Thursday, August 12, 2010

Are you kidding me?

In an eternal effort to eradicate every possible dull moment from life, Caren spiked a fever on Tuesday evening. In all honesty, her health has slowly declined since seeing the surgeon last Friday. At first we thought is was just the harrowing trip to Mt. Sinai that had wiped her out.

After nearly 8 hours of traveling for the follow-up appointment, she spent almost 48 hours recovering. Saturday and most of Sunday last weekend was a complete wash. In retrospect, we now know that it was an infection getting a handhold and carefully deciding where to set up shop. She continued to feel run down through Tuesday when it really hit the fan.

There I am proctoring my summer class' final exam and up pops an innocent IM from Caren: "I have a 101.5 fever." Here's where my initial dismay over the fact that we have signs of an infection turned to near rage as I find out that the symptoms of her urinary tract infection never actually went away! Oh yeah, I can see you sitting out there, rocking back in your chair saying, "what does he mean, the symptoms never went away?" Well, let me tell you that I was as surprised to get that tid bit of information as you are! Caren, staying true to the stereotype that medical professionals make TERRIBLE patients, decided that the whole, lack of urinary output, pelvic discomfort and painful urinations, WASN'T THAT BIG A DEAL!

Ok, I'm past it, just needed to get that out of my system...thank you all for receiving my rant, I'm better now. Oh, wait a minute, I knew there was something else that fired me up about the whole situation...I had to threaten to call the surgeon my self before she agreed that informing him of her symptoms would not be considered annoying. She didn't want to pester him! Somehow, I thought that, maybe, just possibly, he might be interested to hear that a post-surgical patient, who happens to have a single kidney, was experiencing signs and symptoms of a urinary tract infection, including a fever higher than 101! On a side note, I've recently learned that 101 is some magic number in medicine. A fever less than 101 to a doctor is kind of like a solid "C" student to a teacher, their there, but certainly nothing to write home about, but I digress.

The bottom line is that I was right! (There I said it) Caren called the surgeon and within the hour was on Levaquin. We hoped that that would be the end of it, but oh how wrong we were. Yesterday afternoon, after 2 doses Levaquin and absolutely no improvement, I convinced her to email him and see if she should see her primary care physician up here. He called a short time later and gave the OK.

Fortunately, we were able to get a 9:30 appointment this morning; fortunately because of what was potentially discovered and for how friggin long it took! At 9:30ish, Caren was peeing in a cup at the lab, figuring that a UTI would be proven, beyond a shadow of a doubt, the Levaquin would do it's job, and soon we would be back on the road to recovery. After leaving her deposit in the lab, we reported to the third floor of what can only be described as a colossal medical associates building. I should remind everyone that Caren hasn't seen her primary care doctor in a while, so we knew we were going to have to catch him up on the latest developments. If only I could have gotten a picture of his face! It went something like this:

"So I had a colectomy last month and instead of spending 5 days in the hospital, I was there for 11. And while I was there, I had a massive urinary tract infection, that they put me on IV Zosyn for. Oh yeah, did I mention that they found a clot in my hepatic portal vein?"

I was watching his face at this point in the interview and his eyebrow nearly jumped off his face!

"And when they did the initial surgery they saw a polyp on my gallbladder and they took that out too." I think he actually shuddered, as in he had a momentary loss of voluntary muscle control. But, being a true professional, he recovered well and, without missing a beat, turned to me and asked, "How have you been?"

He was good, he took it all in stride. It helped that I've known him since I was a teenager and he is well aware of our medical backgrounds. He reminded us that coming into the situation at this stage means that he has to rule out EVERYTHING! And so the testing began. We went back to the lab for urine cultures, blood cultures, a CBC, I think they even stuck a swab in her belly button to be safe. I was afraid they were going to attempt to swab me, but my "Don't Fuck with Me" tattoo must have been visible through my flowing locks of golden hair (hey, a guy can dream right?), so they left me alone.

In addition to having every surface of her being, both inside and out, combed for a microbial presence, he wanted to have a CAT scan done to rule out anything in the abdomen. So, after spending two hours drinking two humongous bottles of "Creamy Vanilla Smoothie" barium, that, incase you were wondering, tasted NOTHING like cream, vanilla or smoothie, Caren got her scan.

About 45 minutes later, we're in an exam room 2 floors up and I hear him say something about abcess and my head started spinning. I remember thinking, can this get any worse? The Radiologist saw what he thought could be an abcess in her mid-pelvic region; the exact area where she continues to have pressure and pain. I wanted to thank him personally for being as vague as was humanly possible, but it was probably safer for everyone that I steered clear. Our primary care physician told us that we needed to see a surgeon, but we could choose whether to see a local doctor or go back to our original surgeon. We were actually able to get her surgeon on the phone from the office and let him know about the findings.

Clearly he wasn't happy to hear the words "abcess" and "mid-pelvic area" spoken together regarding one of his recent surgical patients. He did mention that Radiologists often have difficulties reading scans of J-Pouch patients, and it wouldn't surprise him at all if the "abcess" turned out to be part of Caren's newly re-arranged internal parts. He was cautiously optimistic when he instructed us to overnight the CD-ROM with the CAT Scan results to him. He wanted to see the scan personally before he jumped to any conclusions. So we wait. Caren was researching what they'll do if it is an abcess, but had to stop when she read about drainage tubes in places not meant for drainage tubes.

He'll have the disc by noon tomorrow and we should know more by later in the day. When we know more, you'll now more. Sorry for the lengthy post, there was a lot to report and the kids are at my parents house tonight. When given a topic and the time, I write. I'll update everyone tomorrow.

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