Colon to bladder fistula: Anyone have experience with non-surgical treatment of this condition from diverticulitis?
I thought I would start a new thread. Has anyone had experience with non-surgical treatment of this condition from diverticulitis?
Mom does not want surgery, which I support since surgery would be a bowel resection, be painful, and possibly end with a colostomy if she survived the anesthesia.
Right now the providers are all playing hot potato which is infuriating! PCP referred her to Urologist. Urologist looked at the dx and they won’t even see her. Go to a colorectal surgeon, they said. But she doesn’t want surgery she wants non-surgical palliative support. So does this mean hospice? But doesn’t her PCP need to certify her as terminal? No one seems to know what to do with her.
Has anyone had experience with hospice continuing antibiotics and providing a catheter for comfort? I have a feeling she won’t want stool softeners if it will give her chronic diarrhea again. Her social life is her top priority.
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Hospice is not only for those who only have 6 months to live. It's impossible to predict how long a patient has left. My husband was admitted to hospice care because his dementia is a steady downward slide. Dementia patients are terminal. We just don't know when the end will come, especially when they have other issues as my husband does. He has been in hospice care for almost 2 years. My mother was in hospice care for 2.5 years. My dad had hospice for 8 months (cancer) and had a catheter most of that time.
Call a hospice company yourself. Ask for an evaluation. Their doctor could admit mom (I think, but all situations are different). You could ask more than one hospice company if that seems appropriate. If you think your mom needs hospice, be her advocate. If her PCP has dropped the ball, use this workaround or some other. Due to the good advice here, you're now well informed and can move forward with some confidence that you'll know the right questions to ask. Good luck!
At 91, I too would wonder If surgery was warrented. Lets hope the antibiotics clear up the infection.
I agree that she needs palliative care through hospice since I don't think her PCP is able to provide it and eventually the antibiotics will stop working. She is in no pain, just a little nauseous and a little uncomfortable from the pressure in her bladder from the gas. She has also started to leak stool (she's already in depends for bladder incontinence), though she is unsure which hole it is coming from since she doesn't know it is happening until she pulls down her briefs. I'm convinced that any surgery at this point would end with her permanently bed bound and in a nursing home. She said if she gets to be in unbearable pain, she wants to be "put down." Hospice seems like the best path if they will accept her.
My MIL went thru this operation when she was 70. They took out 10 inches of her intestine and I think she used a bag for 8 months while she healed. The worst she said was when she went back to going on her own. If your Mom does nothing, she could become septic and that may kill her. I would think she is in a lot of pain, my MIL was. In the end, its her decision. I don't think palliative care will be enough, she may need Hospice care. Her PCP can write an order or call Hospice, they have a doctor affiliated with them.