suggestions to docs

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I just want to know how other people feel about this. Maybe I'm just a chicken, anyway... I took my grandmother to the doctor yesterday because she has recurrent UTIs and also she was complaining of muscle cramps in her arms, neck and legs. He prescribed Cefzil for her UTI which was fine, but when we asked him about the cramps he showed her stretchs to do with her legs and told her to drink a gin and tonic because the tonic has quinine? This isn't her regular doctor by the way. He didn't order any lytes like I thought he should have. I left there feeling frustrated. It seemed like he totally blew her and me off. I should have suggested the lytes, but he is the type of doctor to get very offended and not order what you suggest anyway. I know I should have my grandmas best interest at heart. I feel terrible about this. I just called his office and spoke to his nurse about this and she's suppose to call me back so wish me luck.icon9.gif

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Creature, it's so easy for doctors to try and ignore or intimidate patients/families. That's why it's so important to always be the patient advocate...Hopefully your phone call into the office will get an order for some labs...Good thought...in the mean time, make sure your grandma is well hydrated and possibly a good calcium/magnesium supplement may help with the cramps. Soak in a tub with 2 cups epsom salts. Also, if the office doesn't return your call in a timely manner, take her to an urgent care center so they can give a second opinion and do labs there. If she is on medicare it shouldn't cost too much. Best wishes!!

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Maybe you could randomly ask when the last time her electrolyte levels were checked?

Has a culture been done to find the offending bacteria? Any other studies done- bladder residual, etc? Also why isn't she on some sort of propholaxis dose like macrodantin?

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Specializes in Geriatrics/Family Practice.

I work in a clinic for family practice and internal med and have found that patients are very intimidated by the doctors. I can't say that I blame them because I am too with some of them. But I have just come to the conclusion that they do put their pants on the same way I do and if I'm always intimidated than I'm not being a very good patient advocate. I just graduated from LPN school less than a year ago so I'm scared due to inexperience but I found that by speaking up and requesting something, that the doctors will usually do it, of course with an attitude, but I'm kind of getting used to it. I always tell myself that they to are human and can forget something. When I've went back into a room and a patient says that she wishes she would of said something regarding her treatement, I always say that your in control of your care and I go and get the doctor, especially if it is something that is very important to the patient.

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I would be careful about starting calcium or mag supplements without input from a healthcare professional ... not all supplements are harmless and could be detrimental if someone has kidney disease or other metabolic/endocrine issues

Definitely make a follow-up appointment with the doctor concerning the UTI ... and raise your concern about the muscle cramps/aches again ... and ask "do you think there might be something wrong with her electrolytes?"

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Hi everyone,

I called his office and asked about getting lytes done and he refused. I then scheduled her an appt with her regular doc. What a joke hey? Her last culture showed E Coli so he went by that seeing she had just finished Macrobid which never did clear it up - put her on Cefzil. Her UA that day did show infection. No shes not on any prophylactic antibiotics, but thats another thing I'm going to bring up to her regular doc. Shes been taking the quinine and her daughter who is an RN also told her to take Magnesium and vitamin C. The cramps are less, but still there. Regular doc couldn't get her in for 2wks? What? I'm so frustrated, worse than before.

Creature

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Specializes in FNP, Peds, Epilepsy, Mgt., Occ. Ed.

Statins for cholesterol are also known to cause muscle pain. That needs to be looked at as well.

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Specializes in cardiac/critical care/ informatics.
Hi everyone,

I called his office and asked about getting lytes done and he refused. I then scheduled her an appt with her regular doc. What a joke hey? Her last culture showed E Coli so he went by that seeing she had just finished Macrobid which never did clear it up - put her on Cefzil. Her UA that day did show infection. No shes not on any prophylactic antibiotics, but thats another thing I'm going to bring up to her regular doc. Shes been taking the quinine and her daughter who is an RN also told her to take Magnesium and vitamin C. The cramps are less, but still there. Regular doc couldn't get her in for 2wks? What? I'm so frustrated, worse than before.

Creature

If her uti's are from e-coli then maybe some education about wiping from front to back is needed. especially older folks they weren't taught or don't know. Sometimes we think it is obvious but not everyone does it. Just a thought.

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Specializes in cardiac/critical care/ informatics.
Statins for cholesterol are also known to cause muscle pain. That needs to be looked at as well.

yea alot of people don't know that, including docs.

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Thanks for suggestions. I have talked to her about cleaning and wiping front to back. Her problem is she wears nylons constantly and also showers once a week and in between washes up. I have talked to her about this, but she is set in her ways.

Creature

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Specializes in Nephrology.

Not sure if this will help but my mother has been fighting a UTI for 4 months (Ecoli). When it was first DX. they put her on Cipro without a C&S, so of course the Cipro did not work. She ended up voiding pure blood and went by ambulance to the local ER, there they put her on some type of IV antibiotic not sure what it was?, she was in Florida. This also did not work. From there they finally did a C&S put her on Macrodantin for 1 wk, did another C&S still had the infection, needless to say it now been 4 months and multiple course of macrdantin numerous C&S, and seen both a Nephrologist and Urologist. Finally the Urologist did a cystoscopy and xrays to find that she had a very spongy kidney loaded with kidney stones which their opting not to do anything about even with lower back pain, and that her urethra needed to be stretched due to the fact that her bladder was not emptying completly encouraging bacteria growth. Ended up he gave her 2 injections of gentamicin and put her on macrodantin 1 pill qd/x 1 month as a prophylaxis. Her symptoms have lessend but we wont know 100% if the Ecoli is gone till the next C&S. Maybe taking her to a Urologist instead of her family Doc. would be helpful. I know that with my mother she was so deathly ill we did blood cultures to see if she was septic,THANK GOD she was not. Hope this helps. Keep me posted if you find something that works or would be helpful. THANKS!

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He actually suggested a gin and tonic??? :uhoh3:

That alone would make me go somewhere else.

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