To MFS: Naturally, I rarely read my messages before I send them...
...and I finally, just now, reread the message I sent you earlier and noticed that I said: "She is in the classic category of the Overmedicated Elderly..." [corrected in the online quote] I meant to write: She isn't in the classic category of the Overmedicated Elderly...". You know how I know this? You'll love this...one day when Mom and I went in for one of her appointments, it was a quiet afternoon at the office and one of the staff had patient files all over the place updating them. Each time a patient comes in for an appointment, when they leave they get a printout of their stats, which usually takes a half page, then a list of all the current medications they have been prescribed and are currently on (both over the counter and Rxed meds) and instructions. Usually, when Mom and I walk out, our printout is one page, sometimes one page with a tag line on the second page noting the time of our next appointment. MFS, most of the patients that clinic sees get printouts anywhere from five to ten pages long, most of it medications and instructions! I know this isn't because these doctors are medication happy, at least Mom's isn't, he is always circumspect about prescribing, even more circumspect when he suggests something new, he is always thrilled when I am able to cut back on medications or find an alternative (for instance, rubbing her feet and lower legs and arms twice a day rather than giving her furosemide to help her expel internal retained water, which he, earlier this year, prescribed for her everyday and I balked at).
    Anyway, I have to tell you this, too...weird, weird, weird. I decided, instead of writing the colonoscopist, I'd call her office and, even if I was only able to talk to her assistant or her nurse, maybe, with their experience, they'd be able to tell me if Mom's initial reaction to The Cleansing and The Colonoscopy were normal and which part of the entire procedure would most likely account for it. Well, her surgical assistant was there so I ran all my observations by her. She was stumped and put me on hold to consult with someone else. As it turns out, it was the colonoscopist's partner to whom she talked. Mind you, MFS, I had already told the assistant that one of the things I'd discovered is that her blood sugar was so much easier to control that I was not putting her back on the Glucophage and that she didn't appear to need iron three times a day, so far. So, the assistant comes back to the phone and says to me, "[The colonoscopist's partner] says it's the new medication she's on."
    My brain goes "!?!" My mouth goes, "But, she's not on any new medication. In fact, I've cut her medication back."
    "Well," the assistant tells me, "that's what he said."
    That's what he said?!? Hello, Ms. Assistant to the Coloscopist, is anyone home? Needless to say, I let that conversation go and will now be writing a letter to the colonoscopist.
    So, I decided to call the PCP's office. Knowing that he probably won't be able to talk to me, I expect to get one of his nurses, and do, a new, young one who is actually quite good, if somewhat inexperienced, but is definitely well versed on Mom and the way I handle her medical care. I tell The Nurse right off the bat the unexpected results of the colonoscopy and the strategies I'm putting into place because of these developments, that I will be continuing them, with severe monitoring and dogged circumspection, for the next week, and, of course, will reverse my path and do "as the doctor orders", the moment my observations and her blood sugar indicate that she either needs the iron or the Glucophage. I tell her several times, because I want to make sure she's taking notes, that I am giving this information to her to pass on to Moms PCP so that he will have some time to think about and, if necessary, research these developments, my reactions to them, call me, if necessary, to tell me to stop what I'm doing and continue with prescribed treatment, and to let him know well ahead in case he wants to order another blood draw before next Wednesday so he can see how my strategy (and/or the aftermath of The Cleansing) is working.
    Throughout the call she stops me at various places and says, "You know, I don't have the authority to authorize treatment changes," and each time she tells me this I tell her, once again, "Nurse, I'm not asking you for permission. I'm going to do these things, regardless. I'm asking you to pass on information. That's all."
    Finally, when I'm done, she launches into a strange (thank you, Neil Young) little sermon about how people shouldn't take their medical care into their own hands, blah, blah, blah...
    ...and I'm thinking, well, in that case, since doctors typically don't have enough time on their hands to take on the complete and observant medical care of all their patients, who's supposed to do this and I think further, damn, I'll bet this message is going to be so cryptic when it gets to Mom's PCP that he's not going to get the gist of it. Actually, there's a good chance that I'm wrong on that, but, you know, MFS, and I'm sure you do, the medical profession is just very, very weird, now.
    MFS, I especially wanted you to know all these medical-adventure details because I know you have a strong interest in becoming a nurse. You're a brave, brave soul, MFS, wanting to go into medicine at this time. It isn't "Your Mother's Medicine" anymore. My experience with managing Mom's health care is proof positive of this. Medicine needs people like you, older people who have experienced the ass end of medicine and still want to go into it, and I know, if you get to pursue your desire, you'll be fabulous.
    I'll keep you posted as Mom and I continue in the aftermath of the colonoscopy. She awoke from a somewhat longer than usual for the last few days afternoon nap (I took one, too, today...my exhaustion from trying to keep a constant eye on Mom finally caught up with me) complaining that she didn't feel good, "...like I have a fever without the fever...". After some probing questions and noting, mentally, that she was looking a little pale (although nothing like she'd been looking before The Cleansing), taking her temperature, asking specific questions about possible pain and discomfort, taking her blood sugar (which was normal, 98) noticing that she was a little dehydrated, I decided it was time for a good dinner (she, of course, told me she wasn't hungry), some Glucotrol, plenty of fluids and an iron pill. I got her Wendy's chili (she loves this stuff and, I don't know if you've noticed this but it tastes exactly like Mom's used to taste, which isn't the typical way chili tastes), gave her some cottage cheese, made her drink a 16 oz. glass of water, let her chase that with some of our mounds of left-over Jello, she wolfed the entire dinner down and started feeling much better. She actually pulled out of going to Costco this afternoon, but that was okay with me. She's still A Weak One, both from the procedure and from months of being almost non-ambulatory, and I expected that she would over-estimate her energy level so I wasn't surprised and didn't push her. But, just the fact that she is still, even this evening, talking about doing this, doing that, going here, going there, when are we going to Prescott, etc., well, this is the best indication to me that she is feeling better, even if she is somewhat overestimating her abilities. My job now, I think, is to maneuver between her conception of her energy and her actual strength, which is poor but I think shows excellent signs of improvement, and make sure that her personal optimism isn't overwhelmed and dashed by her current (but, hopefully, temporary) inability to do what she now wants to do.
    I am, by the way, for my (at this point) almost non-existent audience on the Mom & Me website, going to put this up without names (although I'm sorely tempted to put the names of all medical personnel just to expose the ridiculous nature of medical care, right now).
    I am really beginning to get the feeling that someday, at some point, someone who is either taking care of an Ancient One or is medically involved with lots of Ancient Ones, will see the site, read and begin to think more deeply about what they not only are doing but aren't doing.
    So, without further ado (and verbal doo-doo), I'll read this over and send it off. MFS, if you're worrying about Mom, don't. She's doing better than okay, right now, and I have high hopes, and so does she.
- posted by gail rae @ 17:09   email...this post