Friday, January 13, 2006

Refeeding syndrome? CT scan, Anti-seizure meds stopped

Yesterday: The GI surgeon told us that Denise might have something called "refeeding syndrome" rather than the SMAS mentioned recently (artery pressing against & collapsing part of the intestine). TPN was started last night at 9pm. It's got lots of sugar in it, so they're testing her blood sugars and will give her insulin if needed, which is to be expected. The presence of so much sugar makes a great playground for germs that would like to start an infection, but her white cell is in a normal range, so let's hope it stays that way to indicate no infection. My aunt touched base with Denise's hospitalist to see if we can make the next discharge, whenever that may be, much more successful. There was talk of, if Denise is stable, discharging her Saturday. Uh, needless to say, I'm not too keen on that. Interesting, isn't it, that both her discharges have been at the beginning of long holiday weekends, and this is another one, with MLK day on Monday? When all was said & done, it seems that we have an understanding that there will be no discharge happening this weekend.

Today: Denise couldn't wake herself up when Gracie & I came to visit before work/school this morning. I don't blame her... I could hardly wake myself up this morning, either. Denise ate very little of her liquid diet and didn't vomit until the night time, but only a little at that. Almost, if not all, of her meds are being given through the IV right now. When at home, she had to take 32 pills per day, most with plenty of water. Doesn't leave much room for food, does it?
PT came to visit & she took a short walk, then did some exercises in bed. She was very tired but was a trooper and tried her best. Calcium is almost back to normal at 10.6, potassium at 3.5, they're checking phosphorus regularly & adding it to the IV.
Denise's new primary care physician came in to check on her, and it was his first day of his "vacation." He & his wife are expecting their first baby on the 18th (the six month mark of Denise's hospital stay). That's dedication. It's kind of funny... the same sort of thing happened with the doctor that was in charge of Denise's case at Arcadia Methodist CCU.
The infectious disease doctor ordered a CT scan of Denise's head to check on any hydrocephalus or any other problems related to the meningitis that she had. He stated that we don't know if the meningitis is still active or gone, and we don't really want to put her through a spinal tap right now. So this is the least-invasive thing to do.
The regular neuro doctor is off right now, but the doctor covering for him discontinued Denise's anti-seizure meds (Lamictal). She's been on such a low dose for a week & hasn't exhibited seizure activity. Her electrolytes were very low when she had the seizure back in rehab, and they're low now... maybe it was just a one-time thing. I remember reading somewhere that a fourth to a third of people that have a seizure have just one and then that's it.
The rehab doctor also came by to visit Denise. No decision has been made as to whether she'll be accepted back into rehab to regain the ground she's lost since being discharged from there. But the rehab doctor will be following her case.


Anonymous Anonymous said...

Prayers continue daily for improvement for Denise, wisdom for her physicians, and some kind of rest for you Phil. Although you obviously prefer having Denise home, let us all pray that she not be released until she is truly well enough.

January 14, 2006 11:58 PM  

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