Mom & Me Three Archive

commented the lab tech at my mother's PCP's office on Tuesday as she signed the release forms necessary for the drawing of blood to be tested.
    He's right, it is. This is something I've noticed before when she signs checks for deposits and all types of forms. I almost always allow her final signature of anything after she's read the document, I've thoroughly explained the contents and we've discussed the implications of her signature. Once in awhile, during bouts of illness and weakness, the pressure of her signature fades to light, but its smoothness of line bespeaks the durability of her determination.
    Just before she signed the release she voiced one of her favorite lines, "I charge for my signature, you know."
    The lab tech laughed. I added, "Mom, you know, if you charge for your signature, shouldn't you also be charging for your blood?"
    She glanced at me, that "at heart I'm a barterer" look in her eye and looked back at the tech expectantly.
    "Too late," he said, slipping the needle out of her vein.
    While we were getting reacquainted with her former PCP, now her reinstated PCP, and he was reviewing prior treatment my mother spoke up several times, understood and responded to questions clearly and with her wry humor and generally made an excellent impression. At one point when the PCP and I were discussing something about how she is doing generally at home, she interrupted me to add detail to some issue over which I'd glossed. I grinned at her and said, as an aside to the doctor, "She remains very feisty."
    "Good," said the doctor, "very good!"
    It is good. Although I may cover the day and the visit in more detail later, here are some highlights:

• Her blood oxygen level, sitting in the office without oxygen, was 94.
• The PCP reviewed all the data about her frequent UTIs with me, agreed with me that scoping and imaging were out of the question and proposed putting her on a low (100 mg) daily dose of Macrodentin (nitrofurantoin macro) to prevent them. I agreed.
• He took blood for a CBC, Iron & TIBC, Ferritin (I think), a CMP and a Hemoglobin A1c (I will be obtaining copies of all results and posting them here, as usual). "I don't think we need to check her cholesterol," he said. She seems to be doing fine and continues to fall into the category of The Elderly w/Occasionally High Readings of Cholesterol Who Are Not Prone to Heart Disease. I agreed.
• He was singularly pleased, maybe even a little surprised, at her "excellent" blood sugar and blood pressure reports. He agreed with the way I've been administering her medication and controlling her diet.
• All medications, supplements and dosages remain the same except for the Rx for Macrodantin.
Her monthly CBC with continue. He agreed with me that the BMP probably only needs to be done at every two draws. He also agreed the the monthly urinalysis can be dropped. He did, as well, write out an as needed prescription for a culture urinalysis if she shows signs of a UTI despite the daily dose of Macrodantin, and, as well, an as need prescription for Levaquin, 500 mg/7 days. Frankly, I'm not expecting to have to use these. Neither is he.
• If all goes well, he doesn't want to see her again until late October/early November, which exactly dovetails with what I consider prudent.
• Although she does well resting without oxygen in the Valley, her oxygen prescription remains unchanged, for the time being, up here. The doctor is confident of my ability to tell when she needs it by her mouth breathing when she's at rest up here, she will continue using it when she sleeps and, of course, when she moves around, with the proviso that as she moves around "more" (which is always a hope of mine), she will probably need it less.

    Overall, the doctor was well prepared and relaxed in his own surroundings. He literally sprawled in his chair once we all realized we could be comfortable with one another. I volunteered information about why Mom was dismissed by the new doctor at her (and this PCP's) former clinic, including the fact that it was my upbraiding of him that "did the trick". He expressed neither surprise nor dismay. He knows me well. Although it wasn't necessary, he mentioned that he knew nothing about our former doctor. He did, however, mention that "90% of my former patients followed me to the clinic" and apologized for the fact that his informational letter to his patients didn't reach us, surmised it was because we had sold our Mesa house just previous to his move and the sending of his letter (I was pleasantly surprised that he'd remembered all this about us), with which I agreed, as we had problems with the forwarding of mail immediately after the sale. I apologized for not following him sooner. He also mentioned, when I praised The Wondrous FNP we'd had in January, that she had left The Other Clinic along with another FNP who was a diabetic specialist and one of our much appreciated medical resources. Luckily, our two favorite nurses joined him at his new clinic. One was on summer hours, since his clinic, like many others in the Valley that cater to an older demographic, suffers from patient downturn in the summer, so we weren't able to connect with her, but I left her a note. Both Mom and I are relieved that she is back in familiar medical hands.
    I am very satisfied with the visit, despite the fact that, I am ashamed to say, I managed to get a ticket for making a California Stop at a red light. I've received only one other ticket in my life, for speeding on a freeway during the 55 mph nationwide limits, almost 30 years ago, so I was not thrilled about the laxity of my driving. I've always considered myself an excellent, more than defensive driver and was appropriately taken to task when I was ticketed. I signed up for Traffic Survival School in order to have the fine lowered and the ticket dismissed. It will occur on August 6th, a Saturday. Unfortunately, there are no classes being offered up here before my court date. We'll be traveling to North Phoenix, just off I-17, for the class. Since the class is 8 hours, Mom will be ensconced in a motel room for that time but I'll have one break to check up on her. We've discussed it and Mom is looking forward to being "left alone to do what [she] wants" for 8 hours in a hotel. I've checked us into the same hotel that is hosting the class. We'll be there the night previous and into the early evening of the night of the class. I've promised her two dinners out, which pleases her. I have some anxiety about her incontinence but we'll come prepared and I'll use my break during the 8 hour class to make sure she's dry and changed and knows I haven't forgotten about her. I've already begun to drill into her that she is not to leave the hotel room for any reason. She is sure she won't. "I expect I'll sleep most of the day, since you won't be there to make me get up, or, I'll watch TV. Make sure it's on Animal Planet," she suggests with an anticipatory gleam in her eye. I expect she's right, and I'm not worried about this.
    Things are going well and Mom's been asleep for 12 hours so it's time to rouse her. Although it seems that I've been able to cover all of what I intended to cover about our Valley visit on Tuesday, I'm sure I'll be back...
    ...later.