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A. Schuyler, NP
A. Schuyler, NP, Nurse Practitioner
Category: Health
Satisfied Customers: 14906
Experience:  Board Certified NP, MS, RN. Private practice & hospitalist
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My dad had open surgery for AAA (y graft procedure)... His

Customer Question

My dad had open surgery for AAA (y graft procedure)... His kidney's have not returned to normal functioning. (his baseline creatinine levels were 2.9). He has been in ICU receiving hemodialysis three days a week for two week now. He was on ventilator/ NG tube and  life support with DOPAMINE, PROPOFOL and FENTYNAL epidural for ten days His Cr. levels range from 5.1 to 7.8. He is very set against long term dialysis but his kidneys are not producing any output. He is very weak. Is there much hope that they will suddenly start functioning and he can stop dialysis? Also, "they" wanted to put him on Zoloft to change his "anti-dialysis attitude", but we told them not to put him on Zoloft just yet. Should we reconsider and allow them to put him on Zoloft?

Submitted: 1 year ago.
Category: Health
Expert:  A. Schuyler, NP replied 1 year ago.

Hello,

Answers provided are for informational use only and do not confer patient-provider relationship. My name is XXXXX XXXXX I will do whatever I can to try to help you.

 

Depression is a frequent accompaniment to any serious illness. Zoloft is an antidepressant and antianxiety medication that can help with the problem. It takes a while for the medication to reach a level in the body where it produces a noticeable change (days to about 3-4 weeks), so the sooner it is started the better. It is a drug often recommended after any serious illness (heart attack, for instance) to help the person deal with the health problems.

 

No one can predict miracles, but in the meanwhile, he will need dialysis in order to live since his kidneys aren't working. Without it he will die since his kidneys aren't functioning properly. Does he understand that? If his kidneys should one day begin functioning again, then dialysis can be stopped. But until they do, dialysis is what will keep him alive. I'm sure this isn't what you wanted to hear, but his condition is grave indeed and he will need dialysis to live.

 

Please let me know if you have questions.

 

 

All the best,

 

Schuyler

 

Customer: replied 1 year ago.


we understand the dialysis is a life or death measure... but don't feel that Zoloft is absolutely necessary. He is aware of dialysis - my mother was on dialysis 5 years ago and choose to stop and she died soon after discontinuing the dialysis at age 68. She also had pancreatic cancer, diabetes and multiple amputations. My father does not want to be on long term dialysis due to the suffering she went through - but she was in a lot worse shape. I think the depression is normal and giving him another pill to try and change his attitude is unwarranted. He didn't have much choice with the dialysis as he was unconscious - but we respect his right to make his own decisions later. He has agreed to the dialysis in the hospital and hasn't said he won't continue in the future. He just expresses strong dislike for the dialysis.. "i'd rather die than keep this up"...

Expert:  A. Schuyler, NP replied 1 year ago.

Of course, unless he has someone else making medical decisions for him, no one can require him have a procedure that will keep him alive. My own mother was on dialysis, so I am confused about why he thinks dialysis is "suffering." The antidepressant is to help with his depression so he feels better. Many people who suffer serious illnesses are on antidepressants for a short time to help them heal. One's mid set does have an influence on ability to heal. It is no different than requiring an antibiotic for an infection. It is not just a pill to make him accept dialysis. Of course he can refuse to take the recommended medication, just as he can walk out of the hospital against medical advice at any point. We have to allow people to make their own decisions about what they want to do about their recovery.

 

I'm sorry your family is having to go through all of this. Dealing with end of life issues is doubly hard when it is unexpected. I pray you will all make decisions you can all live with.

 

Kind regards,

 

Schuyler

 

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