Tuesday, 28th June

If it's not one thing then it's the other....

Jimmy was discharged yesterday and is now recuperating at home.  But this was not without its dramas.  On Saturday he started with what felt like gout in his foot.  By evening he had a full blown gout attack in both his feet and right knee and was in so much pain he could not even change position in bed.  This of course led to his back muscles cramping up again and a very miserable patient.  I don't think the staff on duty have had much experience with gout in high care, which probably makes sense, but unfortunately they did not give him the treatment he needed fast enough.  They were giving him pain injections which should have been administered 6 hourly but they weren't having much effect so he was getting them 2 hourly.  The more we tried to tell them that he needed a voltaren injection they wanted to wait to see if he would get relief from the tramacet injections.  On Sunday morning after Dr Du Toit had seen Jimmy he prescribed the voltaren injection.  When I got there at 1:30pm Jimmy had still not had the injection.  When I asked about this they casually said they would phone the pharmacy to see if it was ready.  Jimmy got his injection and within 30 minutes, although still in pain, the throbbing has stopped.

So yesterday he got discharged but could still not walk due to gout.  We wheeled him to the car in a wheelchair and then Emma and I lifted him into the car.  Once home we had to support him and take as much weight off his feet as possible to get him into the house.  Last night he could still not walk to the toilet or the bedroom at bedtime.  The good news is that he is better today.  He still can't walk unassisted but he can at least move his feet without terrible pain.

And of course Jimmy lived up to being Jimmy and announced to me this morning that if his feet are better tomorrow he is going back to work.  His blood counts are all below normal and he really doesn't need a secondary infection so I had to convince him to take Prof's instructions seriously and go back to work on Monday which is when he has been booked off until.

His platelets have come up nicely again to 127 and we got the infection marker results back and these had dropped back down to 18 from 80 (10 being normal).