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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