My Uncle's Sudden Health Decline After Lung Surgery

Q: My Uncle's Sudden Health Decline After Lung Surgery

Hello： 1. Only the physician who personally cares for him knows. 2. It is quite common for cancer patients to take sedatives; if they are unable to speak, communication may rely on writing to assess their level of consciousness. 3. The information you provided

What is the condition of my uncle?

Hello Dr.
Chen, my uncle has been diagnosed with a suspected malignant tumor in his lungs.
The initial hospital advised against surgery, but after transferring to the current hospital, they recommended immediate surgical intervention.
He underwent surgery on August 2nd (Monday).
Three days before the surgery, while in the intensive care unit, his condition was quite stable; on the third day, he even asked the nurses to call us because he was hungry and wanted to eat.
That evening, we sent him a honey cake.
We did not visit him on the fourth day, but on the fifth day, the hospital informed us that his condition had deteriorated significantly due to mucus accumulation in the lungs and difficulty breathing.
They also mentioned that to prevent him from resisting treatment, they needed to administer sedatives to help him maintain a better recovery state.
A week later, they asked us to sign a consent form for a tracheal stent procedure, stating that mucus was obstructing the trachea, leading to breathing difficulties.
My uncle was still in a deep sleep due to the sedatives administered by the hospital.
Recently, the hospital requested that we sign a consent form for a tracheostomy, and many friends advised us to think carefully before proceeding with the tracheostomy.
Therefore, on August 30th (Monday), my father expressed to the hospital that we needed a few days to consider our decision.
However, today (August 31st), the hospital insisted that my father sign the consent form immediately, stating that it was necessary to transfer him out of the ICU, as the general ward lacked respiratory support equipment, making the tracheostomy essential.
I have the following questions: 1.
Why did his condition suddenly worsen to pneumonia and mucus accumulation after three days of being stable, able to speak and eat? 2.
Is the prolonged use of sedatives over three weeks intended to enhance treatment effectiveness, or is there another reason? How can we assess my uncle's level of consciousness? 3.
Given the decline over the past month, is there a possibility of medical negligence? 4.
Should we proceed with the tracheostomy immediately? As a helpless layperson, I seek your clarification and advice! Thank you! 2004.08.31

Ms. Chen, 30~39 year old female. Ask Date: 2004/08/31

Dr. Chen Sirong reply Oncology

Hello: 1.
Only the physician who personally cares for him knows.
2.
It is quite common for cancer patients to take sedatives; if they are unable to speak, communication may rely on writing to assess their level of consciousness.
3.
The information you provided is difficult to evaluate, but surgical complications can easily occur within a month post-operation, such as stroke, heart disease, pneumonia, or other conditions.
4.
The truth is hard to determine, but I tend to favor tracheostomy, as it is just a minor procedure.
Sincerely, Dr.
Chen Sih-Rong, Oncology.

Reply Date: 2004/08/31

More Info

Dear Patient,
I understand your concerns regarding your uncle's sudden health decline after lung surgery. It is indeed distressing to witness such rapid changes in a loved one's condition, especially after what initially seemed like a positive recovery. Let’s address your questions one by one.

1. Sudden Decline in Condition: It is not uncommon for patients to experience fluctuations in their condition post-surgery. Several factors could contribute to your uncle's sudden deterioration. After lung surgery, patients are at risk for complications such as pneumonia, atelectasis (collapse of part of the lung), or accumulation of secretions (mucus) in the airways. These complications can arise quickly, especially if the patient has underlying lung issues or if the surgery itself was extensive. Additionally, the use of anesthesia and post-operative pain management can affect respiratory function, leading to decreased lung expansion and increased secretions. If your uncle was unable to clear these secretions effectively, it could lead to infection and respiratory distress.

2. Use of Sedatives: The administration of sedatives post-surgery is a common practice to help manage pain and anxiety, especially in patients who may be agitated or uncomfortable. However, prolonged sedation can lead to decreased awareness and responsiveness. It is essential to communicate with the medical team about your uncle's level of consciousness and any concerns you have regarding the sedatives. They should be able to provide you with information on how they are monitoring his sedation levels and overall responsiveness.

3. Medical Oversight: While it is natural to question whether there has been a medical oversight, it is crucial to understand that post-operative care can be complex. The healthcare team is responsible for monitoring the patient closely for any signs of complications. If your uncle's condition changed rapidly, it could be due to factors beyond immediate control, such as the body's response to surgery or pre-existing conditions. If you feel that there has been a lack of communication or clarity from the medical team, do not hesitate to voice your concerns and ask for a detailed explanation of your uncle's treatment plan and any changes in his condition.

4. Decision on Tracheostomy: The decision to proceed with a tracheostomy is significant and should be made with careful consideration. A tracheostomy can provide a more stable airway and facilitate easier breathing, especially if your uncle is experiencing significant respiratory distress. However, it is essential to weigh the benefits against the risks and potential long-term implications. If the medical team is recommending this procedure, it is likely because they believe it is necessary for his survival and recovery. It would be beneficial to have a detailed discussion with the healthcare providers about the reasons for this recommendation, the expected outcomes, and any alternatives that may be available.

In conclusion, I recommend that you have an open and honest discussion with your uncle's medical team. Ask them to clarify your uncle's current condition, the reasons for the proposed procedures, and any potential risks involved. It is essential to be informed and involved in the decision-making process regarding his care. Your uncle's health and well-being are paramount, and the medical team should be there to support you and provide the necessary information to help you make the best decisions for his care.

Best wishes for your uncle's recovery, and do not hesitate to reach out for further clarification or support.

Sincerely,
Doctor Q&A Teams

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