I know this is not covid related, but I know doctors do read this board. So please forgive me. Staff please delete if inappropriate.

I'm in search of advice. My elderly mother fell yesterday and hit her head on the concrete. They rushed her to a Nacogdoches hospital. The doctor did a CT scan and determined it was too much blood to perform surgery. So they convinced my dad to "pull the plug", so to speak. That was at 2pm yesterday. Well, she made it through the night breathing on her own and I'm told her vitals are normal...I guess that means blood pressure and all. My sister says she groans some through the night. We just don't know what to do. Nothing against Nacogdoches, but we are wondering if we should transfer her to Houston or something. I'm in Minnesota waiting to get on my flight. Any hospital recommendations in the greater Houston area? Any advice in general, especially from the docs on the board. I'm just lost right now.

Herman or St Luke's? Heck probably anything is better than where she is now.

Prayers for your family. I am not a medical professional but I am married to one.

T&P. Hope she can fully recover.

This kind of highlights the case for a permanent medical forum on here, to the extent the great docs and other experts on here who have been so helpful are willing t to continue sharing insights, discussion and advice. Not as a substitute for normal medical care and essential physician/patient process, obviously, but clearly helpful.

Best wishes for your Mom.

one thing i've learned over the years in medical...always get a second opinion..and in a case like this, even consider a third opinion. You only get one mom. don't pull the plug unless you are convinced and comfortable, and you know it's what she would want. If those boxes aren't checked get a second opinion.

Moving to another hospital with more resources it probably a good decision.

This is a very tough call, and I don't envy the position you are in, but I will give you some information. You didn't mention how old your elderly mother is, but as you get older, your ability to recover from injuries diminishes. A hip fracture in a 75 year old is far more deadly than a hip fracture in a 70 year old, for example. Furthermore, even getting surgery for a hip fracture can be more deadly than not doing anything sometimes.

Regarding your mother, there are several different types of brain bleeds. Some bleeds are very superficial between the skull and the brain and easily evacuated. Some are actually within the brain itself and often impossible to repair. The 3 bleeds are epidural, subdural, and parenchymal. So knowing what type of bleed she had will be important to prognosis.

But, regardless of the bleed, you said she is elderly. Even if they operated on the bleed, she would be in rehab for weeks to months most likely. I don't know what level of function she was at before, but the chance of her regaining her full function is slim. The question you have to ask each other is, what if she "recovers" but is completely bed bound for the rest of her life? Every day would be a challenge to prevent bed sores, she would likely need a feeding tube to feed her inserted directly into her stomach if she didn't have full control of her hands. If she had damage to her face muscles she may risk something called aspiration, resulting in nasty lung infections.

As far as her breathing and groans, the brain stem is what controls breathing, and that is one of the last things to go. It's not uncommon for people that have no higher brain function to keep breathing on their own for days.

"pulling the plug" is rarely instantaneous. It can take up to 2-3 days sometimes. The idea is to keep them comfortable the entire time with the use of morphine and other medications to help with pain and other issues.

To be blunt here: if you start going aggressive, how much additional quality years or months of life do you think she'll get? Is just being alive good enough for your family? Or do you want her to also be able to enjoy that life?

I recommend watching something on Netflix called Extremis - it's 20 minutes, and in a time like this it may be tough to watch. I normally recommend everyone watch it before they face a decision like this, but it may give you some insight into what I'm talking about.

Prayers for you and your family. Please let me know if you have questions.

We had a situation with my elderly MIL. She was 80 and is in a skilled nursing facility because she is disabled but her brain is really sharp. Anyway, she fell from the hoyer lift from a pretty high height and was sent to the hospital. Her blood pressure was low and she was put on what they called "pressers." The ER doctor basically said that she was going to die and there was nothing to be done and wanted to even discontinue the pressers. But we didn't think that really sounded quite right. We eventually made them transfer her to a bigger hospital 40 minutes away, and long story short, she is still alive (now 81) and back to her old self. She did have to get surgery on her leg as well. She never needed to be intubated or resuscitated so it was just really strange to us that this doctor basically seemed to have given up on her and thought no treatment was the answer. I totally get what the poster above is saying about quality of life, but I still think trying some treatment and medication wasn't out of line for this situation. It was just really weird how much we had to fight to get her transferred and how they tried to make us feel guilty about it.

fightingfarmer09 said:

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https://texags.com/forums/48

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And how many of our docs post the kind of stuff on that board that we see here? Looking down the list of topics currently I think the case is there to have an actual medical forum.

Drifter. said:

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Athanasius said:

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I hope things are going ok.

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Unfortunately, she passed early Saturday morning. Thanks to everyone who offered advice and prayers. Be sure and tell y'all's mommas that you love them and hug them often.

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Very sorry to hear. I lost my dad 2 years ago next week. It's still fresh and tough to deal with sometimes, but at least I know his arthritis, and other ailments no longer bother him.

So so sorry for your loss. Lifting you and your family in prayer.

I am so very sorry. I lost my dad at the end of September and it's still very raw. I pray for peace and comfort for you and your family.