Glenn is a 40 year C5-6 quadriplegic of good general health.
8/15/06 he underwent cystoscope 6 years after last scope that read
normal. Glenn started w/new urologist at same group where his
original urologist had retired. 8/15 cysto saw mass in bladder and
deemed that bladder no longer proved workable after 40 years w/Foley
caths. Cysto performed w/spinal that went without incident.
However, urologist needed to use scope to place the cath
properly.
8/22/06 Glenn started to bleed profusely and pass numerous blood clots
around cath. Little urine passing through cath but it too was
bloody. Wife tried to irrigate cath unsuccessfully.
Wife then removed cath which was visually clogged with blood clots.
Wife tried to insert new one. Not successful as when it was in
place, (not easily), it would not drain, and blood & clots passed around
new cath too. (Note: wife has inserted Foleys for 25 years w/o
difficulty.)
Called urology service, went to hospital on their recommendation by
ambulance. In ER cath removed, 28 3-way cath inserted, gravity
irrigated and manually. Six hours later Glenn sent home by
ambulance w/irrigation solution and high hopes. Upon turning Glenn on
bed to prepare him for night she saw puddles of blood/clots/urine under him
and returned to hospital in same ambulance.
8/23/06 urologist forcefully irrigated cath ... etc. 8/24/06 second
cystoscope performed.
Urologist reported that culture showed malignancy found in bladder,
contained and early state. Urologist reiterated and explained need
for cysectomy and ilio conduit.
Placement of working spinal cath was 1 hr. operation due to Glenn's
compressed discs due to previous spinal column injury. Urologist
st'd that he saw no source of bleed, again cauterized biopsy sites, place
cath, again using scope. Urologist told wife that he couldn't keep
placing caths by scope.
8/24 post-surgery to 8/27 Glenn ran fever. Had had chills in Post
Op, was warmed by using heated blankets, came to room with 4 blankets over and
1 blanket under him. Fever diminished somewhat with use of
Tylenol. Glenn asked to have blankets removed. Fever ranged from
100-102.8 F., sometimes Glenn shook with chills, sometimes not. Glenn
asked to have a fan or cooling blanket, believing that autonomic hyperreflexia
might be source and that by cooling is body core he could reduce his
fever. Wife used ice baths, later fan was brought from home and on 8/27
fever came down to low grade-normal range and where it
remains today.
Glenn needs cystectomy (early malignancy found by first cysto) and
ilioconduit and stoma. Glenn needs to find facility
familiar with high level quad care.
Urologist told us today that he will not operate on Glenn and
that Glenn would be better served in facility outside of Lancaster
County. Urologist told us that we could search the Internet to find
both.
Today Infectious Disease doc ordered another ultrasound of kidneys today
to determine what spot was shown on L. kidney yesterday by C-scan. He
st'd that he'd tell us results on 8/29.
What direction to take? Which facilities offer quality
urological care for high level SPI injury quads found within limited
geographic area that Glenn can travel? We are in Lancaster County,
Pennsylvania.
Wife asked what to do if reoccurrence of bleed/clots when they get
home. Go to ER?
"I guess so" was Urologist response.
How & Where can we start
research?
