After yesterday's bloody sputum started and continued this morning, David saw Dr. Clemo this morning. She agreed that stopping Pradaxa yesterday was good and said to stay off of it for the next three days and call her if anything gets worse or if he is still coughing blood after three days. She also gave him sputum sampling cups and he is to get a sample to day, take it to the lab and a sample tomorrow and take it to the lab. She said that these cultures take a few weeks. He feels much better after seeing her and her calm attitude. The fact that he has no fever and that his bp is low/normal indicates that whatever is going on is not urgent.
He is scheduled to work the polls tomorrow for four hours (It is Super Tuesday in VA) to lobby for anti-gerrymandering. The doctor recommended cutting it back to two hours.
So he is back to the house with me. I had no classes scheduled today or tomorrow since I assigned an online exam and the students can use their class time to take it but not in the classroom. That was really convenient this morning.
Monday, February 29, 2016
Sunday, February 28, 2016
It's been a long time. Since David's pneumonia has not resolved since Christmas Eve the following has happened.
Prior to the pneumonia diagnosis he had a lot of issues with hearing in his left ear and took a course of antibiotics and then the dreaded prednisone for ten days. I think that the prednisone opened the door for the development of pneumonia. Boo Dr. Franz.
OK so finall in January I dragged David, kicking and screaming to see Dr. Clemo who gave him ampicillin for a week. She said if he didn't feel better to do a chest X-ray and blood work. He is reluctant to expose himself to more radiation, with perfect reason and thought he was doing better after a week of antibiotics. However, the NEXT week he had to stop on his weekly walk. He had to stop four times, came home and fell asleep. The next day he had the x-ray and the following day the Dr.'s office called with the pneumonia diagnosis and an appointment. She examined him and prescribed augmentin. He had a terrible GI reaction to it. Since it is the ONLY plausible outpatient treatment, we split the dose into four times a day and added Imodium AD. He seemed to feel better but was still coughing so a CT was ordered. Now it gets complicated.
The CT showed pneumonia had not improved AND that the pattern and densities indicate an atypical mycobacterial infection. He has no fever, no chills (he is ALWAYS cold) and seemed to feel OK so Dr. Clemo referred him to the local pulmonary practice where he has an apt March 10. She also said she encouraged activity and that he can walk. So today he went on the Sunday walk for the first time in three weeks. Then he came home, showered and had lunch and we went up to Alexandria to visit with his cousins at La Madeline. On the way home I95 was a parking lot and we took Rt. 1 (double time and lots of lights). He starts coughing...up....blood and was freezing cold. He declined to go to the emergency room. At home he continues to cough bloody mucous, but his bp and heart rate is normal. His temperature is low, not high. But he has very little energy and asked me to crush his pills and pour out his Jevity. I gave him the meds and Jevity but we decided to forego the Pradaxa since he is bleeding. I will call Dr. Clemo, his internist, in the morning at 8 and hope that she can see him and possibly fast track the pulmonologist apt. I am extremely concerned and wonder if it is not an atypical mycobacterial and is bleeding in his lungs from Pradaxa. Hoping and praying that he gets better.
Prior to the pneumonia diagnosis he had a lot of issues with hearing in his left ear and took a course of antibiotics and then the dreaded prednisone for ten days. I think that the prednisone opened the door for the development of pneumonia. Boo Dr. Franz.
OK so finall in January I dragged David, kicking and screaming to see Dr. Clemo who gave him ampicillin for a week. She said if he didn't feel better to do a chest X-ray and blood work. He is reluctant to expose himself to more radiation, with perfect reason and thought he was doing better after a week of antibiotics. However, the NEXT week he had to stop on his weekly walk. He had to stop four times, came home and fell asleep. The next day he had the x-ray and the following day the Dr.'s office called with the pneumonia diagnosis and an appointment. She examined him and prescribed augmentin. He had a terrible GI reaction to it. Since it is the ONLY plausible outpatient treatment, we split the dose into four times a day and added Imodium AD. He seemed to feel better but was still coughing so a CT was ordered. Now it gets complicated.
The CT showed pneumonia had not improved AND that the pattern and densities indicate an atypical mycobacterial infection. He has no fever, no chills (he is ALWAYS cold) and seemed to feel OK so Dr. Clemo referred him to the local pulmonary practice where he has an apt March 10. She also said she encouraged activity and that he can walk. So today he went on the Sunday walk for the first time in three weeks. Then he came home, showered and had lunch and we went up to Alexandria to visit with his cousins at La Madeline. On the way home I95 was a parking lot and we took Rt. 1 (double time and lots of lights). He starts coughing...up....blood and was freezing cold. He declined to go to the emergency room. At home he continues to cough bloody mucous, but his bp and heart rate is normal. His temperature is low, not high. But he has very little energy and asked me to crush his pills and pour out his Jevity. I gave him the meds and Jevity but we decided to forego the Pradaxa since he is bleeding. I will call Dr. Clemo, his internist, in the morning at 8 and hope that she can see him and possibly fast track the pulmonologist apt. I am extremely concerned and wonder if it is not an atypical mycobacterial and is bleeding in his lungs from Pradaxa. Hoping and praying that he gets better.
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