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Thread: mum back from rehab can't talk or open eyes

  1. #31
    Quote Originally Posted by riyasa
    Hello Everybody thank you very much for all your kind advises. Today My mum is better than yesterday. She can open her eyes and mouth. But she says that her mouth is very painful. She could not remember anything which happened yesterday. I did some tests from her blood the resulths are as follows,

    haemoglobin - 8.9 g/dl
    w.b.c. - 16.9 x 10000000000 / l
    neutrophils - 93%
    lymphocytes - 07%

    ELECTROLYTES

    SODIUM - 140
    POTTASIUM - 4.2

    P/S URIA - 3.0

    IF ANYONE KNOWS WHAT THE ABOVE RESULTS MEAN PLEASE LET ME KNOW.

    THANKS.

    RIYASA
    Riyasa, are you sure that the WBC (white blood count) is correct, with the correct number of zeroes and that the units are per l (the small letter of L)? Normal white blood count is 4,500 to 10,000 per microliter (also sometimes signified by µl or mcl). Since one liter has one million microliters, 16.9 x 10,000,000,000 / l = 16.9 x 10,000 / µl = 169,000/ µl. This would mean that she has a very significantly increased white blood count. She should also have a fever.

    The fact that she has an infection is supported by the higher percentage of neutrophils. Normally, 55-70% of white blood count should be neutrophil. A 93% neutrophil count is abnormal and is strongly suggestive a bacterial infection. The percentage of lymphocytes is normally between 15-40% but, given the increase in 15-fold or greater increase in total white blood count, there is an absolute increase in lymphocyte count as well.

    Normal hemoglobin (haemoglobin is the British spelling) varies depending on whether age and sex but it should be greater than 12 for adult women. Therefore, your mother has anemia (low blood) as well. This is not surprising if she has not been eating well and has a chronic bacterial infection.

    Her sodium and potassium levels are normal. I am uncertain what the values of P/S URIA should be. In the United States, kidney function is usually in dicated by BUN or blood urea nitrogen. Normal BUN levels should be between 8-20 milligram per deciliter (8-20 mg/dl). Sometimes, urea levels are indicated by a ratio of urinary/plasma (U/P) urea levels. Normally, U/P should be in 4.8 or greater. Lower values are indicative of renal failure or dehydration. Are you sure that it says P/S and not U/P?

    You did not provide the glucose levels. If you have glucose test results, it should be less than 140 mg/deciliter (140 mg/dl or 7.8 millimole/liter or mmol/L). If she has eaten within 2 hours, it may be as high as 140 mg/dl (7.8 mmol/L). If it is a fasting glucose level, i.e. a glucose that is obtained after not having had any food or liquids other than water for 8 hours, it should be less than 110 mg/deciliter (6.1 mmol/L). In 1997, the American Diabetes Association defined the diagnosis of diabetes as having a fasting glucose level of 126-140 mg/dl. If she has diabetes, she may well have fasting glucose levels as high as 140 mg/dl. If she is getting insulin or other treatments, her blood glucose should not be greater than 140 mg/dl.

    So, just on the basis of the test results that you have provided, it is likely that your mother has an ongoing systemic infection. You should find out her body temperature. If it is above 37˚C or 98˚F, this would explain her altered mental status. The source of the infection should be identified and she should be treated with antibiotics. You had mentioned the fact that she has an infected pressure sore. This may be a source. Another likely possibility is that she has a urinary tract infection. I don't know what a P/S Uria value of 3.0 means but if it is anything related to Plasma/Urine ration, it suggests that she is dehydrated or has reduced kidney function. She is very anemic as well. These must be treated.

    Wise.
    Last edited by Wise Young; 09-01-2006 at 11:04 PM.

  2. #32
    the white blood count is 16 X 109 / L .

    I am sorry for the mistake can you please suggest a suitable prescription for her so that we can buy the medicine and give. Can we give her an antibiotic tablet? And for the blood increase what can we give her.
    Please advice.

  3. #33
    The source of the infection (urine, lungs, wound, etc. ) would first need to be diagnosed by a physician, and then a culture done of the infected area to determine the correct antibiotic. It could be dangerous to just start on an antibiotic without knowing where the infection is located and which antibiotic is the correct one.

    She could be anemic due to bleeding someplace, but it is more likely she is anemic due to both poor nutrition and whatever illness is occuring. If she can take food, she needs foods high in iron such as spinach or other green leafy vegetables, and also meat such as red meat (beef and pork) and liver (in limited amounts). She can take an iron supplement pill as well as a B complex vitamin, but be careful as iron pills can cause bad constipation. Keep these away from children too (they can be deadly poison in large amounts).

    (KLD)

  4. #34
    dear nurse and all the others,

    Thanks for all the valuable information. Now we are giving her all the things the nurse mentioned. Except we are unable to bring a doctor to chek her. She also has a bed osre on her back. We are cleaning it with saline water and putting fusidine. 'Please note that bringing a doctor home is very expensive so even if we take her to the hospital where they put free medecine they just clean the wound and put some mild medecine. So if you have any suggestions on what medecine we can use on her would please let us know.

    Thanks,

  5. #35
    Riyasa -
    If it is at all possible, avoid ANY pressure on the sore.
    Sitting up in bed puts a lot of pressure on the tailbone area.
    - Richard

  6. #36
    Hello and how are you? We are fine here. regarding my mother's tests I talked to Dr. Fareed ( he helped us alot when my mum was in the colombo hospital in the earlier stageof the accident ) and told him the results over the phone. He told that she has an iron deficeny and also a bacterial infection. So he wanted me to give her an "iron injection with saline", iron syrup and antibiotic tablet. So I had to hunt several pharmacies for the iron injection but noone had this instead they had the iron tablet, so as i do not have any options I bought the tablets. Now she is taking the iron tablets and the antibiotic also. she has a bed sore in her back again. she is still week but better than before. but today she was telling me that in the night her hands, shoulders, neck and back ache alot and she wanted to know if she can take any pain killers daily. Ann what do you think about sleeping tablets? will it help her to sleep well? Now she can open her mouth and we are looking after her. ann but the cleaning problem is there. As I donot live with my sister I think I don't know the half of it. To be frank with you I will explain how we do our mum's bowel care. First we take a pampers, then on the pampers we keep a big clothe ( old clothes ) then on that clother right where the stool comes we keep several square shaped small clothes and on the place where the stool come we keep a big piece of gauze so when cleaning we throw everything except for the pampers as it won't be dirtied. I feel silly to tell this to you but this is how we work, so it is really difficult as my sis has small kids ( 5 and 2 )and she has to be very very clean. I also help my dad my the necessary stuff.

    We planed to bathe her the day after tomorrow since it is a national holiday here and my sis can stay at home. when we are bathing her my father carries her to the comode and he makes her sit on the closed toilet seat. then one person holds her then we bathe her. she must be feeling very sad. when we do this. right? there is no other way to bathe her right?

  7. #37

    bathing

    Quote Originally Posted by riyasa
    To be frank with you I will explain how we do our mum's bowel care. First we take a pampers, then on the pampers we keep a big clothe ( old clothes ) then on that clother right where the stool comes we keep several square shaped small clothes and on the place where the stool come we keep a big piece of gauze so when cleaning we throw everything except for the pampers as it won't be dirtied. I feel silly to tell this to you but this is how we work, so it is really difficult as my sis has small kids ( 5 and 2 )and she has to be very very clean. I also help my dad my the necessary stuff.

    We planed to bathe her the day after tomorrow since it is a national holiday here and my sis can stay at home. when we are bathing her my father carries her to the comode and he makes her sit on the closed toilet seat. then one person holds her then we bathe her. she must be feeling very sad. when we do this. right? there is no other way to bathe her right?
    there are a number of ways to bathe and clean your mother.
    my husband (used to be fiance - yep, we got hitched
    sits on the toilet seat, with the lid up. he is able to support himself (he is level t6-7), and there is a bar installed on the wall to help him steady himself if needed.

    there is a bidet (water source) next to the toilet, he sprays himself off with this and washes himself with soap and water.

    this doesn't have to be embarassing or a sad occasion for your mother. if she has the strength, she should clean herself. otherwise, try to be as clinical as possible, and act as her nurse as you clean her.

    i am concerned about what you said about using diapers for her bowel care. if she has to sit in her stool for ANY length of time, she could easily get pressure sores.

    try this:
    http://www.dinf.ne.jp/doc/english/gl...2/dwe00227.htm
    someone on the carecure forum had listed this site once.

    also, if you send me a private message with your email, i'll send you the pdf on bowel management that people on this forum recommended to us.
    “Our lives begin to end the day we become silent about things that matter.” -- Dr. Martin Luther King, Jr.

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