Guest guest Posted January 2, 2000 Report Share Posted January 2, 2000 Hi Peg, I am going to call the doctor tomorrow and see if he wants me to bring him in. I started him on Levaquin today, the doctor had given me the prescription just in case something like this came up. I spoke to one of his associates who was covering for the weekend this morning, and he agreed that he should start it. I guess we will see tomorrow what the doc thinks. Right now he has no temp and is feeling pretty good. Thank for your concern, I will keep you posted. Liz Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 2, 2000 Report Share Posted January 2, 2000 Liz, Glad Jim is feeling well still. Starting antibiotics rapidly cleared things up for me. My regime was to take the antibiotics at a high dose for 10 days then low dose for 20, e.g. Cipro 500mg bid for 10 days then 500mg per day for 20 days. I alternated using Cipro and Augmentin (Cipro worked faster). Tim --- Rnurse987@... wrote: > > Hi Peg, > > I am going to call the doctor tomorrow and see if he wants me > to bring him > in. I started him on Levaquin today, the doctor had given me > the > prescription just in case something like this came up. I spoke > to one of his > associates who was covering for the weekend this morning, and > he agreed that he should start it. > > I guess we will see tomorrow what the doc thinks. Right now > he has no temp and is feeling pretty good. > > Thank for your concern, I will keep you posted. > > Liz __________________________________________________ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 3, 2000 Report Share Posted January 3, 2000 Hi Tim, He woke up today feeling great. No temp at all. I am waiting for the nurse practitioner from his doctor's office to call me back, to see if they want him to come in today. Thanks for your concern. Liz Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 3, 2000 Report Share Posted January 3, 2000 Hi Liz, This is a classic medical dilemma. It certainly sounds like it wasn't/isn't classic cholangitis. As you know, antibiotics should not be used indescriminately. That's how we got into this situation with bugs that don't respond to common antibiotics (VRE, MRSA). Your description makes it sound like the flu which is making the rounds of North America. The fact that your husband was a bit better before he started the drugs and the improvement with only one day of antibiotics means it probably wasn't a bacterial infection. They don't respond in 24 hours or less to the start of antibiotics. If Jim is susceptible to recurrent cholangitis he should have antibiotics on hand to start when you suspect its beginning again. Then he can go and have the appropriate investigations done to confirm it. I'm sure you're aware that C. difficile is one of the bugs that occurs due to too many antibiotic treatments. So again, you have to be wary of not overreacting. And that's tough to do. It's difficult to strike the right balance, but your nursing/medical knowledge should be of great assistance to Jim. As someone else mentioned, PSC patients really need an advocate and someone to watch over them because we don't think that clearly due to our disease and the fact that it becomes so emotionally overwhelming to have a chronic illness. All the best to both of you. Aubrey Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 3, 2000 Report Share Posted January 3, 2000 Hi Aubrey, Thanks for your response. The doctor also thinks it probably was not cholangitis, however he is sending him for a MR Cholangiogram, which he was due to have done in the near future anyway. He drew blood today as well. He did recommend he stay on the Levaquin for 10 days, which makes me uneasy, for the reasons you mentioned. I will not take them, nor do I put my kids on them, unless I absolutely have to, which happens very infrequently, thank God. His hepatologist is Dr. Hillel Tobias, who is affiliated with NYU, and he seems quite good so far. I am currently in the process of trying to have my insurance company approve the MR cholangiogram, as my doctor refers only to a private radiology practice which is not in network, even though it is within the physical confines of NYU medical center, which is a participating hospital. I found most of the places on the list of in network radiology practices didn't even do MR Cholangiograms. I have found the stress of dealing with Blue Cross worse at times than dealing with the diagnosis. I appreciate your input, and value having someone with your knowledge, as a physician and a patient, in the group. Can you tell me what are the appropriate diagnostic tests to evaluate if a situation like this may indeed be a cholangitis? Thanks in advance. Liz Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 4, 2000 Report Share Posted January 4, 2000 Hi Peg, Thanks for the advice. I was intending to e-mail you privately today, as I am having a little bit of trouble coping this week, which really is not related to Jim getting sick, as it started before that happened. I figured you (my buddy) would understand. I am going out tonite, as my 18 year old son is taking me to see a Broadway play and to dinner for Christmas, so that will cheer me up. If you don't mind, I will e mail you tomorrow. I appreciate your input. Liz Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 4, 2000 Report Share Posted January 4, 2000 Liz, I have found that taking acidophilus along with antibiotics helps keep the colon with the right amount of healthy bacteria to conteratic yeast and other problems. Infact, Phil and I take it all the time. I used to get yeast infections (not only where you would expect them) every time I took antibiotics and I've almost never had a problem since I take the acidophilus ( we can't eat yogart because we are dairy intolerant). Peg Rnurse987@... wrote: > Hi Aubrey, > > Thanks for your response. The doctor also thinks it probably was not > cholangitis, however he is sending him for a MR Cholangiogram, which he was > due to have done in the near future anyway. He drew blood today as well. He > did recommend he stay on the Levaquin for 10 days, which makes me uneasy, for > the reasons you mentioned. I will not take them, nor do I put my kids on > them, unless I absolutely have to, which happens very infrequently, thank > God. His hepatologist is Dr. Hillel Tobias, who is affiliated with NYU, and > he seems quite good so far. > > I am currently in the process of trying to have my insurance company approve > the MR cholangiogram, as my doctor refers only to a private radiology > practice which is not in network, even though it is within the physical > confines of NYU medical center, which is a participating hospital. I found > most of the places on the list of in network radiology practices didn't even > do MR Cholangiograms. I have found the stress of dealing with Blue Cross > worse at times than dealing with the diagnosis. > > I appreciate your input, and value having someone with your knowledge, as a > physician and a patient, in the group. Can you tell me what are the > appropriate diagnostic tests to evaluate if a situation like this may indeed > be a cholangitis? Thanks in advance. > > Liz > > ------------------------------------------------------------------------ > Want to send money instantly to anyone, anywhere, anytime? > You can today at X.com - and we'll give you $20 to try it! Sign > up today at X.com. It's quick, free, & there's no obligation! > http://click./1/332/4/_/24674/_/946948680 > > -- 20 megs of disk space in your group's Document Vault > -- /docvault//?m=1 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 4, 2000 Report Share Posted January 4, 2000 Hi Liz, The main diagnostic test is the physical examination. There is another test for infection might be helpful, a gallium scan. Perhaps the vaunted CT/MRI might help. But really the diagnosis is made best based on the history and examination. Symptoms and signs are 95% of any diagnosis. Glad to hear your husband is better. Tough thing to have to continue the Cipro for a 10 day course but it's great that he's feeling good again. Aubrey Quote Link to comment Share on other sites More sharing options...
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