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911Doctor
911Doctor, Doctor
Category: Health
Satisfied Customers: 5086
Experience:  Board Certified Emergency Physician
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Hello. My mother is 69y/o, and she just had an emergency appendectomy

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Hello. My mother is 69y/o, and she just had an emergency appendectomy this past Wednesday. She came home on Wednesday afternoon, citing abdominal pain, with pain radiating around to her lumbar region. She had n/v and diarrhea. After doing a CT Scan it was found that her appendix was inflammed. After she came back from the OR to recovery, she was in extreme pain from the CO2 gas that was pumped in her abdomen. The recovery room nurses kept giving my mother Hydromorphone (Dilaudid) for pain, which just made her absolutely "loopy". She was moved to a semi-private room and she still was given Dilaudid via IV for pain and still was "loopy" afterwards. I asked the nurses not to give her anymore Dilaudid because of how it does my mother, and instead the physician ordered Norco. Yesterday when I went to visit her, I was told that she had been Dx'd with pleural effusion, atelectasis, pulmonary edema and a touch on pneumonia, which explained why her oxygen saturation would drop down each time she would ambulate from her bed to the bathroom and back again. She was maintaining a fever of 101 F, and I'm a bit concerned because she was started on three antibiotics. Will this condition resolve itself and my mother will make a full recovery? I'm very worried about her. Thank you.
Submitted: 1 year ago.
Category: Health
Expert:  911Doctor replied 1 year ago.

911Doctor :

Welcome, My answers are for educational purposes only. Remember please, that we do not get paid if you do not click 'accept' / give positive ratings!

911Doctor :

I doubt that she has ALL of the following... effusion, atelectasis, pulmonary edema ,and pneumonia. More likely, the radiologist reading her chest x ray or CT scan saw things which were clear (an effusion is clear on either Xray or CT) but the atelectasis can mimmick pneumonia as can pulmonary edema.

911Doctor :

atelectasis, a localized collapse of the lung, is quite common after surgery as is pneumonia.

911Doctor :

a pleural effusion is less common and usually is a result of pneumonia or a heart problem.

911Doctor :

The fact that she has a fever adds some evidence to the pneumonia possibility.

911Doctor :

I'm glad they have started her on 'triple antibiotics', this gives her the best chance of clearing this infections quickly...

911Doctor :

the reason for three different ones is that certain bacteria are resistant to our most commonly given antibiotics.

911Doctor :

I'm sure they are concerned about the possiblity of 'aspiration pneumonia' given her recent general anesthesia... this is caused when some saliva or stomach contents are inhaled into the lungs, and this requires coverage with an antibiotic to cover entirely different bacteria than usually cause pneumonia.

911Doctor :

finally, since she is in the hospital, they probably have her on Vancomycin along with levaquin and flagyl (just guessing here) because MRSA bacteria, common in hospitals, could be causing her pneumonia and Vancomycin is the only antibiotic that reliably kills this bug.

911Doctor :

As they get more studies back and figure out exactly which of the hundreds of bacteria that can cause pneumonia she has, they can tailor the antibiotic coverage more specifically.

911Doctor :

She is gettting excellent care and should recover fully. One thing, if the pleural effusion is large, they may need to drain it.

911Doctor :

This is done either with a small needle and plastic tube, or with a larger plastic tube called a 'chest tube'.

911Doctor :

She definitely has some hurdles to overcome, but they are on the money with her care.

911Doctor :

She has survived the most dangerous threat to her life, the appendicitis, and now she has an unfortunate, but relatively common consequence of being sick and having to have surgery to fix it.... the pneumonia.

911Doctor :

I hope I have answered all your questions... I am standing by if you have further questions for me.

911Doctor :

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911Doctor :

Further questions can be typed in the box below, and then clicking the 'reply' button.

911Doctor :

Good luck and God bless.

911Doctor :

911Doc

911Doctor, Doctor
Category: Health
Satisfied Customers: 5086
Experience: Board Certified Emergency Physician
911Doctor and 5 other Health Specialists are ready to help you
Expert:  911Doctor replied 1 year ago.
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Customer: replied 1 year ago.

Thank you 911Doctor! She's taking Vancomycin, Cipro and one of the cephalosporin drugs- Ceftriaxone I think. We were just wondering how is it that a 69 year old can come down with appendicitis? Isn't that most common in people WAYYYYY younger? But then again when I was 15, I was dx'd with gallstones and had to have a cholecystectomy- AT AGE 15! My mother, on the other hand, also had a laproscopic cholecystectomy- but when she was 61 back in 2004! Will her SpO2 levels even out and allow her to be weaned off of the continuous O2 soon do you know?

Expert:  911Doctor replied 1 year ago.
Appendicitis hits people of all ages. We do not understand WHY it happens, though there are some pretty good theories. She is lucky to have had it diagnosed as in elderly folks they sometimes wait a long time and the appendix bursts and then some die.

THIS IS A GOOD REFERENCE FOR YOU ON APPENDICITIS.


I have no way of knowing how soon they will be able to wean her.

Hope she gets better soon.

Positive feedback appreciated.

Best
911Doctor, Doctor
Category: Health
Satisfied Customers: 5086
Experience: Board Certified Emergency Physician
911Doctor and 5 other Health Specialists are ready to help you

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