DH has had Crohn's since early adulthood...now 73. He has had two abdominal fistulas since shortly after his last resection in 2004. Area surgeons have told us they do not want to operate on him again unless it is an attempt to save his life. As you might guess, after years of Crohn's and it's meds, he has numerous other health conditions. Overall is underweight, little to no energy most days. In December, he noticed his belly was hard & sore above the fistulas. It was during the Holidays and trying to get into a doctor and then scheduled for a CT was a mess, finally accomplished however. CT showed an abcess. By this time, it had
opened and was draining through one of the fistulas...we repeatedly asked if he shouldn't have an antibiotic...none was discribed. Fast forward to earlier this month and the abcess is unsurprisingly back. With second occurrence of abcess, he received IV antibiotics and oral as well. In December, GI had set up a referral for him to be seen at state med center because he doesn't know what else to do for him.
The med center appointment was Friday. "Doogie Houser" was pretty straight forward about the overall nutritional health of DH, weight, signs of dehydration, fistulas, abcesses, etc., etc. Doc said Humira looses it's effectiveness at a rate of 20% per year...DH has been on it since 2006. First time we had heard that. He reviewed the most recent CT scan and thought DH should be admitted right away and they most likely would need to put a drain into the abcess, (which is currently not draining and causing no pain), to further drain. He talked about fistulas never healing unless the bowel is allowed to rest with the patient being on TPN. Said no surgeon would operate on him because of his extremely poor nutritional status. He said he wanted to get him into surgery to at least get abcess drain/drain inserted yet Friday afternoon. Admitted, get assigned room, doctors begin arriving...questions, questions and more questions.
Doctors return after reviewing CT and say that DH is not appear to be as "sick" as they had been led to believe so they are going to slow things down. And their radiologist doesn't like the local hospital's CT scan, (surprise!), so have to do another one before any decision on draining abcess can be made. But they will be putting a picc line in and starting fluids/meds. CT finally done after midnight...doctors in this morning appeared not in any hurry to do any type of invasive procedure but said they want to further discuss with radiologist. Hospitalist in later and said no picc line just yet, tech showed up to put picc line in...DH conveyed what Hospitalist had just said so tech went to track her down and came back and said picc was on hold for now.
What a mess! Wish I had just brought him home! He hated so bad the idea of staying. There was certainly no reason for him to spend the entire week end laying down there by himself. I have been sick for a week and needed to come home...will travel the 90 miles back down there tomorrow, but not expecting any updates because it's Sunday. I hate this!!