The CT scan showed a moderate to high grade bowel obstruction with a visible transition point. The "visible transition point" just means they can pinpoint the exact spot of the blockage, which is very helpful if they have to go in to fix the blockage with surgery. Surgery would normally be considered at this point but due to all the abdominal surgeries Karen's had in the past, scar tissue is holding everything together and it'd be hard to get/cut through to the blockage. So, we're back to the old waiting game. Karen's been admitted and they found her a room. I imagine this will take a few days to work through.
They finally put an NG tube in her nose around 3pm. Based on past experiences I felt this should have been done much sooner. They were giving her very strong pain medication - hydromorphone (Dilaudid) - but it was barely helping at all. I even felt the nurse was suspicious of Karen's claims of pain, at least until the CT results came back. When she'd be hit with a wave of pain, it'd spike up into the 8 to 10 range, and would hover around a 5 in between. The amount of time in between those waves of pain has also increased significantly, from once every two to five minutes to once or twice an hour. And the although she's still hovering around a pain level of 4, the waves of pain are less severe. They were also giving her a lot of medication to help with nausea. It's been a couple hours now since she's had the NG tube in and her nausea has vanished completely.
I had mentioned an NG tube shortly after we were admitted, but Karen really hates having them shoved down her nose and asked me not to bring it up again. However, when it finally happened, the nurse did an excellent job inserting the tube. The process was pretty much pain free. By far the easiest NG tube Karen's ever had inserted. Hopefully this experience along with how much it seems to have helped will make her more comfortable with the idea of NG tubes in the future.
Tuesday, January 10, 2017
Another Obstruction?
Karen's back in ER again. This seems to be another intestinal obstruction, but it seems to be a lot more painful this time - either that or the nurse is just making a big deal about the pain meds. To my recollection it does seem like it's being given more frequently. This makes me a little concerned that this might be a much worse blockage than we've had in the past.
Karen had a bit of pain around 1 in the morning, but just enough to take naproxen (Aleve). She began to have some serious pain about 4 am, and an hour or two after that she became nauseous. We figured at this point there was probably some sort of blockage, but Karen wanted to wait and see if it would improve on it's own if she just went onto a liquid diet. We didn't get a chance to try it out because the pain became too much and we decided to go into ER. We arrived at Mayo Clinic Hospital a little after 9.
The way they usually check for a blockage is with a CT scan of the abdomen. While we got into a room very quickly, there was a very long delay in getting the CT scan - several hours. The contrast they make you drink before the CT scan has gotten things moving again for Karen at least once in the past, but due to her nausea they decided to skip it this time. We're still waiting on the results of the CT. It seems strange to me that they haven't put an NG tube in yet, this might be due to the long delay on the CT scan and the resulting CT scan review, but I believe it was something they have always done shortly after we've come in with a blockage. I guess they just aren't sure it's a blockage? Or maybe they aren't sure of what kind of blockage it is.
Karen had a bit of pain around 1 in the morning, but just enough to take naproxen (Aleve). She began to have some serious pain about 4 am, and an hour or two after that she became nauseous. We figured at this point there was probably some sort of blockage, but Karen wanted to wait and see if it would improve on it's own if she just went onto a liquid diet. We didn't get a chance to try it out because the pain became too much and we decided to go into ER. We arrived at Mayo Clinic Hospital a little after 9.
The way they usually check for a blockage is with a CT scan of the abdomen. While we got into a room very quickly, there was a very long delay in getting the CT scan - several hours. The contrast they make you drink before the CT scan has gotten things moving again for Karen at least once in the past, but due to her nausea they decided to skip it this time. We're still waiting on the results of the CT. It seems strange to me that they haven't put an NG tube in yet, this might be due to the long delay on the CT scan and the resulting CT scan review, but I believe it was something they have always done shortly after we've come in with a blockage. I guess they just aren't sure it's a blockage? Or maybe they aren't sure of what kind of blockage it is.
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