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» Friday, June 29, 2018Adventures in Medical Land
Warning! Major medical neep!
James had his urodynamics test on Monday. This is basically a test to see how much pressure his bladder builds up before he feels various urges to void. He said he now has a better idea of women's visits to gynecology; they had him up in stirrups. Needless to say, this was not a pleasant test, and they discovered that now, without the Foley catheter, he can no longer void at all. The doctor told him there would definitely be some sort of bleeding as the test had irritated the areas tested, so we expected blood in his urine. Without being too graphic, there was quite a bit. What really frightened me is there was also blood coming from the entry point of the catheter. It was not flowing, but it was dribbling, and I got quite upset and did not sleep most of the night. Of course this was contagious and James was also restless most of the night. Nevertheless, he got up and teleworked until he could call the doctor at 8:30. The doctor called back about an hour later and assured him that unless he was developing signs of an infection (fever, swelling, etc.) or the blood was gushing out, this was normal. (The blood loss was more like a menstrual flow, which is normally only a couple of tablespoons.) James went back to work feeling relieved and I crawled onto the futon and slept a blessed three hours.
Later Tuesday night we thought we had a problem: when you have bleeding in that area you have clots. Clots block catheters. James had no output from noon onward. So when he finished work he cooked dinner, because if we had to go up to Urgent Care to get it flushed out it would take hours and we wouldn't eat until late. While James was moving around in the kitchen evidently the blockage broke loose, so we didn't have to go. But around bedtime it looked like it was happening again. Since we were seeing the urologist early Wednesday morning, we just showered and went to bed. (The only good news was the dribbling blood was gone.)
Needless to say James was under a lot of pressure on Wednesday morning, and was so full he was having overflow around the catheter. This "runoff" caused a little relief, but not all. And of course we had to drive all the way out to Kaiser Glenlake in rush hour traffic. (Didn't I retire not to have to do this crap anymore??? Even riding in the truck instead of driving myself I was stressed out.)
The moment James' name was called we told the nurse what was going on. She reported to the doctor, who told her to take care of it before he came to talk with us. She was really sweet. I asked if I could watch because we have an irrigation kit here at home and I wondered if I could do this instead of always popping up to Urgent Care. So I watched carefully. She did something different than the nurse at the emergency room at Wellstar did back in April; instead of irrigating first, she put the empty syringe—with the plunger all the way in—at the end of the now open catheter tube, then she very gently pulled back on it. Pop! out came the clot and the waterworks flowed. After a while, James smiled. 😌 I bet! Apparently, I even came in handy; the nurse needed three hands to do the entire process and I provided a couple.
Dr. Starr came to talk to us after that. He said that last week's MRI, because the catheter was not properly inserted when it was taken, definitely showed the proof that James' bladder is backwashing into his kidneys. Kidneys don't work backward; this is probably what has caused most of his kidney problems. The first step is called a TURP. You can look that up for yourself. General anesthesia, overnight stay, and it will hurt for a while, but what's best for his kidneys. So we are going for it if his cardiologist and nephrologist and GP sign off on it. As always the caveat: it may not work, or may not work forever. It's presently scheduled for August 27.
So home we went. James went back to drinking his water and teas, but he was way behind on it, and when his output didn't meet the usual numbers by evening, we wondered if it was just that. So we went to bed, but I woke up at 4:30 Thursday morning to find James in the bathroom and nothing in the night bag. Well, boys and girls, time to see if I was watching carefully yesterday. I scrubbed my hands, decanted the irrigation kit, got the syringe in proper position, then we popped off the container bag and I put the syringe in place at the output end and very gently pulled back the plunger.
Pop! out came the clot and then came the deluge.
Wow. It did work.
And then I cleaned up and we both went back to bed. In the real morning, everything was clear and flowing, if you get my drift.
Yes, I truly didn't realize that once I retired I'd get a crash course in nursing.