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.
Monday, September 8, 2014
Initial visit with breast surgeon
Heading up to Georgetown Med Center to visit Dr. Shawna Willey for a consultation on the little lump in my left breast. The paper work is crushing and I have all of the mammogram films from Fx Radiology. I'm really glad that I stayed at one place for all of the mammograms. I'm nervous and distracting myself by deciding about what cupcakes to get at Georgetown Cupcake. It is raining and I won't stand outside in line in the rain, so no line is a sign....that I can have cupcakes. Otherwise it is a stop at Shirlington for the Carlyle's New Orleans shrimp with grits. Either way it is something to look forward to. Food cures right?
Post visit
Dr. Willey says that we will observe over time. If there are changes, then come in; otherwise she will re-check it Jan 5. It is so small and hard to find that it was hard to locate. She would not do a needle biopsy because the local anesthetic would make it hard to find. A surgical approach without imaging would not produce unambiguous results and would produce scar tissue obscuring further mammograms and prevent detection of new growths. She told me to stop worrying, do weekly (not daily) self exams and get a professional bra fitting at Nordstroms.
David said something about my being a dr. too and I said that in the medical setting I was not a Dr. that my doctorate was academic. I told Dr. Willey " I educate, you medicate" She retorted, "You educate, I operate." Finally Ph.Ds investigate and educate MDs medicate and operate.
Feeling much relieved. Had a fantastic hazlenut gellato. Was not interested in Georgetown Cupcakes menu for today and so passed. Since traffic was moving on I95 I passed up my meal at the Carlyle too. Just happy to be home watching the Men's finals of the U.S. Open Tennis with David...who is also really relieved.
Post visit
Dr. Willey says that we will observe over time. If there are changes, then come in; otherwise she will re-check it Jan 5. It is so small and hard to find that it was hard to locate. She would not do a needle biopsy because the local anesthetic would make it hard to find. A surgical approach without imaging would not produce unambiguous results and would produce scar tissue obscuring further mammograms and prevent detection of new growths. She told me to stop worrying, do weekly (not daily) self exams and get a professional bra fitting at Nordstroms.
David said something about my being a dr. too and I said that in the medical setting I was not a Dr. that my doctorate was academic. I told Dr. Willey " I educate, you medicate" She retorted, "You educate, I operate." Finally Ph.Ds investigate and educate MDs medicate and operate.
Feeling much relieved. Had a fantastic hazlenut gellato. Was not interested in Georgetown Cupcakes menu for today and so passed. Since traffic was moving on I95 I passed up my meal at the Carlyle too. Just happy to be home watching the Men's finals of the U.S. Open Tennis with David...who is also really relieved.
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