't already been) by her admitting doctor(s). As for what can be done, that will depend on what is found. If the kidneys are not functioning, temporary dialysis can be considered. The hepatologist would need to look for the cause of the raised liver enzymes - medications, infection, blockage, and many other things. Treatment would depend on what was found.


Without access to her chart, and all her tests as well as an examination, it isn't possible to say what to expect next. Her treating doctors and any consultants would need to answer than question.