Right now our plan is to get her released to hospice care --- at home. Once we get her, we are going to drive her to Shands Emergency. They have to take her.
She is not getting the aggressive treatments at Ocala Regional which she desperately needs!!! She is going to die if she remains where she is.
God bless you for loving Marilyn enough to buck the system and get her the care she needs.
I've been associated with several hospice nurses.
I considered them to be first class professionals.
If not, have you been designated as the guardian?
These are a couple of things you might prepare yourself for.
Hospitals can get very obstinate about not releasing patients.
I just got off the phone with one of Marilyn's RN friends from New Jersey. She's on her way to help, she should be here by tomorrow.
Right now our plan is to get her released to hospice care --- at home.
Once we get her, we are going to drive her to Shands Emergency. They have to take her.
EXCELLENT IDEA!!!!
PRAYERS!!!!!
Good Luck and God Bless you all!
Medical therapy: Treatment involves a combination of 3 modalities: surgical drainage of the abscess cavity, identification of the infecting organism, and administration of appropriate antibiotics for a proper length of time.
During the entire course of treatment, steroids are used to reduce spinal cord swelling and edema associated with the abscess.
As mentioned in Lab Studies, cultures of the abscess cavity should include tests for aerobic and anaerobic bacteria, fungi, and tuberculosis. Slides looking for parasites are also recommended.
Prior to identifying the organism, administer a broad-spectrum antipenicillinase penicillin.
Once the organisms are identified and sensitivities established, the appropriate antibiotics can be administered.
Surgical therapy: Once MRI has localized the abscess, laminectomy is performed to expose the lesion and surrounding cord. Laminectomy is usually performed one level above and below the abscess edges for complete abscess visualization. The dura is opened and the area of spinal cord involvement, as indicated by swelling, hemorrhage, and distended veins, is identified.
At this point, aspiration of the lesion is performed for culture of both aerobic and anaerobic organisms as well as for fungus and tuberculosis. Immediately complete Gram stain and India ink preparation. Perform a myelotomy over the length of the abscess, and completely drain the abscess cavity. Irrigate the wound and abscess cavity with antibiotic solution, and perform closure in anatomical layers. A drain is optional.
Preoperative details: During the preoperative and postoperative phases, dexamethasone is used to reduce cord swelling. The usual dosage is 4-10 mg every 6 hours.
Postoperative details: Intravenous antibiotic therapy is continued for at least 4 weeks following surgery. During the preoperative and postoperative phases, dexamethasone is used to reduce cord swelling. The usual dosage is 4-10 mg every 6 hours. Steroids are tapered on a delayed basis (eg, after 2 wk of treatment).
Follow-up care: Obtain a follow-up MRI to detect recurrence of the abscess. However, enhancement of the cavity will likely continue for several weeks.