Dehydration vs. Retention...that accursed prostate gland

P_RN, ADN, RN · Sep 15, 2004

Good luck at the doctor's appointment. Tell him everything you have written here. As far as the anemia, there are dozens of things that could cause it. Was the ER doctor concerned?

begalli · Sep 15, 2004

Maybe you could try drinking gatorade? It's a wonderful substitute for water. I love Fierce Grape. Soda will just further dehydrate you.

You sure are drinking lots of water. Maybe you are just experiencing a dilutional anemia.

Also, maybe the vicodin as well as the abx is contributing to your n/v? You obviously need something for pain, maybe the doc could perscribe something for the nausea as well? Maybe compazine?

And...remember that tomato juice is high in sodium. Be sure to drink reduced sodium tomato juice to avoid retaining water. Or forget the tomato juice all together.

One last thing, be sure to let your doctor know that when you have these bouts with retention, that when you finally are able to go, you dump large volumes of urine within a very short period of time. I know that's probably the nature of urinary retention, but your doctor should know about the 3 liters in 40 minutes. That's not so great for your body.

Your doctor will be able to help. Hang in there and Get Well Soon FZ1Tom.

Farkinott, RN · Sep 15, 2004

You need to rule out diabetic nephropathy. What is your urea and creatinine?

FZ1Tom · Sep 15, 2004

You need to rule out diabetic nephropathy. What is your urea and creatinine?

Okay, let me take a look. Got 5 sets of results from 8/24 thru 8/28 for the BUN levels - 19, 13, 10, 8, 10, reference range 9-20, and my creatinine 1.4, 1.0, 0.8, 0.7, 0.8; reference range 0.7 to 1.5. So, within normal limits there.

Begalli - thanks for the advice, but Gatorade's got too much sugar for me. Even the tomato juice spiked my BG pretty good. I don't normally drink 6 liters of water.....hate the stuff, remember? Only drank that much on Sunday b/c I was trying to get rehydrated. 1 to 2 liters is more typical. Trying to swear off diet soda, which is hard. Would tomato juice and other high-sodium fluids and foods result in low sodium levels? I've NEVER seen a single lab of mine, going way back to last fall, that had my sodium levels up to normal. Always below normal, around 130 or so.

Funny about the nausea......first go around with Levaquin (the kidney infection on 8/7) I DID have an Rx for Compazine, but not since then. Something to ask about. There any over the counter meds for N/V?

How long is too long to be taking that Vicodin? I know its a narcotic, and has the potential for dependence. Could it be conceivable that my pain or retention is being exacerbated by taking/not taking it? Been on it since 8/20, smaller dose than when I originally started (the 5/500 2 tabs made me dizzy, in hospital two 5/325 tabs worked about right, and presently on one 5/325 tab q 6hrs).

I'm just so frustrated! I can't afford to lose work or quit (in fact the boss is giving me all the hours I can handle and then some, actually well intentioned because I need the money but its wearing me out even more at the same time), about to get evicted because the rent's not paid in two months, gotten bills totaling $15k so far from the hospital in addition to the tens of thousands in debt I already got (for which I can thank credit cards, insurance companies, and vehicle loans gone bad). I feel like a miserable heel because I'll never be able to pay all this mess off without filing bankruptcy.....that is, if I can ever save up enough to pay the freakin' LAWYER first. All i want is for the damned PAIN to go away, be able to pee something normal again, lose some weight (actually dropped 40# so far) and start feeling better again. You know, the usual?

By the way, an amusing irony in all this. My website name here is FZ1Tom. Name is just plain old Tom, of course, the FZ1 referred to the Yamaha motorcycle I used to own and ride till the bank came and took it back last year. One of the true joys of life....I miss it, bad. I would sure hate to think I would not be able to ride a bike again (eventually) because of a stupid prostate gland! Maybe I would have to buy a cruiser instead b/c the gyno chair position (an inside joke of mine) on them would be more comfortable than the FZ1's UJM standard-influenced position was (snicker, snicker).

And now back to bed for a while.....thanks for all your help and support!

Tom

neneRN, BSN, RN · Sep 16, 2004

Actually, it's not sounding as if you've been dehydrated; you're consuming more than enough fluid, your BUN is not elevated, and H&H is low as opposed to higher values that you normally see with true dehydration. Your low sodium could be caused by your excessive oral water intake. Also, being diabetic, if your sugar runs on the high side, you'll see lower sodium values. Your low blood counts (anemia) may very well be dilutional from all that fluid too.

As for the nurse not being "the brightest person in the world" for her choice of placement of your line, assuming you're right handed like the majority of us, the non dominant hand is an appropriate choice; especially given the fact that ER nurses are often slammed for using the AC. Also, given that you're a diabetic, do you have great big veins all over that the nurse had her pick of any site she wanted? Sorry, you just hit a sore spot with that comment.

Correct me if I'm mistaken, but from your posts, it seems like you've had a lot of ER visits. Do you have a primary MD that knows you and knows your Hx that would be able to better manage all the problems you're having? Have they given you referral docs to follow up with after the ER that would maybe help you to avoid the ER visits?

FZ1Tom · Sep 16, 2004

Thanks, Nene!

I think you mentioned a couple interesting tidbits. While I still don't think I really drink too much H20, I didn't realize that high blood sugar (mine usually is) would cause low sodium readings. So happens I used to work with a mentally ill client that DID drink way too much water (200-300oz a day) and would have terrible behaviors when we tried to redirect him from loading up on water, and even his sodium levels were only a couple points lower than mine. I just figured that last weekend I was getting dehydrated simply b/c I was urinating so much less and the urine was getting very dark and strong smelling. That infection could be making a comeback tho - had slightly elevated temps the past couple evenings (99-100), I sure hope not.

It just occured to me that both last Sunday, and that weekend before I was in the hospital I DID drink a lot of water. Of course when yer running a 103-104F fever and soaking the bed in sweat something's gonna end up out of whack.....for me, my potassium level (if only I had been able to eat something, anything). It sounds like dilutional anemia isn't a big worry in the short run, but I will ask my doc about it. FWIW, I THINK I found a good doc I want to stay with as a primary care MD, regardless of my insurance situation, etc. In hindsight, the first follow up doc (one that told me my urethra was "irritated" 10 days after being cathed) probably should have suspected prostatitis after I told her my symptoms. Perhaps she misunderstood me? Anyways, this doc is very good at communicating with me (with my hearing and speech misunderstandings/miscommunication is a real problem for me) and everything. I dont know if I could have avoided this last ER visit or not, at the time it seemed like the right thing to do. What if I had waited at home for 4 hours while my bladder swelled up and for whatever reason I actually couldn't have urinated (heck, I was stuck at work for 12 hours....as a MR/DD caregiver, I have to stay till someone comes in, even if I drop dead :rolleyes: ).

Now about this "not the brightest bulb in the world" thing......all right, I admit I can be a real smart-aleck at times, and I'm much too intelligent for my own good. Maybe the nurse was just plain tired, had a bad day, who knows. Honest truth is she just didn't seem all that aware to me. But I really strongly wish to emphasize (and this goes for the infamous Motel 6 thread in the ER nursing forum) that I NEVER, EVER intend to begrudge or complain about nurses, hospitals, doctors, management merely for the sake of it. Nor do I ever entertain malicious intents. I just don't do it. I grew up raised by my grandfather, a miserable, hateful and bitter old man who relentlessly criticized, berated, offended, baited and griped at me through my entire life. Needless to say, I learned how to deal with people by learning what NOT to do. Also, I was a student for three years in a Catholic college prep boarding school - its amazing how deeply they instill certain values in you. Even today, I can't bring myself to hate people who probably deserve it.

But I do have a warped sense of humor, and if a nurse or anyone else doesn't seem too sharp, then hey, he/she probably isn't. Just don't take it personal. Nobody's perfect, right? :chuckle Believe me, you should hear the venting that goes on in my line of work about state beauracracies and agencies like the Dpt of Mental Health and the State of MO and administrators and such. Its pretty bad.....but truth is, if you kept everything inside it would eat you alive. Most caregivers are gone within a month, I'd say only 1 in 100 (or more) last 6 months. I've lasted six plus years so far.......it must be all that griping :)

I just hope that I recover and don't relapse and regain my energy so I can work and everything.....its hard to be optimistic, but I gotta try.

Tom

PS: And from now on I promise to try to make shorter posts that don't take 1/2 hr to read - if any questions, just ask!

leslie :-D · Sep 16, 2004

you sound like a candidate for the turp procedure.