Dr. Cohen - Monday

We followed up the ER experience with Dr. Cohen. He reviewed the ER doctor report and said that the "congestive heart failure" diagnosis was probably based on one particular blood test which seemed elevated. He said Mom does not have CHF based on his tests and her history. He also had a reading of her pacemaker and it showed no event changes since her last reading on Dec 28. He asked Mom a lot of questions relative to her breathing experince/pain and said she was in "great shape". We are to follow up in 6 months but that is for a reading of her pacemaker and just a reg. check-up.

January 28 - Emergency Room

Mom called at 6:45am to say she was in agony breathing and wanted to go to the ER. I asked her about her pain and suggested that we call 911. She described the pain as happening whenever she inhaled and that she didn't think that we should call 911. This pain started at 12:30am but Mom waited so as not to disturb me. We discussed this and she now knows that waiting to call is a very bad thing and that she is not to do this ever again.

We arrived at ER at 7:45am. They did an EKG, an X-ray and a series of blood tests. While we waited they monitored Mom's blood pressure and gave her oxygen. The EKG came out "normal" for Mom. The X-ray shows that she has some fluid in the paracardium indicating mild congestive heart failure. The blood tests came out normal. At 11am Dr. Yadim (sp) Patel, Mom's attending physician in the ER came in to say that it did not appear that Mom was having a heart attack. He said that he would order a CT scan but after 30 minutes of waiting with nothing happening, Mom decided that she had had enough waiting and wanted to go home. I talked with Dr. Patel and he ordered up another blood test to make sure that Mom's blood chemistry had not changed and as soon as that came back normal we were discharged with two prescriptions and an order to have Mom see Dr. Cohen. I took care of that while we waited for the discharge papers and we will see Dr. Cohen on Feb. 7 in the afternoon. Mom rec'd a prescription for a sedative elixir and a muscle spasm thing. Had I not asked for the muscle spasm stuff Mom would only have the sleeping aid. As it worked out the muscle spasm stuff did the trick and mom slept for the remainder of the day and the entire night without incident.

By January 29, Mom awoke pain-free but still tired. I gave her the hydrochlorothyazide (diuretic) in the morning. She did not take her heart medications on the 28th which I forgot to give her under the cirucmstances. I had tested her INR before going to the ER so I'd have that info, and that was normal so I was not too concerned about forgetting the pills. Mom resumed her heart medicines in the evening of Jan 29.

The pain in her chest and back has now been attributed to muscle strain because of her effort in picking up Ella Grace on Thursday. The price of love, eh!

Dr. Iatredes -

Mom was concerned about her post nasal drip and continuous coughing thinking that it might be a carry over from her Dec. bout with an upper respiratory infection. The doctor did 6 breathing tests and 1 6minute treadmill test plus a chest x-ray (or two). Mom's lung capacity has improved since we saw him 1 1/2 years ago. He is amazed at how vibrant Mom is. The X-ray shows that she has a bit of asthma which could be allergy or something else. We discussed the fact that Mom was on allergy medicine until she was about 90 and then they wouldn't give it to her. Dr. I said he doesn't know of anyone 90+ on allergy medicine. (Dr. Cohen explained that there are too many potentials for complications with allergy medicines and heart medication which is why they don't use it on Mom.) Anyhow, Dr. I has prescribed Advair for the asthma, something else for her runny nose*( and also gave her an emergency inhaler in case of something dire. Now we have the inhaler and an epi-pen in the house, in the cabinet with the salad plates. As of today, on Advair alone, Mom feels considerably better just using the Advair once a day instead of 2X's so... we'll stick with that for the time being. Her runny nose isn't running either so this is good news.

*I'll correct this when I remember what the other inhalent is.

Wednesday update

Mom is improving slowly. Her voice doesn't sound like a squeek and her nose isn't running so profusely. Karley recommended Mucinex and that has helped the cough so I expect that in the next few days, Mom will feel much better.

Her INR level (Coumadin measurement) has dropped to 1.8 which is too now thick and I have spoken to our contact at the coumadin clinic. She's upp'd the dosage for today and then we are supposed to go back on Mom's standard regimine and check her blood in a week. Fat chance! I will continue to check until things stabilize. Meantime, we did chicken soup and yogurt for lunch...diahrea again from the antibiotics...and then had a regular dinner. Mom's taste is gone for the moment along with her appetite.

Tomorrow we go to the Boniva clinic for Mom's arthritis med's. Never a dull moment.

The day after Christmas

We have spent a week with gastro-intestinal upset that was truly upsetting. Mom suffered from Sunday, Dec. 19 ending Friday Dec. 24. The severe diahrea threw her INR (coumadin) rating to the sky raising it to 7.8. I finally called Dr. Cohen who told me to feed her greens and take her off the coumadin until her blood came down to 2.2 or 2.3. That is now in progress. Meanwhile, Mom now has a cold with laryngitis. So, today, Dec. 27, we are off to Dr. Cantwell, hoping to get some remedy that will prevent this from going further.

Dr. McCune Dec 15

We went to see Dr. McCune today. He is the haematologist/oncologist. Mom is doing well. Her white blood count was down a bit from the last time. Her red blood count was also down a bit so he wants her to take an iron suppliment twice a week. This is an over the counter remedy. In the meantime, her complete blood workup will be ready by Friday (maybe) and we will get another reading of other things. This information will also be faxed back to Dr. Myerson so Mom can have her Boniva infusion next week.

Re: Boniva. I asked Dr. Myerson the rhumatologist last week whether there was any questionable interaction or adverse impact on CLL from Boniva. He said no, there was not.

I asked Dr. McCune about Karley saving her cord blood for Mom or any one of us should the need arise. He said he had done two years of cord blood work when he was at Duke Univ. and they were nothing but trouble. It did not produce the results desired, it could only be used on little adults and, at that, it took two transfusions. Apparently the stem cells in the cord do not work as well as other stem cells for the purpose of CLL and perhaps other things. Dr. McCune also said that Mom would not be a candidate for this modality anyhow. He also said it was very expensive to save cord blood, about $100/month and that the cells only stayed viable at the outmost for 2 years, hence, he would not recommend saving it for Mom or any of us. Thank you Karley for thinking about this for all of us!

McCune thinks Mom is doing very well for 92.

We are scheduled to go back in April, 2011.

sept 21 - blood follow-up

Finally Dr. McCune's office called. Mom is deficient in iron and needs to have a multi-vit with iron in it. Otherwise, her thyroid and vitamin B12 levels are just fine.