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Stephanie78
04-05-2012, 11:05 AM
Where do I even begin? After testing ANCA negative for 3 months in a row (Yes we do realize that the test alone DOES NOT constitute a "Remission" status) along with no symptoms and increased strength John's dr's said that "remission" was a safe assumption. We celebrated Christmas thrilled at the news and went into the New Year with hopes of a Health(ier) year.
John's Creantine levels were still higher then the neuphrologist liked (1.7) however they had remained stable at that number for right at 6 months. In November we adopted a puppy that would play Johns companion during the days while I was at work and the kids were in school. Callie (Our black lab, pit mix) is the SWEETEST dog ever! In January John begin to have Sinus issues again (Just stuffy) He went to the neuphrologist (who is he overseeing dr with the diesase) and they suggested that he go and see his ENT. After seeing the ENT going on a low does of Pred and returning after a week the ENT said that it was allergies (possibly to the new puppy) but that there was NO swelling in the sinus' as there had been before when he was having a flare.

March 10th we had driven to Durham (Actually outside of UNC) to pick up a friend who had flew in from Kansas to visit for the week. We stopped at a resturaunt to have lunch and watch the Carolina/State ball game and then began our ride back home (2 hours). On Friday (the day before) we had closed on our new home and would be working on it the next week so that we could move in by the first of April.

Within a hour and a half into the drive John started complaining of being tired and barely able to keep his eyes open. Neither of us found this odd because as all of you know you wear out eaiser after being dx with WG. After getting home I decided to feel his forehead and he was warm. After checking his temp (it was 100.1) I called UNC and spoke with his neuphrologist. Our oldest (Zac) had been sick with a viral thing earlier that week with a fever (no vomiting just fever and tired). The doctor called him in a antibiotic (NOT beause he thought it was infection but to kinda ward off infection) He too thought it was viral and said as long as we keep it below 101 we were good.
The next morning John woke up feeling better. We went shopping for new flooring for our new home and went to check out the paint job (we hired painters so that he would not be around the fumes due to the lung involvement he had back last summer).

After returning back home he laid down for a nap. I checked his temp again and it was 99.9. His dr had called and checked up on him twice that day. The next morning, he seemed fine. I left for work and called a couple of times to check on him. Never did he sound "sicker". One I returned home I knew something was wrong. He was shaking like he was freezing. I checked his temp and it was 102. I called the hospital at UNC and found that his dr was not on call. (Now don't judge me here but I got aggressive) I DO NOT trust just any "oncall" dr. His neuphrologist gave me his personal cell # and for the first time (he gave it to me in July) I dialed that number terrified of what I was doing. It went to Voice Mail but he returned my call within 60 seconds (Literally). I gave him the update and as he was telling me "You need to bring him into to UNC now" I walked into the room to find John vomitting in the sink. At that point he basically yelled "Get him to the closest ER NOW!"

By the time we arrived at the local ER (Which was filled to the MAX with patients waiting to be seen) they could see how sick he was and got us at the top of the list.

By the time we were settled into a room (In the ER) he had uncontrollable vomit and diareaha. His temp had spiked to 104.9 and his BP was 75/40.

DX was a severe virus accompanied with a severe kidney infection. They admitted him to the hospital.

The next day they could not get his BP up so they admitted him to ICU so they could give him a BP drip to help raise his BP. During the night (before they moved him to ICU he passed out (while in the bathroom) and fell and hit his head/face.

By mid day they decided that he had to be transfered to UNC and were waiting on a room in the CCU. They had him scheduled to be airlifted however by the time UNC had a room the weather had gotten so bad they had to take Vita-Link (A ground transportation which had two actual RN's on the truck)

Long story short (He was there for 2 weeks) John started out with a virus called the "nora virus" Due to the fever and extreme vomiting and diahreha he became dehydrated which is horrible with already compromised kidneys. This caused his kidneys to shut down. This in return caused fluid to build up in his body (around his heart) and... Wait for it... Wait for it... CAUSED HIM TO HAVE A HEART ATTACK! Once at UNC they were doing heart test due to his BP being so low. One of the blood test showed that fluid that leaks out when one has a heart attack (Ta Da.. Now we had a reason for why he fell in the bathroom!)

After a couple of days his kidneys continued to get worse. At the worse his Creantine levels were 7.6. This led to them putting in a port in his neck and him having 3 treatments of dialysis.

By the 3rd day his levels had gone down and they chose to moniter. By Saturday they were back at 2.5 which they were comfortable with. (Last Thursday they were 2.09) Johns kidneys are functioning at 50% which the dr said he can go FOREVER with. However they have decided that they will NOT allow his immune system to build back up for a while longer, meaning when he gets sick (which is easier) this is what we will deal with. They have also informed us that IF his kidneys get to a point where he would need "Long Term" dialysis they will NOT go that route. They will instead opt for a kidney transplant.

Johns heart did take a big hit this time. He goes back to the cardiologist in UNC on Wednesday.

OH he also had pneumonia. While vomiting he had some go into his lungs which caused pneumonia.

Luckily the dr's DO NOT believe the disease was flaring. They believe it is all secondary and the virus caused a long reaction to the organs that were already damaged from the disease. They also said he has ATN (A kidney thing, I can't remember what it stands for, I know what it is ).

He came home 10 days ago and has been doing well (tired of course). My family was awesome with caring for the kids AND getting the house ready for us while we were at UNC.

That's about it, I mean we can't handle to much excitement so we try to keep it simple (Yeah Right).

Al
04-05-2012, 11:41 AM
Yikes, Stephanie-you and John have really gone through it. I am extremely sorry that all this has happened. "Excitement" is good in baseball, bowling, or even seven card stud. I'll bet you could enjoy reverting to boring.

Infections, whether viral, bacterial, or fungal, are when immune suppressed patients live it terror of. And John has now shown exactly why there is this terror. Your horror a strong lesson for the rest of us. I will repeat my mantra: For Weggies, there is no such thing as "just a cold (or flu or other infection). Once the immune system is suppressed, any infection is potentially a nightmare. I am glad, though, that John seems to be on the mend without incurring a new flare.

ATN is like a kidney stroke: mostly, it is caused by oxygen deprivation--in John's case, this is probably related to the heart attack.

Next report, we want to hear "boring" again!

Al

drz
04-05-2012, 01:11 PM
Sorry to her about your nightmare experience, the one many of us fear. It is very impressive that you survived it so well. My doctors say you can survive with kidney function in the high teens but it it needs to be double that to feel fairly well and 40-50 % function is considered good enough for most things so glad to hear he recovered so well again. How much heart damage from the attack. Will he be doing any cardiac rehab?

Thanks for the update and hope things get "boring" for you both again soon.

pberggren1
04-05-2012, 07:08 PM
Kinda thought u must be busy Steph. Haven't seen u around on FB. Good to hear John is home and doing well again. I am glad he has UNC to go to.

mishb
04-05-2012, 09:19 PM
I'm glad to see your update Steph.
My daughter asked the other day how John was going and I said that I hadn't seen an update on fb for a few weeks and we both hoped and prayed that all was okay.

I too hope that John gets back to his "boring" old ways.

Take care of him and yourself

Stephanie78
04-05-2012, 10:13 PM
Thanks everyone. Drz, I'm not sure the amount of heart damage that was associated with the heart attack. They considered doing another heart cath but due to the infection felt that they needed to wait. His BP finally picked up (after the drip for a couple of days) and then got on the higher side. Then they started back on his heart medications and it seemed to level off. I'm hoping to find out more information at next Wednesdays appointment with his cardiologist.

The worse part of this sickness (I forgot to mention) was he developed blisters all over the inside and outside of his mouth. This made it nearly impossible to eat. They have healed for the most part now (took 3 weeks). They didn't know if it was a reaction to the large dosages of Cipra they were giving him in the IV or a part of the virus itself. He looked pitiful! It now looks like a "Burn" where the new skin developes in the place where the blisters were. Seems scared at the time, hoping it will go back to normal. But as long as he can eat then I guess that part shouldn't matter much.

They put him on a 2G Sodium diet for the meantime due to his kidneys (2000MG) . That is hard! Even milk has sodium! Worth it though if it helps his kidneys stay better.

They did say that they wanted his kidneys to remain between 40-50%. For about 4 days they wouldn't work on their own period. THey gave him high dosages of lasics to the point where his entire body was swollen plus the bages of fluids. A cathater was placed and would get only a tiny bit. The dialysis definitley is what kickstarted the kidneys back to life!

Sangye
04-06-2012, 03:00 AM
Man Stephanie, I'm just catching up. This is awful! I'm so sorry for what John went through! Glad he's stabilizing now. Noravirus in an otherwise healthy person is horrible. I can't imagine getting it while immune-compromised. Hang in there. :sad:

watersedge
04-06-2012, 09:12 AM
Hope your husband starts to feel better. I am almost sure that ATN stands for "acute tubular necrosis".

Dryhill
04-06-2012, 10:42 AM
There is never a good time for anyone to be extremely ill, but when it happens at the already stressful time of sorting out and moving into a new home is not fun. I remember getting German Measles (aged 32) just as I was due to take some accounting exams and moving house, I still wonder how my poor wife coped. Stephanie, you clearly have a great family which is really esential for any of poor old weggies.

I hope and pray that John recovers soon and that it does prove not to be a WG relapse.

Jim

Al
04-06-2012, 11:23 AM
Still thinking about Jane's thread. As I've repeatedly opined, for Weggies there is no such thing as "just a cold", or other infection. Norovirus is very common, and most people encounter it several times as "stomach flu", or "24 hour flu". It is the most common reason for non-bacterial gut infections. (It is also a regular passenger on cruise ships; maybe it likes a holiday as much as the rest of us.) All this is highly annoying and far from a pretty sight, but normally, the immune system fights the buggers off in relatively short order. But when the immune system is suppressed, you really don't want to be dealing with it. In John's case, things got quickly out of hand. So another lessen for Weggies: If you feel anything like a flu, gut or otherwise, watch temps like a hawk, and do not hesitate to call (even on the weekend, or at night) if a fever pops up. And you know those messages, "If this is a medical emergency, please hang up and call 911"? They just might know what they are talking about.

Al

Stephanie78
04-06-2012, 12:39 PM
Al, I totally agree! The NoraVirus has been horrible here, I have known healthy adults that have been to the ER from it. That being set to the side, John is not healthy. Last week we were at UNC for an appointment with his neuphrologist and I made it VERY clear to my husband (in front of the doctor) that in the future if he runs the SLIGHTEST fever that we will be going to UNC not wait a day or so to see what happens. I DO NOT blame his dr for giving it a day or so. I never realized (nor did John) until this sickness how sensitive his kidneys are and how important it is to make sure he doesn't run a fever for fear of dehydration.
Sometimes it is hard to tell the difference between "Weggie Tired" and "Sick Tired". That is what John has to learn and to be more aware of. The one thing I have learned is that if it doesn't feel like a "normal day" then it's probably not.
He ran a fever of 104-105 for over 24 hours straight and vomitted for 36 hours straight and had diareaha for 72 hours straight (When I say straight I mean almost NON-STOP). We (meaning myself, the nurses and drs) were at a loss of where the "extra" stuff was coming from! At home time the pharmacist suggested an enema to make him stop, the nurses exact words (I heard her on the phone) "This guy has more **** coming out of his ass then I do out of my mouth, we can not possibly put anything up there". (I actually had a good laugh at that one).

Watersedge, that is exactly what it is. They say that with they the kidneys almost always heal themselves. I'm curious to how that will turn out.

Thanks again to everyone for your kind words. It's great having a sound board of people who truly understand!

Sangye
04-06-2012, 01:35 PM
Stephanie, even though I dislike using labels like this, it's helpful to remember the phrase "medically fragile" in future dealings with ER staff, EMTs, etc.... They understand that and can shortcut their questioning. It's also very good for John to keep a list of his serious conditions and current medications in his wallet. I have one and have used it a few times when speaking is difficult.

Al
04-06-2012, 04:08 PM
Fact is, Stephanie, that we we all live in a microbial "soup"; various microbes surround us, infest us, and are--literally--part of us. Most are harmless, and even useful; it is a good thing that these aliens have their "green cards". (What would we do without mitochondria, for instance, which are highly embedded within us, though they began as independent bacteria? Or all our gut soldiers? Without them, normal digestion would be impossible.) But not all. How is an immune system to know which to allow and which to banish? This is clearly even tougher when the immune system has its own existential problems.

Quite the thing, that John's nurses are so colorfully (and laughably) descriptive, and willing to call bureaucratic messing around for what it is: its own kind of diarrhea. I agree with Sangye's solution. And yo are right: It is extremely important be sensitive to what is "normal tired", and what is really sick. Now you, as well as John, know what to look for.

I'll admit that I was somewhat surprised that John's nephrologist allows 2 grams of sodium per day, as that is about the recommended maximum for normal people. My doc suggests a maximum of a gram and a half, and I usually come in around 1200 mg or less. It can be done, though it takes some planning. For instance, I use most of the herbs and spices on Nicole's list regularly, and I never add salt at the table. I know, some things are really hard to take unsalted--like grits, which, I am assuming, that you eat in NC. Still, with garlic and unsalted butter, you are halfway there. Nut butters, assuming that they are allowed, do not need salt to be delicious. Nor does oatmeal. Yes, dairy foods have some sodium, but the amounts are not outrageous, so long as you don't overdo it. There are a lot of good foods our there, Stephanie, that deserve a try, in my opinion. Go for it!

Al

Jaha
04-07-2012, 12:32 AM
Stephanie,

I'm so sorry John and you had to go thru that awful scarey health crisis. I'm glad to hear he is on the upside of that episode.It is so wonderful that you are by his side and come hear to the forum to learn and share. I've been trying to get my husband to read the valuable information here, for almost 2yrs, so he will know more about this crazy disease. I'm alot like your husband, I think things will just go away on there own, the truth of the matter is that, I can't think straight when I get so sick. Thank goodness he has you with all your understanding and patience. I hope things go well for both of you in the Moving and with your Health from now on.
Jana

Al
04-07-2012, 03:32 PM
...I've been trying to get my husband to read the valuable information here, for almost 2yrs, so he will know more about this crazy disease. I'm alot like your husband, I think things will just go away on there own, the truth of the matter is that, I can't think straight when I get so sick. Jana--The sad truth is that men are, at least statistically, more into denial than are women. Oh, there are surely cultural reasons for this. But study after study affirms it. And yet, individually, men can be educated, believe it or not! We guys are not total losers-not all the time anyway....

Al

BrianR
04-08-2012, 05:39 AM
I have nothing helpful to add to this thread. I only want to say how scary this must have been for you and your family Stephanie. I was horrified to read this.

Take care

Psyborg
04-09-2012, 07:01 AM
Stephanie,

I'm glad to hear John is doing better now, but sad to hear about the difficulties. I hope he gets some relief with better health for a while.

Stephanie78
04-11-2012, 03:04 PM
Sangye, I have learned to throw out the whole "Chemo" word when we go in. For some reason that really starts a fire under their feet to get him seen ASAP (at the local ER). At UNC (since they have all of his records in the computer there) he is sent to the front of the line.

We are FINALLY settled into the new home. Now if we could just get into a routine! I took medical leave this time so that I could be here with John for a while. I return back to work next Tuesday.

John is doing great right now. He tires out easily, but that's understandable.

We go to the Cardiologist tomorrow at UNC so I will update once we get back from there.

Thanks again for all of the comments, encouraging words!