Urology came by a second time.
I asked if her bladder can go back to it's normal size and how long it would take. He said yes and it is immediate.
He wants to do a kidney ultrasound to make sure no permanent damage was done. Because urine can reflux back up in to the kidney and cause damage. All bloodwork for kidneys look good.
They want to stop the Zyrtec that she takes for allergies it could cause urine retention.
They are going to remove the foley and do a straight cath every 4 hours. This is not necessarily what we have to do at home, they just want some data now. They will do a bladder scan before the cath and then a bladder ultrasound after the cath. This will tell them how much she emptied versus how much she has left in her bladder to see if she fully empties her bladder with a straight cath. They will also be teaching me how to cath her...yippee (said 100% sarcastically)!
We are supposed to follow up with urology in 1 to 2 months to do a "uro-dynamic study". This tells them, among other things, what pressure her bladder has to reach before she urinates.
Then the hospitalists came by and went over the overall plan for the day...
Her blood labs and urine and blood cultures all look good except for 1 number and that is her lipase. The lipase has to do with the pancreas. The normal lipase number is under 100. When she came in on Tues, her lipase was 200. Which is higher than normal, but they were OK with it. This morning her lipase was over 3000!!!!! They think she might have pancreatitits which just means an irritated pancreas. She doesn't have the normal symptoms however. Normally you would be in severe pain, vomitting, not tolerating feeds. She is not. Her heartrate is slightly elevated (probably from pain), her stomach is twitching and she is sleepy (probably due to pain). They need to consult with gastroenterology.
They also want to consult with Dr. Murphy because she is familiar with Ellie and she deals with complicated kids like Ellie all the time.
They want to consult with Orthopedic surgery to see if the spine surgery could have damaged nerves, or if this is a common side effect they see.
They want to possibly consult with neurosurgery to check on her shunt since she is sleepy...I don't know if they will end up doing this or not.
They redid the abdominal xray this morning to see if the free air could be seen. I have not heard the results on that.
1 comment:
Oh my...WOW! Cora has had elevated lipase for 4 years!! GI has been following and they think she has chronic pancreatitis. It gets somewhat better and then flares. It does cause her pain and we manage it. Dr's thought is was medication related. Now not sure. I have had this "discussion" with Dr's for years about her pancreas. They say it is unusual because it is lipase and not amylase.
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