Shirley - a medical emergency

[David Kilpatrick]

She's got right basal pneumonia - one lung only - feeling fine when sitting down, but she came for a walk to the hospital shop with me to pick up a puzzle magazine and some better tasting water than the tap stuff, and I could tell she was getting out breath even with very slow careful walking.

We were supposed to have a week away in Tenerife in a few days, but an extremely hilly resort (almost vertical) and our usual habits of walking many miles each day mean I'm going to talk to the insurance providers. We don't generally do the sitting on beaches or round the pool stuff. Our apartment is only a few yards from the rooftop pool, so if she just had to sunbathe all day, we could have our first ever inactive, non-photographic holiday. Then again, we had planned to go to the summit of Mount Teide (12,000ft) and walk Masca Gorge (5km of steep ravine paths).

Somehow I think we will be postponing any travel for a few weeks.

David

[paulmurphy]

Hope Shirley recovers soon. I bet you feel lost without her around.

Best wishes

Paul

[Greg Beetham]

I'm sortof surprised that they haven't suggested a gravity drain if the congestion is that bad, they get you to lie on an incline (head lower than lungs), and over a period of an hoiur the fluid drains down to a point where one can cough it up, hopefully including the foreign particles. BTW the dissolving of a tablet in water might not give a true indication either, mucus contains enzymes that dissolve things more powerfully than water does.
Greg

[David Kilpatrick]

Understood. Right basal appears to be typical of aspiration pneumonia, but the hospital has pretty much dismissed the background with the pill stuck in pharynx as a cause. It is interesting that they seem able to discount patient (and patient's husband) accounts of the experienced pathology, and to rely instead on standard clinical tests (principally blood test, X-ray, and the usual readings). They may be right with antibiotic treatment, the pill could have taken pathogens into the airways.

I've studied the chemical composition of the vitamin pill - it is clearly intended to be most soluble in an acid environment, and resistant to neutral pH moisture caused deliquescence (a fairly obvious way to design a pill which won't go soft when the bottle is opened). I would have rated its solubility in mildly alkaline conditions, like the mouth, as low - again, a good design aim, as you don't want the pill to go clammy when put in the mouth. It took over eight hours immersion in tap water to break down to a point where light mortar grinding could reduce it. The result is a fairly coarse suspension of small mineral particles in a colloidal suspension (milky in appearance) formed I presume by the main bulk of the pill.

I don't think these pills are very good. I really don't want to be eating titanium dioxide, there's enough of it to be a listed component; I don't think the body can make much use of titanium. It belongs in photographic papers!

Today (Saturday) I think we find out whether any real progress is being made. I am a bit more worried than I sound.

David

[aster]

Hi David,

Any kind of pneumonia is serious enough to require full-time monitoring. I went through very hard moments when I was diagnosed with pneumonia and it has a way of repeating itself because the real cause of pneumonia is still not as clear to medical researches as we might assume as patients. Everytime it returned, I was treated with different approaches and medication.

Lungs are important and we need them to be at their healtiest until the end. I hope Shirley gets the best treatment because it has a way of recurring in the most unexpected ways. It should really be taken seriously.

Unfortunately, I learned it the hard way and know what it can do or lead to.

Best wishes to the both of you,

Yildiz

[Javelin]

Reading up on this. the antibiotics are one method of diagnosing "Foreign Body Aspiration" Pneumonia should respond quickly to the drug and if it doesn't they may shift their diagnosis to the ingested pill. I guess the problem is that it likely won't show up on an x-ray or fluoroscope exam and they may have to use another tool (bronchoscope) ...non surgical... to go in and get the object although this is done under a general anesthetic.

I hope they solve this soon for both of your sakes.

[Greg Beetham]

At an educated guess, the titanium dioxide is used as an inert? 'binder' or a glue paste for the active components of the pill, and as far as I know it's used in the paint industry as a white pigment as well.
Greg

ps. I just had a look at the Wiki article on titanium dioxide, and came away not all that much the wiser...http://en.wikipedia.org/wiki/Titanium_dioxide

[Dusty]

We'll put Shirley on our prayer list. Pneumonia is nothing to trifle with.

I used the horse pill sized vitamins daily when I lived in Brazil, since I was never sure I was going to get balanced meals. I do think they need to make them smaller and have you take 2 a day.

Of note, my 95 year old Aunt got a pill stuck in her throat last year that wouldn't dissolve. When she went in for a check on it they found esophageal cancer. They're giving her treatments and she'd doing fine, albeit she's now bald from the treatment.

Hopefully they won't find any other problems with Shirley.

Dusty

[Greg Beetham]

David, you will try and keep us informed won't you? now that you've gotten us all worried.....
Greg

[KevinBarrett]

I'm praying for her, DK, and I hope she makes a speedy recovery.

[David Kilpatrick]

We were given a wheelchair and portable oxygen supply for her to spend half an hour in the hospital cafe and visit a stall selling Himalayan craft goods which had been set up in a dining room for the day (the hospital is good like this). That went well. Tonight, we tried to arrange a chair and go to the cafe again but no-one could find a fresh oxygen cylinder. They took her off oxygen for 20 minutes and ran a test. She didn't do well despite being just seated all the time, so when I left, she went in for a second X-ray to compare with the admission X-ray to check progress. Tomorrow I guess we will know more.

This has really surprised her (and me). Such a minor incident, and such a sudden and rapid deterioration to a state she's never experienced before.

David

[Javelin]

hopefully the diagnosis and course of action won't take too long and you won't have to learn any more new things in this regard.. good luck you two

[David Kilpatrick]

Our own diagnosis was right first time - even though the hospital was obliged not to listen to the patient, and to spend three days running routine tests for pneumonia caused by infection. Today they finally admitted it was not pneumonia, took her in for a CAT scan, pinpointed the vitamin pill lodged in the airway to the collapsed right lung, and scheduled her for bronchoscopy tomorrow to remove the pill and hopefully re-inflate the lung.

We are keeping fingers crossed for a straightforward outcome, but the pill has been in her lung for something between four and eight days (depending on how long it took to get from the pharynx into the airway). It's mid-chest level, or one large visible fragment is. I'm a bit worried about the remaining very small particulate, I guess they will see it through the scope if it is obvious. Hopefully the collapse of the lung will have prevented particles from going much further. They can maybe use a flushing solution and suction of some kind.

David

[bakubo]

I hope Shirley will be good as new in a few days. As you say, it is disorienting to see how fast one's life and health can change. Get well soon, Shirley!

[aster]

Best of luck in the procedure Shirley and David! I hope it will be over without any further agony soon...

Yildiz