Thanks for all of this information / support.
And I love the specifics re urine output.
What he has been doing (urine output) the last 12-18 hours is around 75-175 mL per 3 hours. So that is (except for the 1 reading of 75 mL) roughly within that 30 mL per hour. I love having real basic guidelines. Thanks!
(But still way less than the 500-600 to 800 mL per 3 hours he usually does. He
So the (new) hospitalist came in. She is very verbal, listens, and very encouraging and agreeable when appropriate. I was pleased.
She said that since he is sleeping (round the clock for 18 hrs) and not eating, she doesn’t want him to be sent home.
She is on board with the ID doc re me giving meds at home in picc line. She said the home health rep was coming by today. She did just come by and we practiced. I will watch the next few times when the nurse does it here. ✅
I told her that his belly still hurts and his pain is managed with IV morphine and I need another plan before he leaves. I asked if we could start trying oral meds to see if that does the trick, so I would have a plan at home. I let them know something non-opioid would be better. Maybe a bigger dose of Tramadol than we have been using for bad days at home. That way there would be less worries re his past issues with opioids. She was really happy that we wanted to implement oral meds in prep to go home. ✅
Also, re the belly pain, she palpitated his abdomen and for the first time, the worst pain was just over the bladder rather than above the belly button where it has been.
She asked him how his pain level was, and H said it was better today - no need for pain meds. Because the antibiotic has had time to start working, doc believes it is very possible the belly pain was referred pain from the bladder. So because the bladder is getting help with the antibiotics, the stomach pain is also better. I’m ok with that till something proves / indicates otherwise. ✅
Re the vitals, she believes that his vitals were in better check with meds the last few days, and she believes the really bad ups and downs are related to his bladder - the fact that with the nursing students and their inability to get him cathed, that we waited too long before I finally took over, and his bladder might have been distended, and therefore he was at the beginning of dysreflexia. He has never been that sensitive about dysreflexia before, but with all these infections, I can see that. No really large output recently, so more balanced vitals. ❓
The ❓ is because I just now cathed him - he has been drinking better the last few hours, and produced 1000 mL. And…absolutely no vital signs going crazy. So does that bust that theory??? Maybe just the bladder pain screwed up the vitals.
BTW, 1000mL is not especially over the top for him. But if it leads to or exacerbates UTIs, I will cath more often. Seems like a trade off…less frequent and maybe distended bladder. Cath more often, more chance for germs. 😢
So, a lot addressed today. I’m thinking the bouncing BPs might not be bladder related, but I just don’t know.
One scary thing…they are going to check how expensive the antibiotics are…seems they are more expensive if we do one a day, than if we spread it over 3x per day ?
Also they are thinking we may have reached our max on Medicare. Shit!
Oh well. I’ll find out about that by tomorrow.
Thanks for hanging in there with me!!!
[This message edited by WhatsRight at 9:17 PM, Friday, July 22nd]