Patricia, thanks to your sage advice, I called the doctor (why does it always have to be a weekend??!) He called back in about an hour, which is good for him, and when I described Dad's symptoms, he said to get to the ER immediately.
When we arrived, there was 1 doctor on duty and at that time he had 20 patients! Needless to say, we had a bit of a wait, but they did take us back immediately and started Dad on IV fluids. When the ER doc finally did get to us, he ordered nausea meds and an abdominal x-ray. Dad's abdomen has swelled to the size of a 9-month pregnant woman. He was in quite a bit of pain so they gave him some morphine and drew blood. His scrotum is swollen so much as to be unrecognizable. The urologist said to give it time and the fluid would reabsorb. In the meantime, my Dad has to sit on and walk this huge painful part.
The abdominal x-rays showed a bowel obstruction (which might explain why Dad hasn't had a bowel movement since last Wednesday in the hospital and then it was induced by a suppositor.) Dad's urologist finally arrived at the ER and immediately called a general surgeon in for a consult. Both agreed that they did NOT want to open him up again so soon after the 7.5 hour operation to remove the bladder and prostate. They decided to try to get the obstruction (or what they think is an obstruction) to break up with an NG tube. I never want my Dad to have to go through that again. You could hear him wretching and screaming all the way to the waiting room. When he heard he was going to have to have that awful tube again, he broke down and said he didn't think it was worth it. That was difficult to hear.
Both doctors felt a CT scan would tell them more of what they needed to know to see what was causing all my Dad's ailments, so the contrast was ordered and poured down the NG tube. He couldn't hold all that was ordered. Then the wait began. They transported us to a room where we waited for the CT contrast to stay in Dad's system the required hour before the scan. Three hours later no one had come to pick him up to take him for the scan! I had the nurse page the urologist since I had been told by the ER nurse that the contrast had a 3 hour life and I didn't want Dad to have to endure the stuff again. The doctor called radiology and someone was there to get Dad within minutes.
The CT scan showed major fluid in the abdomen and the blood work showed a massive white cell count. However, Dad never ran a fever. The urologist suspected a urine leak where he had joined the ureter to the conduit. He called it a "uronoma" or something like that. He ended up assembling a team that night around 10pm to use a scan to guide him to place a pelvic drain to drain all the fluid from the abdomen. (Yes, this is the same surgeon who forgot to order bowel prep.) For some reason, the radiologist placed the pelvic drain in Dad's buttocks in a spot right in the middle of the cheek where it really hurts to lay on it! The drain is hooked to a big bag like a night drainage bag and is draining steadily what looks like blood to me. When he was first hooked up to the NG tube on Sunday, the green acid stuff just poured out. No wonder he was feeling nauseated!
After the initial fluid was drained off, he seemed to perk up a bit and I spent the night in his room and he slept most of the night. They took more x-rays this morning and the urologist and general surgeon both said that they saw gas in the colon which was a good sign. His white cell count has also gone down due to massive antibiotics they are giving him: Zosyn and Flagyl. They aren't sure yet what the bacteria is, or if they are the haven't told me. Another x-ray is scheduled for tomorrow to determine if any progress is being made. We haven't had gas or bowel movement this time in yet.
Today they put in a PICC line and were going to take out his staples. The urologist put him back on intravenous food today. He hasn't walked since we got to the ER on Sunday. With the extra 2 bags beside his Foley night bag that they have him hooked up to all the time, walking is going to be a challenge.
He still feels lousy and lethargic and has pain from the drain in his butt cheek. It's amazing to me that he went from eatng 3 meals a day on Friday when he was dismissed from the hospital and walking the halls five times that day, to lethargic, vomiting, weak, and back in the hospital on Sunday. This is a horror story. How much more poking and prodding and tubes and stitches can one man take? Especially an 80-year old. He said to me today: "I was feeling so good before the surgery. I wish I had not had it." I don't blame him. When he leaves the hospital, the pelvic drain will go with him until it is clear. The radiologist and urologist both think that if we can get the area dry, the leak will heal itself. I pray they are right.
Sorry for the lengthy post, but a lot has happened since Sunday.
