Had a day and a half off from the office so that was appreciated and was back to work on friday the 2nd. I came in at 7:45a and we already had pts waiting in the hall, doc was surprisingly late that morning which added to the stress of our day. There is nothing we can do about it though so muster through and see the pts, do the vasectomies, do the cystos, the us/bx, and my favorite.... take the phone calls.
I get called to the phone at about 10am or so and one of my pts daughters is on the phone saying "my father became dizzy last night, blacked out, had convulsions, his eyhes rolled into the back of his head, and he urinated bright red blood on himself!" (The scariest part of that... urinating blood on himself... was actually the most normal thing that happened to him unfortunately. He had a stent put in two days prior and with his hx of coumadin use that is normal..) So i ask the daughter which hospital they took him to... "No, he didn't want to go, he just went back to bed he is really stubborn"
OMG!! im thinking wtf!!, that is one of those lets call 911 moments im pretty sure... So after my shock i tell her "well dr is in surgery right now, im going to call the room but you really need to get your father to the nearest ER...or his family dr if he is really stubborn like you say" "well call you call my dad and tell him that he just wants to go get his check cashed and lay back down.." she says
OMG again ok ill call him... call the pt and tell him that they need to get to the er to get checked out... " well can you just ask the dr, i really just wanna go get these errands done, no time for hospitals " OMG "well sir can you please stay put until i talk to dr please, that way we know you aren't out driving or by yourself in case you happen to black out again" ...
Call dr have my call put into the OR suite, dr answers i tell him the story and he says "well what did you tell the pt? ' i told the pt that he needs to get to the ER or his family dr STAT" Dr: " your opinion is my opinion, call the pt tell him he HAS to go to the er" OMG i know my dr trusts my judgment and this reiterates this fact, i love that about him actually!
OK OK long story short, this pt does go to the er , dx: blood in urine, swear to god, and i check his labs on our portal ,
Creatinine is off the wall 7.7
urea nitrogen 147!
worst of all GFR is 7 no shit, 7 and im like "wow dr those are the scariest labs i've seen in a long time!" Im hoping that when i make it back to the office on monday that this pt is still with us, hoping he got to the hospital on time and maybe there is something they can do to help him a bit...
Well im done rambling i suppose
have a great week!!
4 comments:
That's some wicked renal failure going on. I wonder what caused the seizure though?
I am thinking hypovolemia . his haemoglobin today was 9.2? Its my guess.
Couldn't a build-up of toxins in the blood cause seizures? If his kidneys are that far gone, he has to have some nasty sh*t running through his veins...
This is very true, the rest of this blood work is pretty normal don't think they tested for any sort of toxins however, heard he is doing better , well as much as he can be at least....
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