Showing posts with label tales from the hospital. Show all posts
Showing posts with label tales from the hospital. Show all posts

Monday, October 26, 2015

a lot of things happen in five years - medical

*removes spiderwebs*

It has been a long time since my last post. Why? It's called Major Depressive Disorder (MDD) that's been poorly managed. I become a hermit when my MDD is being poorly managed, online and real world. Don't feel bad, I was irrationally afraid to communicate with everyone, including my family. Living with MDD is a bitch.

First, it was trying to find a medication or combination of meds that would work. That didn't go so well and I ended up spending 3 days voluntarily inpatient in the psychiatric unit at a local hospital to get on different meds and somewhat stabilized. I was having a really bad day and leave it at that. Part of the problem was my insurance at the time, it didn't cover any psychiatrists in the Huntsville area, so my only choice for specialist care was inpatient admission. The doctors told me that if I needed any adjustment to my medications to just voluntarily admit myself again, since my insurance would cover inpatient psychiatric care 100%. No, it makes no sense at all; covering the more expensive care but not a physician in a local practice.

Had to change general practitioners (GP). Most of my meds had the "May cause drowsiness" warning on them, so I slept a lot. I asked my new GP if there was an anti-depressant that would not make me drowsy. Yes, there was a new one that fit the bill, that treated MDD and would not put me to sleep. Just the opposite, actually. Great, I'll take it. Which I have been for the past 2 years. One problem: no one told me that it should be taken with food or else 1/2 of the dose is lost in the digestive system. Oops. No wonder it stopped working so well, I was taking it on an empty stomach. I discovered this around 9/1/15, so almost two months ago now. So I spent most of September of this year adjusting to the effective doubling of my dose of meds. Yay, such fun when one's neurochemistry is being messed around with.

Then the first of this month rolls around and I'm dehydrated from having nausea and vomiting with a mild fever for 3 days and end up going to the ER on the October 1. What a way to break in my new insurance which went into effect that day. I was delirious at times, I was so low on fluids. A good friend/adopted family/neighbor (I'll call her Hera, in keeping with the Greek pseudonyms for people) took me to the ER since hubby was at work. Hera stayed with me until Evil Timmy (hubby, yeah, no Greek name for him) could get off work and meet me in the ER, then stayed a little longer to find out what the doctor said before she went home, despite how the chair had to be hurting her back (another story for another time). Long story short, yes, I was very dehydrated: 3 liters of fluid given in the ER  and I couldn't keep anything down, despite all the Zofran I was given. Reglan finally stopped the vomiting, so if it took that drug, I was going to be admitted.

So testing for C. diff, which was negative, but landed me in contact isolation for about 24 hours while the test was being run. Contact isolation protocols mean that I was restricted to my room and anyone who entered first had to put on a paper gown and gloves before entering since C. diff is transmitted by touch. I was allowed out of my room once, at 5am for a CT scan, and I had to wear the gown and gloves outside my room. I was given two lap blankets to cover myself with in the wheelchair, and I got to keep those since they were potentially infected. I ended up with a lot of blankets by the end of my stay. 

The morning I was scheduled for discharge I began to have double vision, vertically, which is pretty odd to see. The doctor on call was an ass, he dismissed my concerns about optic neuritis by telling me I needed to go see my optometrist (not ophthalmologist, who is a medical doctor specializing in the eye, but just get my glasses prescription adjusted). Now, I've had optic neuritis twice before so I know the symptoms, which include a sudden change in vision as the optic nerve becomes inflamed. The first time I wrote it off as needing a new prescription for my glasses, waited 4 days until my appointment with my neurologist, and got my butt chewed on for waiting so long since if the inflammation isn't immediately treated then there can be permanent damage and partial blindness. Lesson learned, don't screw around when my vision suddenly becomes abnormal.

The ass of a doctor wanted to send me home, and I'll admit, I became a bit emotional at the prospect of re-admission for IV medication treatment for my eyes. It was a Sunday and he said there weren't any specialists at Madison Hospital on the weekend. I said that Huntsville Hospital (HH, both are in the same hospital system) had neurologists on staff on the weekends and would he please call one of the neurologists and see what they wanted to do. Well, a HEMSI ambulance was called for me to be transferred to HH's Neurological Progressive Care Unit (NPCU, and doesn't that sound impressive). Screw you Dr. Asshole. Well, out of spite or something he ordered a psych consult for me while I was in HH because I was "overly emotional" or something like that. The psychiatrist said that it's perfectly normal to be terrified of going blind, especially for a visual artist. In other words, I had a normal, human reaction. Take that, Dr. Asshole, no I wasn't wanting to stay in the hospital just because I'm a hypochondriac or something like that. I just wanted to be sure I wasn't going to end up partially blind. No, I'm not bitter or anything.

An MRI of my brain and cervical spinal cord (neck) didn't show any lesions at this time, but that doesn't rule out the possibility of microscopic lesions that wouldn't show up. Another MRI of my eyes and optic nerves revealed no inflammation. The diagnosis? Multiple Sclerosis. Yep, back to MS as the source of my neurological problems. I'm going to be seeing a specialist in MS at Vanderbilt Medical Center in Nashville to try to figure out what's going on. I'll go up for an exam, then the doctors at Vanderbilt will coordinate with my neurologist in Huntsville so I don't have to keep going to Nashville for treatment. It will be January before I can get an appointment; they're booked that far out.

On the up side, a diagnosis of MS guarantees I'll receive disability benefits, which I'm in the middle of re-applying for. Hopefully I won't have to get a lawyer involved and I can keep all of my disability back-pay.

Next update - more of what's been going on, moving on from medical.

The photos show much better than I can describe what edema (retained water) from 19.8 liters of saline given over the course of a week when input > output looks like. That's 19.8 kilograms or 43.5 pounds of water, mostly accumulated in my legs. I'm wearing thigh-high anti-embolism stockings to provide compression for the edema, both to reduce the pain and the edema itself. After 4 days of not being able to eat and dehydration landed me in the ER in the first place. The same pen is used for scale.




Then I was given Lasix by my GP and I lost 40 pounds in 5 days! Wanna guess how? You probably guessed right. Ugh. And I had to keep my oral fluid intake at normal so I wouldn't get dehydrated again...

Sunday, August 24, 2008

an actual update from the hospital

I've just had my evening meds, so hopefully this will stay coherent.

The Crohn's had been improving slowly since my last hospitalization in June. Of course, pretty much anything is better than needing 2 units of blood transfused every two days because an ulcer had to make a fuss.

At the beginning of this month I started feeling a little crappier, like a minor flare of the Crohn's within the overall flare. No big deal, it happens. I'd had a nice stretch of good days so a few bad days in a row were bound to happen.

On the 10th of this month food stopped becoming my friend completely. I tried giving my GI system a break by well, not eating solid food. Tomato soup, lemonade, and Boost High Protein shakes are pretty much what I lived off of. Plus the usual handful of pills.

Long story short, I went to the doctor, he gave me some antibiotics since it seemed I had a C. difficile infection, based on my symptoms. A week later (Wednesday night) I was getting worse and went to the ER. Early Thursday morning I was admitted and here I've been ever since.

A CT scan showed no abscesses in my abdomen, lab work was negative for a C. difficile infection, and an ultrasound showed my gallbladder is just fine. As of right now, the only explanation for what's going on is a flare up of the Crohn's. That doesn't mean there isn't something else going on, but on the flip side, the longer one has Crohn's, the worse the flares become.

There's still the possibility of an intestinal infection that's not C. difficile, which is why I'm being treated with 2 antibiotics right now. Or I could have a viral infection, in which case I have to wait it out.

My treatment also includes, among other medications, increasing one of my meds that reduces inflammation in the intestines, IV steroids, and Valium (which eases intestinal spasms, relaxes painful skeletal muscle spasms associated with the MS, minimizes the tremor that has developed in my hands as a side effect of another medication, reduces anxiety, and helps with insomnia).

Today I had my first solid food in two full weeks, since the 10th. The doc won't send me home until I can tolerate solid food again, and without the need of heavy-duty IV pain medication. As of right now, I've had two half meals and two snacks consisting of real food (Jello doesn't count as a real food, it's considered a liquid). This hasn't gone as well as I'd hoped. I'm eating small amounts of food with more frequency than I usually do, so I don't overload my system. I'm doing all the right things, but the transition isn't as smooth as I'd hoped.

So that's what has me in the hospital this time; nothing as dramatic as a bleeding ulcer, but a slow downhill slide that requires inpatient care.

When will I be going home? My guess is Tuesday, since I haven't been having a smooth transition to solid food. If I'd been having an easier time, the doc said he might have felt comfortable with sending me home Monday. It all depends on how well I respond to treatment and when we figure out what's causing the abdominal pain that's completely unlike the pain I generally experience with a Crohn's flare.

Did that make sense? It does to me, in a rambling sort of way. A couple of the meds for MS and migraines leave me in a permanent brain fog, so what makes sense to me doesn't always make sense to everyone else.

The joys of the Autoimmune Trifecta.

Friday, August 22, 2008

i had to go and run my mouth, er, fingers

There's a few remarks I made in my previous post that with 20/20 hindsight, might have been inspired a great deal because of feeling ill and being somewhat pissed off at the world in general because I felt like crap. It happens.

That's not exactly what this post is about.
...because I can't get an increase in my pain medications without an office visit, or an actual hospitalization, because some people like to get high.

Now, I'd be lying if I said I didn't enjoy some of the side effects of using my meds properly. Yes, they make you feel good. Anyone who says differently is a liar. Admittedly, a bullet would feel better after gut-wrenching pain for four fucking hours.

Maybe I do need a nice Thorazine vacation. I don't need 10 years EMS experience to tell me that delusions are not a good sign.

Well, I'm not getting a Thorazine vacation. I'm getting IV antibiotics, anti-emetics, more solumedrol, and pain medication because I may or may not have a Clostridium difficile, or C. diff, infection on top of a flare of the Crohn's Disease.

Based on what I've been told so far, I will be here until at least Sunday. The original C. diff diagnosis was made based on my symptoms. This time the hospital lab will be analyzing a fecal sample each day for 3 days looking for things like what specific strain of C. diff I may have, if I have any parasites, or any other abnormalities. This is in addition to the second CT scan I've had in the past week, and the metric crapload of blood that's been drawn.

This is the long way of saying so far we don't know crap. (go ahead and groan)

I'm sure if I dig agound on this machine I'll find some cat pictures and make Friday Catblogging for once.

Monday, June 16, 2008

going home, maybe

Well, it looks like I'll be going home later today. Maybe, if the detox continues to go well.

...

Ok, here's the short version of why I'm in the hospital.

Memorial Day - Woke up with blurred vision. In denial about serious problem, blamed eyestrain, needing new glasses prescription, anything but something neurological.

May 29 - Had appointment at the Pain Center. Was told to get my butt to the neurologist, and I assured them I had an appointment the next day.

May 30 - Get thee to a hospital! Optic Neuritis, definitive diagnosis of Multiple Sclerosis, despite having mild symptoms but no lesions for 3 years. All previous symptoms could be blamed on other medical problems, and were.

That weekend - Hospital Hotel. Solumedrol IV twice a day to get my eyes back in order, get the swelling down. Didn't feel sick, enjoyed the stay as much as possible, considering I was in the hospital for a serious medical problem.

Monday, June 2 - Went home. All was well. Taking oral prednisone to taper down from the solumedrol.

Friday, June 6 - Woke up with gastric bleed, and a very serious one. Called my gastrointerologist, waited to hear back with instructions. Went to ER, admitted to the hospital.

Saturday - Continued to bleed from somewhere in my large intestine. Received 2 units of blood that night.

Sunday - Began prep for colonoscopy the next day. Had blood count monitored every 6 hours, as I had since admission.

Monday, June 9 - Colonoscopy, upper GI endoscopy at the same time. Bleeding had stopped by the time the scopes were performed. Recovered in my room, blood count continued to drop. Second transfusion of 2 units overnight.

Tuesday - Thursday - convalescence. Began to show signs of demerol/prednisone/solumedrol toxicity. Tapered down as quickly as possible on the prednisone. Switched from demerol to nubain to control pain.

Friday - now - Consults with various specialties - physical therapy, psych, pain doc, pharmD, psurprise pseudospeciality. Detox by IV and oral fluids like normal saline and iced tea.

So here we are. I've had internet access the whole time, wireless broadband. I love living in Huntsville. High tech rednecks. Bless this city.

I went downstairs with my nurses - I've moved in by now, on staff or whatever, and hung out in the Smokers' Den (courtyard) when I saw this....

huntsville hospital june 2008 008_bright-contrast

How cool is that?

ETA: A couple of my nurses had gone down to smoke and I went with to get the hell off this floor. I went out to the smoker's courtyard with them, chilled, chatted, then saw the landscaping. I had my camera, and snapped the photo. Although they had no idea what I was doing - possible crazy patient alert - which was hilarious. Then they loved the photo, and how I saw what they didn't.

Friday, June 13, 2008

we have internet again!!! and friday catblogging

Having drug-induced mania and insmonia and not having internet is really not cool, at all.

Of course as soon as the hospital fixed their internet problems, it was Consult Time. And vitals checks, and lunch, and another consult, and, and...

Yeah.

The parentals arrived from a land far, far away where there is a metric shitload of water covering everything, floating down here in their custom-built ark. Well, not an ark exactly. It's a Toyboata, so it's a bit smaller. You have to have a Dampervan before you enter the ark size range.

Just google those two vessels.

On with the show.

Insomnia, mania, tremors, paranoia, depression, inappropriate emotional responses, auditory hallucinations, visual hallucinations. Name that condition.

No, you're wrong.

Steroid psychosis. It's so much fun, and deserves it's own post. That is one of those topics.

It's still Friday, it must be Friday Catblogging. Tonight, Freya's tonsils.

100_8181
Momma, why you flashy light at me?

Now for a bonus photo...



When bloggers end up in the hospital what do we do? Take pictures and post them on the internet.

The track marks on my arm from repeated sticks for bloodwork. Photos? Yes or no.

~~~

Be sure to head over to Modulator for the Friday Ark and some soggy moggies, among other beasties.

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