Hospital Day 8
8:30 am - Rebecca arrived around 8 am and Dianne was awake and alert, she was watching TV and drinking some fluids. She was still in a lot of pain. She didn't have a very restful night, her bladder was causing a lot of pain. She said she felt like she bugged the nurses every 15 minutes or so to use the bathroom. She did get some chicken broth down and has been sipping water.
Dr. Tangel came and didn't really give any new information but wanted to check to see how things went over night. He did say that he had Dianne's CT of her bladder reviewed and that didn't show anything new.
10:00 am - Dr. Gill stopped in. She asked some questions and did a check up on Dianne, and was going to read over the chart to determine what steps should be next. She did mention that so far none of the blood cultures or other bacterial cultures are growing anything, so that's good but also still leaves us with no answers to any type of infection.
Dr. Tran also called the nurses, and Rebecca spoke to her as well. She explained that she wanted to try doing an MRI on her brain to see if there would be any hints as to why Dianne starts to speak jibberish when she starts to spike a fever. She should have that done this afternoon and the results should be to Dr. Tran by tomorrow morning. Dr. Tran will come into the hospital either tomorrow then, or Wednesday morning. If the MRI doesn't reveal anything she has a couple more ideas of things to try to see if this is a Lupus related issue. It seems today that Dr.'s Gill, Tran and Tangel have all been in contact and working towards the next steps.
They did change her pain meds again so she is now starting to feel less pain in her legs and muscles, but still having bladder pain. They did note this morning that she was no longer on the anti-spasm drug for the bladder that Dr. Manion had put her on last week. They have orders in for that, so hopefully soon she will be in less pain all together.
12:00 pm - Dr. Manion came in and went over the medications again with Dianne. He got the order in for the anti-spasm med for the bladder, and was also providing a temporary medication for the next couple of days just to ease the pain. He will most likely regroup after that medication is done, to find the solution to the pain.
The MRI was performed and results should be known by tomorrow morning. Dianne ate a solid lunch for the first time in a few days, although she doesn't have much of an appetite.
3:00 pm - Dr. Cagan arrived with good news! They found the source of Dianne's problems. She has a Mycobacterium infection - similar to tuberculosis but this is NOT tuberculosis. Dr. Cagan was calling Dr. Gill now to switch her antibiotics to the correct one for this infection. We did ask if this infection was contagious and the nurses said that the doctors had talked about possibly moving Dianne to a secluded room in case of contaminating others but they believe that it's not contagious. Because Dianne's immune system is so weak she was affected by this bacteria, whereas others with healthy immune systems aren't phased by this infection.
Sun Jan 30, 2011
Hospital Day 7
7:30 am - Jeff arrived at the hospital and Dianne was still in a lot of pain. The nurses said she groaned and cried most of the night from the pain. She has been listening to questions and answering with "yes" or "no". Sometimes she just says "bathroom" or "bladder" but everything is generally one word responses. From what she has said, all of her muscles are hurting and her bladder. They kept her on pain killers and antibiotics over night. The pain killers seemed to be pretty mild and weren't taking away her pain.12:00 pm - Dr. Tangle visited and ordered a CT of her chest (for lungs) and pelvis (for bladder). He had requested consultations from both Dr. Gill (infectious disease) and Dr. Tran (Lupus doc). They are guessing that we will hear from them tomorrow because today is Sunday. Dr. Tangel did order a more broad spectrum of antibiotics and a much heavier pain killer.
3:00 pm - Dr. Tangel stopped in again and said that the CT showed that Dianne's lungs looked about the same as they did last week. He wasn't able to accurately analyze the CT of her bladder because that wasn't his area of expertise, so he has sent a request to have the radiologist take a better look with the urologist giving a better look tomorrow. Dianne is doing better on the new pain meds. She has been sleeping more, which seems to make her more comfortable. She isn't moving around at all and crying as much. She does wake up every so often to go to the bathroom but it's normally a jolt out of bed. She is very uncomfortable the whole time. Once she is able to lay back down and is covered up she falls back asleep very quickly. Her temperature has been fluctuating throughout the day but nothing over 101.
5:30 pm - Dr. Tangel will not be in for the rest of the night, so the plan is to keep her comfortable and out of pain for the night. As of now, we are waiting for results on the pelvic CT and for Dr. Gill, and Tran to visit her tomorrow.
Sun Jan 23 - Sat Jan 29, 2011
Dianne was on the phone with Eva at 4:30pm. Eva noticed that Dianne was shivering badly and unable to understand what she was saying. Eva called Jeff, who was in the driveway washing the cars. He came in the house and Dianne started throwing up and seemed disoriented. They went to the ER.
The ER started an IV of pain killers, and antibiotics right away. They also did some chest X-Rays. She was moved to a regular room in the hospital around 11 that night. They continued testing to find out why she was spiking fevers, having shivers, and disoriented. Dianne remained in a non-coherent state, and sleeping most of Monday.
By Tuesday, Rebecca went to the hospital to be with her and she was up and alert and watching TV. Most of the blood tests all came back negative. The doctors did say that they noticed more blurry type spots on her X-Ray, compared to how things looked in October of 2010.
They kept her on antibiotics and was seen by Dr. Gill, Dr. Cagan, Dr. Manion and Dr. Tran, as well as Dr. Tangel. Dr. Manion changed some of her meds for her bladder, and added in an anti-spazmatic type medication to help with the pain in the bladder. Dr. Tran took her off one of the medications she was on. She was on 2 types of steroid drugs for the lupus. Dr. Tran mentioned that if there was an infection somewhere, the steroids would be helping to suppress her immune system, so as to not have a "lupus flare" so this could be defeating the antibiotics purpose as well. So she wanted to put her on as little steroids as possible until they could find the root of the problem.
Dr. Tangel scheduled a Bronchoscopy to clear out some of the mucus or congestion in her lungs, as well as pull some samples to test. This was done Thursday, January 27. She was able to provide a sputum sample Thursday and they were able to determine she had a staph infection in her lungs. This is what was in her lungs in October of 2010. They changed her antibiotics to address the staph. By Friday they switched her over to oral antibiotics and took out her IVs.
On Saturday January 29th, she was able to go home. Rebecca took her home and she was well spirited and communicating well. She seemed to get up and down to get water and papers just fine. She mentioned a slight discomfort with her muscles, an all over achy feeling. Her bladder was causing some pain as well, but this seemed to be "normal" pain to her.
She was home by 2:30pm. She mentioned she was going to take a nap and shower and make some phone calls. Rebecca went home. At 5:00pm, Jeff tried calling her multiple times and she did not answer. He arrived home about 30 minutes later and asked Dianne if she was feeling OK. She replied "I think so". He ran to get her prescriptions at Walgreens, then came back and she was still on the couch. He asked her again how she was doing and again, she said again replied that "I think so". She seemed very disoriented so Jeff decided to take her back to the ER.
Dianne had the shivers and didn't make sense, but while in the car she warm up and starting talking and was understandable. She was able to repeat what intersection they were at when they got close to the hospital.
The ER staff checked her right in, and started pulling more blood and running more tests. They hooked her up to IVs of fluids and antibiotics, as well as pain meds. She seemed to get progressively worse while in the ER. She was making sense with most questions, however most of the time she would not answer when asked a question. She was shivering and freezing. She did not have a fever though. This is normally a symptom that she has during this stage.
The ER doctor called Dr. Tangle, who recommended they get her up to the regular hospital rooms and keep her over night. They did another X-ray. Dianne's pain seemed to get progressively worse. She was complaining of bladder pain and also muscle pain. She said every muscle in her body was hurting. She became very agitated and uncomfortable.
The pain meds they were giving her did not seem to help her at all. The nurse tried giving her some Tylenol and she ended up throwing it up right away. Dianne started saying "Oh God" over and over again. A few times she would say "OK, I'm ready" but other than that she wasn't really answering any questions or saying anything else. Her pain seemed to be really bad at this point.
She was moved to room 3008, and the new nurses tried to assess her once she arrived. They were unable to get any answers from her, but paged the doctor that was on the floor. Gina, Dr. Tangel's PA, monitored her over night. She kept her on pain killers and antibiotics. They were waiting until morning until Dr. Tangel was available. She seemed very uncomfortable most of the night.
The ER started an IV of pain killers, and antibiotics right away. They also did some chest X-Rays. She was moved to a regular room in the hospital around 11 that night. They continued testing to find out why she was spiking fevers, having shivers, and disoriented. Dianne remained in a non-coherent state, and sleeping most of Monday.
By Tuesday, Rebecca went to the hospital to be with her and she was up and alert and watching TV. Most of the blood tests all came back negative. The doctors did say that they noticed more blurry type spots on her X-Ray, compared to how things looked in October of 2010.
They kept her on antibiotics and was seen by Dr. Gill, Dr. Cagan, Dr. Manion and Dr. Tran, as well as Dr. Tangel. Dr. Manion changed some of her meds for her bladder, and added in an anti-spazmatic type medication to help with the pain in the bladder. Dr. Tran took her off one of the medications she was on. She was on 2 types of steroid drugs for the lupus. Dr. Tran mentioned that if there was an infection somewhere, the steroids would be helping to suppress her immune system, so as to not have a "lupus flare" so this could be defeating the antibiotics purpose as well. So she wanted to put her on as little steroids as possible until they could find the root of the problem.
Dr. Tangel scheduled a Bronchoscopy to clear out some of the mucus or congestion in her lungs, as well as pull some samples to test. This was done Thursday, January 27. She was able to provide a sputum sample Thursday and they were able to determine she had a staph infection in her lungs. This is what was in her lungs in October of 2010. They changed her antibiotics to address the staph. By Friday they switched her over to oral antibiotics and took out her IVs.
On Saturday January 29th, she was able to go home. Rebecca took her home and she was well spirited and communicating well. She seemed to get up and down to get water and papers just fine. She mentioned a slight discomfort with her muscles, an all over achy feeling. Her bladder was causing some pain as well, but this seemed to be "normal" pain to her.
She was home by 2:30pm. She mentioned she was going to take a nap and shower and make some phone calls. Rebecca went home. At 5:00pm, Jeff tried calling her multiple times and she did not answer. He arrived home about 30 minutes later and asked Dianne if she was feeling OK. She replied "I think so". He ran to get her prescriptions at Walgreens, then came back and she was still on the couch. He asked her again how she was doing and again, she said again replied that "I think so". She seemed very disoriented so Jeff decided to take her back to the ER.
Dianne had the shivers and didn't make sense, but while in the car she warm up and starting talking and was understandable. She was able to repeat what intersection they were at when they got close to the hospital.
The ER staff checked her right in, and started pulling more blood and running more tests. They hooked her up to IVs of fluids and antibiotics, as well as pain meds. She seemed to get progressively worse while in the ER. She was making sense with most questions, however most of the time she would not answer when asked a question. She was shivering and freezing. She did not have a fever though. This is normally a symptom that she has during this stage.
The ER doctor called Dr. Tangle, who recommended they get her up to the regular hospital rooms and keep her over night. They did another X-ray. Dianne's pain seemed to get progressively worse. She was complaining of bladder pain and also muscle pain. She said every muscle in her body was hurting. She became very agitated and uncomfortable.
The pain meds they were giving her did not seem to help her at all. The nurse tried giving her some Tylenol and she ended up throwing it up right away. Dianne started saying "Oh God" over and over again. A few times she would say "OK, I'm ready" but other than that she wasn't really answering any questions or saying anything else. Her pain seemed to be really bad at this point.
She was moved to room 3008, and the new nurses tried to assess her once she arrived. They were unable to get any answers from her, but paged the doctor that was on the floor. Gina, Dr. Tangel's PA, monitored her over night. She kept her on pain killers and antibiotics. They were waiting until morning until Dr. Tangel was available. She seemed very uncomfortable most of the night.
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