Engineer Jansen calculates drips and avoids mansplaining (part 10)

The (precautional) second course of antibiotics now runs almost 1.5 weeks, so 5.5 weeks antibiotics in total, 1.5 weeks still to go. Last week another round of blood was extracted from the engineer, to see if Borrelia (Lyme) can now be detected (no), and to see if IGM toxoplasmosis is positive, meaning an active infection with that (no). Good.

The past few days engineer noticed a slight degradation in vision in the left eye, like there was a slight mist, so back to Urgencias, again. Passing on to Oftalmología did not take long. Fortunately the doctor that knows the whole history. Off to puerta 5 for CV test (campo visual, field of vision). The engineer thought the upper half of his eye sight had degraded, the doctor saw in the results that the lower half had deteriorated.

Thinking about that, the engineer thinks that both she and he are correct. The whole field of vision has slightly deteriorated, meaning the lower half indeed got worse. But the upper half too. Only, the machine does not detect that because the engineer could still see those small light flashes through the mist.

[Field of Vision test: the inside of a 40 cm white hollow half globe is in front of your eye, then randomly displays tiny white flashes in random places on the inside surface, and you must press a button when you see the flash. So they know if parts of your vision are missing.]

Anyway. Look into the eyes: we see no inflammation activity (good!). That was a relief, because one of the engineers’ worries was that the inflammation was back. That can happen if it’s not Lyme after all, but something else, like an autoimmune thing, a fungus, …  

So far the cause is undetermined. Lyme, toxoplasmosis, rick-ettsia (ha ha ha) all negative, according to last week’s serologia. That is good too. (Lyme and rickettsia both are tick borne diseases.) A negative lyme test does not mean much, nor does it when positive, as they are insensitive and indecisive.]

Losing one eye is bad enough, the other eye may not go down that path (please), that would catastrophic, hence this repeated visit to Oftalmologia via Urgencias. 

Verdict

“No inflammation, but we are going to give you 3 days of prednisolone intravenous 1 gram per day to try and speed up recovery” (Big single or a few doses of prednison or antibiotics are called “pulse treatment”)

“Come back in 10 days for revision, with OCT and CV” (a scan and field of vision)

Mansplaining in the Sala de Sillones 

Off to Urgencias, and the Sala de Sillones again, for the IV drip.

This time no pump, just an intravenous 500 ml bottle, with 1 gram written on it. Good. 

“No pump?”

“No”

“How long will it take?” (So engineer De Waal can plan his trip home and back)

“1.5 to 2 hours”

Drip

Drip

Drip

Engineer Jansen wondered after about 45 minutes that not much had been dripped into him. The first marker was reached, indicating that 100 ml had been used. Even though the bottle is sucked a bit hollow-ish. Hm. Remembering (chemistry lessons, titration) that one drop is about 0.05 ml he started counting and timing. 10 drops in 15 seconds. So, 40 in a minute, which is 40 x 0.05 = 2 ml per minute. 500 : 2 = 250 minutes, is 4 hours+. Hmpf.

Not wanting to be the mansplainer in the Sala, the engineer wondered what to do. 

As innocently and casually as he could manage, he asked the nurse, when she was near, how much time left?

“Are you in a hurry?”

“No, but it’s for the planning the return trip, else they have to wait a long time outside”

“1.5 to 2 hours left”

That is not the correct answer.

Certainly not after 45 minutes.

Asked the male nurse when the female nurse was away.

“I have no idea”

That is an honest answer, though meaningless.

Drip 

Drip

The engineer tried again. 

“This will take more than 3 hours still”

“Hmm”

“We can set it quicker”

She turned up the speed a bit, but that would still take 2 hours more, from this moment.

Half an hour later: Up! to 33 drops per 15 seconds, 132 per minute, is 6.6 ml per minute, meaning 25 minutes more.

That was the correct answer.

All in all the session took 2 hours 45 minutes. Without the engineer interfering (again!) it would have been 4 hours 10 minutes.

How can these people have no idea how long a drip takes? They do this every day!

PS

According to dr. Google Ad Interim, prednison and doxycycline do not interfere. Good.

The engineer quite agreed with himself.

PPS

They still have not called!