Wednesday, August 11, 2004
All blood tests I have received have been entered.
Instead of me listing them all here (there were a jillion), you can go to Mom's Tests and you'll find them all listed, from August 1st - August 9th. All I have left to enter are her urinalyses, none of which are remarkable except for the Urine Osmolality which indicated over hydration. Her Sodium Urine Random was good, though, so she was on her way back to normal hydration when the sample was drawn.
Some of the tests, like the Serum Osmolality, are connected to determining whether she was over hydrated, which she was on 8/1/04. Some, like the Probrain Natriuretic Peptide, are connected to determining the presence or absence of congestive heart failure, which she does not have. Others were done to rule out types of anemia. Others are connected with clotting factors.
There are some bedside glucose tests which I may enter in Mom's Daily Tests and Meds, then again I may not. It seems that both the hospital and the SNF are not as good at controlling her blood glucose through diet as I am. She seems to be getting insulin shots on a pretty regular basis. As well, they were and are insul-ating her whenever her glucose strays well above "normal", despite the fact that I've been instructed not to worry unless she goes above 200. But that's okay. She'll stay within a good range with their tactics, as she will with mine, and a few days of lots of insul-ation shouldn't hurt her.
Yesterday, because of the 1.2 drop in her hemoglobin from its stability in the "10" range, I spoke to the medical director of the facility about reintroducing Niferex-150 to her daily meds, despite the hospital's decision to (or negligence in) not include(ing) it on her list of daily meds for the SNF. He agreed that this would be a good idea. The nurses and CNAs cringed. I've been hearing the argument for too many days from them that they don't want her on the Niferex because it constipates her and then they have to administer a laxative. So yesterday I took the day nurse and the nursing director aside and explained that I've had very little problem keeping her regular on "all that iron" (including the Niferex-150 and 36 mg of Iron Protein Succinylate per day) since soon after her blood transfusion in early June. Aside from telling them that she eats a diet very high in fiber at home (which is decidedly not happening at the SNF), I gave them the following instructions (within, I might add, the doctor's hearing; not purposely, but happily): One 11.5 oz can of V-8 juice per day (which I provided to the SNF) and snacking on popcorn (which I provided for the weekend, since their popcorn machine isn't used over the weekend). I also provided a large, marked bowl for her popcorn and, as per the nursing director's instructions, had notes added to her chart regarding both. I also added a note that if they should consider her constipated, it is best not to administer the recommended laxative dose of Phillip's Milk of Magnesia but, rather, half that or the antacid dose, depending on how many days they believe she's been constipated.
Assuming that they are amenable to taking direction from me (which, typically, most professional health providers aren't, but, you know, that's their problem unless they create a really uncomfortable problem for my mother by not listening to me), these tactics should solve their problems. One of the LPNs tried to nix the V-8 juice because of the fluid restriction upon which they have my mother. I pointed out that she is not even consuming liquids to the limit of her restriction and, furthermore, they might keep an eye on whether she is accidentally dehydrating herself because of this. Another one tried to nix the V-8 juice and popcorn because of her caloric restrictions. I responded that V-8 juice has only 70 calories per can and at one can per day they need not worry about this. I didn't respond to the popcorn "problem". I figure, she can certainly use the extra calories, they aren't paying attention to the extended glucose range for her (which, in fact, neither did the hospital, god, I'll tell you, get a bunch of health care providers together and they run rampant all over charts and instructions) and they're playing around with insulin, anyway, so they can do whatever they think is best with her as far as the popcorn is concerned, which will constipate her, upon which they will, no doubt, administer the maximum laxative dose of Phillip's Milk of Magnesia, upon which they'll have another busy, messy 6 hours or more on their hands. But, you know, again, that's their problem. They don't have to listen to me and they don't have to think, either. Some of them do listen, some of them do think, but, I believe that the non-alternative medical-industrial complex encourages (in many cases, with laws and the threat of law suits) a type of soldierly obedience which often stands in the way of non-alternative medicine's ability to treat patients with personal dignity, respect and in line with what is really "wrong" with them and how they really need to be treated.
I'm not sure when I'll get around to entering the urinalyses. I've got some cleaning and fixing up to do here, some of Mom's clothes to launder, some business to handle, some movies to watch that are due today and I've got an early day tomorrow. I made a 0730 appointment in the Valley to have the oil changed, a lube job, tires rotated and balanced and the belts and hoses checked in one of the cars before I arrive at the SNF.
I'm doing well, as well, at least, as my mother. My spirits are high. She's working hard and so am I. The Little Girl is still crying in Mom's room in the middle of the night and crying at the door when Mom doesn't come through within seconds after I enter the house but I understand how she feels. It is very odd not to have Mom here.
Later.
Some of the tests, like the Serum Osmolality, are connected to determining whether she was over hydrated, which she was on 8/1/04. Some, like the Probrain Natriuretic Peptide, are connected to determining the presence or absence of congestive heart failure, which she does not have. Others were done to rule out types of anemia. Others are connected with clotting factors.
There are some bedside glucose tests which I may enter in Mom's Daily Tests and Meds, then again I may not. It seems that both the hospital and the SNF are not as good at controlling her blood glucose through diet as I am. She seems to be getting insulin shots on a pretty regular basis. As well, they were and are insul-ating her whenever her glucose strays well above "normal", despite the fact that I've been instructed not to worry unless she goes above 200. But that's okay. She'll stay within a good range with their tactics, as she will with mine, and a few days of lots of insul-ation shouldn't hurt her.
Yesterday, because of the 1.2 drop in her hemoglobin from its stability in the "10" range, I spoke to the medical director of the facility about reintroducing Niferex-150 to her daily meds, despite the hospital's decision to (or negligence in) not include(ing) it on her list of daily meds for the SNF. He agreed that this would be a good idea. The nurses and CNAs cringed. I've been hearing the argument for too many days from them that they don't want her on the Niferex because it constipates her and then they have to administer a laxative. So yesterday I took the day nurse and the nursing director aside and explained that I've had very little problem keeping her regular on "all that iron" (including the Niferex-150 and 36 mg of Iron Protein Succinylate per day) since soon after her blood transfusion in early June. Aside from telling them that she eats a diet very high in fiber at home (which is decidedly not happening at the SNF), I gave them the following instructions (within, I might add, the doctor's hearing; not purposely, but happily): One 11.5 oz can of V-8 juice per day (which I provided to the SNF) and snacking on popcorn (which I provided for the weekend, since their popcorn machine isn't used over the weekend). I also provided a large, marked bowl for her popcorn and, as per the nursing director's instructions, had notes added to her chart regarding both. I also added a note that if they should consider her constipated, it is best not to administer the recommended laxative dose of Phillip's Milk of Magnesia but, rather, half that or the antacid dose, depending on how many days they believe she's been constipated.
Assuming that they are amenable to taking direction from me (which, typically, most professional health providers aren't, but, you know, that's their problem unless they create a really uncomfortable problem for my mother by not listening to me), these tactics should solve their problems. One of the LPNs tried to nix the V-8 juice because of the fluid restriction upon which they have my mother. I pointed out that she is not even consuming liquids to the limit of her restriction and, furthermore, they might keep an eye on whether she is accidentally dehydrating herself because of this. Another one tried to nix the V-8 juice and popcorn because of her caloric restrictions. I responded that V-8 juice has only 70 calories per can and at one can per day they need not worry about this. I didn't respond to the popcorn "problem". I figure, she can certainly use the extra calories, they aren't paying attention to the extended glucose range for her (which, in fact, neither did the hospital, god, I'll tell you, get a bunch of health care providers together and they run rampant all over charts and instructions) and they're playing around with insulin, anyway, so they can do whatever they think is best with her as far as the popcorn is concerned, which will constipate her, upon which they will, no doubt, administer the maximum laxative dose of Phillip's Milk of Magnesia, upon which they'll have another busy, messy 6 hours or more on their hands. But, you know, again, that's their problem. They don't have to listen to me and they don't have to think, either. Some of them do listen, some of them do think, but, I believe that the non-alternative medical-industrial complex encourages (in many cases, with laws and the threat of law suits) a type of soldierly obedience which often stands in the way of non-alternative medicine's ability to treat patients with personal dignity, respect and in line with what is really "wrong" with them and how they really need to be treated.
I'm not sure when I'll get around to entering the urinalyses. I've got some cleaning and fixing up to do here, some of Mom's clothes to launder, some business to handle, some movies to watch that are due today and I've got an early day tomorrow. I made a 0730 appointment in the Valley to have the oil changed, a lube job, tires rotated and balanced and the belts and hoses checked in one of the cars before I arrive at the SNF.
I'm doing well, as well, at least, as my mother. My spirits are high. She's working hard and so am I. The Little Girl is still crying in Mom's room in the middle of the night and crying at the door when Mom doesn't come through within seconds after I enter the house but I understand how she feels. It is very odd not to have Mom here.
Later.
