BJM
Very Active Member
Previously
02/13/2012 Spitzer is slowly stabilizing
Spitzer is just about done with all the different meds prescribed - only doxycycline left, having finished metronidazole, cyclosporin, & azithromycin. I'm keeping him on the ondansetron, as he doesn't eat without it, even with Pepcid on board, which I'm also continuing.
I'd run out of the ondansetron last night, and sure enough, this morning his glucose was 125 from not eating. Obviously, I couldn't give his full 4 unit dose of Lantus. I halved the regular dose down to 2 units as he did eat some. At late lunch time (+6) he was barely over 200. After I was able to pick up the ondansetron and dose him again, I gave him a half unit of N to tide him over until I got home tonight. I couldn't do Lantus, as it would be off cycle and I wasn't sure how fast the ondansetron would work for him, so I had to be conservative in giving any insulin.
When I tested him this evening, he'd obviously been eating, the morning Lantus had worn off, and his glucose was well over 400. So, tentatively, he's back on track - cross your fingers, everyone. I gave him a 3 unit dose of Lantus (he may still go lower over night, and his GI issues may still be unstable, so I was conservative dosing him) and a small drop of R to knock the edge off. Tomorrow, I hope to have him back on his regular dose of 4 units of Lantus.
Once the cyclosporin and metronidazole were gone, he started presenting me with the occasional heap of poo by the front door again. I think that may support an inflammatory bowel disease diagnosis. He lies there, I think, because it is cooler there and feels good on his swollen abdomen (thickened intestines on ultrasound).
He has a follow-up apt on Wednesday afternoon. I suspect she is going to want me to get his intestines biopsied, endoscopically, laparoscopically, or surgically. I'm not sure he is stable enough to do that, and would like to see him put on some weight before trying.
02/13/2012 Spitzer is slowly stabilizing
Spitzer is just about done with all the different meds prescribed - only doxycycline left, having finished metronidazole, cyclosporin, & azithromycin. I'm keeping him on the ondansetron, as he doesn't eat without it, even with Pepcid on board, which I'm also continuing.
I'd run out of the ondansetron last night, and sure enough, this morning his glucose was 125 from not eating. Obviously, I couldn't give his full 4 unit dose of Lantus. I halved the regular dose down to 2 units as he did eat some. At late lunch time (+6) he was barely over 200. After I was able to pick up the ondansetron and dose him again, I gave him a half unit of N to tide him over until I got home tonight. I couldn't do Lantus, as it would be off cycle and I wasn't sure how fast the ondansetron would work for him, so I had to be conservative in giving any insulin.
When I tested him this evening, he'd obviously been eating, the morning Lantus had worn off, and his glucose was well over 400. So, tentatively, he's back on track - cross your fingers, everyone. I gave him a 3 unit dose of Lantus (he may still go lower over night, and his GI issues may still be unstable, so I was conservative dosing him) and a small drop of R to knock the edge off. Tomorrow, I hope to have him back on his regular dose of 4 units of Lantus.
Once the cyclosporin and metronidazole were gone, he started presenting me with the occasional heap of poo by the front door again. I think that may support an inflammatory bowel disease diagnosis. He lies there, I think, because it is cooler there and feels good on his swollen abdomen (thickened intestines on ultrasound).
He has a follow-up apt on Wednesday afternoon. I suspect she is going to want me to get his intestines biopsied, endoscopically, laparoscopically, or surgically. I'm not sure he is stable enough to do that, and would like to see him put on some weight before trying.
