Post-Appendectomy Weakness: Recovery Challenges in Seniors

Q: Post-Appendectomy Weakness: Recovery Challenges in Seniors

Hello： It is important to encourage your grandfather to get out of bed and be active, even if he lacks the strength to walk. <br>He should at least be able to sit up, as elderly individuals who remain bedridden for more than a week may experience muscle atrophy and weakness. <br>

Post-appendectomy weakness?

Hello Doctor, my grandfather recently underwent surgery for appendicitis and stayed in the hospital for over a week due to bloating for observation.
He was discharged only after he was able to pass stool and gas successfully.
However, after being discharged, his condition has worsened.
I'm not sure if it's related to the IV fluids he received during his hospital stay or the reduced mobility, but now he can only lie in bed and wear adult diapers.
He has no strength to stand up, feels dizzy, and can only sit for a short while.
His appetite has also significantly decreased; he can only eat two or three bites of porridge before saying he's full, and he only drinks a few sips of water at a time.
The only thing he can tolerate is a nutritional supplement (Nutren 995), so throughout the day, he only consumes one bottle of 995 along with a few bites of porridge and some water.
I would like to ask if this is normal.
Could it be that his gastrointestinal function is still recovering? His current situation is worrying everyone, and my parents are reluctant to take him back to the doctor for fear that he will have to undergo more blood tests and injections, which would be very painful for him.
If his condition does not improve, I believe we should still see a doctor, but I am not a professional, so I would like to seek your opinion.
Thank you very much!

Peng, 80~89 year old female. Ask Date: 2022/05/26

Dr. Cai Anshun reply Gastroenterology and Hepatology

Hello: It is important to encourage your grandfather to get out of bed and be active, even if he lacks the strength to walk.
He should at least be able to sit up, as elderly individuals who remain bedridden for more than a week may experience muscle atrophy and weakness.
Additionally, if his appetite is poor, his overall strength will noticeably decline.
It is advisable to encourage small, frequent meals.
If he has a fever and continues to refuse food, it is safer to seek medical attention.
There may sometimes be underlying infections, such as pneumonia, pleural effusion, electrolyte imbalances, cholecystitis, or intra-abdominal infections.
Changhua Hospital cares about your health.
Dr.
Tsai An-Shun.

Reply Date: 2022/05/26

More Info

Post-appendectomy recovery can be particularly challenging for seniors due to several factors, including age-related physiological changes, pre-existing health conditions, and the effects of prolonged hospitalization. Your grandfather's situation, characterized by weakness, dizziness, decreased appetite, and limited mobility, is not uncommon after such a surgical procedure, especially in older adults.

Firstly, it's important to understand that after an appendectomy, the body undergoes a healing process that can take time. The surgery itself, along with any anesthesia used, can temporarily affect gastrointestinal function. This can lead to issues such as decreased appetite, nausea, and difficulty with digestion. In your grandfather's case, the prolonged hospitalization and reliance on intravenous fluids may have contributed to a lack of stimulation for his digestive system, which can further delay recovery.

The symptoms you describe—weakness, dizziness, and a significant reduction in food and fluid intake—are concerning. Weakness and dizziness can be attributed to several factors, including dehydration, electrolyte imbalances, and the effects of anesthesia. When a patient is less active, as often happens during hospitalization, muscle strength can decline rapidly, leading to increased difficulty in performing daily activities post-discharge.

It's also worth noting that seniors often have a lower baseline of physical strength and endurance, making them more susceptible to post-operative complications. The fact that your grandfather is only able to consume minimal amounts of food and fluid is particularly alarming. Adequate nutrition and hydration are crucial for recovery, and a lack of both can lead to further complications, including increased weakness and potential hospital readmission.

In terms of recovery, it is essential to encourage gradual mobility. While it may be uncomfortable for him to move, gentle activities such as sitting up for longer periods, standing with assistance, or even short walks can help stimulate his appetite and improve his overall strength. Physical therapy may also be beneficial in helping him regain strength and mobility.

Regarding his reluctance to return to the doctor, it is understandable that your family may want to avoid further discomfort associated with medical visits. However, if his condition does not improve, it is crucial to seek medical attention. A healthcare professional can assess his hydration status, nutritional needs, and overall recovery progress. They may also provide interventions such as appetite stimulants or adjustments to his diet to ensure he receives adequate nutrition.

In summary, while some degree of weakness and decreased appetite can be expected after an appendectomy, the severity of your grandfather's symptoms warrants further evaluation. Encouraging mobility, ensuring adequate nutrition and hydration, and consulting with a healthcare provider if there is no improvement are essential steps in supporting his recovery. It is vital to prioritize his health and well-being, even if it means facing the discomfort of medical assessments.

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