Any doctors or nurses out there? I need help reading my son's

discharge summery. Monday afternoon I took him into ER with a flare up of his Crohn's disease. At some point between 10 and 11pm, he apparently almost died. I had just left the local ER to go on ahead of the ambulance that was transfering him downtown.

on physical exam T 38, BP75/30 P: 135 pt was resusitated with 3 Liters of LR fluid before he was started on levo drip. pt was transfered to MICU with following issues:

1. septic shock: pt had a fever, abdominal pain, refractory hypotension, mildly elevated white count, and rigors on presentation. pt was resusitated with almost 11 liters of 0.9 NS, and LR, agter which he was able to get off levo.

There's more, but I have no idea what any of this means. He's home now with a catheter in his arm for 10 more days of antibiotics. He's 23, so all info was being given to him, and he can't remember a lot of what they told him. Any help would be appreciated. Thanks.

T= temperature...38 is Celsius, 37 is normal but I don't know exactly what 38 is in Fahrenheit.
BP= Blood Pressure and it was very low. P= Pulse which was a bit high also. So, they gave him a fluid resuscitation with 11 liters of IV fluid and levophed ( a medicine for his low BP) An elevated white count can indicate an infection. Rigors are chills or shaking. Septic shock is the body going into shock from overwhelming infection. Maybe someone who works ER or Med/Surg can be more specific but hopefully this explains some of the jargon. NS and LR are types of IV fluid.
Hope he's feeling better.

I'm trying to find out just how bad off he was, so I can figure out how to prevent it from happening again. Unfortunatly up till now, he's just treated his disease as a minor irritation.

not a good thing at all. He most likely had a very bad infection and it seems he was probably dehydrated as well. Was he feeling badly enough that he did not drink a lot?

Those two things could cause all of this. Watch for infection and make certain he takes his meds and is nutritionally optimal.

Best advice is to call his doctors office and discuss this with either the doctor or his nurse.

He started vomiting and diarrhea early monday morning, but thought it was the flu. I didn't know an adult could dehydrate that fast. I do now.

and write it down. That is a difficult disease, so many variables. It does not take long to dehydrate, especially when you have both diarrhea and vomiting.

A lot of what they say you may not understand but make them explain it until you are certain you understand. Hopefully they will have a booklet and you can do some preliminary study by looking it up on the internet if you have not already done it.

I don't know how long he has had it. You may already know more about it and I have forgotten a lot but it never hurts to look a little farther.

Edit for clarity

At that time his doctors didn't indicate that it was anything more than a chronic condition that could be some what controlled with medication, with periodic hospitalizations in extreme attacks. Nobody ever even hinted that it could be fatal. His second was in july of last year, and it was an overnight stay. His dad is already starting the research that we should have done after the first one, but he's 23yrs old, and said he'd done the research, and everything was under control. His ICU doctor clued me in, in a round about way, about how sick he was. My son thinks that Crohn's is a minor irritation in his life.

It is where I go. They have the best Crohn's protocol that I have seen.

Crohn's is extremely destructive. My dear friend and cousin in law recently had a colostomy bag connected after the disease destroyed her large intestine. Now, with treatment, she is able to go out and do things with her kids, work part time and enjoy life. Best of luck to your son. I would recommend going to the UofM though. Their G.I. Dept is the best. :hi:

The hospital downtown has been wonderful. It's the satellite ER that didn't take him seriously enough. Maybe because they could hear him saying "just give me the morphine, and stop this". I think they took blood first and tried to find out if he was an addict. By the time they realized that he wasn't, he was going into shock.

:hi:

But I would recommend U of M if his condition gets really unstable. They are nationally known for their research and advanced treatment options for Crohn's patients. They saved Terri's life.

He's an adult, but as of yesterday his dad and I downgraded him to 12yrs old. I'll share this with my ex tomorrow. Thank You.

He wishes it was only that. I think it would be a good idea to get him really clued in. He will need to learn how to control it or he will be uncomfortable a lot. I have 21 and 19 year old sons, they have a difficult time with issues like that, it is normal but it is chronic and he needs to take it seriously.

the alt.support.crohns-colitis newsgroup (Your ISP probably has a means of joining newsgroups - the mechanics are slightly different for each ISP). A fantastic and supportive group of folks hang out there. Mostly folks with IBD, but there are a few parents and I have always felt welcome. I joined 10 years ago when my daughter (then 5) was diagnosed with UC (the other inflammatory bowel disease). I only drop in occasionally now, but they were incredibly helpful for the first two years after diagnosis.

Although the early diagnosis creates a greater risk for complications (cancer, with UC) it at least gave me a long time to help her create good health habits, including a healthy respect for her condition and a healthy skepticism for how completely any physician really understands it.

Feel free to pm me if you want to talk to a parent of a sister condition.

Thank you.

His nurse told me the next day. They give you a code number which means that the patient has given consent to the medical staff to give you information, but only what you ask for. I didn't even know what questions to ask.

He was in shock and it can kill you. He should have a good GI workup - there may be a chance of perforation of his bowel in Crohn's disease. It's a nasty disease and he has to get a grip with it.
Just my 2c, I hope he's feeling better now, and make damn sure he finishes the antibiotics.

perforation? Dear Lord. I know now. thanks. A home nurse is coming tomorrow to show us how to do the IV antibiotics. I'm worried about keeping the site of the catheter clean. I'm not worried about him finishing the drugs, because he's in a weakened condition, and I can sit on him if I have to.

but you need a specialist. Lots of good advice here.

Been out of medical field too long..but have three good friends with Chrone's. One had leg amputated from infection...besides bag.

It's nothing to fool around with. but good news..one friend has been in remission for 7 years since she took up golf. yes golf! You can't think of anything else when golfing...took the stress away.

My thoughts are with you.

His doctors keep bringing that up. He's unemployed, and living with me(his mom). I don't bitch at him to get a job, but when his writing isn't going well he get's tangled in an "I'm a loser" mode. Thanks, something to think about.

please don't take it wrong. But I found it fascinating. There's definitely a mind body connection imo.

Two of my friends are brother and sister suffering with crohnes. They are two siblings out of 6. Father was terrible alcoholic and beat his son up every night at dinner. His sister was traumatized by it. They both suffer from the disease...but their 4 siblings don't... and have no memory whatsoever of the childhood trauma.

The son is the one with the amputated leg... his sister is in remission since playing golf but had some very scary episodes.

My office manager suffers from it as well.. she got on antidepressants...hasn't had an episode since. Had utopic childhood but was depressed over relationship problems.

Hope this helps?

Not those actual circumstances, but early trauma? I can't say any more, I've already put his shit out here too much, but I've got to wonder, and track this down. Good, good, good, thanks.

for me? :-)

We went that route last year. Modern tools make it very simple, and the site is wrapped well so it's pretty hard to get dirty. My daughter even went to school with hers. Got lots of sympathy for it!

I also want to reinforce that your son nearly died. He had a total of 14 liters of fluids intravenously...14,000 cc's of fluid! That is a lot. He needs to get a grip on what is wrong with him. It is understandable that he sees it as a nuisance; most young people see themselves as immortal. Young males "typically" see themselves this way. He needs to have a whole lot more respect for this illness. It could take his life. I'm sorry to sound this way, but those are the facts. (I'm an RN, and once in a while I worked in the ER, BTW.)

He's in the bathtub right now. Thanks.

If I were you, I'd show him what everyone has said. Unless you think it would overwhelm him, and make him defensive...And obviously you know him a lot better than I do, lol! There's a reason that women outnumber men...We take better care of ourselves than they do. On the whole of course. Good luck!

He got reamed. I'm going to show him this entire thread tomorrow. I'm giving him a grace period to heal a little. His dad's family will start on him sunday. Kevin is being given no choice.

http://www.ccfa.org/

I check in there now and then. I admit I am another one who brushes off her disease as a nuisance (But mine is UC, which is not as bad as Crohn's by any stretch of the imagination.)

Hope your son gets better soon and stays as well as can be. *hugs*

Thank you. I also sicked my brothers on him last night. I come frome a large Catholic family, 1/2 of whom are still practicing, all of whom are stuck like glue. My biggest mistake was keeping(at Kevin's request) his condition secret. thanks for the hug's. I needed them tonight. Oh did I mention that we got in a car accident on the way home from the hospital?

to help him stay healthy. It's a tough disease to live with, especially since IBDs can be very embarassing. :(

But, the point is we _can_ live with them. My hubby rolls his eyes at me because mine is so unpredictable. THIS time I can eat the pizza, but next time, who knows? And he loves to stock up on Immodium for me. Not. But he does it anyway. *lol*

But not for long.

Crohn's is one.
This is a good site - there's a lot of good info for you (((hugs)) to you both.

http://www.healingwell.com/library/ibd/info1.asp

I need to go to bed now. It's been the week from hell. I lurked in the lounge all week to take my mind off what was happening to my son. When they finally let me see him at 2:30 tuesday morning, he was hooked up into so many lines. The one that scared me was the catheter in his carotid. His ICU nurse saw me looking at it, and said "that's so we can push fast" ???! Thank you Lounge for keeping me company on lonely nights, and for making me laugh.

you sound so open and loving and i just have to say how heartwarming that is to see. all our best to your family

"Push fast" means give intravenous drugs quickly into the vein. When this is done, the drug takes effect immediately, like right NOW! The catheter into the carotid is a common place to put these tubings. It is a safe and stable place.
Please take care of yourself. I think he will get better, and stay better too, now that you have all this info for him!

:pals: