I'm sorry for your loss.Delirium can be caused by many factors including infections, metabolic imbalances, medications, and underlying medical conditions. In your brother's case, the low sodium levels may have played a role, but it is also possible that there were other contributing factors such as an underlying infection or a reaction to medications.His low sodium could be due to frequent urination, or due to his low sodium diet, or it could be due to an underlying medical condition such as adrenal insufficiency or kidney disease.Don't know about the oxygen - but, changes in oxygen levels can occur due to changes in respiratory function, changes in blood pressure, or changes in heart function.The fact that he was on monitoring does not guarantee that a cardiac arrest could not occur. It is possible that the cardiac arrest was due to an underlying medical condition or a sudden event such as an arrhythmia. But, ultimately I don't know.
Hello Reddit,My younger brother was 27, Male, maybe 6 foot and 375 pounds, half white/asian, no drugs, no smoking, extremely rarely drinking (like less than once a month).I don't recall what his early symptoms were but I found a virtual chat that said he may of had "uncomplicated cystitis" and had antibiotics prescribed for it. He saw a urologist and eventually had a nephrostomy tube, then had surgery later and was noted with a failed kidney. They were unable to remove it due to his weight and having hemorrhage concerns, at least that was my understanding, and that's it for a his existing medical condition, with an exception.I'm first wondering how he developed this condition to begin with. Would the failed kidney have caused the infection? I wish I had the full records so I could paint a better picture, but ultimately I can only guess that his high blood pressure was a cause, plus having a high stress job.Ever since all this, he had to urinate every like hour and this caused issues with work and sleep. I really don't understand why this kept happening and nothing was given to him for it. Would having a failed kidney cause that? This started back at the end of 2020 and the tube and surgery may have been in Q2/3? I now can't remember what happened first.From that I'm mostly wondering about the reason for frequent urination and if he would have got infected some other way outside of high blood pressure. He almost never leaves the house, and I fear he'd only get sick if a family member came home with something.Fast forward to the bulk of my reason to post. On January 13, 2023 he mentioned some nasal congestion and some body aches. He didn't seem to get better on the 14th so I asked if he wanted to see a doctor and he said not yet. This eventually came with some headaches so we tried to go to an urgent care but the wait times were 3+ hours so we figured try a Teladoc (98point6 for this call) and get an appointment later. He mentions a head ache lasting 4-5 days, dull/sharp pains in waves from front to back, also going behind his eyes. He was taking ibuprofen, and was asked about a fever and he said he wasn't sure but his head seems warmer compared to his body. They basically said to take Afrin and Excedrin and go to urgent care if things don't get better. When he went to take the afrin that night, he blew his nose and had a nose bleed, and per our father he had nose bleeds from time to time, but not that super often.Come January 19 I take him to urgent care and I do have his visit summary. Blood pressure 174/89 (why the fuck didn't anyone talk about this), temporal temperature of 98.1 (maybe the medication lowered it?), pulse 90, respiration 18, oxygen saturation 97. They gave him Toradol and sent him home. I feel like a fucking asshole that I wasn't in there with him, I had to drop him off and attend a work meeting that I should of canceled, and our mother picked him up. This is all very local, like within 15 minute drives.He doesn't seem to get better and on the 22nd he talks about some vision issues so I immediately take him to the nearest ER, which is a satellite and not attached to a large hospital. He goes to a back room almost immediately after checking in - alone, and again I feel like a fucking loser as I should of gone there with him to help explain everything - who knows exactly what he said since he was dealing with headaches. I did come back and talk to one of the nurses, but that didn't seem to change anything they expected.He had the following lab tests done, CBC With Diff, CG4 PANEL POC, Comprehensive Metabolic Panel Poc, PCR Influenza A & B and Covid 19 (POCT). Also had a CT Head W/O Contrast and EKG. Done today was just the CG4 and Comprehensive Metabolic, guess the CBC was still processing? I don't recall any notes on this, and his MyChart is closed.They didn't seem to find anything, even though he had a 171/105 blood pressure, they did ask if he had history and I didn't have a full answer, but said it wouldn't be surprising since the rest of the family has medication for it, but he didn't have a primary care doctor to prescribe it. He had trouble finding one since COVID and it really pisses me off that I didn't help him find one somehow. He also had 100.1 temperature.They gave him .9% NaCl (NS), tylenol, benadryl, toradol and reglan, and sent him home.The next day I don't remember exactly what triggered this, maybe balance, but we took him to the ER attached to the hospital and the doctor almost immediately said he wasn't going home that night, he saw something. They put him in a gown and my brother was shivering mad, and he normally likes it cold. Sometime that night I believe he got a room and had some tests, and they said he had meningitis, and shortly after was uncertain of contagious so the room was adjusted and we had to wear N95 masks and a face shield / gown. This went for maybe 2-3 days, and it bothers me so much because this was the most critical time that I could of had talking to my brother and I minimized my time like a coward and asshole. I believe our mother was there the whole time though.After that 2-3 days it was cleared for bacterial and said likely viral (they never said what he had) and the additional PPE was stopped. I remember he texted me to bring apple juice, yogurt, and fruit cups, which I did, but asked if it was okay because I thought hospitals didn't want outside food. They said it was okay as long as it conformed to a low sodium diet, which those did.During this I know he had a lumbar puncture, which is likely how they found the meningitis, and had a CT/MRI that they said was clear. Then suddenly the next day he developed delirium. He was able to answer our questions and knew who we were, but it was like he was living in a video game or something. He'd also spring up very quickly pulling wires to urinate (and frequently) which caused concerns for the monitoring and fall prevention, since he was a little wobbly and I think bumped his side one day because of the bar being down for the accessibility access for the toilet.The doctors believed the delirium was due to his lowered sodium levels, which could have been to the frequent urination and low sodium diet. He was drinking a ton of Gatorade at home back home, probably around the 16th I was buying him multi-packs as I felt those helped me recover. Eventually they put him on a EEG and because of the frequent getting up and sometimes he'd just try to rip the things off, they restrained him. I wasn't there when it happened but our mom was there and it sounded a little traumatic, like saying "why are you doing this mommy, and then attempting to bite her". Not sure if that's exactly what happened but he was restrained. Either at that point or shortly after he did have a nurse assigned to be next to him 24/7 to monitor, and help him pee as he'd be responsive if he had to go and the nurses asked.During this delirium he'd talk about random stuff, sounded like he was in a game, he couldn't explain where he was, but he was still answering questions. Everyday I visited I'd ask if he knew who I was and he'd start by laughing and saying of course, and I had to be more specific with him and he'd confirm my name and that I'm his brother. During this time we had a family member with him 24/7, but would occasionally talk to him, I know I'd hold his hand and he'd squeeze back, but we'd end up sitting to the side talking to each or reading a book, etc.Finally on the 30th I was coming in to swap out with our father, who said that my brother was a bit quieter today, maybe he was finally getting some much needed sleep as it seemed like he wasn't getting any. I also noticed that he had an oxygen tube under his nose, which wasn't there before. I didn't want to wake him so I didn't do much, and this was the first day I decided to pop up my switch and play some yoshi crafted world, and I kept one ear bud out just in case.I know he had a lumbar puncture done either before I came or just as I came, and an MRI earlier (might have been the previous day, it's becoming a blur now and I hate it) and the neurologist said they see a lesion, and it looked like one of the quadrants of the brain. I honestly can't remember but it felt like a sizable portion. I also looked at the EEG from time to time as I assume they were looking for seizures and I swear I saw alerts on the machine detecting them.This was the first time that I was going to pull the all nighter, and it was normally our mother that would do that and I offered to stay but she wanted to get some rest which I understood. A bit after I was there I noticed they swapped the tube with an oxygen mask, and I regret to this day that I did not look at that monitor better, seeing if oxygen was dropping, etc. There was a nurse there but I don't know how well they were watching, I swear one of the guys before was on his phone most of the time. I remember there was a night shift change, and I don't recall how long after before the most traumatic part happens. I did ask if my brother snored normally to our parents, as I never really heard him sleep and our father said yes, and he should get a sleep study done. It reminded me of our father's sleep apnea when napping on the couch during movie night. I don't remember how long this went on for, but I think they adjusted the bed height or something, don't remember... yet another thing to add to my list of regrets.That night after playing a bit I remember my arms getting tired so I pulled the little side table near me to prop my switch up on so I could just use the remotes, and all of a sudden a bunch of nurses come rushing into the room and one of the nurses checks his neck and says no pulse, then a code blue is called. I am escorted out of the room and just panicking. I don't remember hearing the monitor beeping prior (remember 1 ear bud and I had the volume at like 1 tick), and I don't recall him snoring just before either. For all I know the sensors were faulted and he was out for awhile, I have no idea how immediate it was, or if maybe the table pulled/squeezed the oxygen tube (this all happened in like 10 seconds). I know that his monitor was beeping a lot earlier due to his blood pressure, and I don't know if they gave him medication, but I don't remember that monitor beeping at all that day. Maybe the last nurse silenced it? I don't know. I also don't know how well the nurse was watching. One of the nurses in the morning/afternoon was great and I know she was looking at his face and the monitor with great focus, and I fear the night nurses not so much. I know the nurse that night was from newborns, and just helping out.I don't understand why or how he code blued, how quick it was, or anything, but I know it took them over 20 minutes to bring him back and he was on a ventilator. They did the 24 hour thermal treatment of going cold then normal, and after that for the next few days they'd do an eye test and pain test with no responses. On February 1 they did some test with a dye to see blood movement in the brain and I saw the results that night saying there was little blood flow but not clinically brain dead. I had a spark of hope but knew I wasn't a doctor. The next day we talked to the neurologist and confirmed that he was indeed brain dead and I felt like I lost my brother for the 3rd time in that hospital. Once during delirium, then the cardiac arrest, and now. We had to decide when to pull the life support, and I watched him officially die, for what felt like the 4th time.Having to find the courage to join our father for the funeral arrangements, then the funeral which was a visitation before cremation, then picking up the urn a week later, it's been waves of trauma and it still feels like yesterday a month later. Everyday I've gone home to see my parents, and touch the urn and cry. I don't understand why he's in there and not at our house playing video games with his friends.I don't understand how he got sick to begin with, he moved in with me back in May and I tried to make things as comfortable for him as possible. This was his first winter with me and I think this house is a bit drier than the parents he lived with, but I wouldn't think that'd cause the issue. He almost never leaves, he works from home and plays games. If he caught anything it'd be from me, and I know I got sick at the end of June with COVID and he caught that from me, what a fucking loser I am. I did another trade show in September and got sick, not sure if he got it then, he didn't report time off to work (and he tries to take every time off he can).I don't understand why the teladoc didn't ask other questions, or the urgent care to find anything. Then later the first ER only commented on the high blood pressure, and it wasn't until the second ER that they knew something was up.Why did he get delirium, why did they let sodium levels drop? What was going on with the oxygen? With the monitoring he had, how did they let a cardiac arrest happen?I have so many questions and it pains me knowing that even if I get knew, it doesn't change that my baby brother is gone. We had so many plans this year, such as cooking better for ourselves, working out to lose weight, and most critically spending more time outside of his room to try new things like restaurants and take vacations. The last vacation I had with him was 2007, and he was in Hawaii with the parents in 2008 where I was rejected from going because I didn't have a job after high school.Before his delirium I remember one big ask, which was to get a hug, and that he was ready and wanting to go on adventures with me. I hadn't seen my brother much outside of a quick dinner talk from time to time, and when he moved in I was glad to be bonding with him again, and we didn't even get 1 year. We had so many plans, and the world robbed him of that.During the visitation I played the Halo song "Never Forget". He was a big Halo fan and that song always gave me the feels. I hugged his cold body for that entire song, wishing I could give him more.This is a long post and I apologize, I just needed to write, and I wonder if anyone knows what may have caused things. I fear that my lack of knowledge and experience failed to get him to the ER sooner, but it didn't seem like that even helped, they may have just done the same as they did on the first visit and turned him around.I failed to protect you brother, I am so sorry. This world is just not fair and you deserved so much more. You were the nicest person anyone would of met and you made those around you happier. I miss you so much brother, and I love you even more.I will see you again one day.