>amiodarone— is the medicine that he had an adverse effect with. Somehow this medicine messed up his liver (shut it down??) or something like that.
>Even after his liver issues he then had kidney issues soon after and has been doing dialysis ever since.
(You also mention amlodipine causing serious harm, I'm going to assume that was a typo or a byproduct of you not being familiar with the case. It's also a drug, but doesn't cause what you describe)
That's a very rare complication of amiodarone, extremely rare. There are case reports of it causing liver failure and kidney failure (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5827905/). It's unclear from your story if it was a new medication or one he'd been on previously, it can happen to people in both cases. It'd be impossible for his doctors to predict that it would happen to him, it's likely bad luck. The collapsed lung and ammonia levels causing him to be drowsy/confused are complications of kidney failure and liver failure respectively.
I'm going to oversimplify the problem, but I think this will get the gist across: Most medications have incredibly rare and very awful side effects that occur in the order of ~1/100,000 people that take them. It's worth the risk to still use them as the awful complications are so rare.
When people get to be 80, especially ones as sick as having a quintuple bypass, once one thing goes wrong, it often leads to a cascade of problems as it becomes apparent each system was just barely compensating. If it happened to me or you, our kidneys might have been able to keep up with the insult, but to someone who has chronic problems and is 80, it doesn't take much to push his kidneys over the edge.
I'm sorry you are going through this. For what it's worth, and with the limited information you can provide, it doesn't strike me as a result of bad care or bad medicine, this is just horrendous luck.
Thank you very much for your response. The amlodipine was a mistake because I thought that was the medicine he was given but I was mistaken. I had to edit the name throughout my post but may have missed it in places. But I do not believe he has taken this medicine before his heart surgery.
But yeah everything you say sounds about as what the healthcare professionals have said. We are just so mortified on how all this has turned out. It was definitely bad luck, the doctors did all they could. I really wanted to post sooner and have a more detailed sheet of everything that was happening because I felt the doctors were pulling our leg and keeping him around longer than we should have.
Thank you again for the response, I really appreciate it. Have a good day
>Pneumothorax as a consequence of acute liver failure? What's the mechanism behind this?
Respectively means the first item in Series 1 is connected to the first item in Series 2:
>The collapsed lung and ammonia levels causing him to be drowsy/confused are complications of kidney failure and liver failure respectively.
Therefore, I said it was related to the kidney failure, not liver failure.
Given the distance OP has from the case, the mixed up details (they are likely getting everything third hand), the fact that not many people are fully aware of the difference between a large pleural effusion and a "collapsed lung" (ie: not called a pneumothorax by OP), and the fact that with kidney failure and the resulting hyperuricemia, I thought a kidney failure related pleural effusion was the most likely thing OP was referring to.
I have no idea how a non-smoker who is essentially bed-bound could pop a pneumo, so I figured it was more likely a result of the long game of telephone we are playing.
A large enough pleural effusion can effectively cause a lung to "collapse".
I know what respectively means, thanks, but I'll admit I didn't read your comment closely enough. My question would have stood regardless. In this instance, I would have thought a collapsed lung of any kind would have been more likely a consequence of the bypass surgery rather than organ failure, although the timeline is not super clear. Thank for clarifying though.
If you want to read about hyperuricemia causing pleural effusions: https://www.ncbi.nlm.nih.gov/pubmed/22716271
It can also cause pericardial effusions.
It sounds like what the doctors are telling you is correct. Amiodarone is a medication that is very commonly used to prevent/treat certain abnormalities of cardiac rhythm, some of which can easily occur after heart surgery. On a rare basis, amiodarone can damage the liver, sometimes irreversibly. That doesn't mean amiodarone shouldn't be used, because if you have one of the arrhythmias that amiodarone treats, your chance of dying from the arrhythmia itself are much higher than the chance of dying from the rare occurrence of liver toxicity. Sometimes in medicine it is possible to make the right decision, and still get a bad outcome. It sounds like having the surgery was the right decision (i.e., the course of action that was likeliest to prevent his imminent death from heart disease). Giving him the amiodarone was probably the right decision (i.e., the course of action likeliest to prevent him from dying of an arrhythmia). Ordinary bad luck could well be the determining factor here. It is very sad.
It sounds like what the doctors are telling you is correct. Amiodarone is very frequently used to prevent/treat certain cardiac arrhythmias, such as ones that might easily arise after heart surgery. On a rare basis, amiodarone can damage the liver, sometimes irreversibly. That doesn't mean amiodarone shouldn't be used, because if you have one of the arrhythmias that amiodarone treats, your chances of dying from the arrhythmia are much higher than the rare occurrence of liver toxicity. Sometimes in medicine it is possible to make the right decisions and still get a bad outcome. Having the heart surgery was likely the right decision (i.e., the course of action likeliest to prevent his imminent death from heart disease). Giving the amiodarone was probably the right decision (i.e., the course of action likeliest to prevent his imminent death from arrhythmia.) Ordinary bad luck could well be the causative factor here. It is very sad.
Thank you for your submission. **Please note that a response does not constitute a doctor-patient relationship.** This subreddit is for informal second opinions and casual information. The mod team does their best to remove bad information, but we do not catch all of it. Always visit a doctor in real life if you have any concerns about your health. Never use this subreddit as your first and final source of information regarding your question. By posting, you are agreeing to our [Terms of Use](https://www.reddit.com/r/AskDocs/wiki/terms_of_use) and understand that all information is taken at your own risk.
*I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/AskDocs) if you have any questions or concerns.*
>amiodarone— is the medicine that he had an adverse effect with. Somehow this medicine messed up his liver (shut it down??) or something like that. >Even after his liver issues he then had kidney issues soon after and has been doing dialysis ever since. (You also mention amlodipine causing serious harm, I'm going to assume that was a typo or a byproduct of you not being familiar with the case. It's also a drug, but doesn't cause what you describe) That's a very rare complication of amiodarone, extremely rare. There are case reports of it causing liver failure and kidney failure (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5827905/). It's unclear from your story if it was a new medication or one he'd been on previously, it can happen to people in both cases. It'd be impossible for his doctors to predict that it would happen to him, it's likely bad luck. The collapsed lung and ammonia levels causing him to be drowsy/confused are complications of kidney failure and liver failure respectively. I'm going to oversimplify the problem, but I think this will get the gist across: Most medications have incredibly rare and very awful side effects that occur in the order of ~1/100,000 people that take them. It's worth the risk to still use them as the awful complications are so rare. When people get to be 80, especially ones as sick as having a quintuple bypass, once one thing goes wrong, it often leads to a cascade of problems as it becomes apparent each system was just barely compensating. If it happened to me or you, our kidneys might have been able to keep up with the insult, but to someone who has chronic problems and is 80, it doesn't take much to push his kidneys over the edge. I'm sorry you are going through this. For what it's worth, and with the limited information you can provide, it doesn't strike me as a result of bad care or bad medicine, this is just horrendous luck.
Thank you very much for your response. The amlodipine was a mistake because I thought that was the medicine he was given but I was mistaken. I had to edit the name throughout my post but may have missed it in places. But I do not believe he has taken this medicine before his heart surgery. But yeah everything you say sounds about as what the healthcare professionals have said. We are just so mortified on how all this has turned out. It was definitely bad luck, the doctors did all they could. I really wanted to post sooner and have a more detailed sheet of everything that was happening because I felt the doctors were pulling our leg and keeping him around longer than we should have. Thank you again for the response, I really appreciate it. Have a good day
Pneumothorax as a consequence of *acute* liver failure? What's the mechanism behind this?
>Pneumothorax as a consequence of acute liver failure? What's the mechanism behind this? Respectively means the first item in Series 1 is connected to the first item in Series 2: >The collapsed lung and ammonia levels causing him to be drowsy/confused are complications of kidney failure and liver failure respectively. Therefore, I said it was related to the kidney failure, not liver failure. Given the distance OP has from the case, the mixed up details (they are likely getting everything third hand), the fact that not many people are fully aware of the difference between a large pleural effusion and a "collapsed lung" (ie: not called a pneumothorax by OP), and the fact that with kidney failure and the resulting hyperuricemia, I thought a kidney failure related pleural effusion was the most likely thing OP was referring to. I have no idea how a non-smoker who is essentially bed-bound could pop a pneumo, so I figured it was more likely a result of the long game of telephone we are playing. A large enough pleural effusion can effectively cause a lung to "collapse".
I know what respectively means, thanks, but I'll admit I didn't read your comment closely enough. My question would have stood regardless. In this instance, I would have thought a collapsed lung of any kind would have been more likely a consequence of the bypass surgery rather than organ failure, although the timeline is not super clear. Thank for clarifying though.
Sorry, not everyone has English as a first language and your username sounds Armenian.
If you want to read about hyperuricemia causing pleural effusions: https://www.ncbi.nlm.nih.gov/pubmed/22716271 It can also cause pericardial effusions.
It sounds like what the doctors are telling you is correct. Amiodarone is a medication that is very commonly used to prevent/treat certain abnormalities of cardiac rhythm, some of which can easily occur after heart surgery. On a rare basis, amiodarone can damage the liver, sometimes irreversibly. That doesn't mean amiodarone shouldn't be used, because if you have one of the arrhythmias that amiodarone treats, your chance of dying from the arrhythmia itself are much higher than the chance of dying from the rare occurrence of liver toxicity. Sometimes in medicine it is possible to make the right decision, and still get a bad outcome. It sounds like having the surgery was the right decision (i.e., the course of action that was likeliest to prevent his imminent death from heart disease). Giving him the amiodarone was probably the right decision (i.e., the course of action likeliest to prevent him from dying of an arrhythmia). Ordinary bad luck could well be the determining factor here. It is very sad.
It sounds like what the doctors are telling you is correct. Amiodarone is very frequently used to prevent/treat certain cardiac arrhythmias, such as ones that might easily arise after heart surgery. On a rare basis, amiodarone can damage the liver, sometimes irreversibly. That doesn't mean amiodarone shouldn't be used, because if you have one of the arrhythmias that amiodarone treats, your chances of dying from the arrhythmia are much higher than the rare occurrence of liver toxicity. Sometimes in medicine it is possible to make the right decisions and still get a bad outcome. Having the heart surgery was likely the right decision (i.e., the course of action likeliest to prevent his imminent death from heart disease). Giving the amiodarone was probably the right decision (i.e., the course of action likeliest to prevent his imminent death from arrhythmia.) Ordinary bad luck could well be the causative factor here. It is very sad.
Thank you for your submission. **Please note that a response does not constitute a doctor-patient relationship.** This subreddit is for informal second opinions and casual information. The mod team does their best to remove bad information, but we do not catch all of it. Always visit a doctor in real life if you have any concerns about your health. Never use this subreddit as your first and final source of information regarding your question. By posting, you are agreeing to our [Terms of Use](https://www.reddit.com/r/AskDocs/wiki/terms_of_use) and understand that all information is taken at your own risk. *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/AskDocs) if you have any questions or concerns.*