Portland, Oregon

Portland, Oregon

Wednesday, September 28, 2016

Be Careful What You Wish For

We've been without a pet for two years. People told me I'd eventually be glad to be pet free but I've yet to reach that state of being. I would prefer a dog but understand a cat is the more practical choice.

Our son and his family are cat magnets. I think they're up to five now. I decided if I was patient a nice kitty would show up at their place that would be perfect for me.

Yesterday Son sent me a text that another hungry cat had showed up on their porch. I was excited, thinking it surely must be meant for me.

Next I thought surely not. Surely this is not the cat I've been waiting for, surely not.

Son says it's the skinniest cat he's ever seen, just skin over bones.

He says it's a friendly cat and very loving.

The report this morning was it was eating well and using the litter box like a pro.

At the moment it has a private bedroom in their home. In the morning it goes to the vet.

I'm thinking the following:
1) It will have a chip
2) Feline Leukemia
3) Thyroid Problems

It won't be cheap just figuring out it's health situation. The very least will be an office visit and a panel of blood tests. After that there may be medicines and shots or possibly the expense of euthanizing it. It's not cheap to befriend a homeless cat. They would not consider taking it to a shelter.

Bob began his usual rant about them taking in another cat. They're cat people, what can I say. They have a 14 year old son that's a cat person as well. He didn't answer when I asked him what he would have done if he'd opened the door to it on his porch, what would he have said to grandson?

He didn't want to talk about that. I'm really hoping this is not the cat meant for me, that might be a problem.

Sunday, September 25, 2016

It Was The Blood Pressure Cuff

Who knew a blood pressure cuff could inflict such damage?

They took Bob's blood pressure twice when we saw the new cardiologist on Friday. All seemed well when we left to go to the anti-coagulation lab but the report there was not good. He'll be seeing them again in the morning. Blood thinners can be tricky to deal with sometimes.

Are you going to watch the presidential debate? I seldom watch them because I'm never an undecided voter and I don't enjoy debates.

The bar is so low for Trump, if he just shows up he'll be declared the winner. I can catch a replay of any stupid things he says or does.

The bar for Hillary is set incredibly high. She's suppose to appear trustworthy, warm and friendly while managing to protect herself from the erratic Trump who has been unleashed on her.  It's very hard to look relaxed and appear to be having a good time under such circumstances.

It remains to be seen how much effort the moderator will put into controlling Trump's behavior.

I'll probably choose the less stressful way by following it on Twitter. Not just Twitter in general but particular people on Twitter.

Saturday, September 24, 2016

No Guardian Angel

Before I go further let me explain the reason I do not believe in guardian angels. The people I know who believe in such a thing also believe there's only one God, and that God favors the United States. That makes no sense to me. I have to believe if we live in a world of guardian angels they have to be everywhere, since they seem to be the product of one God. Surely God would not play favorites by countries. If there are guardian angels for the children in Syria I have to say they're doing a poor job. I choose to go it without guardian angels, I don't trust them.

That said, this young woman was a real game changer in our lives this week. We had received a phone call from the cardiologist's office saying the Medicare contract for the new cardiologist had not yet been approved and therefore she was not yet seeing Medicare patients. I was told they would need to move Bob's upcoming appointment out six weeks. I was not happy but saw I would have to take it higher than the appointment desk to get the problem resolved. 

I was surprised a few days later to get a phone call from the happy nurse pictured above. I had spoken to her on the phone a time or two but had no face to put with the name, didn't really know anything about her. 

She said she was looking at Bob's file and saw his appointment had be moved to November and wanted to know why. After I explained she said she was not happy with the situation and would get back to me.  Shortly I received a call from an appointment person who moved his appointment to yesterday morning.

We assumed they had worked something out and we would be seeing the new cardiologist.

Wrong, we saw the cardiologist pictured above. Later I would learn the nurse works for this man and thought he would be a perfect fit for Bob. 

We were a bit confused at first. My only real concern was the possibility of an accent Bob would have a hard time understanding. He is Filipino and does have some accent but not enough to be a problem. He was wonderful with Bob and talked to me like he thought I had a brain. 

I got more information from him in that one visit than I'd gotten in 12 years from our cardiologist that retired. The old cardiologist very much believed only one person needed to know the details and that was him. He did not welcome questions. This man welcomed questions saying it was our right to know. (Would you believe he's been in practice 20 years?)

We left very happy with the new cardiologist.

Wednesday, September 21, 2016

Some Things Amaze Me

Life continues on around here. Some days are more interesting than others. I'm almost never caught without my phone, that's where I store my brain, but earlier this week one of the medical offices had a cancellation and called to see if we might like to come in earlier. I was tempted to reply "not really" but like to help if we can. It would give them some time to fill our vacated time later in the week.

We dress first thing in the morning so we're ready to ride at a moment's notice. The appointment was for an echocardiogram so my services weren't needed. In the waiting room I reached into my purse and a sick feeling came over me, no phone. Panic, how would I occupy myself?

Desperate, I turned to a TIME magazine on the table beside me. I began thumbing through the magazine and suddenly boredom was no longer an issue.

I consider myself to be progressive and open to LGBT rights but this brought me to a sudden stop. It was referred to as 'chest feeding.'

1) Why would TIME post such a picture?
2) I found it jarring.
3) How do you explain it to a child?

Is my age showing that I find publishing such a picture disturbing? I don't think it's helpful to the transgender discussion

Friday, September 16, 2016

A Surprise

It was a surprise to learn Bob's cardiologist retired without a word to his patients. A letter is in the mail I was told. He is a private man who I'm sure felt he could not bear chit chatting about his retirement plans with every patient he saw. I can understand that but it was a shock.

The cardiologist taking his place is a woman that I believe is coming from Rochester, NY. She took care of what I needed today and wants to see Bob in her office next week. I have no reason to think she won't be just fine but will be a little nervous until we meet next week.

It is not often all the pieces in medicine work in harmony as they should but I now know it actually does happen occasionally.  Today Bob's geriatrician changed how he takes Prilosec. A few hours later I was surprised to receive a call from a pharmacist in the anti coagulation lab at the hospital. Said she saw the doctor had changed how Bob was to take Prilosec and since it is a drug that changes the count in people taking blood thinners they would need to see him earlier than his next scheduled appointment. I hung up and thought, "Wow, that's cool. That's how medicine is supposed to work." 

My task for today was dealing with Bob's foot pain. I'll be the first to tell you I don't like dealing with feet. He's been complaining for several days about his feet. I thought about it a while and decided some busy work might help. This afternoon I brought home some Epsom Salt and a tube of some kind of cream that's suppose to turn cool and be refreshing. I took the sack to his room and instructed him how HE was to do it. He set right to work on it. I don't have a clue about what to do for foot pain but figured that would make him think I did. I love the saying his geriatrition uses about old people. She says "sometimes it just takes a tincture of time."

Thursday, September 15, 2016

New Subject

Up early to read and plan my day. New subject to deal with today, extra nutrition for Bob.

First did another call to cardiologist since Lasix dose is not taking enough fluid off him. He's short of breath and unsteady on his feet. Likely cardiologist will increase dose and have me continue. Waiting call back on that subject.

Second, made appointments for flu shots. Got to keep up with all the immunizations they want us old folks to have.

Third, talked to sister-in-law about her painful hip and back. Told her to do what the doctors recommended or keep that subject to herself.

Fourth, began researching extra nutrition for Bob. He's continuing to lose weight. Called anti coagulation lab to see if any truth to what I'd read that people on blood thinners should not use commercial high nutrition drinks because they often do not play well with blood thinner medications. Yes, that is true because most of them contain vitamin K. Can use those drinks but must notify lab and take him in for blood tests to see how it's affecting his clotting numbers. They will adjust medication accordingly.

That seems like a lot of trouble. Suggested I make high nutrition shake at home, and maybe add protein powder. Nope, they're also concerned about how much protein he's getting.

Taste buds don't work as well in the elderly. They often begin to crave spicier foods, and like the taste of salt and sugar. If you visit a nursing home at mealtime you will often see workers opening packets of sugar to sprinkle over patients' food trays. They may not know what they're eating but will enjoy the sweet taste. Other things that affect appetite are medications and dementia.

This afternoon I'll be researching juicing, high nutrition shake recipes, extra nutrition through snacks and hiding foods from a food processor to regular recipes. Probably need to move to several small meals a day rather than normal three.

I'm thinking having him in the kitchen may be a problem because he will see when I'm slipping in extra nutrition and may disapprove. If he doesn't see it, will probably never know it's there.

This is all very opposite to what I need to be eating. He'll never remember to eat multiple times a day because that will be new to him. He can still do a little cooking if it's an old recipe with few ingredients and directions. Anything new will be beyond his ability.

Have call in to hospital education department in hopes they'll have some recipes and suggestions for me.

I'm feeling a little overwhelmed. I can be nurse and caregiver, I think I have a handle on that. Nutritionist  food shopper, and cook, not so much.

Wednesday, September 14, 2016

Angst, Worry, OCD, or Dementia

Bob had a doctor's appointment this morning. On the way I noticed the leaves are beginning to turn and that is very exciting to me because fall is my favorite season of the year.

Angst, worry, OCD or dementia, I don't even bother to try to distinguish one from the other. Makes no difference. Whatever it is requires my attention in the same way, so I just deal with it and move on.

Bob is in heart failure and as it progresses he picks up additional problems that go with the disease. He's now retaining fluid, which is common in heart failure patients. It's a fairly new development for him. Yesterday I called the cardiologist for some guidance since it's now pretty clear this is here to stay.

My question was about managing Lasix (diuretic). It seems to me giving Lasix every day is probably not good if you can manage to do otherwise but what do I know?  I know Lasix drains the system of potassium because I have to give him potassium when I give Lasix.
1) How do I know when to give it?
2) How often do I give it?
Word back from the doctor was when he's gained 5 pounds give him Lasix for 3 days. If he's not returned to his base weight call him.

Seemed simple enough to me but boy did that throw Bob for a loop. The simple thing seemed to be to tell him not to worry, to just leave it up to me to manage it. He was having none of that. He was off and running. We are now into day two of angst over taking Lasix.

Off and on all day yesterday I explained the situation to him. He'd be okay for a while and then we needed to do it all over again.
1) What if I have a doctor's appointment on a day I'm taking Lasix?
2) Why do you tell me one day I need to eat more, and the next day say I need to lose 5 pounds?
3) Why take it for three days and not every day?
4) I can't read the scales (wearing his glasses would probably help).
5) Why is Dr. P (cardiologist) doing this when I see Dr. K (pulmonologist) for my breathing?

On and on it goes. Eventually he'll move on but I'm not sure when. Tonight I'll begin weighing him in his pj's, and I'll read the scales. That will give me a good consistent picture. I'm now in possession of the Lasix and potassium. I'll decide when he takes it.

What can I say, he's 84, in frail health, but still on his feet and moving. He's still walking unassisted (most of the time), still washes his own clothes, still attempting to cook, but that's requiring a lot more of my help, still able to take care of his own hygiene. I have good medical support. All in all, life is good.