I need help with diagnosing UTIs.

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So I took my grandma to the ER today to check for an infection. She's been crazy and not herself and honestly just been so confused. She has dementia. I keep Dipsticking her testing her UTI but it always comes up with negative. She was refusing food and water and pills the last two days so I finally had to take her in. (I couldn't yesterday as there was a huge snow storm). They did blood work, a urine sample which was extremely dark but still negative, and a chest x-ray. They said everything came back normal and sent her home. She's been screaming on top of her lung (something new) and seeing people who aren't there and saying they are beating her up. Still is refusing stuff and as a diabetic that's disturbing. Can a UTI be there if the dipping stick is negative? She's been so abusive the last two days and so angry. She was like this one other time before. I took her to the ER and it came back negative then when she got to this point she was a positive for an untreated UTI. I just need help! I'm losing it here.

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I agree with Jeanne; one of my mom's dipsticks came back negative but the geriatrics doc she was seeing insisted that a culture be done. It came back positive after three days. I must say, after that, I always insisted on a culture. UTI's are just too debilitating and dangerous in elders to be dismissed.
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Reply to BarbBrooklyn
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I went to a walk-in clinic to test for a UTI. I asked the doctor whether the drug store kit was worthwhile. Should I test with that first?

She said if the dipstick (drug store) test came back saying I had a UTI, I did, and I should go to a doctor for a culture to see what kind of infection it was and for treatment. If the test said I didn't have a UTI I could still have a UTI, and if symptoms continued I should see a doctor. So going the DIY route might just delay things.

Relying only on the dipstick test, whether done at home or in ER, is not sufficient. Knowing what I know now I'd always insist on a culture, no matter what the dipstick indicated. But realize that the culture takes 3 days to develop and read. Often an antibiotic is given in the meanwhile.

littlemisskitty, I think the help you need is a culture.
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Reply to jeannegibbs
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Hi,
First off, I'm appalled at any ER that would send someone away with a BP that high, especially at her age! Unreal! My next couple of questions, who does her pills? Does someone give them to her? Does she have access to them to take herself even if she sneaks them? Any of those could be an issue. Another probable cause (as we see it a lot in our hospital) is sodium levels too high/low. That can cause a LOT of confusion, plus could tie in the dehydration, etc. Like others have mentioned, does she have a primary care physician that would have her complete medical records? Does she appear to be in pain (besides the erratic behavior). There could be an infection manifesting itself somewhere else like kidneys, bladder, etc. Lots of things to consider besides UTI. Does she have early signs of dementia or has she been fairly "normal" except recently? She definitely needs to be seen by a doctor immediately and I for sure would take her to a different ER, possibly one with a trauma center if there's one nearby, as they may run more extensive tests. And as far as the IV, baloney. We've had tons of patients with behavioral problems that we've gotten IV sticks in, and if they need lifesaving meds through an IV, you FIND a way to keep it in. Any way, she is a danger to herself if left alone for any length of time until you get answers, which SHOULD make her a candidate for immediatel hospital admission. Even if she has a family member with her, we would NEVER send someone home in this state, especially if she's throwing herself on the floor, etc. Please keep us updated on what happens! This is scary stuff!
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Reply to Gracie65
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My late mother had frequent UTI's. Remedy she was told to drink was cranberry juice.
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Reply to Llamalover47
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I cannot believe the hospital ER in your area would treat your Grand Mother this way and help her more. I have experienced some of same UTI  and similar behavior by my patient, and he is usually kept in the hospital for 1-3, and even 5 days!
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Reply to Ricky6
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She needs to see medical professionals that give a hoot.

If I can as a non professional, not Dr or nurse, give my opinion. Antibiotics kill bacteria indiscriminately, good, bad beneficial et al. Long Term use can lead to c-diff, highly dangerous infection. Good bacteria need to be replaced. I use and have used for 35 years+, my husband my dad and anyone else I can convince, our gut health is so important for overall health.

Take pre and probiotics, I buy them online at Swanson vitamins and they are a life saver, my dad has not had one UTI since he started taking them. I use Dr. Langers 16 strain with FOS (prebiotic). Lots of choices available, I recommend doing your own research to decide what you feel is best. Take them 2 hours either side of antibiotics, I use 2 a day if I need antibiotics, which I haven't needed except after surgery. This helps keep the beneficial bacteria active while the bad is being killed off. So no matter what happens, I recommend adding this to daily regiment. For everyone in the house.

Again, I have no medical training so she definitely needs medical diagnosis and the sooner the better.

Best of luck getting to the bottom of the matter.
Take care to take care of yourself during this hard trial and may God grant you wisdom to know how to proceed. Also, God Bless you  for taking care of your grandma.
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Reply to Isthisrealyreal
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I have dealt with my mother having UTIs for years and it leaves the patient often in severe shakes and tremors, glazed eyes, confusion, and wetting all over her. Every time a UTI comes on in an elder person, it leaves them more and more unhealthy and does affect their minds. Look for these symptoms if any thing in doubt go to a doctor and be checked good luck
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Reply to Carolyn55
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Dear One, My ALZ mother fell, went to the emergency room and was sent home with bruises and two cracked ribs, yet continued to be in such pain and distress. She cried, yelled and couldn't sleep. Finally my sister stayed overnight and took her to the family doc the next day. She had also fractured two vertebrae and was immediately put in a nursing home for treatment. Sounds like you need more answers from the doctors. Something is distressing her and it could be any number of things. Good luck.
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Reply to jkrusebaron1
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When my LO had similar symptoms, the ER doctors asked me if I had considered Hospice. I did take it up with my LO's primary, but, he tried something different for now, but, it is an option. My LO did not respond well to the repeated visits to the ER. She was frightened, confused, anxious and then they had to catheterize to get urine sample, multiple sticks to get blood sample, she's crying out, "I'm scared!, waiting, confined to bed, etc.......just too much for her.  I did ask her primary about a daily antibiotic to ward off UTI's, but, he said let's wait. It is an option, if it continues. So, we are waiting. 
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Reply to Sunnygirl1
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My experience with aunt's ambulance trip was similar. She passed out, fell, and stayed unresponsive 10 minutes. Ambulance had no ER choice, no bloodwork nor hydration done in ER. She was sent home in less than an hour. Two mornings later she got up in pain, and the start of her unusual UTI behavior. She luckily wanted to see a doctor, so I took her 45 minutes to another hospital, telling her it was the only walk-in clinic around (which is almost true.)

Hydration was started immediately. When they took the urine sample the physical indications of UTI were there (before the dipstick said no.) This had been her experience before, yet antibiotics had worked, so they tried it. I took her home with the medicine, and she showed improvement within 24 hours. I am glad she didn't have to wait for a culture. Without hydration and medicine, her UTI would have progressed to hallucinations and stubbornness. Good luck figuring it out.
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Reply to GrannieAnnie
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