Monday, June 7, 2004
I was finally able to complete my research, today...
...regarding from what my mother is suffering, now. It appears that she probably has developed acute mitral valve regurgitation. We've known that she has had mild mitral valve regurgitation since 2000. It has appeared to cause no problems and her doctors through the Mesa clinic have kept an eye on it with regular ultra sound exams, mentioned it in passing and considered it not worthy of treatment; so unworthy of treatment that I never bothered to research the variety of prognoses. At any rate, taking into consideration the sudden swelling of her feet and ankles, her alarmingly low blood pressure of late, her fatigue and weakness, I think her condition has become acute.
I'll be calling her Mesa physician tomorrow, explaining what is going on and obtaining an appointment, hopefully within a day or two. I have all the tools to "control" where she's at with it, now, and have been doing a fair job of it. Unfortunately, my mother does not respond well to diuretics, as we know, and the last few days of me judiciously administering furosemide, well, as she puts it, "I've had better days." And, she has.
I'm not completely positive that this is what is happening because when these same things happened in August/September of 2000 she was tested up and down and in and out at the hospital and no mention was made of the possibility of acute mitral valve regurgitation. Of course, they never figured out what she had. I attributed her episode to a blood pressure crash (which was, in fact, what she experienced, and I'm trying hard to keep the same thing from happening, now). Now I'm wondering if perhaps she is having episodic occurrences of acute mitral valve regurgitation. This time, though, I think I can prevent a blood pressure crash, simply because I am aware, now, of the dehydration factor, and very aware of how my mother responds to diuretization. It's been tricky. Her diastolic numbers have been running in the 40's and 50's. Her highest systolic number has been 112; she's been averaging around 100. I've been pumping her with sodium and potassium through diet as I've been administering the furosemide. Her appetite remains healthy. Since she's been feeling so bad, though, she only seems to respond to really delicious foods so I've been making treats for her, including blueberry cobbler for lunch today. Tonight I fixed a spicy tomato marina with sausage and lots of vegetables. It may have been too rich for her, though. She threw it up soon after going to bed. She usually only has problems with throwing up when she's being heavily medicated or is in severe pain. I know she's not experiencing pain so I guess this time it's the medication.
We had planned on a routine visit to the doctor anyway. I had called Friday but I guess the office took an unscheduled day off. No one answered. I'm not worried about her ability to withstand the trip down or back up for that matter. I am concerned that her PCP might want to hospitalize her for observation. There is also the possibility that he'll want to see her more than once within the next few days. I'm trying to decide whether it would be best to go down and up or move back down there for a few days if hospitalization or multiple closely scheduled appointments occur. I'm leaning toward going down and up. We have almost nothing with which to live at the house in Mesa anymore and I'm in the process of trying to get rid of it. There's also the matter of the cats. Our financial situation is also quite tight, now, while we continue to own the mobile home. Firing it up for a week or two at this time is not a good idea. Very tricky circumstances all the way around.
I'm also leery of having her "observed" in the hospital. Her last hospital experience at Banner Health's Mesa Hospital was not good. For that matter, her experience in the emergency room at Yavapai County Medical Center when I took her in for her back was not good. If she is admitted to the hospital, if I cannot convince her doctor to allow me to treat her at home for this (or, if it is impossible to treat her at home for this) I'm going to insist that I stay with her and will most definitely be keeping a close eye on both the procedures and medications prescribed for her as well as her general her treatment.
I'm prepared for the possibility that this could be something else. I am prepared for anything. And I'm thinking like an attorney and feeling like a loyal junk yard dog.
I just heard her coughing and checked on her. Although she's been down since a little after 2300 and it's been over an hour since she vomited, she's awake. She says she hasn't slept although I know she has. I've been checking on her every 5 to 10 minutes since I began putting the house to bed and writing here. She says she "feels fine". Sometimes, I swear, I wish she was more of a hypochondriac. At least she'd be familiar enough with her body to be able to describe symptoms to me whether or not they existed.
I'm scared, too. She isn't. She has no reason to be scared. She believes she's immortal. I know better, though. It's not that I'm afraid of her dying. It's that I'm afraid of the possibility that conventional medicine will not treat her adequately and thoughtfully and leave me to pick up the pieces, which has often been the case. I don't know if I'm capable of picking up these pieces this time. This is what scares me.
Touch her mitral valve. Calm it. Allow her body to reenliven itself. Take her by surprise, rather than letting her dwindle in the distracted care of the current medical establishment in the U.S. This isn't her style. It doesn't suit her. Let her be wearing and feeling her Sunday Best when she heads out this door. That's how she lives. Let it be how she dies.
I'll be calling her Mesa physician tomorrow, explaining what is going on and obtaining an appointment, hopefully within a day or two. I have all the tools to "control" where she's at with it, now, and have been doing a fair job of it. Unfortunately, my mother does not respond well to diuretics, as we know, and the last few days of me judiciously administering furosemide, well, as she puts it, "I've had better days." And, she has.
I'm not completely positive that this is what is happening because when these same things happened in August/September of 2000 she was tested up and down and in and out at the hospital and no mention was made of the possibility of acute mitral valve regurgitation. Of course, they never figured out what she had. I attributed her episode to a blood pressure crash (which was, in fact, what she experienced, and I'm trying hard to keep the same thing from happening, now). Now I'm wondering if perhaps she is having episodic occurrences of acute mitral valve regurgitation. This time, though, I think I can prevent a blood pressure crash, simply because I am aware, now, of the dehydration factor, and very aware of how my mother responds to diuretization. It's been tricky. Her diastolic numbers have been running in the 40's and 50's. Her highest systolic number has been 112; she's been averaging around 100. I've been pumping her with sodium and potassium through diet as I've been administering the furosemide. Her appetite remains healthy. Since she's been feeling so bad, though, she only seems to respond to really delicious foods so I've been making treats for her, including blueberry cobbler for lunch today. Tonight I fixed a spicy tomato marina with sausage and lots of vegetables. It may have been too rich for her, though. She threw it up soon after going to bed. She usually only has problems with throwing up when she's being heavily medicated or is in severe pain. I know she's not experiencing pain so I guess this time it's the medication.
We had planned on a routine visit to the doctor anyway. I had called Friday but I guess the office took an unscheduled day off. No one answered. I'm not worried about her ability to withstand the trip down or back up for that matter. I am concerned that her PCP might want to hospitalize her for observation. There is also the possibility that he'll want to see her more than once within the next few days. I'm trying to decide whether it would be best to go down and up or move back down there for a few days if hospitalization or multiple closely scheduled appointments occur. I'm leaning toward going down and up. We have almost nothing with which to live at the house in Mesa anymore and I'm in the process of trying to get rid of it. There's also the matter of the cats. Our financial situation is also quite tight, now, while we continue to own the mobile home. Firing it up for a week or two at this time is not a good idea. Very tricky circumstances all the way around.
I'm also leery of having her "observed" in the hospital. Her last hospital experience at Banner Health's Mesa Hospital was not good. For that matter, her experience in the emergency room at Yavapai County Medical Center when I took her in for her back was not good. If she is admitted to the hospital, if I cannot convince her doctor to allow me to treat her at home for this (or, if it is impossible to treat her at home for this) I'm going to insist that I stay with her and will most definitely be keeping a close eye on both the procedures and medications prescribed for her as well as her general her treatment.
I'm prepared for the possibility that this could be something else. I am prepared for anything. And I'm thinking like an attorney and feeling like a loyal junk yard dog.
I just heard her coughing and checked on her. Although she's been down since a little after 2300 and it's been over an hour since she vomited, she's awake. She says she hasn't slept although I know she has. I've been checking on her every 5 to 10 minutes since I began putting the house to bed and writing here. She says she "feels fine". Sometimes, I swear, I wish she was more of a hypochondriac. At least she'd be familiar enough with her body to be able to describe symptoms to me whether or not they existed.
I'm scared, too. She isn't. She has no reason to be scared. She believes she's immortal. I know better, though. It's not that I'm afraid of her dying. It's that I'm afraid of the possibility that conventional medicine will not treat her adequately and thoughtfully and leave me to pick up the pieces, which has often been the case. I don't know if I'm capable of picking up these pieces this time. This is what scares me.
Touch her mitral valve. Calm it. Allow her body to reenliven itself. Take her by surprise, rather than letting her dwindle in the distracted care of the current medical establishment in the U.S. This isn't her style. It doesn't suit her. Let her be wearing and feeling her Sunday Best when she heads out this door. That's how she lives. Let it be how she dies.
