Visits from 2 doctors

Finally, finally, FINALLY I got to talk to Dr. Rutland today. He is confidant that the cause of this latest ammonia spike is the urinary tract infection (UTI). Tom probably got that from the catheter he had during last weeks hospital stay. They are giving him the antibiotic Cipro which is a broad-spectrum antibiotic right now while they "grow cultures" to see what specific kind of antibiotic they can give Tom for the UTI. I asked Dr. Rutland when that would be complete and he said "maybe tomorrow". Because Tom is allergic to several antibiotics he may need to continue to take Cipro which he was taking in pill form about 3 weeks ago. I asked Dr. Rutland what I could have done in this situation to keep Tom out of the hospital. He basically said "nothing". Even if Tom would have had blood tests run in the doctors office on Wednesday, he still would have been sent to the hospital. The advantage of being in the ER, i guess, is they check everything, including urine or it would probably have been a while (if ever) before anyone thought to check for a UTI. Tom has not had a temperature and his white blood cell count is only slightly elevated. It's just always something different!!

Last night Dr. Miller, the gastroenterologist, came in to Tom's room and talked to him for about 45 minutes. He was instrumental in getting Tom to UAB. We've sort of had a love/hate relationship with him in the past. Tom was really impressed that Dr. Miller spent so much time discussing various things about the different transplant programs and such. He also encouraged Tom to keep doing what he was doing and not to try to skip meds or anything like that to try and advance the process. I think it really helped Tom a lot.

Of course, Tom wants to go home. Dr. Rutland said maybe in a day or two, once they get the results of the cultures. Good news for us is that Dr. Rutland is on call this weekend so he will be seeing Tom.

All of Tom's levels look good. Aside from lack of sleep (for both of us) and that the lab had to draw blood from Tom twice today because the first blood "clotted", Tom has had a good day. The second blood draw was extremely painful. I was there and watched the tech practically dig to China with the needle.

Since Tom is on a low sodium, low protein diet, I asked Dr. Rutland about that and its relationship to the ammonia level. Although he doesn't think anything Tom ate specifically affected the recent ammonia level issues, food can be a factor and he suggested we monitor it and make sure that Tom doesn't consistently eat high-protein foods and that there is balance. In the recent past Dr. Rutland was more concerned that Tom simply got nutrition/callries and he is still emphasizing that.

So, into the weekend we go. I will remain on "high-alert" to pick up Tom the moment he is discharged.