Thursday, March 7, 2024

Back to the Emergency Room

2024 has not been a good year for me – at least medically. I started out by going to the ER the first week of January – a visit which resulted in getting a TransMetatarsal Amputation (TMA) of my right foot, and ultimately spending 2+ weeks in the hospital followed by 2 weeks in a rehab facility. I’ve been waiting for a custom toe-filler prosthesis to be made so I can walk normally and be able to drive again.

But then this past Sunday evening (3/4), I was preparing for bed around 9pm when things went south once again. The symptoms were not fun – an urgency to empty my bladder every 15 minutes, the process of doing so being VERY painful, and, the most upsetting to me, the very obvious presence of blood in my urine. After two hours of dealing with it, I got my wife up, brought her up-to-speed, and we made yet another unscheduled trip to the ER. Fortunately, we have excellent healthcare facilities in the county and it’s only a 20-minute drive away.

I checked in (in the process impressing the nurse on duty when I was able to recite my MRN (Medical Record Number) from memory. During the 30-minute wait, I gave a urine sample (more pain!). Then I was escorted back to a room in the ER. Standard procedure – remove all clothing except my socks, don a tie-in-the-back hospital gown, then get hooked up to various monitors (heart (5 stickers on chest), blood pressure cuff, index finger iron monitor). Also get an IV inserted in my arm so they can administer any needed medications quickly. Had two vials of blood drawn for testing, as well as the urine sample sent off for cultures, etc. They also took me down the hall for a CT scan of my abdomen.

Initial diagnosis was possible kidney stone being passed (although that didn’t show up on the CT scan), or one of several other kidney/urinary tract issues. Decision was made that I needed to be admitted, probably for two days, so Donna was able to drive back home (at 3AM!). (All these medical visits have been just as hard on her as on me – thanks, Honey!) Like back in January, they initially placed me in one of their “flex rooms” at the end of the ER corridor until they had a room available in the main hospital. They also hooked up my IV with a general-purpose antibiotic. By morning, I was feeling much better, figured maybe I had passed a kidney stone. They unhooked me from the auto-monitoring system after lunch in prep for moving upstairs. I even got the opportunity to walk with my IV pole to a nearby restroom so I could void properly.

I was placed in room 7BP5B – just four doors down the hall from where I spent those two+ weeks in January. But this time I had a roommate. Unfortunately, he was 90 and dealing with “confusion”, so kept getting mixed up on whether it was day/night, was confined to bed (with loud alarms if he tried to get up), kept calling for the nurse as he couldn’t comprehend the bedside alarm button, kept getting cold (eventually having 4 blankets wrapped around him), soiled his bed every few hours so they had to change to bedding. I tried to talk to him (through the curtain which separated us) but was unsuccessful. So, I just endured his outbreaks as well as the seemingly continual nurses/techs attending him. I suppose that’s why I was there – because I’m so tolerant of others and will pray for them instead of complaining about them. I also told the nurses that I viewed my job as making their life easier so they had a counter-balance to patients like my roommate.

I was still confined to bed because of my IV hookup, but otherwise I was feeling pretty good – relatively “normal” if that’s possible in a hospital. Had various visits from different doctors – urology, nephrology, etc., and a variety of staff – nurses, techs, cleaning staff, hospital reps, therapists, etc. Never a dull moment in a hospital!

My bloodwork, which they took a couple of times, was showing definite improvement. My urine color and flow was also normal. I was eating normally, etc. Only issue was that I was still waiting on the urine culture – they confirmed that it had been sent to the lab at 11am on Monday and indicated that it usually took 24 hours or so. But I was beginning to get “antsy” to go home as there was nothing negative going on.

Finally, in early afternoon on Tuesday they were preparing to send another dose of antibiotic through my IV port and it began leaking badly. The nurse was perceptive and said that she’d check if they could switch to an oral antibiotic instead of having to remove my IV and find another place to stick a new one in. She went “to bat” for me and contacted the hospital doctor who then called me and said I could go home with the oral antibiotic and a prescription for taking them 4x/day for several days.

At that point I already had two follow-up visits with the urology specialists (one for an MRI of my bladder, and one for the insertion of a camera into my bladder/kidney to confirm the issues behind the bleeding). I also had scheduled additional bloodwork to confirm that the improving trend on a couple of indicators was complete. So I called my wife to come pick me up and waited for the first oral antibiotic dose to be given.

I was glad to get home – and to have the opportunity to catch up on missing sleep as my sleep the prior night didn’t get started until after midnight because of the fuss my roommate was taking and (per typical hospital protocol), ended at 3AM when the shift change meant a visit to take my vitals.

But the story does not end there. Early this morning I received a call from the hospital doctor letting me know that the urine culture had finally come back late at night and the diagnosis was MRSA. But that meant that the antibiotic they had prescribed would not work and they had ordered a new one. I checked with the pharmacy and they did not have any in stock, nor was it covered by my insurance. But if I was willing to pay for it (the grand sum of $8 for a week’s supply), they would order some from another nearby pharmacy and have it ready later that day.

There has also been a good side to this just like there was for my amputation. Because of the way that the various medications I’ve been taking impact various body organs, they have removed two more of my medications that I had been taking daily. So instead of 7 pills each morning and 3 each evening (2 of which are repeats), I’m now down to just 3 each morning and 2 each evening (just 1 repeat). I’m also going to check with my PCP when I see her next week to see if I really need the weekly shot of Trulicity anymore. I’ve not had any for a month as it’s unavailable and on back order at the pharmacy. It’s also the most expensive one I’m still taking so I’ll be glad for that savings as well. My glucose numbers are doing fine without it, so why do I need it?

Besides being able to reduce the number of meds I take each day, my glucose levels are also staying down. And, perhaps, related, I’m keeping the weight I’ve taken off from coming back. I’ve had a number of people at church tell me that I’m looking pretty healthy, so those remarks are very encouraging.

As a friend told me, “You’ve used up all your sick days for the year.” I agree. And I’ve already got 7 visits scheduled for the next few months (follow-up with hospital doctor, bloodwork, semi-annual visit with PCP, toe-filler prosthesis, bladder MRI, urologist, and follow-up with foot surgeon). That’s already too many! I’m ready to stay healthy for a while!