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Unable to urinate? Is it BPH or Bladder Disease caused by DMT2?
My dad is 79 yo male with history of DMT2. Who been to the ER on 12/25 and 12/26/22, He was brought in by ambulance for having pain and not able to pass urine, started today the 25th. After they examined him. Placement of foley on the ultrasound shows his has 957mL of urine in his bladder and not his prostate. Plan to start with Tamsulosin and see an Urologist. Next day 26th, back to ER for more pain with blood clots in the bag. UA shows WBC clumps cystitis, Keflex was prescribed. Lab work unremarkable for AkI . BPH with LUTS and change Foley size 16 to 23 then sent home the same day. Got an office appointment with his PCP 12/28. (At this point not impressed of communication from the involved doctors). My dad get an Urgent Urology Referral Appt for 1/3/2023 in Orange County per his insurance. That night he started to have seizures at my home. Call 911 and he was taken to Hoag Hospital ER and admitted. He stayed there for about a week. Now the hospitalist is explaining that had hypoglycemia, that caused ARF and infection on his prostate. What? My dad does not have a prostate problem ever. So now I do my owe collection of his medical records. Because I'm no doctor, and want to get an idea what going on and the research starts from Mayo Clinic, John Hopkins and Cleveland Clinic along with U.S. Department of Health and Human Services, National Institutes of Health . American Urological Association Education and Research, Inc. National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) Journal of Urology and Atlas of Human Anatomy book. By keeping his records and cc each doctor they were able to keep current. None of them use the same same labs. My dad decides not to do any surgery and want to try meds first for the enlarged prostate (Which we don't believe is causing this) and the Foley in and changed every month now is every three weeks because of plugging and bladder stones. A year is passing us by. His PSA Level went from 0.4 in 2015 to 56.92 in 2022. With meds it jumped down to 27.30 Dec 2022 and 0.6 in 2023 now its 0.3 in 1/2024. Whats was caused his infection his DM meds per the doctor at Hoag. He is home now. Mean time I am requesting for some type of rectal exam be performed or new x-rays be done for comparisons to see if worsen or improved from his hospital stay. Before any surgery happens TURP procedure. The doctor got put off by this. He gave us an order for an ultrasound of his Renal and Bladder finally. Had an appt to see him for the results. I got sick and unable to drive him, we missed our appt in Nov 2023, his next appt is not until Feb 22, 2024, more time is passing by. Stop me if i'm wrong how about a phone call. Something, We finally see the doctor and tells us that he referring us out to other Urologist for consult and HoLEP procedure. Trying to ask him why based on what? What changed to have TURP to HoLEP? When did he decide this? Why? Writes the referral and walks out. Now my dad is fed up with doctors with no answers. What are we missing? HoLEP first appt August 1, 2024. Anything?
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@heysp22, you and your dad have been through a lot. I moved your post to the Men's Health support group. You may find these related discussions helpful:
- HoLEP vs TURP: Looking for guidance
https://connect.mayoclinic.org/discussion/holep-laser-for-prostate/
- PSA numbers after HOLEP?
https://connect.mayoclinic.org/discussion/psa-numbers-after-hotep/
- HoLEP procedure experiences?
https://connect.mayoclinic.org/discussion/holep-procedure-experiences/
You mention that your dad also has type 2 diabetes. Has that been discussed with his doctor too? How is he doing?
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2 ReactionsThank you I just did not know which discussion to start. My dad has a better understanding of his complex medical history of diabetes type 1, HBP and UTI. A foley placed in for Urine retention. To having an acute kidney injury, bladder and prostate problems. At this point, I just made a chart on him. I collected and explain all reports to my dad. I didn't know he was having problems expressing his questions to the doctors. He wanted to know what happened to him & about his hospital stays. Its been hard to get his doctor's to talk with other doctors about TURP & HoLEP any testing. But now they know our questions are typed & given to them day before the office visit. But Dad is just glad I understand it and if not I will. I just don't want to miss anything.
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1 ReactionHe is Type 2 not 1. Sorry about that.
Just a suggestion to obtain help with understanding what wrong and happening with your dad. No matter what type of Medicare insurance he has for part B a liaison nurse should be available via phone to speak with you/him regarding his condition and it’s part of your part B beneficiaries
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1 ReactionThis is a bit off topic, but I recently spent 9 hours in our local ER for bloody urine (with occasional small clots). Final result: went home with Foley catheter and bag. The catheter was some of the worst pain ever. had to go to PCP to have it removed five days later. That was a week ago. I have not been able to get good control over my bladder. Up every three hours at night. Anyone have a similar expereince? The EMT who put the catheter in was not very gentle. I still have some pain in the urethra when I pee.
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1 ReactionWhat a wonderful child you are.
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1 ReactionThe first ER visit, just did labs and put foley 16 and bag. Discharged him home with antibiotic. Also, make an appt. to see his PCP. The next morning my brother calls me, He says, Dad urine looks red in the bag. Send him back to the ER I'm on my way. But he won't go, until I get there to go with him. I'm retired from the medical field 29 years. Get there, I read over his discharge paperwork from the night before. The 2nd ER visit, his catheter was killing him pain level at 12. Now labs shows Acute kidney injury. Still no x-rays only an ultrasound for placement of the catheter. The second ER doctor reviewed records from the last visit change him to a 22 foley added Flomax 0.4mg and sent him home. I had so many questions. Two days later after Christmas he see his PCP who was given copies of his medical records from both ER trips. Get all the questions, Because now I have gone through the same records. Who was directing his DM 1 on metformin 2000md daily for the past year? Did this cause his Urine retention? Since when did he have a prostate problem? ect... and every time the doctor said iI don't have those records. BAM here your copy. But when I requested clotrimazole and betamethasone cream for his penis. He wanted to see what the Urologist would say. What??? The day he was to sed the specialist, he had a seizure and rushed to ER in Newport Beach, Dx with Hypoglycemia of 30 and alter mental status. I need to stop here I'm getting upset. Forgive me..
The i'm getting are from Mayo Clinic, John Hopkins Clinic, Department of Endocrinology, Kidney, Urology and NIDDK, Because he has multiple problems, which one start like dominos. My dad signed over his medicare to a HMO insurance- IPA Medical Group. I never got switched to so many departments from Member Service to Edibility Service, Benefits call centers Write it down the person you spoke to and which department phone number and job title. And Always ask for A tracking number of the phone call. Have the person to take time and read the prior message. This avoids confession and anger of explaining it again. Keep a phone log...
No need to apologize. I understand completely. My ER visit was my worst nightmare. Nine hours to ultimately have a Foley put in. I’m not sure the EMT gal even used lidocaine lubricant. Five days of torture. They were supposed to refer me to a urologist, but when I called, Doc was out of town. As a new patient, they told me I couldn’t be seen for two weeks. I finally had to go to PCP to have Foley removed. Some of the worst pain ever. I still have soreness in urethra.
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1 ReactionDid you find out what trigger urine retention? The hospitalist who admitted my dad reported caused by his DM meds and took him off. He now on two insulin shots. I'm watching his intake of food and made some adjustment and log charts to track his blood sugar. So he can eat better and healthier, life adjustments. So far I get the answers pertaining to him answered. With the clinics backing it up in reports.