Re: 1/29 Ruben amps 389 +3 230 +4.75 236 +6 214 still WONT E
"on exam, rubens belly was tense but the rest of his exam was unremarkable. as we wanted to make sure he didn't have any intestinal obstructions or issues with his belly pain, an abdominal ultrasound was preformed which did not show any new changes-his colon lymph nodes were sill a little enlarged, but this was present on his last ultrasound. rubens pancreas appeared normal and his stomach was empty. he did not appear constipated. as we discussed that this could be due to pancreatitis (which could be present despite a normal ultrasound)-side note i dont remember her saying that-frequent diet changes, or some other gi irritant. we gave ruben a dose of pain medication, some subcutaneous fluids, and a dose of cerenia, an anti nausea med that also has some anti pain properties. we are dispensing to you an appetite stimulant-mirtazepine.
if ruben is not eating tomorrow, he needs to be re-evaluated. dr. kessler will not be in but dr. block should be here and able to answer questions.
1. if ruben's bloood sugar is <200mg/dl tonight and he isnt eating you can try skipping his night time insulin dose, but he will need to recieve at least one dose saily. if he still isnt eating in the morning, as long as his blood sugar is >200mg/dl he should recieve 1/2 unit at least once daily.
2. monitor ruben's urine for ketones today and tomorrow. if ruben has any please contact osvs
3. please call dr kessler on thur with an update on how ruben is doing at home
medications
mirazapine 15mg.
give 1/4 tablet orally once every three days to help stimulate his appetite
this is an appetite stimulant
dr. kessler also said she is a vet but that she knows exhaustion when she sees it and to go easy tonight....yeah right. she's right but how do you tell a mother not to worry, if i knew how to do that i would.
so my questions are when to test again, honeslty we both need a brake if even for a few hours.
how do i handle numbers tonight.
how do you treat pancreatitus? she did not do blood work cause she would not get the result for a few days anyway so she said she did supportive treatment, which is what she would do if he had it < is that correct, is what she said up top the correct treatment
i felt so bad he was crying inpain during the exam then got shots fluids a pill hes so not himself
this is like whip cream on top of shite, she also said that while im doing this testing and focusing on the diabetis she doesnt want me to miss something else that might be going on. i asked what she thought and she couldnt say, hopes the treatment helps and for us to rest tonight
whats everyones thoughts? im sick, hope this med helps him not be in pain. when he hurts i hurt too.
