What surprise will today hold?
When I left last night we had just talked to the Infectious Disease Fellow. The Attending will be in this morning. Late in the afternoon the raft of urologist stopped in to inform us the pathology report of the abscess showed AFB and MRSA.
To unpack this a little a Fellow is a Doctor who has complete their residency and is doing a another year to add to their skills. The Attending (said in tones of reverence) is the top Doctor in the field on duty that day as near as I can figure out from how they are spoking of. There is the resistant staph infection in the abscess as well as something that indicates contact with a bacillus.
The Fellow thinks the AFB is probably from the BCG (treatment medium for bladder cancer) that wayfinder38 had in June via the nephrostomy tubes. So the big concern is getting rid of the MRSA. We will see, I don't think we can count on anything at this time.
Yesterday I found out that the early morning fever was over 102° which is the highest one yet. By the time he saw the urologists he was lucid again and could remember that meeting. He has no memory of the RN treating his fever that morning.
I did take the time to go out for lunch with the group from Desert Pueblo. I think there were at least 45 women at the lunch. We met at a local steakhouse called Chad's. It had a western rustic environment and I snagged my new sweater on the edge of the table. The choices were prime rib sandwiches in various forms, salads, soup and the usual chicken salad, tuna salad, and ham & cheese sandwiches. I had the Prime Rib sandwich with a green chile and au jus. The meat was sliced very thin and layered on a French Roll. The au jus was flavorful and thankfully not too salty. I would cheerfully return any time I had a craving for red meat. The conversation was interesting we somehow wound up talking about Native American language groups and migration patterns across North America. It was a pleasant interlude in a frustrating week.
When I returned to the hospital in the afternoon wayfinder38 had another fever so I spent the afternoon watching him sleep. They also took him away for another CT scan and chest x-ray.
My main question today is "How is the Bactrim now going to perform any better than it did last week." Their tests may show the MRSA will respond but experience shows that it didn't.
Many of you who have had experience of our nations medical industrial complex know how difficult it is to speak doctorese. I am fortunate that I worked in a health setting for the last 10 years of my career because I worked as colleagues with doctors and nurses. So I talk to the medical staff at the hospital as if they were my colleagues and generally get the same response. Of course some of the Dr. still have the "Doctor as God syndrome" but we ignore that. Usually wayfinder38 takes an instant dislike to people who act like that. One of he residents seems to have a serious case he needs to learn how to communicate with patients and not just make cryptic statements and then go write orders that are not good for diabetics. I think I got that straitened out but the new orders had not been written before I left.
We have learned that when a Dr. says they will write an order it means sometime today I might get around to putting the order into the computer and then fail to inform the nurse who has to check the computer frequently to find out if anything has changed. Not much better than doing it by hand as they did when I was in the hospital in July.
So I'm off to the hospital now to find out what the plans are now.
To unpack this a little a Fellow is a Doctor who has complete their residency and is doing a another year to add to their skills. The Attending (said in tones of reverence) is the top Doctor in the field on duty that day as near as I can figure out from how they are spoking of. There is the resistant staph infection in the abscess as well as something that indicates contact with a bacillus.
The Fellow thinks the AFB is probably from the BCG (treatment medium for bladder cancer) that wayfinder38 had in June via the nephrostomy tubes. So the big concern is getting rid of the MRSA. We will see, I don't think we can count on anything at this time.
Yesterday I found out that the early morning fever was over 102° which is the highest one yet. By the time he saw the urologists he was lucid again and could remember that meeting. He has no memory of the RN treating his fever that morning.
I did take the time to go out for lunch with the group from Desert Pueblo. I think there were at least 45 women at the lunch. We met at a local steakhouse called Chad's. It had a western rustic environment and I snagged my new sweater on the edge of the table. The choices were prime rib sandwiches in various forms, salads, soup and the usual chicken salad, tuna salad, and ham & cheese sandwiches. I had the Prime Rib sandwich with a green chile and au jus. The meat was sliced very thin and layered on a French Roll. The au jus was flavorful and thankfully not too salty. I would cheerfully return any time I had a craving for red meat. The conversation was interesting we somehow wound up talking about Native American language groups and migration patterns across North America. It was a pleasant interlude in a frustrating week.
When I returned to the hospital in the afternoon wayfinder38 had another fever so I spent the afternoon watching him sleep. They also took him away for another CT scan and chest x-ray.
My main question today is "How is the Bactrim now going to perform any better than it did last week." Their tests may show the MRSA will respond but experience shows that it didn't.
Many of you who have had experience of our nations medical industrial complex know how difficult it is to speak doctorese. I am fortunate that I worked in a health setting for the last 10 years of my career because I worked as colleagues with doctors and nurses. So I talk to the medical staff at the hospital as if they were my colleagues and generally get the same response. Of course some of the Dr. still have the "Doctor as God syndrome" but we ignore that. Usually wayfinder38 takes an instant dislike to people who act like that. One of he residents seems to have a serious case he needs to learn how to communicate with patients and not just make cryptic statements and then go write orders that are not good for diabetics. I think I got that straitened out but the new orders had not been written before I left.
We have learned that when a Dr. says they will write an order it means sometime today I might get around to putting the order into the computer and then fail to inform the nurse who has to check the computer frequently to find out if anything has changed. Not much better than doing it by hand as they did when I was in the hospital in July.
So I'm off to the hospital now to find out what the plans are now.