Mom's first time cathing

So if you recall the first 2 x-rays showed the free air in her abdomen, then the third one showed that it was gone.  So they did a 4th one yesterday it also showed that the air was gone.  So yea!  No surgery.

They tried to consult Dr. Murphy in Special Care (she helps with complicated kiddos) but she was not in so they spoke with one of her colleagues and they gave off the attitude, "why are you contacting us, what do you want us to do about it?"  So very non-helpful unlike Dr. Murphy.

Her kidneys looked good on ultrasound.

They were unable to see the pancreas on ultrasound due to gas in her intestines.  They said we would have to do a CT if we wanted to see it.  The gastroenterologists said we didn't need to do a CT and expose her more radiation.  They said she does not have pancreatitits.  They didn't really care that her lipase was 3000.  I asked if it could go even higher.  They said yes around 15,000.  They said it was just a number.  To be considered pancreatitis she would need to have at least 2 symptoms.  The lipase number would be one, but they would need to see physical symptoms like vomiting or severe pain.  Whether she had it or not the treatment is the same.  The old way of treating it was to stop feeds, support with IV fluids and give pain meds.  The new way is to feed through it.  It has been shown to have a faster recovery rate with less infection.  So whether she had it or not they would not stop or slow down her feeds.

Urology came by several times and not just the resident.  The Dr. came by and I really like him, it is Dr. Wallis.  If you recall the resident said we would need to cath her every 4 hours which I was really not looking forward to. When Dr. Wallis came in he said that he has a patient that doesn't pee and he just cath's himself once a day.  As long as the kidneys aren't getting damaged it is fine to go longer periods of time.  So he wants us to do an ultrasound of her kidneys once a year.  And we can just cath her once or twice a day.  He wants the amount we are getting out to be between 500 and 1000 mL.  So if we are doing it twice a day and only getting 300 mL then we should go to once a day cathing.  If we are doing it once a day and getting 1200 out then we need to go to twice a day.  So thankfully they won't have to be doing it at school either.  If she starts getting infections or it starts damaging her kidneys, we will have to cath her more frequently.  He thinks that she just has a big floppy bladder with low pressure and always has.  If you have high pressure that is when you risk refluxing urine back up into the kidneys and causing damage.  So she can handle larger volumes because her bladder has low pressures.

Also, we don't have to follow sterile procedures at home, only clean technique.  So we don't have to create a sterile field and wear sterile gloves and use iodine.  We can just wash our hands, and clean her with baby wipes and we can even wash and reuse the cathedar's if necessary.  Using clean technique seems a lot less intimidating than sterile technique.

We had arranged at bedtime last night that I would be cathing her for my first time this morning at 6 AM.  She had a wet brief with 580mL and we got out 325 mL out with the cathedar.  I got it on my 3rd try, not too bad for my first attempt.

I was wondering how they weigh the diaper and convert it to mL...I found out that 1 gram= 1 mL.  Why don't we use the metric system?  Seriously.  It is sooooo much better.

I think they want to keep an eye on her today and see if she pees on her own and then how much she is still retaining tonight when we cath her at 6 PM.  Then I am guessing we can go home tomorrow.

I asked the Urology Dr. why her urine retention got worse about a year ago and he said he didn't know.  I asked him why it got acutely worse this week and he said he didn't know.

Here is my guess from the theories that were thrown around...Either the spinal surgery or the infection caused nerve damage to her bladder.  Then for this acute problem I think she had some kind of virus or bacteria.  But who knows.

I think this was a good hospital stay.  It has been long, but I think this new plan will work well for Ellie.  I am assuming we will go home tomorrow morning.

So far she is awake and alert this morning.  Her heart-rate and temp both look good.