dehydration

[chuckt67]

My mother is a peritoneal patient who recently had drop of 30 points average in Blood Pressure ( no one new this at the time) which was followed about 2 weeks later with a bilateral stroke. about 3 weeks later I noticed more confusion and time problems so i'm thinking another stroke. I take her to er. they say she has pneumonia and bladder infection and perscribe cefpedoxime and doxycycline. a few days later she had a 50% overfill and had a new machine sent out. 2 days after that, her primary care doctor said there was no pneumonia and showed me clear xray and negative radiology report. so i take her off antibiotics. She had lost her appetite around the time i started her on the antibiotics so I'm concerned. i take her to the er again ( six days away from the first visit). they say she has pneumonia. and her kidney labs came back bad. they check her in. in 2 days they release her, they give me the same antibiotics to giver her again, they tell me she's eating and the labs are better. i get her home, she won't eat or drink hardly anything, very weak, has muscle spasms when she tries to get out of bed. the whole body spasm when she tries to scoot her butt in bed. she has had mild diarrhea for the last 2 days, she is now complaining of bad heartburn, which I've never heard her say in my life. and i can hear her stomach rumbling from across the room. i took her back the er again. hoping to get some fluids in her by IV the give her malox and tell me all her vitals haven't changed. They tell me to discontinue the antibiotics and then they send us home. i take her to a different hospital last night. they gave her fluids and did chest xray and catheter urine sample. They all come back negative. she never had pneumonia. I filed complaint and am not getting any help from them in keeping the patient hydrated. I give my mom procrit shots but do not know anything about IV fluids/nutrients. i can't keep taking her to the er and i don't trust her HMO anymore. please advise on how to get her properly hydration. once the investigation is over she well be in better hands but i don't know if we have the time. Thank you all.

ChuckT67

[jeannea]

I'm confused. Where is her nephrologist and her PD nurse in all of this? I don't think she will get the right treatment unless you involve them. IV fluids may or may not be what she needs. It can be complicated on dialysis. Call them first thing tomorrow and get an appt.

[willowtreewren]

Chuck,

She may have C-diff. Antibiotics, especially strong ones like Doxycycline kill off the good bacteria as well as the bad and leave the gut in turmoil.

I'm sorry you (and she) are having such a difficult time.

Aleta

[SteveK87]

I'm confused. Where is her nephrologist and her PD nurse in all of this? I don't think she will get the right treatment unless you involve them. IV fluids may or may not be what she needs. It can be complicated on dialysis. Call them first thing tomorrow and get an appt.

I agree.

[chuckt67]

Thank you all for you replies. I should mention another odd pre-event. For 5 days in a row leading to the first 'confusion" episode, my Mom complained every morning about air trapped in her shoulder, like she had forgot to prime. after the second night, I started setting up machine, she still complained. The next night i hooked her up making sure there was no air in the lines. she still complained. the next night when hooking her up i noticed my hands got wet when connecting her. i looked at the catheter transfer connector tube (replaced 1 week earlier) when bent you could see a good sized slit down the side of the tube. a new machine had arrived. and we got the transfer tube replaced. 2 days later i awoke to find her having trouble recalling common nouns. I called her p.d. nurse. she had me read off BP readings for last 2 weeks. at some point she said stop and put me on hold. When she came back, she told me the Low BP is causing the confusion so take away all her BP meds and water pills and monitor her for 2 days. i called 2 days latter to tell them there was no change whatsoever. The nurse prescribed Midodrine to constrict my moms arteries, and told me to monitor her another 2 days. after the first day, I called the primary physician. He scheduled a non cotrast CATscan which showed about 7-8 TIA's and later an MRI later showed the latest stroke to be what the vascular surgeon described as bilateral (damage to same spots on both hemispheres) stroke, but the Nephrologist called it a cholestrol shower. now fast forward a month and a half. i take her to er for new confusion. We are given the wrong diagnosis of pneumonia and Bladder infection. Mom's Nephrologist and PD Nurse work at this hospital and are informed of all proceedings. It was her Nephrologist who ok'd her release on the 18th stating kidney functions improving. now for update. 2 days after hospital release with improviing kidneys, i get a call from PD nurse telling me to add dayfills to her night cycles. so i cant get her to eat and now she's full during the days. a week after the release we attend a meeting telling us her kidneys are no longer responding to peritoneal treatment and an emergency hemo tube will be placed in her chest the next day. i met twice with the PD nurse during this week, both times mom looked like walking death. and not any help was offered or concern shown. then i get told this improving kidney is dying and still to this day no offers of nutrition or fluids and she's still hardly eating, but we had 2 days of hemodialysis. the nutritionist at the dalysis center thinks the confusion is from high BUN levels and will dissapear in a month or month and half, I don't kow haw long her body can go like this. I have yet been able to get her to drink anywhere near her target of a liter of water per day. other symptoms hiccups, belching, heartburn, sense of taste is off, increased gag reflex. she recently was switched from phoslo to Renala, which lists these side effects. But if i have to tell the Nephrologist this, then she is the worst Stanford Med grad ever.