Friday, January 28, 2005
Oh, my! I didn't post yesterday!
Well, I did over at Mom's Daily Tests and Meds. Because I am taking significantly fewer stats, I include a bit more detail about her day over there than here. If you're a regular reader and pickings seem a bit slim over here, try the stats section. I try to remember to alert readers over here if I'm spending more time and detail over there. Consider yourself warned, for the time being.
So, I'm up very early this morning, well, I don't know why, exactly. I believe I finally decided, "Ah, what the hell," at 0315 and decided to do some concerted research about the elderly and iron supplements, since it was mentioned by the FNP during our 1/24/05 appointment.
It could be that she didn't know whether I was aware of the dearth of anxious information regarding the possibility of iron overdose and the elderly versus all the other possibilities due to Mom's ACD and CRF. I took this as a cue that there might be more information, but there isn't. Same old stuff. I am, I notice, becoming more comfortable with the acronyms now applied to my mother. My expectation is that using the analogous codes will allow my mother somewhat more leeway, insurance-wise, for evaluative and treatment options. The openended prescription for Levaquin that lasts for a year, for instance.
In my mother's case, she has a history of bad reactions to iron supplements, too...through pregnancy. Iron supplements used to be standard. But these symptoms have not reappeared throughout her Ancient Iron Supplementation so I have to believe that the nominal rise in her hemoglobin when she is on exactly the type and daily dosage of supplements she is on now is better for her than allowing her to lag for 3 months, get a transfusion, lag for 3 months...especially considering all the health risks to other organs and systems on this yo-yo system.
It is important to note, as well, because of these iron overdose concerns, I did let her lag in iron supplementation (although never completely stopped it) in the spring of last year. Cut her back to 18 mg Iron Protein Succinylate at lunch and dinner (kept her on the 150 mg Niferex in the morning) and frequently 'forgot' her lunch supplement. Before she quit smoking, in fact. This led to a 5.6 hemoglobin and a blood transfusion. And, her first catheterization.
I'm noticing, this time around, the special comments about the stroke prone elderly. This information may have been there before when I began looking up information in the fall of 2002. There is some discussion as to whether excess iron (which many of the elderly exhibit) in conjunction with ACD, has anything to do with stroking, especially if the stroke occurred before the anemia, which is true in my mother's case. Anyway, my feeling is that with the increased blood vigilance, any problems will be noticed immediately and problem areas have already been noted.
I think I may have almost got her out, yesterday, but it was cold, it rained some, always around the time I was discussing the impending and necessary trip to Costco, so she finally won out. I waited to embark on this chore trip until she laid down for a nap. I was gone 1.5 hours. She was up when I arrived home, sitting at the table, reading the new magazines I got her yesterday. She started when I walked in the kitchen. "Oh! I thought you were taking a nap!"
I chuckled. "I wish I could take half the naps you imagine me taking, Mrs. Hudson!"
"Oh! You went to the store!"
"Did you want to go? You said you didn't."
She looks out the window. It happens to be sleeting at that moment. "Absolutely not!"
I can see she's thinking about it, though. Good sign. Besides, she brought something to my attention today that forebodes an early, early spring. Our much neglected/abused ornamental plum tree has already got buds on it. I've also noticed The Little Girl shedding profusely. Unusual this early. This does not, I should add, predict an unusually warm summer. Just the opposite happened, last year: Warmer winter, cool summer. Not that wet but I can imagine a wet summer this year. Maybe my mother is stirring early this year, as is the rest of this area. That would be nice. I'm ready to usher her out and about.
A side observation: I'm not sure if the Detrol is working. I recall mention, at the official web site, that noticeable "changes in urinary frequency" should occur within 12 hours, although it can take up to 7 weeks to work to maximum effect. So far no change at night, although she is awakening herself in the middle of the night to pee. She just doesn't think to change her underwear and, anyway, I'm not sure she remembers where it is. The day changes could be attributed to the clearing of her UTI as well as the initiation of Detrol. She still needs paper underwear. 2 pairs when she's running, 3 pairs when she's down. Yesterday, though, she spent the entire day in the same two pairs and took herself to the bathroom frequently, "just to pee".
We have a four week trial course. We'll know by then if it's helping. There was also mention of special caution when using with the elderly who exhibit symptoms of ACD and CRF (bingo), but not necessarily avoidance. Just heightened alertness. It can be tricky because, physically, my mother is, in some ways, not 87, not even close, considering her life. In other ways she is well past 87. A strong 87, all in all. I got the impression from the FNP that she may see her mother's age at death, 92, and in somewhat better condition, especially more alert, than her mother. Because my mother felt so healthy throughout her life, her medical history is lacking in information but loaded with possibly unreliable anecdote. The stuff about her past reactions to iron supplementation, for instance. The death of a direct older relative from "pernicious anemia", which my mother doesn't have. The possibility that she may have been swimming around in high blood sugar for a long time before it was discovered. And then, there is her metformin usage, which coincides with the worst of her anemia. But, there isn't much of a history before 2000. Both sides of her family are pretty much 'wing and a prayer' people, when it comes to health and healing. They've pulled some surprises out of their hats. Mom doesn't wear hats but she does have this extraordinary fascination with her hair (what little she has) and can be said to wear a hat, almost constantly, in the form of her pastiche.
Later.
Probably.
Later.
So, I'm up very early this morning, well, I don't know why, exactly. I believe I finally decided, "Ah, what the hell," at 0315 and decided to do some concerted research about the elderly and iron supplements, since it was mentioned by the FNP during our 1/24/05 appointment.
It could be that she didn't know whether I was aware of the dearth of anxious information regarding the possibility of iron overdose and the elderly versus all the other possibilities due to Mom's ACD and CRF. I took this as a cue that there might be more information, but there isn't. Same old stuff. I am, I notice, becoming more comfortable with the acronyms now applied to my mother. My expectation is that using the analogous codes will allow my mother somewhat more leeway, insurance-wise, for evaluative and treatment options. The openended prescription for Levaquin that lasts for a year, for instance.
In my mother's case, she has a history of bad reactions to iron supplements, too...through pregnancy. Iron supplements used to be standard. But these symptoms have not reappeared throughout her Ancient Iron Supplementation so I have to believe that the nominal rise in her hemoglobin when she is on exactly the type and daily dosage of supplements she is on now is better for her than allowing her to lag for 3 months, get a transfusion, lag for 3 months...especially considering all the health risks to other organs and systems on this yo-yo system.
It is important to note, as well, because of these iron overdose concerns, I did let her lag in iron supplementation (although never completely stopped it) in the spring of last year. Cut her back to 18 mg Iron Protein Succinylate at lunch and dinner (kept her on the 150 mg Niferex in the morning) and frequently 'forgot' her lunch supplement. Before she quit smoking, in fact. This led to a 5.6 hemoglobin and a blood transfusion. And, her first catheterization.
I'm noticing, this time around, the special comments about the stroke prone elderly. This information may have been there before when I began looking up information in the fall of 2002. There is some discussion as to whether excess iron (which many of the elderly exhibit) in conjunction with ACD, has anything to do with stroking, especially if the stroke occurred before the anemia, which is true in my mother's case. Anyway, my feeling is that with the increased blood vigilance, any problems will be noticed immediately and problem areas have already been noted.
I think I may have almost got her out, yesterday, but it was cold, it rained some, always around the time I was discussing the impending and necessary trip to Costco, so she finally won out. I waited to embark on this chore trip until she laid down for a nap. I was gone 1.5 hours. She was up when I arrived home, sitting at the table, reading the new magazines I got her yesterday. She started when I walked in the kitchen. "Oh! I thought you were taking a nap!"
I chuckled. "I wish I could take half the naps you imagine me taking, Mrs. Hudson!"
"Oh! You went to the store!"
"Did you want to go? You said you didn't."
She looks out the window. It happens to be sleeting at that moment. "Absolutely not!"
I can see she's thinking about it, though. Good sign. Besides, she brought something to my attention today that forebodes an early, early spring. Our much neglected/abused ornamental plum tree has already got buds on it. I've also noticed The Little Girl shedding profusely. Unusual this early. This does not, I should add, predict an unusually warm summer. Just the opposite happened, last year: Warmer winter, cool summer. Not that wet but I can imagine a wet summer this year. Maybe my mother is stirring early this year, as is the rest of this area. That would be nice. I'm ready to usher her out and about.
A side observation: I'm not sure if the Detrol is working. I recall mention, at the official web site, that noticeable "changes in urinary frequency" should occur within 12 hours, although it can take up to 7 weeks to work to maximum effect. So far no change at night, although she is awakening herself in the middle of the night to pee. She just doesn't think to change her underwear and, anyway, I'm not sure she remembers where it is. The day changes could be attributed to the clearing of her UTI as well as the initiation of Detrol. She still needs paper underwear. 2 pairs when she's running, 3 pairs when she's down. Yesterday, though, she spent the entire day in the same two pairs and took herself to the bathroom frequently, "just to pee".
We have a four week trial course. We'll know by then if it's helping. There was also mention of special caution when using with the elderly who exhibit symptoms of ACD and CRF (bingo), but not necessarily avoidance. Just heightened alertness. It can be tricky because, physically, my mother is, in some ways, not 87, not even close, considering her life. In other ways she is well past 87. A strong 87, all in all. I got the impression from the FNP that she may see her mother's age at death, 92, and in somewhat better condition, especially more alert, than her mother. Because my mother felt so healthy throughout her life, her medical history is lacking in information but loaded with possibly unreliable anecdote. The stuff about her past reactions to iron supplementation, for instance. The death of a direct older relative from "pernicious anemia", which my mother doesn't have. The possibility that she may have been swimming around in high blood sugar for a long time before it was discovered. And then, there is her metformin usage, which coincides with the worst of her anemia. But, there isn't much of a history before 2000. Both sides of her family are pretty much 'wing and a prayer' people, when it comes to health and healing. They've pulled some surprises out of their hats. Mom doesn't wear hats but she does have this extraordinary fascination with her hair (what little she has) and can be said to wear a hat, almost constantly, in the form of her pastiche.
Later.
Probably.
Later.
