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ProfessorTomoe

Changing Medications (Level of Trust Required)

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49 minutes ago, mlooney said:

Are they still keeping you on limited water intake?

Yes, and it's not working. I gained another two pounds tonight on top of the extra pound I gained yesterday. The doctor definitely needs to increase the dosage of the Bumex to make the water rationing worth its while.

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Well that sucks. I hope they find a med that works for making you "piss away" your weigh gains.  One of the few times where you can say "Your just pissing away X" where it's a good thing.

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I had an ultrasound run of my left arm yesterday to see if the DVT I developed last August was still in place. Just got the results - it's not. No more DVT. So, I guess that means that the Infectious Disease doctor can have a PICC line implanted in my left arm. 

I still have a bit of trepidation about the procedure, since there are still lumps left over from the DVT. I wonder what's causing them.

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1 hour ago, mlooney said:

Is having a PICC line installed a good thing or a bad thing as far as comfort goes?

You know, I'm not 100% sure. It's supposed to be safer in the long run. I was the exception. 

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I've just had a bit of a confab with the Infectious Diseases doctor and a new challenger, a kidney doctor. The kidney doctor was brought in to address specifically the problem of my leg swelling, by way of the diuretics not working any more. He's going to put me on a continuous diuretic (Bumex) drip to try and get the flow flowing again. In addition, and I hate this so much, he's turning down my fluid restriction from 2 liters per 24 hours to 1.5 liters per 24 hours. Rotten bastard is trying to dehydrate me.

The Infectious Diseases doctor said she is ordering a PICC line for me, hopefully to be done sometime today. I asked her about the lumps in my left arm. She dismissed them as scar tissue. (?) Whatever the case may be, she said it is now safe to put in the PICC line. I'm guessing that it has to go in before the Bumex drip can start.

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5 hours ago, ProfessorTomoe said:

I've just had a bit of a confab with the Infectious Diseases doctor and a new challenger, a kidney doctor. The kidney doctor was brought in to address specifically the problem of my leg swelling, by way of the diuretics not working any more. He's going to put me on a continuous diuretic (Bumex) drip to try and get the flow flowing again. In addition, and I hate this so much, he's turning down my fluid restriction from 2 liters per 24 hours to 1.5 liters per 24 hours. Rotten bastard is trying to dehydrate me.

The Infectious Diseases doctor said she is ordering a PICC line for me, hopefully to be done sometime today. I asked her about the lumps in my left arm. She dismissed them as scar tissue. (?) Whatever the case may be, she said it is now safe to put in the PICC line. I'm guessing that it has to go in before the Bumex drip can start.

Good fortune, man. Prayers, if you don't mind.

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15 hours ago, Darth Fluffy said:

Prayers, if you don't mind.

I'll take whatever's on offer. Thank you.

The PICC line went in around 11pm Thursday night, BTW. It hurts pretty bad, intermittently. Bursts of at least an 8 in intensity. At least the damned thing works. It has two IV tails for two simultaneous infusions, and they've used it to infuse antibiotics and the Bumex drip at the same time. They've also been able to remove the IV line from my right arm, which I appreciate. One less needle shoved into me.

I just spoke with the doctor that's been coordinating this ballet from hell. I am definitely going to be here through the weekend. On Monday, we'll discuss what we're going to do next.

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Hope that the Bumex works and that your swelling goes down.  And that you get some pair relief.

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New hospital developments as of 5/22/2022:

All of a sudden, my right foot has blossomed into a bright, red, scary color. It's a bit swollen and it hurts when I put too much pressure on it. My doctors don't know what the deal is, so I've asked for my podiatrist to be called in. He has privileges at this hospital. Maybe he can figure something out.

I've been told that I'm going to be on IV antibiotics (now three of them) for at least two weeks. Not all of that time is going to be spent in this hospital, obviously. I've learned that, once I've stabilized enough, I'm going to Kindred Dallas Central, a Long Term Acute Care facility (LTAC). I was there last year when my big toe operation went south on me. I requested them, and my wife agreed. Something tells me that move won't be made any time soon, what with my foot now in play.

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My podiatrist showed up today. He suspected a possible abscess was growing inside my foot. As a result, I had a "stat" MRI run after our meeting.

I haven't heard back from the doctor yet, but I heard from my nurse (who's apparently seen the report). She said there's no abscess, just soft tissue swelling. Good news, but swelling due to what? I can't wait to hear from the doctors tomorrow.

And yes, that was a plural case doctors in that last sentence. I have the following doctors working on my case:

  1. Hospitalist (main doctor)
  2. Infectious Diseases Specialist
  3. Kidney Specialist
  4. Podiatrist

Occasionally, they'll bump into each other, like they did today when the Infectious Diseases specialist and my Podiatrist were in the room together. They confabbed and came up with the MRI idea.

I'm documenting the three IV antibiotics I'm on while I've got them fresh in my mind:

  1. Clindamycin
  2. Cefepime
  3. Cubicin

I can never remember #1 for some weird reason. Now I've got it committed to bits and bytes.

One last thing to report - I'm developing a rash across my stomach, stretching all the way from the left side to the right. It's made up of little, tiny, red dots, and of course, it itches. I got my nurse to report it to the Hospitalist. She's put me back on one of my prescribed PRN medicines, Atarax (Hydroxyzine). Let's see how it responds.

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No abscess is good.  Not knowing what the swelling is due to is bad.  Hope you have some good luck.

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I am transferred to Kindred Hospital Dallas Central, the Long Term Acute Care (LTAC) hospital mentioned previously. They've pretty much got my medicines transferred without screwups, including my Dilaudid. I just got my UberLaptop set up last night and am starting to use it this morning.

Last night was weird. Slept with lots of fits and starts. Had to get up a couple of times to use the urinal (no more toilet - I'm hooked up to too many tubes and wires over here). I've woke up with jittery arms and hands. No idea why. Will report if I get any info.

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13 hours ago, mlooney said:

Are you still restricted on your fluid intake?

It doesn't appear so.

They've started me on a slightly different antibiotic trio, with one of them being an oral antibiotic, and they're giving me both physical and occupational therapy. Neither therapy has helped with my arm pain, sad to say. I'm lying down in bed more, which might be helping my legs, but which might be hurting my arm. Urgh. Currently suffering level 8 pain in the arm, mainly in the rotator cuff of my shoulder.

 

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8 hours ago, ProfessorTomoe said:

Neither therapy has helped with my arm pain, sad to say.

It took about 2 weeks, more or less, of physical therapy to have an effect on my rotator cuff pain.  Hang in there.

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Migraines suck and not being able to take aspirin, acetaminophen and caffeine means I'm only knocking it down a couple of points, from a 8 or 9 to a 7 or 6. If I keep getting them I'm going to the clinic and get a prescription for something other than NSAID for migraines. Midrin, which I used to take, is off the market which pisses me off.

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On 5/29/2022 at 0:08 PM, mlooney said:

Migraines suck and not being able to take aspirin, acetaminophen and caffeine means I'm only knocking it down a couple of points, from a 8 or 9 to a 7 or 6. If I keep getting them I'm going to the clinic and get a prescription for something other than NSAID for migraines. Midrin, which I used to take, is off the market which pisses me off.

Some of these look promising: https://duckduckgo.com/?t=ffab&q=midrin&atb=v320-1&ia=web as in, something like is should still be available.

Midrin contains (contained) aceaminophen, is that an issue?

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3 hours ago, Darth Fluffy said:

Midrin contains (contained) aceaminophen, is that an issue?

No, acetaminophen is the only over the counter pain reliever I can take.  The problem is that Midrin has been pulled from the market and can only be gotten via a compounding pharmacy, if that.  The issue was that Midrin, as a combined drug, was never FDA approved.  All the parts were, but not combined together.   Then they got cranky about isometheptene mucate and more less banned it's use.

https://www.fda.gov/drugs/unapproved-drugs/fda-notification-regarding-isometheptene-containing-drug-products

 

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Just got off of a Zoom meeting with my shrink.  Changing meds a bit.  Remereron goes down to 4.5mg for the rest of the week, then as needed if I'm getting night terrors.  This change is to see what we can do about my messed up sleep schedule.   Wellbutrin goes up to 300mg to see if that can deal with my weepy spells.  That should also help with my ADD.

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Hospital Update 6/15/2022:

I have been offline for way too long, trying to recuperate from this cellulitis infection and edema. During this time, the infection started to run away on me, giving me a fever of 99.4 with a low blood pressure of 90/50. Granted, this isn't much of a fever, but know that I extremely rarely run any kind of fever, and that my standard temperature is a low 97.4. In other words, 99.4 is moderately high for me.

Anyway, everything started peaking this past Friday. My old antibiotic trio wasn't handling it. I asked the Infections Diseases person to switch one of them *back* to vancomycin, which is what I was on in the beginning and was working before they switched me away from it (my "vanc trough" value approached toxic levels). She did the switch. Sometime during the night on Saturday, my fever broke, and my blood pressure went back up to normal. I'm thanking the vancomycin.

It's Wednesday the 15th, and I'm just now recovering sufficiently to be lucid enough to type up this update. The double vision and jitters I've suffered are temporarily on hold, and I'm doing my best not to pass out in the middle of typing. I'm still fighting the pain in my right arm, counting the minutes until my next Dilaudid injection comes and provides some relief. I'm only doing a test post here, since it's just now coming back online - if all goes well, I'll crosspost to FB and elsewhere.

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Since my last post, I had another close call with a 99.4 fever. Found out it was because they had to take me off of vancomycin for a couple of days due to bloodstream levels that were approaching the toxic zone. I'm back in the safe zone now, so I'm back on vancomycin. However, my latest fever broke before I went back on vancomycin - go figure.

I'm riding the edema rollercoaster with my legs. One day, they look better, then the next, they look like crap again. As a result, I still don't have a determination on a release date from this hospital. Will let you know when I know.

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Ladies and Gentlemen,

<drum roll>
I am going home.
</drum roll>

The redness in my legs has retreated to a level where IV antibiotics are no longer necessary. My edema has gone down a bit and is now being treated by application of ACE bandages on both legs. My PICC line was replaced with a midline, which is about to be removed altogether either today or tomorrow. I am being weaned off of the Dilaudid in preparation for leaving.

My departure date is scheduled for sometime Friday, according to the doctor in charge of my case.

I guess I am ready to leave this hospital, physically. I am *damned* sure ready to leave, mentally. I've been in this hospital just a few days shy of five weeks, cooped up in a tiny room, tethered to an IV pump most of the time. I can't wait to leave the confines of this cell. I don't know how long it'll take for me to adjust to life back at home, but adjust I will.

Please wish me luck. I don't want to wind up back in here.

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