Re: Infection?

[Guest guest]

Yikes Norma. Not fun. Was she possibly dehydrated?

[Guest guest]

Whew! I will keep you both in my prayers, please let me know the outcome.

Many hugs,

Deb

normalanne wrote:

My Mom has been in the hospital for the past 5 days. She didn't

respond well on Wednesday evening so the caregiver called 911. Her

arms (always contracted) fell to her sides and her head bemt down.

She was better by the time I got to the emergency room though. I

have to admit that I was thinking the worst during my 40 minute

drive.

Just thought I'd post this here in case something similar happens to

others. I was SO frustrated in the hospital by all concerned--

doctors, nurses, aides. Some were polite, but not knowledgable.

Others who thought they were knowledgable were very brusk. I'm

grateful this was the first experience I've had with my Mom in a

hospital.

I will try my best to make this brief and to leave out all

the " smart " remarks. They put a catheter in to take urine. Took

blood. Took a chest x-ray. They started are on a strong antibiotic

(Levaquin) immediately. When I asked why, I was told she certainly

had a urinary tract infection (UTI) or possibly pneuomonia. Within

the hour, the first urine test came back negative. The chest xray

also came back negative. I questioned the doctor by saying, " If you

knew you would have the results of these tests so quickly, why

wouldn't you wait to start her on an antibiotic? Couldn't this

possibly be a virus? " His answer was that this is what they do in

the emergency room. They don't not to anything. Besides, he said,

he probably does have a UTI and it will show up in the later

culture. It didn't. And nothing showed up in the blood. And

nothing, thank G-d, showed up in the next chest x-ray.

They then began focusing on the wound she has on her heel. Nurses

and doctors (over the past two months) have said it isn't infected.

But she was put on antibiotics just in case. An infectious disease

person came in two days ago and took a culture because she thought

it was infected. The culture came back with a little bacteria that

is being treated with antibiotics, but it wasn't substantial. The

podiatrist surgeon said it isn't infected. Today, they took a

sonogram of her abdomen (everything is clear). I can thank the

sonogram person for telling that to us immediately (though she

wasn't supposed to). Otherwise, I would have needed to wait until

7:00 pm tonight. That is the most frustrating part. They are also

taking an x-ray of her foot to make sure an infection didn't go into

the bone. I will need to wait until this evening to hear back on

this.

On the positive side, Mom's temperature is normal today and I'm

certainly hoping she can come home tomorrow.

Thank you all for listening.

---------------------------------

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[Guest guest]

Just a view from a different perspective.... At the hospital (in UT)

my dad recently went to the ER docs were unwilling to give any meds

or even IV fluids until they had results from a UTI and a blood

test. We were desperate for them to start something beforehand,

pleading that with a fever surely it's an infection and surely you

can give antibiotics?! Several hours later after the tests results

came in and IV Levaquin and fluids were given, I asked the attending

MD again about this and she said that in her experience every family

wants treatment to begin immediately just like everyone wants to be

prescribed antibiotics when they have a bad cold or the flu. She

said it's just not good practice.

[Guest guest]

I totally get the reluctance to use antibiotics empirically, but the

fluids thing sorta bothers me; if hydration status is compromised,

the physical symptoms are detectable on examination, and the

contraindications (edema in the extremities, fluid in lungs, etc) are,

too.

The piece I'm currently having trouble wrapping my head around is the

case of suspected UTI and delirium, where the dipstick is

indeterminate, but the culture won't be back for 28 hours. Our ED

tends to admit for fluids and IV quinolones, and continues the course

regardless of the culture results. I wish I understood the underlying

logic there.

One minor note; there is a paper that was just published on the use

of forskolin extract (a popular herbal remedy) in treating chronic

bladder infection. The forskolin seems to shove the bacteria out of

the crypts in the bladder wall so the antibiotics can get to them.

This is early-stage animal research, but forskolin has a pretty

reasonable safety record as a supplement, so we should be seeing

someone starting human trials soon. This might be a development to

keep an eye on if you have an LO with frequently-recurring UTIs where

the cultures keep coming back with the same bacteria regardless of how

you treat it.