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Topic More adventures in medical issues Go to previous topic Go to next topic Go to higher level

By mylove On 2009.07.01 11:01
Well, this morning we are off to the big city to get an emergency endoscopy done. Exactly a week ago my husband had an episode of extreme pain that drove him to his knees, and in the hospital, they decided it was his diverticulitis, so they put him on some Bactrim. Yesterday, he woke up in the morning passing blood (the black, tarry kind). Evidently the Bactrim (as well as many other antibiotics) has not been good for him.

So this morning we get to go have a scope done. Well and good, but they put him NPO since midnight, which we expected. What we DIDN'T expect was that they include ALL medication in that order....which means that for the first time since his diagnosis twelve years ago, he will be med-free. Of course they didn't schedule the procedure until NOON, so he will miss at least two doses. This may be an interesting day.

I think this is absolutely cruel. I understand the risks of him having something in his stomach, but not letting him take his 6 a.m. dose when the procedure is at noon, for G_d's sake?

I had an endoscopy and a colonoscopy two months ago, and they said NPO *except* you could take your normal meds with one sip of water. Is this REALLY standard operating procedure for an endoscopy when they're searching for a bleed? I'm torn.

By LOHENGR1N On 2009.07.01 16:27
WHAT? That is completely unheard of and boarders upon criminal in My book! This is a glaring instance of the medical field not knowing or caring about other conditions in a case. Mylove and anyone else with a similar situation, if you can PLEASE post earlier!!!!! I check this forum every morning around 8ish, In the rare instances of giving a "Drug Holiday" it is done IN hospital, under monitoring. Missing a dose may be able to be gotten away with BUT, I wouldn't recommend it! Especially when (I don't know His schedule, but by noon start before it's done it might be more than two doses). To stop medication (go med free) one HAS to be slowly withdrawn from the med's under medical supervision, you can't just stop! Hopefully no complications will be incurred. However expect to be presented with a plethora of Parkinson's symptoms for awhile until His med's reach the therapeutic level they were at before this interruption of His scheduled doses. I may be wrong and all will be great but just be prepared that it may happen or you'll be in a daze wondering what and where all this came from. I hope all went well, please keep Us posted. If in doubt call the Neurologist and ask if something is ok to do. Parkinson's is greatly misunderstood and little known by the majority of the medical field in general. Take care best of luck and hang in there.

By gilly On 2009.07.01 22:14
My husband had an endoscopy and a colonoscopy in Dec and was allowed pd meds for both.

By Pearly4 On 2009.07.02 05:47
My mother had TWO -- WITH meds. They wouldn't think of having done it without. One was done emergently, one as followup later one. No problem with taking the meds either time. Did you check with his doctor, or just follow nursing preop instructions? Might have made a difference.

By annwood On 2009.07.02 08:46
Ditto... My husband had surgery and a colonoscopy and both times he was NPO but allowed to take his meds. As a nurse I will tell you that the magic time is 6 hrs before a procedure yet everyone is told NPO after midnight. Think about it. Some have surgery at 7 AM and some at 4 PM yet both are NPO after midnight. It is easier that way. The small amount of water required to take meds is really not enough to be of any concern but adjustments are rarely made to the time.

By WitsEnd On 2009.07.02 09:02
I've never heard--even before major surgery--not being allowed to take meds with a very small sip of water.

BTW my mom had a bleed they never did find. They put her through two endoscopies and a colonoscopy. The bleed was somewhere in between. They have a camera they could have tried that you swallow to see that too--but she wasn't a surgical candidate. Even if they found the bleed "in the middle" where neither scope worked--they couldn't fix it--so we didn't do that. We just watched her close for anemia and gave her blood ever so often and it perked her up and made a huge difference in the way she felt and acted.

By lurkingforacure On 2009.07.02 09:29
Mylove, I think you got your answer already but I just wanted to add, OMG what a nightmare for you. I am really sorry you are going through this. This is an excellent example of how coordination between hospital staff and your neuro can resolve problems, here, your neuro could simply advise the hospital people know your husband has to have his meds, that way, he is the heavyweight, they will not argue with him, and your husband is spared. I can hardly believe this-what a lesson for us all.

I really recommend you to read "The Power of Two", I have posted about this before. Told from both cancer-survivor-patient and his wife/caregiver perspectives, it will give you strength to stand up for what you believe is right for your husband. If it were me, I'd have pulled my husband out of that scheduled procedure, he simply would not have had it! Then, I would have our neuro ream the hospital staff for their absurd and unjustifiable position, and reschedule the procedure at another facility if possible.

I hope it worked out OK, please let us know how you all are doing.

By mylove On 2009.07.02 11:14
Well, we are back. It was such an exhausting day yesterday that we both just came home and went to bed rather than do anything else. The larger city we have to go to for more important procedures is about two hours away, so it took at least four extra hours for a fifteen minute procedure. And since it wasn't scheduled until noon, we had a bunch of other running around to do before then (the primary physician wanted us to drop in for a couple more blood tests, we stopped at the attorney's to finally sign and pick up our POA's and Directives, which he didn't feel comfortable going under anaesthesia without). Even medicated all those things would have added up to a miserable day.

To make a long story short, the girls at the GI ward took great care of my guy, although they blew out a vein trying to get the IV started. They had to go for a secondary vein, since he's had so many pokes in the last few days that the insides of his arms look like a sunrise. One of them came by soon after he woke up and reminded him that he needed to take his meds as soon as he was able to sip. Once he got his meds on board, everything came back fairly well, but it was still evening (and a few more catchup doses later) until he felt like a human being again.

I still think it was wrong to make him wait on his meds just for this procedure. The 6 a.m. ones would have been long gone out of the stomach by noon. The neuro would have been absolutely no help, unfortunately. He's pretty much deferred all med dosing and scheduling to my husband. (I feel like he's pretty much useless and wish we were seeing someone else, but that would mean going out of town a few more hours in the other direction, so until things get worse, I guess we're stuck with him) I think next time I will be more forceful with the primary, which is the only doc I feel like takes enough time to listen. But it's hard when my husband isn't in the position yet where he really needs my advocacy. There's a fine line between gently suggesting and making him feel like I'm intruding. He was okay with my taking care of him while he was in and out of anaesthesia and feeling crummy, but once he's medicated and has his feet underneath him he's still a very capable individual, and is offended if I get too 'motherly'. So we're still in that 'no-man's land' where I'm beside him if he stumbles but not hanging on yet. You know?

I think it was handled very poorly. I am grateful for the procedure: even though he didn't want to go and didn't think it was necessary, they did find three bleeding ulcers that do need treatment. Just about what we suspected, but the confirmation was good. Let's hope that this is the end of adventures for a while!

By mylove On 2009.07.03 03:07
Well, here we are at midnight on the second day. He's awake and in a lot of pain, mainly in his hips and legs. Muscle and joint pain seem to be one of his typical symptoms. But now that he's had a bleed, ibuprofen is out, so it will be a long night. We are going to try the tylenol and see if it helps. He's pretty angry and frustrated. We have thirty people showing up here beginning tomorrow for the Fourth of July weekend/family reunion/housewarming party, and he's pretty distraught.

I brought up what some people have said about bringing in the neuro for advocacy in a situation like this and he said "What, on a Tuesday afternoon at 2 p.m.? We would have been lucky for a callback within the next two days, and that's IF he wasn't out fishing!" Unfortunately that's the way with our neuro. We are pretty much swimming on our own out here.

I don't know how to help ease his pain. I don't think there's much we can do at all. I hate watching him suffer. He won't try heat or massage or anything like that, so he gets up and down and will try to find a comfortable way to sleep all night long until exhaustion takes him or the meds finally take hold.

I agree with all of you. What the heck? We asked SPECIFICALLY about him being able to take his meds before the procedure. He even told them he didn't need a sip of water to do it: he's pretty experienced with dry-swallowing when necessary (believe it or not). We were specifically denied. So what do they do with people on cardiac medications? Orally medicated diabetes? Or anything else that requires a titrated dose at a specific interval? I guess it's over and nothing more can be done than learn from it, but this is crud.

Thank God we have one more day in between now and the big event. We're too far into it now to pull out: people are flying in. But I'm going to step up and take over tomorrow, pending how bad he feels. If the family doesn't like it, they'll have to lump it.

By lurkingforacure On 2009.07.03 08:23
Oh boy, that's an awful lot on your plate right now, buck up if you can and slog your way through it, and know that the weekend/reunion WILL end and you'll have your time, space, and place back to yourselves. Whew!

I wish I could think of something to help with your neuro...maybe the next time you see him you could mention this whole ordeal, and tell him that there will be times, hopefully few, where you will NEED to contact him and what is the best way for you to do that? See what he says...also, in some offices the neuro's nurse has "ways" of getting in touch with him, and if you are one good terms with his right-hand nurse, you could contact her and she'll get you the help you need.

Other than that, you have to be the advocate for your husband and that requires that you be assertive and stand up for what you believe is the right thing for your husband. It's not easy, especially in this industry with all the arrogance that I see in it, but that's just how it is. Good luck this weekend, just keep taking deep breaths and know that soon all those people will be out of your house.

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