Behavior change, no UTI (?), feeling defeated

LittleVolcano

I'm a bit depressed this morning because Mom's UTI culture came back "no significant growth" even though the urinalysis shows mild-moderate abnormalities. The doctor hasn't commented on the culture yet (it wasn't ready yet, and now it's the weekend), but she didn't see much cause for concern based on the CBD and urinalysis, despite it's abnormalities. She put in an order for antibiotics (not sure which one) if Mom was having symptoms. I asked Mom (moderate dementia, probably ALZ) if she was having symptoms, but she said she wasn't. I hope she would tell me if she was having issues, if she remembered at all. I hope the tests were accurate and complete enough, and I hope the doc's interpretation of the tests is accurate and complete enough (she's a GP and not a geriatric/dementia specialist).

The reason I'm depressed is that Mom's behavior changed suddenly a couple months ago, and it's starting to look like it's NOT fixable, as in the case of a UTI. She suddenly didn't recognize her home, and that anxiety caused her daily phone calls to increase (from maybe 5-10 times a day, up to 64 on her worst day recently. At first, I thought it might be the atorvastatin that the doc prescribed for her cholesterol 5 months prior to the change. So, with the doc's consent, we stopped the statin, but it didn't seem to make a difference. Then Mom had that 64-calls day, and I got some AZO UTI tests, and she was solidly positive for leukocytes. I felt a glimmer of hope that we could maybe reverse this next stage a little (we had success a long time ago in reducing her anxiety by taking her off her famotidine. She had a near immediate reduction in anxiety. I was hoping we could do the same with either stopping her statins, or fixing a potential UTI).

Mom does have an RBC, urine of 11 HPF (normal is 0-3), so that's not nothing, but I know that vaginal dryness can cause blood in urine too. Hemoglobin is moderate. The sample was also turbid, not clear. Again, I asked her if she had symptoms, but she doesn't think so, but I question how accurate her self-assessment is. Another explanation for the heightened anxiety is her new loss of not recognizing her home. If that's the case, then I hope she adjusts, like she adjusted to not driving anymore, and how she occasionally accepts "the stranger" (Dad). 

Anyway, I'm not sure where I'm going with this. I guess I'm not sure what to do next, if anything. Feel free to chime in. 

Hugs to all of you. 

May flowers

(((Hugs)))

UTIs have been one of the most frustrating things for us. In our case, the urinalysis always comes back negative but he still improved with antibiotics. His previous doctor would just treat in case he had a “silent infection” as she called it. Plus, hospice has treated him 3 times and he improved each time, but the urinalysis still is negative. I wish I had answers for you. I have added cranberry,  d-mannose, vitamin c to his daily meds “just in case”.  Now I think his agitation is either related to his prostate med or progression. Trying a natural prostate supplement  to see if helps any, if now, I know it’s likely just the progression. 

Quilting brings calm

For many elderly, they do not get typical physical symptoms such as burning.  Their symptoms are the behavior changes.  Since there was some  indications in the quick test, just go ahead and follow through with the doctor about the antibiotics.   My mom kept testing negative over the course of about 6-8 weeks even though we felt she had a UTI based on her behavior ( as if the dementia was on steroids).  The doctors would not give her antibiotics.  She ended up in the hospital with urosepsis.  

Truthfully I’m not on board with  doctors hesitation about antibiotics at this point,  my parents are in their 80s, I’m not all that concerned about any overuse of antibiotics. 

LittleVolcano

@May - Yeah, I worry about a silent infection too. Thanks for pointing out that your LO had negative results and yet still improved on antibiotics. My gut says to go ahead and try (Mom's doc did put in an Rx for antibiotics, so it's there if we need it), but I'm of course always afraid that introducing some new med will make things worse. I guess we could always just stop the course if she takes a major turn for the worse. 

@Quilting - Yes, one of my fears is that despite the negative tests, this will get worse. And I appreciate the encouragement to give the antibiotics a try. 

I just checked, and nitrofurantoin (macrobid) was prescribed. Anyone have any experience with this drug? 

Ed1937

I have no experience with it, but here is a good link for you. https://www.drugs.com/nitrofurantoin.html  

May flowers

My FIL was on macrobid a few different times and we didn’t have any issues with it.

LittleVolcano

Thanks Ed and May!

I've also got a callback request in for Mom's doc's office to call me back on Monday so I can schedule a phone convo with the doctor herself. I'm going to ask if it's safe to just try the nitro and see if there's any behavior improvement. Fingers crossed.