Today did not begin well. Minimal tummy pain yesterday afternoon got worse by bedtime, and although he thought what appeared to be indigestion would go away by morning as it had in pre-surgery days, it did not.
He woke at 1:30 and got up again at 2:30 and by 3:20 this morning, woke me with complaints of severe cramping. I thought he needed pain meds, but he said he thought a call to the on-call thoracic fellow at UIHC was in order. So I called. The lady doctor I spoke with recommended an x-ray of his abdomen to see if there was a bowel obstruction. We elected to have that done here in Cedar Rapids at St. Luke's, primarily because it was raining heavy and lightening filled the sky. She also said if there was anything St. Luke's would consider doing, he should be transferred to UIHC, since he is a patient there.
We arrived at St. Luke's ER at 4 a.m. and got in right away. Took labs, urine sample via catheter, received through an IV anti-nausea meds (even though he wasn't nauseated) and pain meds - dilaudid, which is really hydromorphone - once every hour PRN. Also a CT scan of abdomen and chest x-ray were taken. Diagnosis showed a blocked bowel and urinary tract infection. The pain meds weren't helping his pain management very much, with pain levels only dropping from a 9-10 to a 7.
He was transferred to UIHC Emergency, leaving St. Luke's via ambulance, and got there around 9:20 - 9:30. I followed a little later and arrived at 10 a.m.
The UIHC staff drew more blood, put an NG tube down his nose, did another x-ray of his tummy and took a urine culture. The NG tube was to remove air from his tummy which was causing it to be distended. Jimmy thought the problem was a result of what he was or was not eating, but Dr. Nick Yerkes (one of the doctors we saw on his previous 10-day stay) said not so. He wasn't eating anything wrong. He said the blocked bowel is a result of scaring from the surgery and anesthesia.
Dr. Yerkes said surgery was a possibility, but didn't think surgery was necessary at present. Jim is to stay in the hospital at least a couple of days to rest the bowels and hopefully it will resolve itself.
No food or drink or crushed meds to be given by mouth or through the J-tube. His meds all come through the IV, so the meds he has been taking since coming home that had to be crushed and given through his J-tube he won't be getting for now - that includes calcium, proscar, coumadin, melatonin and pravastatin. Of the four liquid meds given through the J-tube, only liquid benedryl is available through the IV, and that one he will be given at bedtime as a sleep-aid and allergy relief.
When I left the hospital at 5 p.m., results of the urine culture were still not available. The culture will give us more information on the urinary tract infection and with what antibiotics to treat it.
Jim called at 7:10 p.m. He was just given an enema - fun, fun - to get his bowels moving. Not working very well. Next step is a suppository.
Side Notes:
He woke at 1:30 and got up again at 2:30 and by 3:20 this morning, woke me with complaints of severe cramping. I thought he needed pain meds, but he said he thought a call to the on-call thoracic fellow at UIHC was in order. So I called. The lady doctor I spoke with recommended an x-ray of his abdomen to see if there was a bowel obstruction. We elected to have that done here in Cedar Rapids at St. Luke's, primarily because it was raining heavy and lightening filled the sky. She also said if there was anything St. Luke's would consider doing, he should be transferred to UIHC, since he is a patient there.
We arrived at St. Luke's ER at 4 a.m. and got in right away. Took labs, urine sample via catheter, received through an IV anti-nausea meds (even though he wasn't nauseated) and pain meds - dilaudid, which is really hydromorphone - once every hour PRN. Also a CT scan of abdomen and chest x-ray were taken. Diagnosis showed a blocked bowel and urinary tract infection. The pain meds weren't helping his pain management very much, with pain levels only dropping from a 9-10 to a 7.
He was transferred to UIHC Emergency, leaving St. Luke's via ambulance, and got there around 9:20 - 9:30. I followed a little later and arrived at 10 a.m.
The UIHC staff drew more blood, put an NG tube down his nose, did another x-ray of his tummy and took a urine culture. The NG tube was to remove air from his tummy which was causing it to be distended. Jimmy thought the problem was a result of what he was or was not eating, but Dr. Nick Yerkes (one of the doctors we saw on his previous 10-day stay) said not so. He wasn't eating anything wrong. He said the blocked bowel is a result of scaring from the surgery and anesthesia.
Dr. Yerkes said surgery was a possibility, but didn't think surgery was necessary at present. Jim is to stay in the hospital at least a couple of days to rest the bowels and hopefully it will resolve itself.
No food or drink or crushed meds to be given by mouth or through the J-tube. His meds all come through the IV, so the meds he has been taking since coming home that had to be crushed and given through his J-tube he won't be getting for now - that includes calcium, proscar, coumadin, melatonin and pravastatin. Of the four liquid meds given through the J-tube, only liquid benedryl is available through the IV, and that one he will be given at bedtime as a sleep-aid and allergy relief.
When I left the hospital at 5 p.m., results of the urine culture were still not available. The culture will give us more information on the urinary tract infection and with what antibiotics to treat it.
Jim called at 7:10 p.m. He was just given an enema - fun, fun - to get his bowels moving. Not working very well. Next step is a suppository.
Side Notes:
- Free parking today -- since Jim was transferred from St. Luke's to UIHC Emergency, that is where I drove to, and there is no charge for emergency parking. Yeah!
- Jim had a bladder scan at 4 p.m., showing 400 ccs, but two attempts at catheterizing didn't work until Jim and I tightly held hands.... interesting... God gave us together the power to produce a flow.
- Jim commented that his room (for 2) is hardly big enough to turn around in.
- When he and I want to be silly, we talk about dancing ... a real slow dance, standing in place. Of all things, there's a picture in the room called "The Singing Butler" by Jack Vettriano and a man and woman are dancing. How fitting.
Room and Phone numbers:
- Jim is back on 4th floor, Roy Carver, East Unit, Room 105, 1st bed
- Phone number is (319) 353-9193
