Guess Who Is In-Patient AGAIN!

[Charlie B53]

STILL NPO. Grrrrrrrrrrr   Saw Dr just before I went outside, talked about what meds have not been written.  Gave him copies of Clinic Log that lists ALL my meds, and a copy of the VA Med printout listing what they provide.  Also mention it's noon, I am still listed NPO until he gives the OK.

Dr assured me he would take care of everything.  Yeah, right.  I am beginning to think he went out to play a round of golf as nothing has been done.

Oh, and I've also been told to stay in my room.  Renal is sending someone to get me.  They want to do hemo.  Already?  The Neph and I talked about that this morning.  PD last night with a Last Fill.  PermaCath in this morning.  Do I do PD again tonight without a last fill or skip it so to do Hemo tomorrow and have something to take off.

Hemo today doesn't make any sense, there is next to no water to take off.  I should pretty much already be at my 'dry weight'.  Taking off anything could cause problems.

What do I know, nothing.  I am just the Patient.

[kickingandscreaming]

Some studies suggest that drinking coffee, caffeinated and decaffeinated, may actually reduce your risk of developing diabetes.

If you already have diabetes, however, the impact of caffeine on insulin action may be associated with higher or lower blood sugar levels. For some people with diabetes, about 200 milligrams of caffeine — or the equivalent of one to two 8-ounce cups (237 to 474 milliliters) of plain, brewed coffee — may cause this effect.

Caffeine affects every person differently. If you have diabetes or you're struggling to control your blood sugar levels, limiting the amount of caffeine in your diet may provide a benefit.

http://www.mayoclinic.org/diseases-conditions/type-2-diabetes/expert-answers/blood-sugar/faq-20057941

[cassandra]

I'm sorry for all the hassle you're now in Charlie. Do you know your blood results? Your peritoneum might be working less? It's not only about fluids.
Good luck tomorrow.

Lots of love, luck and strength, Cas

[Charlie B53]

Pottasium 3.2  I take 60 EU P Supplement daily or it begins to fall off.  What cracks me up is they have me on a LOW Pot Diet. Have to laugh.

Pho 3.3  Evidently that little 4 gfr is working it's collective butt off. As I EAT Meat.

These are the basic #'s that I have followed.  They tell me everything is almost perfectly mid-range.

I am VERY fortunate.  Until today.  I think Dr had a T time at the golf course and had to take of before ordering me FOOD.  I finally got a tray at 4 p.m.  Hamburger and green beans, for my breakfast.  No Coffee.




EDIT - CharlieB53 - Spelling - 12/9/16

[Charlie B53]

Vascular Dr walked in as I was writing the last post so I hit Post without finishing.  Vas Dr was here to get the Release for morning.

Someone in Dialysis may not be happy with me.  I don't know which Dr it is as I haven't met her yet.  Somehow she decided I needed to do hemo immediately now that I have access.  I kept asking 'WHY?' as I am STILL doing PD.  I am still filled with my long dwell of Ico.  Attempting/taking off ANY water would cause either to re-absorb water AND toxins, which could possible skew my labs.  Making everyone think I need MORE dialysis.  Not yet.

I will put her on the spot tomorrow and ask her what she has down for my 'dry weight'.  Then we will talk.  Last time I weighed dry I was about 310 and NOT on Dialysis yet.   All weights she will be seeing and going from listed in my chart are WITH 2 liters Ico in me.  I suspect that will make a little lower # we should maybe start closer to.  Like what I will be if I weigh tonight immediately after draining.

I will find out.   Meanwhile, I hurry up and wait for morning to get rid of the source of this infection.

Y'all Take Care,

Charlie B53
p.s.   I went down to the Waiting Room, they have a Forgers Coffee machine for visitors.   I WAS visiting the visiting room, Right?   Got two!

[cassandra]

Charlie B53
p.s.   I went down to the Waiting Room, they have a Forgers Coffe machine for visitors.   I WAS visiting the visiting room, Right?   Got two!

         O man, I think you're Okay with a potassium like that.

Love, luck, strength and patience, Cas

[Charlie B53]

5 a.m. Fri.  OR Called.  Transport is coming.

No delay today.  Dr Nichol, head of Vascular is leading this parade.   I should be fine.

[kickingandscreaming]

Fingers and toes crossed

[Charlie B53]

Done.  Back to my room, out on the porch by 10.  Just back to my room and find out they are already calling for me to be moved to Dialysis.    What?   No breakfast again?   Nurse told me they lifted the NPO, to get on the phone to kitchen and order breakfast and have it delivered to Dialysis.  OH?    I did.   I like this place.  Sometimes.

Will be moving back to the VA sometime today, after Dialysis.

[Simon Dog]

What?   No breakfast again?

When I was in-patient, I had the food service deliver breakfast to dialysis.   I think they got lost on the way once though 

[Shaks24]

Sorry you are having to go through this Charlie. My thoughts are with you as you go through these procedures. Wishing you a speedy recovery and a return to PD soon if that is what you desire.

[MooseMom]

Oh my God.  What a palaver.

What is it that they used to say?  "Keep on truckin'" and "Keep on keepin' on."

I hope the VA has you back in good operating mode very soon.  You've really been through the wars (in more ways than one).

[kristina]

Hello Charlie, I am very sorry that you have to go through this and I send you my speedy recovery wishes
from Kristina.

[Whamo]

I can't live without my morning java.

[Charlie B53]

My 1st Hemo session done. A late tray, early lunch as too late for breakfast items, was delivered there. Run 3 hours, finished and back to my room. There as a lunch tray waiting. Lifted the lid and saw things I don't normally eat. Called Kitchen, reordered, they had to clear it with my Nurse. Fine. Went outside on the porch. Nurse caught me on my way out, said she has meds and was already told to call transport to move me back to the VA. I asked if I could go outside, and give kitchen time to deliver, that way I could eat here as they have a decent choice of menu. VA you get what they have for your particular diet. Not much choice at all. She laughed and said OK.

I kind of like it over here. I get to choose what I eat, somewhat. I can still go outside, although they don't have the heated greenhouse the VA has. And it is freezing cold out, way more so at night. Far more young Nurses, it's a much bigger place, more people altogether. Better coffee in the waiting rooms. And they have satellite TV, far more channels.

I will most likely stay at the VA at least into Monday. They will want me to do at least one more session of hemo before they cut me loose. And they want Social Services to have a place and time schedule set up. Soo Monday, possibly Tuesday.

[Charlie B53]

I moved back to the VA Fri late afternoon. Felt fine other than having that opening in my belly where they took out the PD cath.  Have been out to the greenhouse (smokekshack) a number of times, all good. Dinner, meds, bed.

Sat morning I noticed both calves tight, making it very difficult to walk even half normal.  Doesn't make sense.  Labs drawn, finally, only a couple of sticks before he found it.

Nurse making rounds a bit later with meds, reading off what she has for me and when she says "Potassium" I said  Oh Really! I mentioned how I knew PD took off so much I needed the supplement but had to wonder about if or how that may change on Hemo.  She looked, labs were already done. I had already risen from my PD normal of 3.2 to 3.5 to an already 4.6

I refused the potassium.  And have to wonder why University Hospital didn't stop it Friday.  Nurse says higher Pot may be the cause of my calves feeling so tight.

Told all this to the Dr's when they came on rounds.  They immediately cancelled the script.  We also talked about how I now need to limit my fluid intake.

PD had so much leeway as far as food and drink.  This is going to be different.  I will need to learn to make some changes.

My mouth has already dried out, very difficult to felt half comfortable and swallow, so dry.  Had a little bag G'son gave me from his Halloween candy, gummy something.   I let it sit and melt.  Worked great to stimulate the glands.  So I had the bright idea of buying more.  Went to the Patient Store, got a bag.  On the way out the door into the hall I ran into one of the Lady Nephs.  Told her what I had, showed her the bag of lillte gummy bears.  She told me I shouldn't have them.  A former patient had big problems with phos.  Turned out to be that he regularly ate gummies.  If I wanted to use something to try the mint candies, lifesavers.   I immediately went back in and exchanged bags.

I am SOO glad I ran into her.  I was about to make a serious mistake.

Sunday morning, weight barely up a pound.  I keep going out to the greenhouse but it is difficult.  Calves don't want to stretch at all, making for very small steps.  What used to take 20 minutes is already 35.  I am so slow.

[cassandra]

Mmm Charlie, bit peculiar they had to be reminded of having to stop your potassium. And I'm sorry you're going to have to bring your reading glasses with you at all times now when you're buying sweets or anything for that matter, to check ingredients.

What kind of 'tight' is it? If it's not the skin being tight (as in possible fluid) it could be your potassium. What did you eat or drink after your last bloods? Whatwas your calcium? Did you mention it to a nurse?

Love, luck and strength, Cas

[Charlie B53]

Dr's made rounds already, both the Medical team and the Neph team.  Good results from both.  Medical will straighten out my blood pressure meds I was missing.   Nephs surprised me when they said my potassium has fallen, no longer well over 4 but only 3.6 to 3.8 I don't remember exactly which.  They attribute the drop to my still producing urine.  And say I may be one of the rare Hemp patients that can relax my potassium restrictions a little as long as I continue to P.   Whoo Hoo.  Told then I weighed and had less than a half pound rise since Fri night.  They said I may also be able to have more fluids.   Wow.  I must be blessed.

So I've been thinking hard, what could be the cause of my tight calvles?  And I am remembering a time long ago, a freind and I at the weight lifting room.  Sort of showing off to each other how easily we could push/pull weight with our legs.   LOT of weight, LOT of reps.  Next day neither of us could walk.  Calves blown up, swollen tight, very painful.  ALMOST exactly like they are now only not near as bad as then.  Almost, but not quite.  Then I also remembered when I got back over here Friday from the UH walking out to the greenhouse that I was taking MUCH bigger steps. I noticed this two or three separate trips out and back.  I woke up with the tight sore calves, can't say if it was after just a nap, or if it was first thing Sat morning.  More likely Sat morning.  So this may NOT be a mineral problem, it may be an over exertion by over extension of weak shortened muscles, screaming their protests and should resolve in a number of days.  Qwap, it hurts in the mean time.

[Charlie B53]

Med madness.  I don't know why they cannot keep my med list in order.  Every time I come here it gets screwed up again.  Just when I begin to get it straightened out I find out it's still wrong.  Pain meds listed PRN instead of scheduled.  Got them all scheduled then went across to University and started the whole bit over.  Finally get straightened out over there and move back here, Guess what?  They've managed to screw it all up again.

I just got BP meds straight while Dr's mad rounds while ago.  Meds come and find my pain meds aren't just screwed, dropped altogether.  Nurse is calling Dr now.     No wonder my legs hurt so much worse today.

I take methadone, small dose, twice daily.  It makes a difference and there is absolutely NO brain buzz.

[kitkatz]

Lordy, lord,lord!  The crap they put you through when in hospital is ridiculous! 
I have had 2 surgeries and 1 declot in the last four weeks, so I have seen the inside of Kaiser a few times!
They can make you crazy with the switch ups they want to do out of hand.
Keep keeping on eye on things.

I hope you get better soon.

[PrimeTimer]

When my husband was in the hospital they wouldn't listen and refused to give him enough insulin he normally takes. Hours later when they tested his blood sugar again, they were "Oh! You need more insulin!"   Duh!  Makes a patient feel like having their meds snuck in to them but I suppose the staff would just end up surprising themselves with test results.

-You guys (Charlie and kitkatz) spend any more time in the hospital this year they should put you on a salary. Complete with full benefits, private room with a view, a company car and stock options. 

[Charlie B53]

I've only really stayed in here because of this re0occuring infection.  What a mean bug.  Now that the cath is out it should heal just fine.  I have to wait until they find me a new clinic closer to home as the PD clinic here 'could' take me, but then I would have that hour plus drive 3X weekly.   Nope.  So I'm sit here growing my butt wider until they get me an assignment closer to home.  There are 3 units within 20 minutes of our house.

Hopefully Mon or Tues they will have word and send me home.  Even if it takes another day or two I'll be fine, just bored.

[Charlie B53]

Home, finally.   Monday had my second hemo session.  Once finished the Social worker came and told me she had gotten me assigned a chair at Fresenius in Wentzville, M-W-F  Since this is M already I will need to be there by 10:15 as there WILL be paperwork.

I mentioned that will conflict with a Dr appt.  The VA had already called and told me I HAD TO have an appt F at noon, the Dr had no other time during the week.   This is THE MAN so of course I agreed.  When I say THE MAN I mean as in THE Dept head of Vascular Surgery, not only there at the VA but one of THE Dept Heads at Uni Hosp across the street.  And I, or I should say he, knows me.  He has been inside my arteries a number of times, has me back at least twice a year just to check up and have them rerun tests.  I tell you, the VA has spoiled me.  They have taken VERY good care of me.  I MUST be Blessed.

Young Social Worker says she'd see about the appt, get it changed.  Came back later and told me Fresenius said to be there by 6  F morning.  I'm guessing it was easier for her to get Fresenius to agree then the Good Dr.

Since I had my 2nd session AND a seat assignment the Dr's told me I was done.  Signed off and I got out of there about 5.  I had to wait for my Son as Wife wasn't to up on me driving myself when I first noticed the infection again.

Tuesday,  Oh, I left out the part about Wound Care.  Since they left both cuts OPEN and packed, thinking "Oh, infection gotta drain"  (Batshit)(My words) packing must be changed not just once, but TWICE daily.  Wound Care Dr Cathy (Blonde, Nice) changed it and told me Home Nursing would come and take care of it, but NOT twice Daily.  She would have a talk with the Surgeon.   Came back and gave me BOXES of supplies and a black case.  Told me Nurse would come by Tues and Thurs to dress/redress my woulds with this Vac system.    Besides all the usual crap I take with me knowing I have to be admitted I now had a SECOND wheelchair of stuff to take home.  Whatever, after 11 days I was glad just to get out of there.

Now Tues, Nursey calls and since she doesn't live to far away set an appt for 2:30'ish, on her way home.  This Girl is thourough.  Spent almost three hours grilling me on my meds (17) not just what, but when I started taking, etc..  About the only thing she missed is the fact that I've had my tonsils out.   She pulled out the packing, cleaned, prepped, then taped carefully around both sites, cut this special foam blck stuff to size and stuffed them into the wounds.  Had some cover tape stuff then put this seal thing that sticks on and has a hose that plugs into a battery powered vacuum pump, both sites plug into a Y-connector then the pump.  It was a VERY strange sensation when she first turned this thing on.  I could swear I could SEE the larger slot sort of suck closed.  Very weird.

So I have traded one type of hose for another.    Wouldn't be too bad as I can carry this thing around with me.  The strap is kind of irratating but I'll find a way to tie it too my belt tomorrow.

So tomorrow I will find out what and where Fresenius is, what it is going to be like In-Clinic.

I got to say though,  After only ONE session sitting in a chair,

My butt got tired.      I am going to have to figure SOMETHING out.  I plan on taking a pillow and my NEW Fuzzy Blankie.

[cassandra]

Glad you're home Charlie

    :

Pillow and Blanky sound like a good plan (there's a thread on that) Maybe take the wheelchair cushion?

Very interesting that wound-sucking-thing sounds interesting. Does it make a noise?

Love and luck, Cas

[Charlie B53]

The Vac thing is pretty neat.  It does have a sound sort of like a small electric air pump only making a pulse a second.  A lot slower than a heartbeat.  Once in a while it will whir as if making a number of turns then immediately back to it's normal slow pulse.

It was a very strange sensation when the Nurse first turned it on.  Sucking on both wounds.  The top one I have hardly any feeling because of nerve damage to that area during my by-pass long ago.  The lower one is another story. You could fit my three middle fingers inside width wise and looks like to the middle knuckle.  As the vacuum pulled I felt and SAW it change.  It seemed to suck closed almost by half.  Amazing, very strange feeling.  I can't say it hurt.  I don't doubt that some that are sensitive may have been screaming, but I am not normal.  I just had a questioning look and began to laugh it was so different.

Nurse thinks I'm strange.

In a little bit I've got to figure out how to dress and go to my first session at Fresenius.  It's cold outside.  In the teens last night and expected to barely make it to 30 if we are lucky.  I'll wear my jacket again.  Not cold enough for my coat yet.   I grew up when this time of year on a good day it would warm up to zero.   I've seen them close the schools here when it was in the teens.   When I was a kid you got dressed and walked to school unless it was over a mile, only then could you ride the bus.

Got my Blankie, just got to decide which pillow.   Are they like prunes?   Is one enough?  Is six too many?

I'm thinking two may be just right.