We had to get insurance to assess the claim and deny the PET scan so that they could have a denial number so that they could do the peer to peer and approve it so it could be done that morning so we can fly home Tuesday. Seems impossible right? Not at Mayo! The short version of the story is that is exactly what happened, sort of. By 9am we (and that includes my "scheduler" friend from Friday) managed to cancel our 7am PET, get insurance to deny the scan, had Endocrinology talk to insurance, Insurance changed the type of PET to a more in depth scan, and got rescheduled for PET at 12pm! WOW what a morning. Since we had time to kill and my sodium was still unstable, we decided to have labs done while I wait for scan. Not even an hour after labs, just before 12pm we got a call...…..My sodium had Dropped!! What the hell! I was on NaCl suppliments and fluid restrictions, how could it drop and drop down 7 points to 120???? The endocrinology department told me to let the PET team know that I need to be transported to the hospital for admission and to cancel the scan.
By 3pm that afternoon, I had been transported to Mayo Clinic's Hospital, St Marys was evaluated in the ED (where they had already talked to Dr Natt and knew almost everything about me) was admitted to the hospital and transported to the floor. In a matter of a few hours following admission the hospital had started forming my "team." This team started out with an internal medicine doctor with his NP, PA and medical student. He was considered my team lead. It was his role to facilitate care with every other specialist from that point on. In addition to him, I had endocrinology and Nephrology visit me as well. They cut my fluids down to 950ml, increased my sodium to 6 Grams a day and added Lasix (a diuretic) in hopes to get some fluid off me and raise my sodium. The PET scan was rescheduled for the next morning and of course labs were being run almost around the clock. Nurses would come in and assess not only my vitals but mental status as well. (At a hyponatremic state as such, many people begin to have neurological affects and are unable to recall location, date or their own name.) Sodium hanging Out at 120s while on supplemental NaCl was a tad anxiety provoking for myself and my team. By the end of the day. Even on 40mg of Lasix, I was still not peeing! None of the nurses could believe it.
I don't know how many times they would make a joke about how "fun" it was going to be on Lasix.....Then the shear look of disappointment when I didn't void. And Believe me, as a fellow nurse, we take Is & Os very seriously!!
Due to my inability to void for hours, Ultrasound was called up to scan my bladder to see if I needed to be catharized....Bladder was empty. This is "important" because it shows how desperately hard my body was working to hold onto fluid and how by holding this fluid my sodium was constantly being diluted. So where was all this fluid- I must have been busting at the seems with 3+ pitting edema right? WRONG. I had no obvious swelling. The ADH production was causing me to hold fluid in third spacing/ intracellularly. This hormone was out of control, and at this point no one knew what was causing it.
Tuesday morning came and the middle of the night sodium check showed I was up to 123. Later that morning I was transported back to the clinic to have a very specific PET scan done to look for very specific tumors called neuroendocrine hormone producing tumors. Yes it was nerve racking, and I was scared shitless but that morning something very funny happened and it had me laughing all afternoon. My sister was coming out to Mayo Clinic from FL and she had actually booked and traveled to the wrong Rochester and landed in Rochester, NY instead of MN!!!!!
Don't worry she had a full on panic attack, was able to catch another (correct) flight to MN and still made it to Rochester, MN by 7pm.
The PET scan took almost the entire day. Between transport, waiting for the Dotatate contrast to be prepped, infusing the contrast and having the scan it took about 4 hours. It was about 4pm by the time I was transported back to the hospital. I was already aware that my sodium had dropped down to 120 prior to PET scan so I was not alarmed that shortly after getting situated back at the hospital the endocrinology team came in. I figured that they were there to tell me that I needed more NaCl. Again, I was wrong.
 |
| A visit from a therapy dog |
No comments:
Post a Comment