Saturday, September 22, 2012

Part II: My Very Worst Urinary Tract Infection

Having complications of seemingly simple issues seems to be the story of my life. 

I can't just have a tonsillectomy, I have to have complications that send me to the hospital.  I can't just have typical side effects to Trileptal, I have to have an anaphylactic reaction that sends me to the hospital.  I can't just have a simple urinary tract infection, I have to end up in the hospital on IV antibiotics. 

Obviously, I've given away the ending to my UTI story. 

Most UTIs are caused by Escherichia coli (E. coli).  Since I can't seem to do anything the easy way, my infection was NOT caused by the usual bacteria.  Instead, the bacteria I had was an antibiotic-resistant Klebsiella pneumoniae.  And, of course, it was completely resistant to the the antibiotic I had been prescribed (Macrobid/Nitrofurantoin).  See below for my urine culture results:
RESULT: Greater than 100,000 CFU/mL of Klebsiella pneumoniae
K.pneumoniae
----------------
INT MIC
AMPICILLIN R > = 32
AMP/SULBACTAM R > = 32
CEFAZOLIN S < = 4
CEFEPIME S < = 1
CEFTRIAXONE S < = 1
CIPROFLOXACIN S < = 0.25
ERTAPENEM S < = 0.5
GENTAMICIN S < = 1
IMIPENEM S < = 1
LEVOFLOXACIN S < = 0.12
NITROFURANTOIN R 128
TOBRAMYCIN S < = 1
TRIMETHOPRIM/SULFA R > = 320
Legend:
S = Susceptible  I = Intermediate   R = Resistant  NS = Not Susceptible
You'll notice that there is a big R next to Nitrofurantonin, which indicates the bacteria I had was resistant to the antibiotic I had been prescribed.  The reason I did not feel better over the weekend was because my antibiotic was doing nothing!  Fortunately, the urine culture results came in on Monday, so the PA prescribed a new antibiotic that the bacteria was supposed to be susceptible to (and that I was not allergic to).

Unfortunately, I did not feel any better on the new antibiotic (in fact, I was feeling worse; pain had started to spread to my lower back), so I made an appointment with a doctor for that Thursday -- exactly one week after my symptoms started.  The doctor decided that I was not on a strong enough antibiotic, so she changed my antibiotic.  By the following Monday, my symptoms had not improved. I felt a constant cramping feeling in my lower pelvis and back; I was nauseated and running a 100-degree temperature.  By now, I'd been sick for about a week and a half. 

I called the doctor's office, and they instructed me to go to an Emergency Room rather than come into the office.  The ER?  I felt awful, but I didn't feel THAT sick.  Oh well, what could I do but follow the doctor's orders.  And just like that, my very first UTI became my very worst. 

As my husband was driving me to the Emergency Room, I commented to him that I hoped we'd be back home in time for dinner.  I figured the ER would give me some IV antibiotics and send me home that day with a new prescription.  No such luck. 

While the ER doctor did order IV antibiotics, he also wanted to keep me in the hospital overnight.  Really?!  I told the ER doctor that I felt sick, but not that sick.  He smiled and said they wanted to keep me overnight for additional tests and observation.  I thought he was speaking in code and really meant "we just want your money." 

While in the hospital, I had a CT of my abdomen and was poked and prodded by numerous doctors (Residents) throughout the night.  I had multiple blood tests, a urine test, and two IV antibiotic treatments over the course of 24 hours.  The hospital I happened to be in was a teaching hospital, so I also kept having to repeat my medical history over and over.  I got very little sleep during my stay (my snoring roommate didn't help).  I was glad that I would be going home after just one night.

Before I could leave the hospital, the Attending Physician (i.e., the senior doctor in charge of the Residents) had to review my case.  I assumed I would be prescribed some sort of antibiotic to take home.  I was right, but I was surprised by the prescription. 

I'll write more about my unusual prescription in my next post. 
 

3 comments:

upnorth said...

What an ordeal Alyson, so sorry this happened. I was in the hospital for IV fluids to a simple stomach virus that never seemed to end in the spring....I think the hospital is about the worst place to be when you're feeling sick....I hope you are doing better now. How's the ME/CFS? Take care.

irene speaks said...

Hi Alyson! I'm so glad you're able to write again. Don't be offended by my saying that I did laugh at one point: why IS it indeed that we have so many complications and nothing goes right, nothing is without some weird things happening???
Your UTI sounds awful and I really feel badly for you. At your age, I got them constantly and you sound a lot like what I went through. Luckily, they have pretty much gone away (there is hope!) but I'm so scarred by them that I make sure that I always have peridium (the med that turns urine red?) at all times...I just can't take that additional pain on top of all the other pains I live with until I get care.
Teaching hospitals: definitely an ordeal.
At any rate, I just wanted to let you know that someone out there knows exactly what you're going through and I really "enjoyed" reading your UTI posts and look forward to the next installment. I most certainly hope that this gets resolved soon - you have so many other problems that need your attention! (My attempt at CFIDS/ME/fibro humor)
Irene xx

alyson said...

Hi upnorth - I'm sorry to hear you were sick with a stomach virus! Those are the worst.

Hi Irene - Thanks so much for sharing your experiences! It's helpful knowing that I'm not the only one in the world who goes through this kind of health drama. We are not alone!