Fluid Overload after surgery

[cyndichurch]

I had an emergency appendectomy (my appendix did not rupture however) after the surgery they put me on oxygen, the day I was released I stood up to leave and said to the nurse "wow, look how swollen my knees are and look my toes are not even touching the floor!" and she asked are you dizzy and I thought a little but not much. Anyhow I was released and went home. The following day I was short of breath and very uncomfortable from so much swelling. I was laying on my couch and was noticing that I had a crackling sound coming from the back of my throat/nose area, my family could also hear it. I fell a sleep and was woken by gasping to take a breath followed by vomiting. My husband rushed me to the hospital and I was put in ICU and on 70% oxygen. After a number of test for my heart and lungs the cardio signed off saying no signs of heart issues, the lung Dr said he really felt that it was fluid overload but because of my age was perplexed as to why I would not have handled the fluid and the hospital Dr. felt that it could be pneumonia. While in the hospital (ICU) I was treated for pneumonia by antibiotics. But my blood pressure which is usually low became high, I was low on potassium, and the swelling was getting worse. When the lung Dr. had my IV taken out, had me on Lasik, and catheter put in I immediately started to get better and soon was off all oxygen. The hospital Dr. still was keeping me because she felt it could still be pneumonia...although I never ran a fever or had any signs from blood test showing pneumonia. Does it sound like this was fluid overload and not pneumonia? Should I be concerned that I am 38 healthy and yet I came down with fluid overload during surgery? All the reading material I have seen states that this happens to much older patients or persons with other issues with their health. I so wish I had some answers as to what happened to me and why?

[John Kenyon, CNA]

Hi there -

Almost certainly fluid overload was the primary issue. The question remains why this happened. Heart issues would seem to have been ruled out (congestive heart failure is the most common cause of this sort of reaction, but apparently there's no indication that would be the case). You could also have developed a pneumonia, but while there would seem to be no infection, pneumonia is a catch-all term for inflammation of the lung with congestion due to fluid and/or mucus. Again, something else is usually at the bottom of it.

The treatment seems to have been appropriate and you've responded well, but I can understand your concern as to what may have happened. Fluid overload can, sometimes, be related to an undetected lowered renal capicity (kidney failure = fluid overload). You may simply have smaller than normal kidneys for your size, or there may be some other reason your body didn't eliminate the fluids as expected.

There is also the remote possibilty that you received more fluids than were appropriate, but this is unusual and would be difficult to prove. The good news is that the situation has been corrected. By all means, should you ever need to have surgery in the future, let the doctors know this happened once, so they'll be on the lookout for it, whatever the cause. It doesn't appear you have an ongoing problem with this, and with the high blood pressure you experienced, it really does seem you were just flooded (fluid overload). I'm glad everything turned out well. This can happen to young, otherwise healthy people, but it's rare unless too much fluid is administered or the output isn't followed adequately. I strongly suspect the latter was part of the problem.

I hope this helps some. Best of luck to you.