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Good News
Thanks for your reply
When I went back yesterday, it had spread his whole hand was 3x the size of his other hand, they had called ID and stopped the oral and started him on iv abs,
He seems better today got out of bed and the pt walked him a few steps although he is in incredible pain
The hand looked better this am, but this afternoon I am not sure.
His hematologist was there today and will pump him with neupogen to hopefully get the count up.
With my direction they are getting the urologist in to see if he can help with the urinary retention, since with his state if they keep straight cathertizing him he will get a uti in addition.
The hematologist really feels he needs rehab , and since no subacute rehab will accept him on the meds(due to the cost), even though I have the meds here as his secondary insurance covers them, and I could administer them, he will get his counts up prior to dc and we will coast till he is functionally better. May mean a visit or two to the ER for an injection.
I am an NP and for 7 years worked in thrombosis my attending md was a hematologist, she was caring for him till oct 08, as I had left the job and her hours were not conducive to his care, at my new hospital the blood is drawn, he sees the doctor and if he needs a transfusion it is all done in the same area.
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