Expert: Wesley - 11/1/2009

Question
hi,mom is 74 had aorta valve replacement,during surgery they popped hole in esophagus!found 4 days later.during that time they put in a feeding tube,which went right through hole.dumped 1 liter of food into chest cavity!opened up stomach to clean out!blood pressure got low,had to get out.6 hrs.later went in to fix esophagus!had to give lots of fluids to keep blood pressure up for next week!the first surgery was on 10/8/09 she was starting to wake up okay the next 2days then hole was found,she is diabetic!it is now 10/31/09 and she opens eyes at about any name,moves around in bed,breaths on her own,just does not respond to commands!
has had cat scan they say shows nothing
had brain activity test say it shows nothing
kidneys and liver they say are ok
has had no infections as far as i know
had at one time 70 pounds fluid in her body,but over last two weeks have brought that down basicly none.
has been off all sedation medication for 8 days
please tell me what you think is going on?
                               thanks dave

Answer
Dave I'm sorry things didn't go as planned. To say the least.

Simply at this point her metabolism is very slow. She will need lots of time and patience. Being mentally slow after a bout of procedures like these is very common, and may last a few weeks.

One consideration that is often missed is the ammonia level, ask about this.

Given that nothing else happens, I would hope to she her emerge slowly over time.