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What Causes Swelling In The Fingers And Neck After Pericardial Window Surgery?

Posted on Wed, 24 Aug 2016

Question: My mum (aged 62) just did her pericardial window (fluid around heart) yesterday . Doctor said it should be from the radiotherapy done for her lung cancer stage 4 . Today , she opened her eyes once and saw my father and panic . Nurse put her back to sleep . Her fingers and neck are seen swelling / swollen . We are worry . Is this common ? We afraid she suffers ... And she is under respirator machine for breathing . Doctor said may remove if she can breathe on her own . Again , more worries

Answered by Dr. Drkaushal85 (1 hour later)

Brief Answer:
She is mostly having heart and lung failure.

Detailed Answer:
Thanks for your question on Healthcare Magic.
I can understand your concern.
By your history and description, possibility of heart and lung failure is more in your mother's case.
Honestly speaking, prognosis is very poor in stage 4 lung cancer especially with pericardial effusion.
Her swollen fingers, neck, poor breathing etc are commonly seen in terminal stage of lung cancer with pericardial effusion.
Please let me know
1. Is pericardial fluid hemorrhagic?
Please reply me answer of above asked question, so that I can guide you better. I will be happy to help you further. Wishing good health to your mother. Thanks.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Drkaushal85 (4 hours later)

Unfortunately i have no feedbacl from the doctoe / nurse on your question . I just visited my mum again . Her swelling has subsided . Nurse said when she was slightly conscious , she did breathe on her own but not 100% yet . Are these improvement / good signs ?

Answered by Dr. Drkaushal85 (1 hour later)

Brief Answer:
Yes, these are signs of improvement.

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
If swelling are reduced and she started own breathing then these are signs of improvement.
She might be receiving diuretics.
Hope I have solved your query.
If you are not having further queries, then please close the conversation and rate my answer.
You can ask me directly on bit.ly/askdrkaushalbhavsar. Wishing good health to your mother. Thanks.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Drkaushal85 (6 hours later)

May i know how is the ventilator usually remove from patient ? During when she is awake ? Will she suffer during the remove process ?

Answered by Dr. Drkaushal85 (3 hours later)

Brief Answer:
Ventilator is for supporting breathing.

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
Ventilator is for supporting breathing.
So whenever she is able to breathe by her own, ventilator will gradually wean off.
It is very difficult to predict exact time for wean off.
It is also very difficult to predict when will she awake because for this I need to know few more things.
Please let me know
1. What is her latest ABG (arterial blood gas analysis)?
2. What are her electrolytes?
Please reply me answers of above asked questions, so that I can guide you better. I will be happy to help you further. Wish you good health. Thanks.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Drkaushal85 (3 hours later)

Unfortunately the hospital that my mum is in do not give us much details . However today her blood pressure has rise to befter level . It was quite low first two days

Answered by Dr. Drkaushal85 (5 minutes later)

Brief Answer:
Where is she admitted?

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
This is very unprofessional from the hospital side.
But rise in blood pressure is also a good sign of recovery.
Where is she admitted?

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Drkaushal85 (7 hours later)

It is a government hospital . Its their culture in my country . However i manage to get ahold of the doctor and he will call me tomorrow . Per a friendlynurse just now , they did try let her breathe on her own ; switching off the ventilator . But after 10 mins she is moving / agitated - which means make breathing rate faster . To avoid her burden the lungs and wound , they gave her minimal sedative dose enough to let her sleep / rest well with the ventilator machine switched back on . She was agitated could be due to pain . They r not giving her heavy dose medicines as that would slow down her recovery .

Answered by Dr. Drkaushal85 (59 minutes later)

Brief Answer:
In my opinion, she is improving.

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
Well, you have to stick to the rules of hospital.
By your history and description, she is mostly improving.
Improvement will definitely take time.
Hope I have solved your query. I will be happy to help you further. Wishing good health to your mother. Thanks.

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Drkaushal85 (20 hours later)

Thank q for your response . The doctor has not called me today . Hopefully he will call tomorrow . Any idea if she recognize us when saw us ? She is agitated moving her hands and legs , trying to pull the hose from her body . Is it the pain ? Is she suffering ?

Answered by Dr. Drkaushal85 (32 minutes later)

Brief Answer:
If she recognize you all then it is good sign of recovery.

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
If she recognize family members then it is a good sign. This suggest that her brain is active and alert.
And some degree of agitation is common in critically ill patients. It is due to pain from various intravenous lines, ventilator etc. So some agitation is expected in her case. And yes, she is definitely suffering.
Hope I have solved your query.
If you are not having further queries, then please close the conversation and rate my answer.
You can ask me directly on bit.ly/askdrkaushalbhavsar. Wishing good health to your mother. Thanks.

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Above answer was peer-reviewed by : Dr. Yogesh D