Mom has been having repeated "episodes" as the SNF staff call them. She will suddenly get weak, spike a fever and oxygen levels drop. One occurred early January then again early February. Negative for COVID/Flu, xray shows lungs are clear, blood work is normal, urine specimens return a 2+ bacteria initially but the extended cultures come back "contaminated". Not a UTI, right? Initial ultrasound of bladder in January showed a small lesion on her bladder. A second ultrasound on bladder and kidneys showed nothing abnormal in February. Antibiotic shot was administered in January, she rebounded in 24 hours. Two antibiotic shots administered in February but it has taken almost 10 days for her to get back to where she was prior. She was scheduled to see a urologist in January but cancelled the day before her appointment. Mom will soon be 90 and doesn't want any invasive procedures which I can understand. I'm at a loss of what this could be and if it may be something corrected with non-invasive means? Anyone had anything similar happen to a loved one?
She also strongly urged mom to use more care in hand-washing; I kept a look out and mom was just rinsing her fingers after using the toilet! Had EVERYONE in the family bring her easy to use liquid soap, which helped.
If she has another episode, try to figure out with the DON why they aren't getting a clean sample.
Perhaps her body is simply wearing out. They're not made to last forever. What worked once or twice for a mysterious illness wouldn't necessarily work a third.
We work so hard to find the causation of illnesses in our elderly LO's and often the answer is simply 'they're wearing out'.
Yet, I would also continue to pursue these odd symptoms.
It appears your mom’s care team believe the problem is one with her kidneys or bladder and mom doesn’t want to pursue that line of investigation by visiting a urologist or is it she doesn’t want to leave the facility for anything?
I had a mystery illness in the height of covid. Lots of tests, lengthy hospitalization. Nothing came of it except I got tests that show what I don’t have a problem with. Which was good to know. I know from personal experience. It is sometimes not easy to find the answer.
However, in your moms case, I think I would ask for a Urinalysis and culture in a few weeks to make sure she is clear of a UTI and not wait for it to make her so ill. After all they really didn’t get a definitive answer on the last one since it was contaminated.
Let us know what you find out. I’m hoping March is a better month for you and mom.
A fever usually means an infection somewhere. Does she take blood thinners. Over time they cause internal bleeding but this should show up in at least a bowel movement. With my Dad the blood thinner was stopped.
Have her re-tested for
UTI (not just a dipstick urinalysis).
Yeast Infection
Bacterial Vaginosis (BV)
All these can be possible after antibiotic treatment(s).
"She has had blood in her urine previously but she believes it was from her blood thinner so she's had them cut her dosage in half now."
Also false conclusion"
"the extended cultures come back "contaminated". Not a UTI, right?"
Perhaps such a cystoscopy could be done for your mom which would reveal issues or put her mind to rest as well.
Good luck!
Best wishes as you go forward.
Are you quite sure that the UTI specimen is being tested for every UTI? I once had a second one, not picked up the first test, which needed a different antibiotic. The litmus-type test in the doctor’s surgery is certainly not enough.
Also, we recently had a post about an elder ex-nurse who was self-administering fecal removal from her bowel. The problem was that she didn’t clean underneath her finger nails afterwards. Have you checked that as well as ordinary hand-washing?
Decreasing her dose of anticoagulant is likely a good idea...recent studies show that the risk of severe/fatal bleeding in the brain or other places inside the body after a fall increases with age. And as her body is wearing out, falling is more likely.
A 'comfort care' focus makes sense...there may be a medical practice that provides services to home bound patients and can see her at the facility when she has 'an episode.' See if the facility has one that already visits their residents.
For my Dad, the internal bleeding showed up in his stool.
When I was young we would get a shot of penisillin when we had ear aches or tonsillitis.
Not being rude JoAnn, I am just amazed that you have never run into that.
I had a homecare client who used to literally pass out unconscious after having a shower. Not during the shower, but when she was all dried off and dressed. I asked her doctor what was causing this. He said it was the activity of showering (she was nearly bedbound) would get her blood flowing pretty much and she'd be overcome. She was never unconscious more than a few minutes.
I stopped showering her and we did only bed baths. The fainting stopped.
Then she started passing out while sitting in the wheelchair. If she was in the chair more than 15 or 20 minutes or so, she would pass out. Her doctor said this can happen to people when they become elderly and feeble. He did every test available and found nothing other than what he already knew. This client lived for several years after these fainting spells or "episodes" started.
My mother's friend (85) has been having fainting episodes for about a year now. Her health is all right and her doctor said the same thing as my client's doctor.
Sometimes it's a phenomenon that just happens with elderly people even when their health is pretty stable and there's no crisis happening.
our elders often have poly pharmacy and some are very sensitive to increased levels of serotonin which can result from that.
the fever brings it to mind but I would also expect her to be confused or unusually quiet.
fevers in elders are rare as they don’t often mount such a response to infection. Maybe have a pharmacist review her meds and good luck!
Convince Mom to go to the urologist and accompany her. Remind her that going to a doctor is not invasive. Some recommended procedures do not hurt and could be performed quickly. This could provide valuable information.
Best wishes.
recommends vaginal estradiol to keep all menopausal women UTI free. Ask your GP.
e.g. Vagirux
Estradiol (10mcg vagnal insert)
Check for aspiration.
Will cause oxygen saturation issues, fevers, muscle weakness as lungs are impacted. Comes and goes as body fights lung infection, then is re-infected by foodstuffs/liquids.
.
My mom did exactly same--sometimes being hospitalized.
It was ALWAYS UTI.
Feb 19, 2022
Thank you! The urine specimens were gathered using a cath catch(?). I don't understand how they could be "contaminated"
she was not taking pills very well so I asked the doctors for IV infusion of antibiotics. she had daily infusion of meds. Not sure how much it helped her body was so weak by then. But maybe it’s another option that may help in your mom case.