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Question RE: CPR & Chest Compressions

1,415 Views | 16 Replies | Last: 3 mo ago by 94chem
AJ02
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AG
For any doctors or nurses who might know....is total arm weakness (muscular, not nerve) that lasts for 2+ weeks a typical "side effect" after having CPR/chest compressions done on you? Not in one arm, and not like a loss of feeling. But both arms just being so tired you can't even lift them to feed yourself or brush your teeth. Still 2 weeks after it's done.

X-rays show no broken ribs or sternum. Obvious soreness as a result.

My father went into cardiac arrest while in the hospital a couple of weeks ago. They performed chest compressions on him. He's 73 and in poor health (pulmonary fibrosis, diabetes, Parkinson's, heart disease....the list goes on). He was in the hospital for a GI bleed, which they were able to fix with banding in his esophagus. While in there, they discovered severe blockages in 2 arteries. They attempted stent placement (bypass not an option) and were not successful the first attempt because of the plaque in his leg artery. So they stopped the procedure and I believe it was that night that he went into cardiac arrest.

They were able to perform the stent surgery about a week later once he was "stable" enough. But I'm just stumped on the reason for the continued arm weakness and I can't get clear answers. My stepmom just keeps saying it's "because of the chest compressions".
DeepintheHeart06
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AG
Unlikely this is related to the CPR. Sounds like he was in poor health to begin with and then went through the ringer and spent weeks in the hospital. Could just be bad deconditioning and will need more intensive rehab/physical therapy for quite some time.

Hoping for a good recovery.
bigtruckguy3500
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Agree with above. Unlikely to be CPR related. Deconditioning sounds more plausible. However could do a good physical exam and ensure it's equally symmetric, and involves all muscles about equally. If weakness is more pronounced in one set of muscles over another (deltoids, for example, but normal triceps, forearms, etc), then hypothetically, the CPR irritated the nerves coming out of his neck towards his arms (for example if he had pre-existing foraminal stenosis, or other condition). But unlikely to be equal bilaterally. All I can think of.
AJ02
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AG
You're kind of confirming what I've suspected...that the excuse my sister and I keep getting given (chest compressions) isn't what's caused the weakness. Any time either of us push further to understand why, that's the token response and it doesn't make sense to either of us.

Would deconditioning set in that quickly? He was walking the halls of the hospital the morning of his first attempt at the stent surgery (that was aborted) and the same day he later went into cardiac arrest (that evening). So no issues with weakness the day of, but then immediately after CPR he's been weak ever since. It seems odd to me that it would be so sudden and drastic. It's not like he was immobile and comatose for 2 weeks before or after.

I guess I'm just wondering....are "chest compressions" being used as a canned response for some other issues? (Not that i expect you to know the answer.) But it just doesn't make sense to me.
KidDoc
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AG
I would also be worried about the potential for a stroke with all those vascular plaques. Ask for neuro visit.
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AJ02
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AG
Yes, definitely a ton of things to be concerned with. Issues that prevent other issues from being adequately resolved which then causes new issues.

If ever there was a lesson in TAKING CARE OF YOURSELF, it would be my father. So many preventable issues with just a modicum of self-control. 3 pack per day smoker since he was a teenager, sedentary, overweight. Yes, some family genetics at play, but still manageable if the right choices were made. It's just so frustrating to know how so much of this could have been avoided if he'd just attempted to have moderately healthy habits.

I live multiple states away, so difficult to be there to get info firsthand, and he isn't always truthful and forthcoming with my sister and I. Heck, he isn't always truthful and forthcoming with his own doctors.
AJ02
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AG
But I guess also back to my original question....would you also agree with the other two posters that total arm weakness being caused by chest compressions two weeks ago (with testing showing no damage or broken ribs/sternum...just bruising) seems odd? Total use of his arms that morning, able to walk the halls of the hospital that morning. Then less than 24 hours later, after the cardiac arrest, he's too weak in his arms to even lift them? And this weakness has persisted for almost 2 weeks. Seems like something else at play, correct? Whether it be mental on his part, or my stepmom not being 100% truthful with us, or some damage occurred that the doctors didn't catch?
bigtruckguy3500
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Needs a good physical exam to determine where exactly he's weak, and how symmetric it is. Would indeed be very odd to develop isolated, bilateral, symmetric weakness in just the arms, and without any sensory changes. Same with a stroke, very odd distribution. There's something called central cord syndrome, but would be hard to imagine it occurring from CPR in bed. Wouldn't be a bad idea to request a neuro consult.

Deconditioning can occur fairly quickly, but would also be a little more noticeable in the lower extremities than it sounds like it is. Trunkal deconditioning is also fairly quick onset. But would depend on how long he was in the ICU/intubated and not moving following CPR.
AJ02
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Never intubated after the CPR. Conscious and breathing on his own immediately after. I was told he had gone in to "cardiac arrest".

Two times in later nights he had AFIB, but I was told by my stepmother that they used a medication to "stop his heart, and then start it back up again". I didn't get the impression that it was for very long then either, and he was conscious afterwards.
DeepintheHeart06
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AG
I think there are some details missing and honestly we won't be able to make any hard conclusions remotely. But in general CPR never causes bilateral arm weakness.

We could create some scenarios where maybe this could happen, but I am involved with CPR patients on about a weekly basis and have never seen this happen from CPR alone. Again not impossible, but neurological and/or deconditioning would be at the top of my list.
AJ02
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AG
Kind of what I was thinking as well...perhaps information about his condition is being purposefully withheld from my sister and I, or no one up there is asking the right questions. It wasn't making sense to me or my sister, but whenever we pushed the issue it got snippy and I was just told "that's the price for saving your dad's life", so I just stopped asking.
Stringfellow Hawke
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AG
Several options to pursue.

*Check the patient portal to view listed medical diagnoses, results from scans, labs etc.
*Consider past medical conditions (Parkinson's) that may contribute to the weakness in both extremities.
*consider seeking evaluation at a different facility if the staff is not willing to answer questions. Edit to say that the comment that is the price for saving life is out of line. Would consider contacting a patient advocacy staff to voice your concerns.
AJ02
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AG
That comment "the price for saving his life" came from my stepmother when I kept probing to understand the arm weakness.

My sister and I have both asked that we be at least listed as "emergency contacts" for my father, but he declined. So if he won't even put us down for a phonecall from the hospital if he shows up in the ER, no way will he allow us access to his medical records.

It's all very weird and I feel like we're not getting the full story. And it's hard to know if it's them (dad & stepmom) being intentionally deceptive, or if they are relaying bad info from the doctors & nurses. All just very frustrating.
bigtruckguy3500
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Your stepmom is probably just very stressed and overwhelmed, and likely not correctly interpreting what she is being told. She's also probably not able to fully grasp and remember what she's being told, and her brain probably fills in the gaps with her imagination. It just happens, not intentional.
94chem
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Does he have a pacemaker?
94chem,
That, sir, was the greatest post in the history of TexAgs. I salute you. -- Dough
AJ02
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AG
No, he does not.

Honestly, despite the rampant heart disease in my family, he opted to stop going to his cardiologist several years ago once he got his IPF diagnosis. Because said he'd "rather die of a massive heart attack than a slow death from IPF".
94chem
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AJ02 said:

No, he does not.

Honestly, despite the rampant heart disease in my family, he opted to stop going to his cardiologist several years ago once he got his IPF diagnosis. Because said he'd "rather die of a massive heartache than a slow death from IPF".


That honestly makes sense, depending on how bad the IPF is. Grace and peace.
94chem,
That, sir, was the greatest post in the history of TexAgs. I salute you. -- Dough
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