Wednesday, December 24, 2008
Dec 24
mom did her physical therapy this morning. She did the pool manually as the treadmill was broken and then she did the land-based treadmill. Legs still hurt.
Monday, December 22, 2008
Dec. 22
This morning we went to see Dr. Iatris. He x-rayed Mom's lungs and proclaimed her in great shape. She still has a little fluid on the left lung but nothing to be concerned with. He also said she has made a magnificant recovery considering what she has been through. Mom told him about her cough and runny nose so he has prescribed a round of Flonase (a steroid inhaler) for the next month. We will get that prescription filled momentarily.
Went to the water therapist this afternoon and did about an hour in the water. Actually, other than being a bit warmer, it was the same exercises that Mom and I have been doing at LA Fitness. Nevertheless, the PT has a leg up on where to massage Mom's thighs etc. and it made her feel better the last time so we shall continue with Wed. and Friday appt.s. After she massaged Mom she put an icepack on her back and let her lie there for awhile. I forgot to check how long but it was probably about 15 or 20 minutes. Mom says her back now hurts when she walks but we haven't been home for more than 2.5 hours and often you feel worse immediately after therapy before the good sets in. At least that is what we are told.
Went to the water therapist this afternoon and did about an hour in the water. Actually, other than being a bit warmer, it was the same exercises that Mom and I have been doing at LA Fitness. Nevertheless, the PT has a leg up on where to massage Mom's thighs etc. and it made her feel better the last time so we shall continue with Wed. and Friday appt.s. After she massaged Mom she put an icepack on her back and let her lie there for awhile. I forgot to check how long but it was probably about 15 or 20 minutes. Mom says her back now hurts when she walks but we haven't been home for more than 2.5 hours and often you feel worse immediately after therapy before the good sets in. At least that is what we are told.
Thursday, December 18, 2008
December 18
Today we went to the water therapist in the morning. We were very impressed. She asked Mom all kinds of questions relating to symptoms and her legs and pain levels etc. Then she tested her legs for strength and mobility and pain points. She did the same with her back. She said Mom probably has a bone spur on her spine, showed me where the curvature is, tested the musculature around the curvature and determined that she could help Mom with massage, onland exercise and water therapy. She massaged muscle notes in her hips and in her spine and Mom was painfree while walking for quite a while. Mom felt she had a great improvement in just one session. We will see the therapist again next Monday and Wednesday.
We then went to see Dr. Ryan Cantwell regarding Mom's feet. They are swollen like sausages. Last Thursday she began to take the diuretic that Dr. Cohen prescribed a week or two after her pacemaker when Mom felt so horribley fatigued and breathless. After the pneumonia went away she wasn't breathless anymore so we all agreed that Mom might not need the diuretic. Anyhow, I advised Cohen that Mom was taking the diuretic and that her feet were swollen and he said the Cantwell could do an equally good job on this subject and we didn't need him. Naturally, when we got there today the swelling was 50% down which could be a result of the diuretic, the massage and relief in the back and hips. He said it could be the daily Advil that causes this but is still waiting for the reports from the neurologist and the spine man. We filled out new forms requesting this data to be sent which they faxed. Otherwise, he is recommending nothing until he gets the reports.
Mom also had low bloodpressure which might account for her lack of pizzaz. We forgot to ask Cantwell what you do about this but left him a message in this regard. It was 92 over something.
We then went to see Dr. Ryan Cantwell regarding Mom's feet. They are swollen like sausages. Last Thursday she began to take the diuretic that Dr. Cohen prescribed a week or two after her pacemaker when Mom felt so horribley fatigued and breathless. After the pneumonia went away she wasn't breathless anymore so we all agreed that Mom might not need the diuretic. Anyhow, I advised Cohen that Mom was taking the diuretic and that her feet were swollen and he said the Cantwell could do an equally good job on this subject and we didn't need him. Naturally, when we got there today the swelling was 50% down which could be a result of the diuretic, the massage and relief in the back and hips. He said it could be the daily Advil that causes this but is still waiting for the reports from the neurologist and the spine man. We filled out new forms requesting this data to be sent which they faxed. Otherwise, he is recommending nothing until he gets the reports.
Mom also had low bloodpressure which might account for her lack of pizzaz. We forgot to ask Cantwell what you do about this but left him a message in this regard. It was 92 over something.
Thursday, December 11, 2008
Dec. 10
We saw Dr. Reuben Sloan the spine doctor. He took 4 xrays of Mom's spine. Needless to say, her spine does not look good. It is full of arthritis, L2 and L3 have slipped which makes the nerve passage tight. She has pretty severe curvature of the spine in the nether regions as well. He thinks that when she fell she caused an arthritic flare up. Because she is on coumadin and can't be off it he can't give her any shot to remediate the pain. He has prescribed water therapy which is different than water aerobics so we will be looking into two places. Apparently water therapists aren't readily available so which ever place has what we need is where we shall go.
Monday, December 8, 2008
December 8
We began the morning by going to the coumadin clinic and getting instructions on how to measure Mom's blood with the coumadin machine. I'm sure it has another name but hey... that's what it does. It isn't any more difficult than taking blood to measure sugar except that the little place that collects the sample is finikky.
This afternoon, we went to the bone man to check out Mom's arm. Today he didn't see that the elbow had been broken but he thought he could see where the wrist had been broken. Seems there's a new story with each visit. Mom and I are really wondering about this fellow's ability seeing as he keeps suggesting that she is 90. I wonder if a broken bone looks different in a 90 year old??? Anyhow, we are supposed to see him on Jan 5, but we are thinking we will cancel it as long as Mom is progressing.
This afternoon, we went to the bone man to check out Mom's arm. Today he didn't see that the elbow had been broken but he thought he could see where the wrist had been broken. Seems there's a new story with each visit. Mom and I are really wondering about this fellow's ability seeing as he keeps suggesting that she is 90. I wonder if a broken bone looks different in a 90 year old??? Anyhow, we are supposed to see him on Jan 5, but we are thinking we will cancel it as long as Mom is progressing.
Friday, December 5, 2008
Dec 5
The coumadin monitor has arrived so Mom and I will go to Piedmont on Monday for an 11am appt. to get our instructions as to how you use it. I observed the week before and it is quite straight forward and doesn't require any genius. Works like a glucose thingy.
From there we go to Dr. Schneider, ostensibly to sign off on Mom's arm and wrist. Good riddance to this twit.
Mom made an appointment for next Wednesday, Dec., 10, with Dr. Rubin Sloan at Resurgens, the same "company") that did her hips, knees, my knees and wrist. So, they have all her data at hand and can use the Xrays that were taken on the 4th. Resurgens has specialists for every joint in the body and, other than Schneider, do a very good job on same.
From there we go to Dr. Schneider, ostensibly to sign off on Mom's arm and wrist. Good riddance to this twit.
Mom made an appointment for next Wednesday, Dec., 10, with Dr. Rubin Sloan at Resurgens, the same "company") that did her hips, knees, my knees and wrist. So, they have all her data at hand and can use the Xrays that were taken on the 4th. Resurgens has specialists for every joint in the body and, other than Schneider, do a very good job on same.
Thursday, December 4, 2008
December 4
Today we saw Eddie Bean, Dr. Kress's PA. He shot a lot of Xrays of Mom's hips and knees and determined that there was nothing wrong/compromised with any of these joints. He then sent her for an xray of her spine. She has scoliosis (curvature of the spine). He also discovered that L2 had broken at some point and has healed. He thinks that because she has no disks left between her vertabrae that when she fell she jossled something and that is what is causing her pain. He recommended that we see a spine specialist and gave us his name. An appointment has been made for next Wed.
December 4
December 3 we visited with Dr. Seiden, a neurologist. He did a complete neurological assement of Mom to see what the problem is with her legs/walking. His conclusion is that neurologically she is just fine. He also said there was nothing he could do about the neuropathy in her feet. Dr. S. suggested that the problem with Gram's legs might be orthopedic or rheumatic and that she should see a doctor in either/both fields for assessment. We are going to see Dr. Kress' PA on Dec. 4 for an ortho-assessment.
Tuesday, December 2, 2008
November 17
Mom awoke in the middle of the night and said her right leg was numb. I massaged it for a bit and then decided that we should return to Kennestone ER as I thought it could be another stroke. The ER doctor said it was probably neuopathy and suggested we find a neuologist. This I did with the help of Dr. Cohen. We are scheduled to see a Dr. Seidon at Piedmont on Dec. 3
October 26
Mom fell in her bedroom and hit her head on the dresser. She was taken to Kennestone ER where a CTscan of her brain was done and x-ray's of her arm. It was determined that she had broken her elbow in three places. The arm was "set" and an appointment was made with Dr. Schneider at Resurgens.
Dr. Schneider reviewed the x-rays, took some of his own and set the arm in a half cast.
Mom also developed fluid on her lung as a result of the fall. Dates of Dr. I are to follow.
Dr. Schneider reviewed the x-rays, took some of his own and set the arm in a half cast.
Mom also developed fluid on her lung as a result of the fall. Dates of Dr. I are to follow.
October 21
On 10/21 - Mom had a small stroke on the left side. She went to Kennestone ER and was admitted. She was released on 10/22 after she was seen by a physical therapist, occupational therapist, neuologist, swallow specialist.
Monday, October 20, 2008
A visit to the lung doctor
Today Mom and I made an unscheduled visit to the lung doctor (Dr. Iatredes). He took two x-rays and ran her through two breathing tests; how much air she could blow out - lung capacity, how much saturated oxygen was in her system. She was compromised on both tests.
1. She has some kind of congestion in the left lower lung. I'd say it looks like 1/6-1/5 of the lung is cloudy.
2. Her saturated oxygen levels were low after 3 minutes of walking so he has put her on oxygen for when she sleeps and or is going to move about for more than 3 minutes.
3. He has her on 8 days of prednisone in case this is allergy related.
4. A 3 tier barium swallow is scheduled for Wednesday to see if there is an obstruction in the esophogus (or what happens when she swallows) which is routing some food particles into her lung. It takes three different kinds of swallows. Thin fluid, medium fluid, thick fluid. This will be done this coming Wednesday, May 22.
5. He does not think it is heart related and he could see no reminants of the pneumothorax.
We will see Dr. Iatredes for follow-up on Nov. 3rd
1. She has some kind of congestion in the left lower lung. I'd say it looks like 1/6-1/5 of the lung is cloudy.
2. Her saturated oxygen levels were low after 3 minutes of walking so he has put her on oxygen for when she sleeps and or is going to move about for more than 3 minutes.
3. He has her on 8 days of prednisone in case this is allergy related.
4. A 3 tier barium swallow is scheduled for Wednesday to see if there is an obstruction in the esophogus (or what happens when she swallows) which is routing some food particles into her lung. It takes three different kinds of swallows. Thin fluid, medium fluid, thick fluid. This will be done this coming Wednesday, May 22.
5. He does not think it is heart related and he could see no reminants of the pneumothorax.
We will see Dr. Iatredes for follow-up on Nov. 3rd
Wednesday, October 15, 2008
October Update on Mom
Well, a lot has transpired since I last posted. Mom had her pacemaker put in. She also got a pneumothorax as a result of a nick in her lung allowing air to get into her chest space. This means she got air between her lung and lung sac. As of today, however
The air in her lung sac is gone
Her pacemaker was adjusted from a 60 beat per minute to a 70 beat per minute pace. This means that her heart will never go below 70 beats per minute.
Doctor Cohen changed her prescription. He has deleted one 25 mgToporal XL and replaced it with Verapamil which is the lowest dose med. and a diuretic which she is to take in the morning. I need to give him a call as Mom/Karen/Mary don't think she is retaining water.
From the question list:
Mom can sleep on any side she wishes.
The extreme pain she experienced the night she came home was probably the air leak pressing on her lung. That is gone now and she has no pain.
She can now shower whenever she wants. Swimming pool next week when the last little corner of the incision is healed.
The light-headedness, floaty feeling and shortness of breath is a result of three things:
Doctor Cohen hopes that the additional meds will take care of the heart issues otherwise, he stated again, that Mom is a candidate for ablation, which means he would cauterize a spot on her heart and she would be totally dependent upon the pacemaker. I asked him about risk and he said that 1 in 5000 have problems and yes, he has had some patients die. An ablation would, however, stop the AF and have her tick just like clockwork. Obviously this is something that can be discussed down the road if necessary.
Mom's coumadin levels went from 1.3 to 2.3 in one week. We will check it again next week, the 22. On the 23 we will see the lung doctor. We will see Cohen again on Nov. 12.
Mom can drive, lift her arm and, in general do what she wants but she shouldn't be lifting heavy objects for a while yet.
Dr. Cohen said it took him 2 months to get his energy back after a small pneumonia last year. So Mom should be patient with getting her energy back as hers was a bit larger than his.
The air in her lung sac is gone
Her pacemaker was adjusted from a 60 beat per minute to a 70 beat per minute pace. This means that her heart will never go below 70 beats per minute.
Doctor Cohen changed her prescription. He has deleted one 25 mgToporal XL and replaced it with Verapamil which is the lowest dose med. and a diuretic which she is to take in the morning. I need to give him a call as Mom/Karen/Mary don't think she is retaining water.
From the question list:
Mom can sleep on any side she wishes.
The extreme pain she experienced the night she came home was probably the air leak pressing on her lung. That is gone now and she has no pain.
She can now shower whenever she wants. Swimming pool next week when the last little corner of the incision is healed.
The light-headedness, floaty feeling and shortness of breath is a result of three things:
- The pneumonia which can take a long time to return to health
- The Atrial Fibrillation - which means that when the heart does the extra ta-da's the blood is not sent out of the heart and thus there is a reduction in oxygenated blood to her organs
- The fast heartbeat which wooshes blood through her system too fast and thus, isn't oxygenated enough.
Doctor Cohen hopes that the additional meds will take care of the heart issues otherwise, he stated again, that Mom is a candidate for ablation, which means he would cauterize a spot on her heart and she would be totally dependent upon the pacemaker. I asked him about risk and he said that 1 in 5000 have problems and yes, he has had some patients die. An ablation would, however, stop the AF and have her tick just like clockwork. Obviously this is something that can be discussed down the road if necessary.
Mom's coumadin levels went from 1.3 to 2.3 in one week. We will check it again next week, the 22. On the 23 we will see the lung doctor. We will see Cohen again on Nov. 12.
Mom can drive, lift her arm and, in general do what she wants but she shouldn't be lifting heavy objects for a while yet.
Dr. Cohen said it took him 2 months to get his energy back after a small pneumonia last year. So Mom should be patient with getting her energy back as hers was a bit larger than his.
Tuesday, September 23, 2008
Second 9/23/08 post
9/23/08. I forgot, the nurse at the coumadin clinic said we can buy a coumadin meter through medicare if Dr. Cohen writes a prescription. Then we would call in the numbers and someone would tell us what to do. I don't know if this is more cost-effective or easier. Opinions please?
First 9/23/08
9/23/2008 Today, Mom and I went to the coumadin clinic at their new address on Hammond Dr. Her count was 4.2 which is quite thin. She is not supposed to take coumadin for the next 2 days (9/23 and 9/24) and then to stay at 2mgs. until Oct 2 when she stops all together in prep for her pacemaker.
Friday, September 19, 2008
Review of July 18 - Sept. 19
July 18 Contact Cohen re: Shortness of breath –
Response :Please call Tranaise Khim,
Cohen’s assistant ,404-605-5196
July 21 Meet with Dr. Cohen for regular meeting
July 30 Tests for Mom’s heart per Dr. Cohen - Thallium stress test, X-ray, Halter Monitor
July 31 Return for X-ray because x-ray machine was
Being repaired on July 30.
Aug 4 Return to Piedmont because Halter Monitor
Had cut wires and they didn’t have a spare
Aug 5 Return Halter Monitor
Aug 13 Write Cohen to find out results of Mom’s Tests
Aug. 20 Meet with Cohen to review test results – decide on pacemaker
Pre-op blood work – x-ray postponed – machine being cleaned
Aug 21 Start to not feel well – getting cold?
Aug 25 Dr. Cantwell – Chest X-ray taken. Cantwell not certain
that Gram’s has pneumonia so prescribes antibiotic,
inhaler and cough gels.
X-ray from Cohen requested through Lisa (Cohen's nurse 404-605-5155)
Z-pack Antibiotic contra indicated because it interferes with Coumadin. Pharmacist doesn’t want to give it to Grams. Insurance company won’t approve inhaler.
Aug 26 Call Cantwell re: prescription for z-pack – raise hell because the
Z-pack interferes with Coumadin.
Cantwell gets back re: prescription Contact Cohen – Cohen
Approves and says have levels checked
Aug 27 Still not feeling well. Cantwell ordered a CAT scan and if needed
to go see a specialist – Dr. Iatridies
Aug 28 Saw Dr. Iatridies – stop Z-pack and started Factive. Dr. I did some
tests to see the extent to which the pneumonia had gone into the
lungs.
Sept 2 Coumadin checked @Cohen’s (3.3). Lisa said to take on 2mg
Coumadin on Tuesday for as long as Gram’s is on antibiotics.
Pacemaker surgery is cancelled for 9/9. Cohen is not available for Tues. surgery until Oct 7 unless we are okay with a Thursday then he could go on 9/25. Gram needs to come back on 9/16 10:30am for new Coumadin check.
9/3 Dr. Iatredies. Gram’s has Thrush. He writes prescription for swish
and swallow and 4 more days of Factive.
New Chest x-ray taken –improved
Can have pacemaker in 2 weeks
Schedule new appt. for 9/11
9/9 Lunch at Karley’s with Karen and Mom and Mary
Go directly to St. Joseph and have Coumadin checked
9/11 Dr. I appointment. Pneumonia is over
New x-ray taken – medical records dept. closed so call tomorrow
for copy of x-ray. 770-948-6041
9/12 Request x-ray report from Dr. I’s office to be sent to Dr. Cohen.
9/16 pre-op appointment at Cohen’s
Coumadin level 1.6. Change nothing
After we get home and I leave Mother feels “floaty”. Contact Dr.
Cohen - take blood pressure and call back. Drive to Mom’s
Blood pressure 151.82 pulse 97 needs reducing per Cohen
Take 2-25mg Toporol and measure BP in one hour then call back.
Blood pressure goes down. Per Cohen, take one 25mg toporol
mornings and one in the evening until pacemaker is put in. Monitor BP every hour to make sure about lower BP and pulse.
Monitor dizzy and pill taking with each BP. Dizzy scale is from 1-10 with 10 being very dizzy.
Mary stays at Mom’s.
9/17 Blood Pressure is down but Gram’s still dizzy and stays at a 9 all
day.
Record BP throughout day. It stays within healthy range
Call Cohen several times – he does not believe it is the heart
Call Dr. Iatredies and wait for several hours – he does not believe
it is the pneumonia
Call Dr. Cantwell – he is in a computer class for the day. Call at 7:30 tomorrow morning
Go to St. Joseph emergency room at 7pm after dinner. We are all
concerned about Mom’s “floaty” dizzy condition. Gram’s is tested for stroke and every other major possibility. They do EKG, blood tests, and Cat Scan of the head. Mom’s Coumadin is still 1.6. Mom will take a 4mg tonight and then remain on original schedule. All tests negative. Released and told to see Internist re: “floaty. Asked about Toporol – told to proceed as Cohen prescribed – 2x’s a day. Mary stayed the night.
9/18/08 Make appt. to see Dr. Cantwell – 9/19 @2:pm BP is normal
We begin to think that “floaty” may be allergy related. Gram’s calls
Atl. Allergy clinic. Last allergy shot was October 2007. Karen and
I think maybe Claritan might be useful. Grams take a Claritan and as of 8pm her dizzy level is at 4. Plan of action: Cancel Cantwell, remain on Claritan and test Coumadin tomorrow.
9/19/08 Cancelled Cantwell, didn't do Coumadin.
BP was normal in the morning, dizziness was 9.
10:50pm BP: 118/83 92P D=3
Response :Please call Tranaise Khim,
Cohen’s assistant ,404-605-5196
July 21 Meet with Dr. Cohen for regular meeting
July 30 Tests for Mom’s heart per Dr. Cohen - Thallium stress test, X-ray, Halter Monitor
July 31 Return for X-ray because x-ray machine was
Being repaired on July 30.
Aug 4 Return to Piedmont because Halter Monitor
Had cut wires and they didn’t have a spare
Aug 5 Return Halter Monitor
Aug 13 Write Cohen to find out results of Mom’s Tests
Aug. 20 Meet with Cohen to review test results – decide on pacemaker
Pre-op blood work – x-ray postponed – machine being cleaned
Aug 21 Start to not feel well – getting cold?
Aug 25 Dr. Cantwell – Chest X-ray taken. Cantwell not certain
that Gram’s has pneumonia so prescribes antibiotic,
inhaler and cough gels.
X-ray from Cohen requested through Lisa (Cohen's nurse 404-605-5155)
Z-pack Antibiotic contra indicated because it interferes with Coumadin. Pharmacist doesn’t want to give it to Grams. Insurance company won’t approve inhaler.
Aug 26 Call Cantwell re: prescription for z-pack – raise hell because the
Z-pack interferes with Coumadin.
Cantwell gets back re: prescription Contact Cohen – Cohen
Approves and says have levels checked
Aug 27 Still not feeling well. Cantwell ordered a CAT scan and if needed
to go see a specialist – Dr. Iatridies
Aug 28 Saw Dr. Iatridies – stop Z-pack and started Factive. Dr. I did some
tests to see the extent to which the pneumonia had gone into the
lungs.
Sept 2 Coumadin checked @Cohen’s (3.3). Lisa said to take on 2mg
Coumadin on Tuesday for as long as Gram’s is on antibiotics.
Pacemaker surgery is cancelled for 9/9. Cohen is not available for Tues. surgery until Oct 7 unless we are okay with a Thursday then he could go on 9/25. Gram needs to come back on 9/16 10:30am for new Coumadin check.
9/3 Dr. Iatredies. Gram’s has Thrush. He writes prescription for swish
and swallow and 4 more days of Factive.
New Chest x-ray taken –improved
Can have pacemaker in 2 weeks
Schedule new appt. for 9/11
9/9 Lunch at Karley’s with Karen and Mom and Mary
Go directly to St. Joseph and have Coumadin checked
9/11 Dr. I appointment. Pneumonia is over
New x-ray taken – medical records dept. closed so call tomorrow
for copy of x-ray. 770-948-6041
9/12 Request x-ray report from Dr. I’s office to be sent to Dr. Cohen.
9/16 pre-op appointment at Cohen’s
Coumadin level 1.6. Change nothing
After we get home and I leave Mother feels “floaty”. Contact Dr.
Cohen - take blood pressure and call back. Drive to Mom’s
Blood pressure 151.82 pulse 97 needs reducing per Cohen
Take 2-25mg Toporol and measure BP in one hour then call back.
Blood pressure goes down. Per Cohen, take one 25mg toporol
mornings and one in the evening until pacemaker is put in. Monitor BP every hour to make sure about lower BP and pulse.
Monitor dizzy and pill taking with each BP. Dizzy scale is from 1-10 with 10 being very dizzy.
Mary stays at Mom’s.
9/17 Blood Pressure is down but Gram’s still dizzy and stays at a 9 all
day.
Record BP throughout day. It stays within healthy range
Call Cohen several times – he does not believe it is the heart
Call Dr. Iatredies and wait for several hours – he does not believe
it is the pneumonia
Call Dr. Cantwell – he is in a computer class for the day. Call at 7:30 tomorrow morning
Go to St. Joseph emergency room at 7pm after dinner. We are all
concerned about Mom’s “floaty” dizzy condition. Gram’s is tested for stroke and every other major possibility. They do EKG, blood tests, and Cat Scan of the head. Mom’s Coumadin is still 1.6. Mom will take a 4mg tonight and then remain on original schedule. All tests negative. Released and told to see Internist re: “floaty. Asked about Toporol – told to proceed as Cohen prescribed – 2x’s a day. Mary stayed the night.
9/18/08 Make appt. to see Dr. Cantwell – 9/19 @2:pm BP is normal
We begin to think that “floaty” may be allergy related. Gram’s calls
Atl. Allergy clinic. Last allergy shot was October 2007. Karen and
I think maybe Claritan might be useful. Grams take a Claritan and as of 8pm her dizzy level is at 4. Plan of action: Cancel Cantwell, remain on Claritan and test Coumadin tomorrow.
9/19/08 Cancelled Cantwell, didn't do Coumadin.
BP was normal in the morning, dizziness was 9.
10:50pm BP: 118/83 92P D=3
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