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She started being more "off" than her usual level of dementia so I suggested rehab test her for a UTI. 2 days later, they took the sample. 2 days later, got the positive results and next day started her on Marcrobid. Now, I think she has been treated for 4 days and she is still asking for dead people (brother, parents), telling me all about a "gala" she will be going to, etc. This is very far away from her normal, pre-UTI behavior.
I'm wondering if this means the meds are not touching the UTI. I have talked with the staff. One told me she thinks they usually do another pee test after the course of treatment which is usually 5-7 days. Ugh. She's so confused and doesn't know what to do with herself. Her short term memory is completely gone so telling her to just relax and not worry about anything, etc. does not work, of course. It might calm her in the moment, but doesn't last.
She did have another UTI, not too long ago, I guess mid/late April.
Any experience with something like this?

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Urine needs to be cultured to determine which antibiotic to use to kill the infection. Otherwise, they're just stabbing in the dark. If the UTI is still present, so is the confusion.

Mom may have some hospital delirium going on, meaning her confusion is very ramped up for the duration of her stay in rehab. I saw it with my mother. Then she was put on a Scopolamine patch to treat her vertigo (at my request 🙄) and while it helped with the vertigo, it made her dementia so bad, she was seeing mice running around on the floor! Is mom taking any other new meds?

Good luck with all this, I know how hard the whole situation tends to be.
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againx100 Aug 5, 2024
Thanks lea. It could be delirium but she's been in rehab for a month now so I don't know. She's pretty used to it there, I think. The staff knows her pretty well from this stay and from her previous visit in April. It's a revolving door! She's on trazadone but that's been a month or two now so hopefully wouldn't start a reaction to it after that kind of time lapse. Mice running around on the floor?? Yikes, I'm sure that was not a welcome hallucination!

I'm going in to visit soon and if she has not improved in the last 24 hours, I'm going to ask the nurse to reach out to the doctor for a new pee test to see if the med is working or not.

Thanks!
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Macrobid may not be doing the trick. Did they complete a culture? The bacteria may not be sensitive to Macrobid. Sometimes, though, it takes a while for the confusion to clear up. First ask about the culture, then if the culture was done and Macrobid indicated give mom's memory a few more days to clear a bit.
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againx100 Aug 5, 2024
I don't know if they did a culture or not. The label of the test result on the portal says "urinalysis with microscopic". Not sure what that means but I'll try to ask them to do a culture if it's not been done. I guess you could be right that it could take time to clear up. Yikes.

Thanks for your response.
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I don't have personal experience with that specific antibiotic but I've never known one to not begin clearing up an infection longer than 24 hours and to see improvement. But now of course you have possible delirium in the mix.

If this med is not working, keep an eye out for signs of sepsis:
Change in mental status.
Fast, shallow breathing.
Sweating for no clear reason.
Feeling lightheaded.
Shivering, fever
Symptoms specific to the type of infection, such as painful urination from a urinary tract infection.

When my Aunt got sepsis (at 103) from an infected cat bite, it affected her brain and manifested in her vision: her vision processing was completely turned upside down (not to be confused with vertigo). The floor was the ceiling and the ceiling was the floor. It eventually returned to normal. So, be aware of any "weird" things such as that.

Wishing you success in getting your Mom the proper speedy treatment!

Remember, once your Mom is clear of the UTI you should consider the maintenance D-mannose if she isn't already on it. It really does cut down on the number of UTIs.
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againx100 Aug 5, 2024
Thanks for the info. I'll keep an eye out. I sent the doc a message about d-mannose but he hasn't responded. Ugh.
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Momma keeps a uti but here is the thing - she has no symtons but it does show up in her blood work. I can tell when she has one just by her behavior. She just got over the last one. Don't know what to do about this. I think she is waiting too long to change out of her depends. Momma told my sister that depends were too expensive. I told momma and my sister to not worry about that we will buy some more. We just want her to be clean and dry.
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againx100 Aug 6, 2024
Yes the behavior is the key. Staying in a wet depend is almost certainly a contributing factor.
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Macrobid is very "lightweight" and likely not working.
The Urine needed to be cultured so that sensitivity to antibiotics could be ascertained. Ask the doctor if both a U/A and a CULTURE were done and ask what sensitivities show. Let him/her know that macrobid isn't doing the job. Doing HALF the job is worse than nothing because it allows the strongest bacteria to survive.
Meanwhile Geaton is correct. D-Mannose....order overnight on Amazon. I used Source Natural Brand and have for many years. My frequent UTIs gone now for over a decade. Works like cranberrry in that it doesn't allow bacteria to attach to the wall of the bladder. It is large pills. But they are good tasking to open capsule and pour in any food or drink. Sweet tasting. About 30.00 for 120 and she should be on once daily to prevent in future.
Good luck, again.
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ElizabethAR37 Aug 6, 2024
Alva: I think I (87) can attest to the effectiveness of d-Mannose in general. I used to get UTIs more frequently before I started taking it at your earlier suggestion (thank you!). I hadn't had one for a whole year until a couple of weeks ago.

I tried to combat it with OTC meds, cranberry and lots of water, in addition to upping my d-Mannose dose, but after a week I ended up calling my healthcare providers consulting nurse service. She instructed me to submit a sample for a UA (which I intended to request anyway) and prescribed the antibiotic Ceftin. They did a UA with culture and the Ceftin was a match for the bacteria present. I may be over the infection now but because I let it go for so long (my bad!), I may need another round. I'll definitely stay on the d-Mannose.
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There are many reasons for UTIs. Ones that keep happening need a culture taken. My daughter, RN, says they start with a broad spectrum antibiotic until the culture comes back. Cultures are not always done, so request one.

Really, Rehab is not a hospital. If Mom is not responding I would ask that she be taken to the hospital where a culture will be done and maybe given the antibiotic by IV. If she is sensitive or allergic to penicillin, tell them that. This was a problem we had with Mom.

Once the infection is cleared up I would ask for her to be given a probiotic and cranberry tablets.
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