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ProfessorTomoe

Changing Medications (Level of Trust Required)

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I was mistaken about the Bumex delivery. I am now back on IV Bumex, but on an injected Bumex dose and not a continuous drip. I assume the difference between oral Bumex and the injected IV Bumex dose is higher bioavailability for the IV. If any of you can figure out the difference, let me know.

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WTF.

I found myself dealing with the sudden onset of what appears to be an upper respiratory infection. My ears, sinuses, and throat have suddenly become sore. Of course, with it being in the middle of the night, I can't get a doctor to prescribe anything just yet. The only thing I had to combat it with is a bowl of hot & spicy ramen. That opened up my nasal passages a bit, but it didn't do much for the rest of me. All I can do is wait for the doctor to show up 

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Yeah, he has, and he didn't prescribe anything. Had another bout tonight. Treated with another bowl of vending machine hot & spicy ramen. Will push harder for some nasal spray or something else when I see him today.

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Finally got some Flonase prn for the sinuses. Seems to be helping.

I've been on IV Bumex for several days now, and it's making a notable difference. My swelling has gone down visibly. The redness of the cellulitis is still there, though. No idea when that is going to start receding.

I'm having problems with my potassium levels now. Latest reading was a 2.7 (should be 3.5 minimum). They just finished infusing a boatload of IV potassium chloride into me. That's going to be a daily ritual for a while now. Gotta be careful with the stuff - get it too fast or get too much of it, and I'm dead. Urk!

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Update 8/4/22:

The doctors are telling me that I'm through the worst of things. The IV Bumex and IV potassium have helped me drop 21 pounds of edema/water weight gain. Now they're saying that the residual redness is not due to infection. Instead, it's due to lymphedema, a swelling caused by a blockage of the lymph gland pathways. This is in addition to venous insufficiency and venous stasis, the combination of the three causing dermatitis of the skin from the edema. Go figure. Anyway, as a result, my legs look like crap, but they're in the best shape they've been in since I was admitted. So, naturally, now is the time to discharge me from the LTAC hospital and admit me to the Mesquite Rehab Institute, which is located on the first floor of the same building as the LTAC.

Sure. Right. Wait, what??? 

Seriously, they want to discharge me to the Rehab Institute (they've already discontinued the antibiotics and are about to remove the cursed PICC line) and keep me there for approximately two weeks. If I relapse again, they can immediately readmit me to the LTAC side of things. If the Rehab accepts me as a patient - not guaranteed - I'll most likely be transferred down on Friday (8/5).

How will it turn out this time? Place your bets, folks.

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I was accepted to the Rehab hospital. I've been doing lots of physical and occupational therapy in the days since my admission last Friday. Was doing good until today. Had a very rough night last night - food poisoning or stomach bug, call it what you will, I was nauseated as hell for several hours and wound up tossing my dinner. Only caught a few hours sleep, and woke up in no shape to do anything, much less work out. Add to it the fact that I'd tweaked my left knee the day before, and I was one sore puppy.

Therapy went predictably well. In other words, badly. I pushed myself as far as I could, but I just couldn't complete a full course of a normal workout. The therapists had mercy upon me and walked me to my room. I've slept most of the rest of the day until being woke up by the nurse to take meds, at which point I got up and typed this. Now you're up to date.

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Update 8/11/22 Saturday:

Things have taken a backward step, as it were. I did a good deal of walking Thursday as a catch up for Wednesday's lack of a workout due to monstrous nausea overnight the previous night. When the time came to take a shower, we noticed two things: large blood blisters on the sides of both big toes, and increased edema on the left leg. My nurse called the Wound Care nurse. By the time she got there, the blood blister on the left toe had broken open. She put an alginate bandage on it and a Curlex wrap around it, then wrapped the left foot and leg in an ACE bandage. She then wrapped the right leg and foot in a double layer wrap of ACE bandages to protect the blister and compress the swollen leg.

The ACE bandages are going to have to stay on all weekend, until the Wound Care nurse gets back on Monday. I'm supposed to reduce the amount of walking I do and keep the leg elevated, which means these updates are going to come few and far between. I'm sincerely hoping that my next stop isn't a stop isn't a stop upstairs in the LTAC to get hooked  back up to another Bumex 24/7 IV diuretic drip again. We'll see what happens.

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Update 8/17/22 Wednesday

My health situation has...well, changed.

First off, I'm home. I was discharged from the Mesquite Rehab Institute on Monday 8/15. I'd met all of my Physical/Occupational Therapy goals and had reached what they apparently thought was a state of medical well-being to allow me to go home. However, wouldn't you know it, as soon as I got home, I started noticing increased swelling in my legs again.

I started making doctor's appointments on Tuesday. The first one I saw was my primary care doctor, which happened this afternoon. He's running blood tests and changing prescription dosages. Up next on Friday will be a doctor who's supposed to hook me up with treatments for lymphedema somehow (don't ask me how). Tomorrow I need to call my pain management doctor and let him know I'm out of the hospital.

My main goal at the moment is to keep myself from winding up back in the hospital yet again for a third stint. Lord knows I don't need that.

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7 hours ago, ProfessorTomoe said:

Update 8/17/22 Wednesday

First off, I'm home.

My main goal at the moment is to keep myself from winding up back in the hospital yet again for a third stint. Lord knows I don't need that.

Good luck. Thanks for the update.

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Update 8/20/22

I saw the doctor at the wound care clinic yesterday about my lymphedema in my legs. Turns out my problem is only 10% lymphedema, according to him - the rest is plain edema, mixed with the venous problems I reported earlier. As a result, he's not referring me to the lymphedema clinic, since applying one of their treatments to my legs would probably "cause my heart to burst." What he did instead was apply wraps to my legs (a double-layer dry wrap to my right leg since it was weeping fluid, and a wet-wrap "unaboot" to my left leg) for compression. He's ordered Home Health to come our 3x a week to change my dressings on M-W-F, and he's made an appointment for me to come back and see him next Friday.

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Update 8/24/22 (yesterday):

Got results from blood tests back from my primary care doctor. He says, "your hemoglobin and hematocrit are low, which mean's [sic] you're pretty anemic." I'm being referred to a hematologist for iron IV infusions. I've actually been anemic for months now, and have been trying to get him to pay attention to my results all this time. He's just now jumping in on it.

Could explain why I'm sleeping so much.

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I wish I could blame my sleeping to much on anemia, but I suspect it's just being bored in the afternoon, mixed with some depressive disorder.  Going to mention it to my shrink next time I talk to her. 

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I got up at 7:00 this morning and took my morning meds.   I don't remember if I took my headache drugs then or not.  I'm assuming I did so I've got about an hour and a half before I can take another dose.  I'm hoping that this headache doesn't get any worse before then.

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Update 8/25/22 (today):

Just now got the official word from the orthopedic doctor on my rotator cuff. He's diagnosed it as a "complete rotator cuff tear or rupture." FYI.

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