Serious delirium after surgery

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BestSisteronEarth

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Jul 13, 2013
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My sister had a long intense surgery of almost 7 hours on Thursday. Since then she's been in a really confused state almost delirious. She has fevers as well but it seems to be getting worse not any better! She says things that dont mske sense to what is going on in that moment. She's 24 years old. I'm just wondering if this is normal and if anyone els has experienced this? Or if you know why. Docs say lack of sleep fevers etc. but I dunno. I know my sister and it seems really off to me.
 
I had an infection following a surgery which produced a fever that made me hallucinate. Fever can produce delirium and if she's on any opiate pain medications they can contribute to altered mental states too. You can be confused after coming round from a general anaesthetic but this shouldn't last too long.

Is your sister still in hospital? Do they know why she has a fever? As far as I know, you shouldn't have a fever from surgery, are you sure she doesn't have an infection or some complication, or is there a cause for her fever besides the surgery?

If I were you I would speak to her doctors and make sure they know the cause of the fever and whether it is being treated. I took antibiotics for my infection, and the fever and hallucinations went away within a day. If your sister is at home and not in hospital, you should probably seek medical attention pretty urgently (take her to A&E/ER) as it's not safe to leave a fever untreated and she should be very closely monitored for as long as she's delirious.
 
I'll second UnXmas regarding the Knowing of why she has a fever. When I had my last surgery, I told them I was beginning a fewer and they came to the conclusion that it was most likely normal since I was on anti-TNF before my surgery and not anymore. They tried to make me think I had no infection and it was just a normal biological reaction to the inflammation following the surgery but I strongly push in favor of excluding any possible infection as they are not rare post surgery.

I hope she gets better soon...
 
We are at the hospital. She does have an infection. They think its in the fluid in her abdomen. She's not making sense at all. We are going down this afternoon to IR to get drains put in. One in left and right side of her abdomen. They think the infection is in fluid. Docs say fevers can cause delirium. I just like to know other ppl have experienced it
 
Infection always has the potential to produce delirium. It is neither uncommon nor unusual so please be rest assured that it is most likely a 'side effect' of the infection and not anything more sinister.

Dusty. xxx
 
BestSisteronEarth said:
We are at the hospital. She does have an infection. They think its in the fluid in her abdomen. She's not making sense at all. We are going down this afternoon to IR to get drains put in. One in left and right side of her abdomen. They think the infection is in fluid. Docs say fevers can cause delirium. I just like to know other ppl have experienced it
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In that case, yes it sounds normal. My fever made me think that my thoughts were very profound - I thought I was discovering the secrets of the universe and the knowledge seemed to come to me so effortlessly I wondered why I'd never realised it all before. I had no concept of time, I didn't know what day it was and every time I opened my eyes I saw a clock opposite me and it seemed like hours had slipped by in moments.

If it's any reassurance: when I was in this state I was at peace - for the first time since the surgery I had no pain and the boredom of lying in bed all day unable to concentrate was completely gone. So although it is a sign your sister is very sick, it may be that she is not actually suffering.

Being in hospital is the best place for her to be right now, and as long as they can treat the infection effectively she should recover from the delirium too.
 
You also have to consider that she was under for 7 hours. My last surgery was about 8-9 hours and I didn't make sense for 2 days. So combined with the infection that she has and that there is still anesthesia in her system, she is in a different state of mind.
I wonder about the infection, infections don't show that quickly from surgery from what I understand, so I just wonder where the infection came from. What was the premise of her surgery? was it emergent? Did they remove anything?
 
They removed 100cm if her intestines. She also had an infection before surgery. She's malnorouished from being in the hospital for 15 mos. she's had so many infections. They drained the fluid out of her abdomen yesterday. She's having blood transfusions everyday it seems. Her bp is so low and her heart rate is steady 138-145 everyday. She's not making sense at all. I hope she's not in pain but she's constantly crying almost that she's ugly and this will all be in the papers. She's also seeing people and things.
 
Docs keep saying this is all normal. That it happens with ppl with infections after surgery. I just feel like the docs don't tell us EVERYTHING.
 
BestSisteronEarth said:
I appreciate the reassurance Xmas! Did you remember anything of those days? She had the surgery on Thursday (illeostomy) of last week!
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There are some stretches of time which I really don't remember - my parents told me it seemed like I was just asleep for hours. The rest of the day is kind of patchy in my memory, I have odd bits of memory, including memories of myself saying and thinking senseless things, but there are a lot of gaps. I got over the delirious stage really quickly though, it was really only the one day before the antibiotics kicked in. My infection came quite a few weeks after the surgery, they never found out why I developed it then and I'm not sure if it's usual to develop an infection that long after having surgery or not. It seemed odd to me that I'd spent weeks gradually recovering and feeling better and then to get an infection.

Your sister might have memories of this, or she might not. A lot of it will depend on what medications she's given too. I've been told that infections are quite common after bowel surgery, because the contents of the intestines are dangerous if they get into any other parts of the body. And fevers can affect the mind. So to her doctors it might just seem like it's a routine complication, but if you don't feel they're giving you enough information or if you have concerns that they're not addressing then don't be afraid to ask them or even to seek the opinion of another doctor.

I'm going to be having an ileostomy in a couple of months time. They can improve quality of life a lot for some patients and/or reduce the likelihood of serious complications in the future. It might be that when these complications are sorted your sister will start feeling better if her Crohn's can be kept under control.
 
Thank you so much for all of your feedback. Really made me tear up. This is such a stressful time.
They started the antibiotics today. So hopefully her delirium will fade. They said if she didn't get the surgery she would have died. She was supposed to get it months ago but every date that it was scheduled and surgery team can't into her room to take her down...she would back out. So I am so thankful she went through with it. It will make her quality of life so much better. She just doesn't see it that way yet. She said "I'd rather die than have a bag". She has so many mental issues from basically living in the hospital most of her life that she just sees no way out. That makes me so sad! She's in good hands and she will continue to be in good hands btw me my parents and the wonderful medical team. We are taking it one day at a time. I hope your surgery goes well and I wish you the best. Thanks for all your great feedback!
 
How is she doing today? Do you know what caused the original infection? Is she bleeding somewhere inside to cause for so many transfusions? sorry for all the questions I am just trying to get a clear picture. Do you know if she was septic at all?
I am so sorry that your sister is going through all of this, and your a great sister for standing by her side. Like unxmas said, she may remember she may not. Some of my most traumatic experiences I only remember bits and pieces of and I want to keep it that way. Whats important is that she has your support and I can't stress enough how great it is that she has you
 
She's ok. As of this moment her temperature is down. Usually very high. They are transferring her back to the ICU. Before surgery she had many blood infections and most recent a fungal infection. She got fluid drained from her abdomen last night and they think the infection is in that fluid. She has been septic before so that might be one of the problems. They are still running tests. She's so malnourished so that could be contributing to the delirium.
 
She had this surgery 10 years ago at age 14 and it was reversed a year later. There's been so many problems over the years but that one year she was at her BEST. she has a lot of PTSD from hospital stays as a child and continues to have these terrible experiences.
 
ICU is the best place for her in her state. So does she have an ostomy now?
 
The antibiotics they give will be what is called sensitive to the infection so they will work at beating it but bear in mind that they will take at least 48 hours to start making an obvious difference.

When my daughter had her emergency surgery she had septicaemia and peritonitis going in. Post op she needed to spend a couple of days in ICU but it all turned out well. :)

I hope your sister is soon better hun and that she is able to start feeling better about herself too, bless her. :heart:

Dusty. xxx
 
You're sister and family have been through so much...I can't imagine how tough it's been. It's heart breaking. Sending all of you my support and best wishes.
 
I hope your sis is doing better. I've been reading your posts, and wishing you the best.

I had a resection about 6 weeks ago. Was delirious for a couple days after because of infected fluid in my abdomen. Sounds pretty similar. They pulled out the big guns antibiotics with Vancomycin, and put in 2 drains. I was better in a couple days. Also had TPN for malnutrition at the same time.

The weird thing was, I knew I wasn't thinking right, but I was OK with that... Ha ha, so try not to worry too much. I know it scared my family, but we all got through it. I got to go home two weeks after surgery.

Please let us know how things are going, and we all with her and you the best!
 
Wow sounds exactly the same! Since she had most of the fluid taken out she's been a little better. Now she's realizing how delirious she was. She is still hallucinating a bit and her emotional state is outrageous. She's crying all the time and very angry. We did walk around the floor 3 times and we were telling stories and laughing. Still has some fluid and high temps.
 
Yes. She is doing much better. She is not delirious or hallucinating anymore. They have her on PO pain meds and she's ready for the next step. She's going to a sub acute rehab bc she has to stay on tpn for a while she's not eating that much. Also since she was in the hospital for over a year she needs physical therapy 2-3 hours a day. Thank you for asking.
 
Its probably understandable she is feeling depressed. Not just the major surgery and delirium but also coming to terms with her ileostomy when she was so anti it and maybe also fear of going home. I have spent a lot of time in hospitals and its amazing how quickly you get dependant on the environment. Going home and rejoining the world can be pretty scary. In the meantime look after yourself too. You are obviously a vary caring sister.
 
annawato said:
Its probably understandable she is feeling depressed. Not just the major surgery and delirium but also coming to terms with her ileostomy when she was so anti it and maybe also fear of going home. I have spent a lot of time in hospitals and its amazing how quickly you get dependant on the environment. Going home and rejoining the world can be pretty scary. In the meantime look after yourself too. You are obviously a vary caring sister.
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It's true about the fear of going home after a long hospital stay. I once spent two and a half weeks in hospital, and though that's not really very long at all, I got anxious being outside again. I can't imagine what it must be like for your sister given the amount of time she's spent in hospital. I think I'd got used to knowing that there were nurses right there to help me if ever something went wrong, so, much as I hated the hospital, when I left I felt kind of exposed and vulnerable, and it was difficult realising that everyone else's lives had carried on while I'd been inside.

Depression is very common after any major surgery. If she can, it may help her to just take it day to day. Try not to talk to her about the future too much since after the kind of experience she's been through, the thought of doing anything can be overwhelming. The idea of living a normal, full life can be exhausting just to think about when you've had all your physical and emotional energy reserves shattered. Just help her get through moment by moment, be prepared that her mood may fluctuate and her depression may continue a while - that's a natural, normal response. You really are such a caring sibling for her and she will be so much better for having your support through this.
 
Yes you all are right. I think that was her main fear for getting the surgery. That she might be healthy and get out of the hospital. That she could possibly lead a normal life with no pain. She's so used to being in the hospital that being on the outside is so much scarier for her. Great points. Also, you're so right about speaking about the future. We just moved into a new house and my dad was so excited. He bought all this new furniture tv and new stuff for my sisters room. Every time he got something he would show her. Obviously thinking that it would make her happy. She would get angry! "I don't wanna hear about it!!" she would say. I understand why now! I guess he thought getting her excited for the new house would give her something to look fwd to but your right! It's all so overwhelming. Thank you for opening my eyes up to this. I will now go visit her with a different mindset. Moment by moment. Thanks
 
One other thing I wanted to mention, and this may or may not apply to your sister.
When my grandpa was in a nursing home kind of thing he got really angry with my grandma for talking about when he was able to go home. Even the day before he was supposed to go home, he didn't want to talk about it. He had already mentally checked out. He already accepted the fact that he was never going to walk through his front door again, and he didn't want to hear otherwise. Maybe your sister has the same mentality. She already accepted that being in a hospital for the rest of her life was her fate, and when it is proven to not be true she gets upset. Or she doesn't want to let anyone down if she doesn't come home. (not saying she won't go home, just that might be her mentality)
 

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