In 2016, when James had his first heart attack, his kidneys were also in bad shape, not just from the heart attack, but from years of metformin and glypizide for his diabetes and Motrin for his back pain. Couldn't do much about the Motrin, but wish we'd known about the diabetes drugs being harmful.
His kidneys also took a hit after the second heart attack. Both times when he came home from the hospital, he just made sure to drink an adequate amount of liquids and both times we got his creatitine count down from 4's (the highest is 5) to low 2's.
2018 hit us hard: in March he had a cardiac effusion and in April a pleural effusion. After the cardiac effusion they inserted a permacath in his chest and put him on four hours of dialysis three days a week. He came home from the first dialysis session in a complete meltdown after he found a poster at the dialysis clinic which called the permacath "the white tubes of death" (since they're an infection vector). Once you are on dialysis permanently you have surgery on your left arm and have a fistula inserted to do the dialysis through so you can do stuff like take a shower (without the help of Glad Press'n'Seal) and go swimming.
But a miracle occurred. When he had the pleural effusion they discovered that the cause of his kidney problems turned out to be his prostate gland. It was enlarged and blocking his urethra, so that even though he was constantly peeing, he wasn't peeing enough. Urine was backing up from his bladder into his kidneys. Once they put a Foley catheter into him, the urine poured out. His weight went down, his creatitine went down to 2.1, his GFR went up (this is good). In October 2018 he had a TURP, which basically "Roto Routers" the prostate out so it doesn't block anything. And after a couple week's recovery, he could pee again. His creatitine would never be normal (under 1.3) again, but the kidneys were holding their own.
And he's been fine, and was fine until last August. Three days after having a series of shots that were supposed to alleviate his back pain, his urine output was halved. No one could put a finger on the shots being the cause, but one of the side effects possible were severe urination problems. His just wasn't severe enough. So James ended up in the hospital three months in a row. He had a cytoscopy and, although the prostate had grown back some, it had not grown back enough to block his urethra. The urologist says it's some sort of bladder sensory failure due to the diabetes, that he wasn't getting signals to pee enough and was retaining too much urine. That's when he put James on intermittent catherization, and we now have that down pat, although UTIs do spring up with annoying regularity (if the stupid urologist would let us use disposable catheters, it might be avoided, but he won't). After the third hospital stay, James' creatitine numbers were up to 4.6. He's presently down to 3.8.
All his appointments with Dr. Kongara (the nephrologist) since October have been benign. He navigated us through Jame being too dehydrated and other problems. But Thursday he dropped a bomb on us. Based on the creatitine not being very much better and his GFR being so low, he thinks James needs to see the vascular surgeon pretty soon and get the fistula inserted since it seems now that dialysis appears inevitable in the future and he doesn't want James to have to go through the thing with the permacath again.
I was all for the fistula surgery the first time it was offered since it appeared to be inevitable and seemed to save James from something worse. It would be less fearful for him, worrying about that permacath. But then we beat off the Dialysis Monster and breathed a sigh of relief. And now five years later it's returned, like an 800-pound grizzly bear showing its teeth and poised to attack, and I am completely, emotionally undone. We beat it off once and I don't see why we can't do it again, if we could only try properly.
I can't seem to make him better no matter how I try and it fucking hurts.
We have an appointment with the vascular surgeon on the 31st.
In other "wonderful" news it appeared James had some sort of food poisoning or something on Wednesday night and was up till 4:30 a.m. on the toilet. It finally loosed its grip and we slept until noon. Good thing it wasn't the week we get the grass cut.
Not to mention a friend of ours ended up in the hospital for a few days after a small stroke. This is the second one she has had and such news is very disheartening since she's already battling cancer.
Plus we had a stark reminder about getting older and "things happening." James was cleaning out the clogged hall bath toilet on Monday and sat down on the edge of the tub to give himself a breather. The towel under him slipped and he ended up sitting crossways in the tub, totally unhurt, but totally stuck, with his knees over the edge of the tub and his feet about a foot off the floor. Of course there was no purchase in the tub to him to push himself off from, and he couldn't turn himself sideways, and at 5'2" I'm about as useful pulling large things up as a canary. So, yes, the fire department made a visit to our home that afternoon; a fireman grabbed each arm and merely pulled him up until he could put his feet on the floor and that was that. I made lots of jokes about Emergency, but it really was a jolt of what could happen should one of us be alone.
The one bright spot of the week was Apria finally coming to pick up the oxygen bottles we've had cooling their heels in the garage since James got taken off portable oxygen in December. Thank goodness they aren't in the way anymore.
And we took a box of junk to Goodwill, too.
Labels: events, friends, health, sickness
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