Saw Dr. Myerson today. He's the rhumetologist. He did a thorough history on Mom and looked her over. Tested her strength, listened to her vitals.... He pronounced her amazingly healthy and well recovered from her 2008 ordeal.
He too said her dizziness is from Positional Vertigo and said we should get a referral from Dr. Cantwell for an occupational and physical therapist. They can help get the "rocks" in between the semicircular canals reorganized (the cause of the vertigo). He explained that the rocks don't move as well between the 3 canals as they do when we are young, hence, the dizzy sensation. These rocks can be moved via therapy so this gives us a new mission in the New Year.
Regarding her hands, he gave her some meds to try out that won't interfer with the coumadin. If they work we can get a prescription, if they don't it hasn't cost anything for the samples.
Tuesday, December 29, 2009
Wednesday, December 23, 2009
A visit to Dr. Cohen
Mom saw Dr. Cohen today and her heart is fine. The readout on her pacemaker is that it will last between 5.5 and 7.5 years before a new battery is needed. Mom told him about her dizziness and he asked her to describe it. There are two kinds of dizzy 1) when we get up to fast and 2) when we move our head. Mom's is in her head. So he recommends we see her neurologist. Fortunately, we already have one. Cohen, said that he wasn't an expert in this field but it sounds like Position Vertigo. This has something to do with the inner ear swishing around. His recollection is that there are training exercises that can be provided and/or medicine but reiterated...see the neurologist on this score. This explains why Mom has fallen down twice in the last month. Once going over the treadmill to close the blinds and once when she stood up from putting some papers through the shredder. Cohen also suggested that she use her cane more frequently.
Monday, December 7, 2009
Dec. 7, 2009
As indicated, Mom and I stopped at the 700 bldg. and picked up the CD imaging for her pulmonary nodule. We then went directly to Dr. Cantwell for a report on the CT and to address the problem with Mom's face - it is swollen making her look like Droopy. We think it is an allergy. He has prescribed a steroid pack if it becomes worse and an epi-pen in case something terrible should occur. He said that the bendryl tablets were the right thing and that she needn't take the steroid unless it gets worse rather than better.
On the CT scan. The report today indicates that "they" (specifically the radiologist), knew there were 2 pulmonary nodule on 8/28/2008 however, in the report of 8/28/2008, there is no indication of a nodule(s) using that particular language. It is a very comprehensive report covering her brain, intestinal system, heart and chest. Hence, I see no reason for Cantwell to have known there was a nodule present at that time. (I have the cd of these images.)
In today's report (12/7/2009) it says, " There are 3 pulmonary nodules identified, one of which is calcified. The noncalcified nodule is in the left lower lobe image 227, 3mm, and right upper lobe image 100. (I have the cd with these images). Both of these nodules were present on the previous examination of 2008 representing stability over a 1 - year period indicating a benign lesion. The previously seen inflitrates and effusions in the lung basis have resolved."
Karen and Karley wonder if we might need a second opinion. Diane - do you have an opinion. I am comfortable with the opinion we have. If we get a second opinion, it would be easy. All I have to do is give the cd to a radiologist and him/her read it.
On the CT scan. The report today indicates that "they" (specifically the radiologist), knew there were 2 pulmonary nodule on 8/28/2008 however, in the report of 8/28/2008, there is no indication of a nodule(s) using that particular language. It is a very comprehensive report covering her brain, intestinal system, heart and chest. Hence, I see no reason for Cantwell to have known there was a nodule present at that time. (I have the cd of these images.)
In today's report (12/7/2009) it says, " There are 3 pulmonary nodules identified, one of which is calcified. The noncalcified nodule is in the left lower lobe image 227, 3mm, and right upper lobe image 100. (I have the cd with these images). Both of these nodules were present on the previous examination of 2008 representing stability over a 1 - year period indicating a benign lesion. The previously seen inflitrates and effusions in the lung basis have resolved."
Karen and Karley wonder if we might need a second opinion. Diane - do you have an opinion. I am comfortable with the opinion we have. If we get a second opinion, it would be easy. All I have to do is give the cd to a radiologist and him/her read it.
Wednesday, December 2, 2009
Dec. 1
Dr. Cantwell's office called to say that on the X-ray taken a week ago to diagnose Mom's bronchitis , contained a pulmonary nodule. This was found by the radiologist who has the last word on the X-ray. When I talked with Sharon, Cantwell's nurse, she said a Pulmonary Nodule is common but you definately want to check it out.
Today, Dec. 2., I got an appointment for her to have a CT Scan at Kennesaw Imaging Center (Bld 700). A CT scan appears to be the gold standard for diagnosing the benign/not benign aspect of the nodule.
So, tomorrow at 11:45am we will go for the CT and them proceed to the Dr.s building near Northside Hospital for her Boniva infusion. More news to follow.
Today, Dec. 2., I got an appointment for her to have a CT Scan at Kennesaw Imaging Center (Bld 700). A CT scan appears to be the gold standard for diagnosing the benign/not benign aspect of the nodule.
So, tomorrow at 11:45am we will go for the CT and them proceed to the Dr.s building near Northside Hospital for her Boniva infusion. More news to follow.
Thursday, October 15, 2009
Mom's pre-diabetic
I spoke with Dr. Cantwell's nurse today about Mom's elevated blood sugar levels and A1C... Mom is pre-diabetic but just only. No medication is necessary and she should moderate her sugar intake.
Saturday, September 19, 2009
Update
We visited the dentist on Thursday and were advised that Mom's tooth has to come out. He will not take her off the coumadin but will pack the tooth to stave off the bleeding. In the meantime, Mom's coumadin levels are really quite stable 2.3-2.6 which is really good. I will test her on Tuesay morning - the day of the removal - so that the doctor can make any adjustments. He was quite "impressed" that we could do it at home. He is now going to order a coumadin reader himself for the office.
Sharon, from Dr. Cantwell's office called Friday to say that the results of Mom's blood had finally arrived and they compared her creatine levels with her previous blood test. The one from Myerson was slightly elevated "had she been fasting or exercising?" She had been exercising at aqua class which might account for it. I asked if this could be an indication she isn't drinking enough fluids and she said it could be but lets run a fasting blood test. Mom's glucose level was slightly elevated as well...again, it could have been her exercising but they will run an A1C (I think that's the name) to check her glucose levels over the last 3 months. That's the test they ue for diabetics. Mom had been tested for diabetes before when her foot neuropathy began and did not have it so... I am hoping all of this was her lean-mean-exercise regime.
Ok...Tuesday - Tooth out
Thursday- Blood test
10-days after that - blood test results
Sharon, from Dr. Cantwell's office called Friday to say that the results of Mom's blood had finally arrived and they compared her creatine levels with her previous blood test. The one from Myerson was slightly elevated "had she been fasting or exercising?" She had been exercising at aqua class which might account for it. I asked if this could be an indication she isn't drinking enough fluids and she said it could be but lets run a fasting blood test. Mom's glucose level was slightly elevated as well...again, it could have been her exercising but they will run an A1C (I think that's the name) to check her glucose levels over the last 3 months. That's the test they ue for diabetics. Mom had been tested for diabetes before when her foot neuropathy began and did not have it so... I am hoping all of this was her lean-mean-exercise regime.
Ok...Tuesday - Tooth out
Thursday- Blood test
10-days after that - blood test results
Wednesday, September 16, 2009
Skin doctor - A-ok
Mom's body is in good shape. She had a mole on the top of her forehead removed with a lazar, a blemish on her cheek removed, and a do-dad on her chest frozen off. None of these were anything but cosmetic.
Monday, September 14, 2009
An interesting week in September
Today, Mom and I went to the dentist. She had an absesce that manifested on Saturday. So, combined with the note from Dr. Myerson (her Rhumetoligist) that she has decreased kidney function... we have a few things to check out.
The dentist said that it appeared that the tooth is cracked and, given he tried twice to treat it (two previous gum boils), she should see a dental surgeon. So, we have an appointment for him on Thursday.
Sharon, Dr. Cantwell's nurse called me today to say they had not received the fax from Myerson last Tuesday or on any of the days inbetween. I told her I would have it sent again..and she said she would watch for it. I called Dr. Myerson andt he lady told me she would send it. I asked how I would know if it really got there. She told me she would wait for confirmation and if that didn't happen...try again. So I expect that tomorrow we should be having another conversation with Cant'well's office. I did ask Sharon if a decreased kidney function was normal with aging and she said it could be but there could be underlying causes and that they wouldn't know what until they saw the lab report. At that point, Cantwell would either see Mom or recommend a Kidney specialist. So we are waiting with patience.
Wednesday we go to the skin doctor to have an overall look at Mom .... and I am having a look as well just to be on the safe side. I will let you know what goes. Mom has a thing on her cheek that she is concerned about and so, it is good to have it looked at.
Karen is taking Lilly, the kitty, to the specialist vet tomorrow to have her checked out. She is anemic. And on Friday, Inge is having her trigger thumb operated on so she will be in better shape. Nothing like a full week of entertainment!
The dentist said that it appeared that the tooth is cracked and, given he tried twice to treat it (two previous gum boils), she should see a dental surgeon. So, we have an appointment for him on Thursday.
Sharon, Dr. Cantwell's nurse called me today to say they had not received the fax from Myerson last Tuesday or on any of the days inbetween. I told her I would have it sent again..and she said she would watch for it. I called Dr. Myerson andt he lady told me she would send it. I asked how I would know if it really got there. She told me she would wait for confirmation and if that didn't happen...try again. So I expect that tomorrow we should be having another conversation with Cant'well's office. I did ask Sharon if a decreased kidney function was normal with aging and she said it could be but there could be underlying causes and that they wouldn't know what until they saw the lab report. At that point, Cantwell would either see Mom or recommend a Kidney specialist. So we are waiting with patience.
Wednesday we go to the skin doctor to have an overall look at Mom .... and I am having a look as well just to be on the safe side. I will let you know what goes. Mom has a thing on her cheek that she is concerned about and so, it is good to have it looked at.
Karen is taking Lilly, the kitty, to the specialist vet tomorrow to have her checked out. She is anemic. And on Friday, Inge is having her trigger thumb operated on so she will be in better shape. Nothing like a full week of entertainment!
Monday, March 9, 2009
March 4
March 3rd, Mom finished up with her physical therapy sessions. She has made great progress both with her ability to walk and her shoulders. She was sent home with papers showing her exercises that she is to do at home. She is supposed to use 4 pound weights for her arms/shoulders, the red/yellow bands for the rest of her arm exercises and then she is also supposed to use weights to increase the strength in her legs. Mom has sufficient weights in all departments - the challenge is for Mom to use them.
March 4th we went to Dr. Iatredes and he took another X-ray and said that her lungs had almost entirely cleared up. He gave her a prescription that should relieve the week's worth of continuous diarrhea, v. itch and early thrush in the mouth that came from the antibiotic. Att: Mom seems to be very susceptible to yeast infections with antibiotics.
Dr. Iatredes also said that it could be that Mom is actually inhaling food particles. She has a Zenkers Diverticulum (http://en.wikipedia.org/wiki/Zenker) which catches particles of food and could be causing the inhalation of food particles. Anyhow, Dr. I says that if she has another bout of chest congestion that isn't caused by obvious factors (cold, bronchitis etc.), then we need to see a speech pathologist who will teach Mom to swallow more efficiently to minimize the adverse effects of a ZD. (I see I didn't mention this in my October posting... The result of the 3 tiered barium swallow was that Mom had the Zenker's Diverticulum. Somewhere in here she was also assessed by a speech pathologist but at this point I can't remember when. Dr. I has a report from the pathologist, however.)
We will be starting a regular regimen of exercise at LA Fitness starting next week. We will do Tuesday and Thursday like we did at Midtown before all this brouhaha started. We plan on doing water exercises and, if I have my way...a bit of weight lifting to augment her strength.
What's left? Mom still fatigues easily. I think, now that the bronchitis is over, time, beautiful weather, and exercise will remedy this situation. She also needs to improve her overall strength and that we can remedy with exercise at home and at the club.
March 9 - the yeast infections are over. I don't know about her mouth but the diarrhea and v. itch are gone.
March 4th we went to Dr. Iatredes and he took another X-ray and said that her lungs had almost entirely cleared up. He gave her a prescription that should relieve the week's worth of continuous diarrhea, v. itch and early thrush in the mouth that came from the antibiotic. Att: Mom seems to be very susceptible to yeast infections with antibiotics.
Dr. Iatredes also said that it could be that Mom is actually inhaling food particles. She has a Zenkers Diverticulum (http://en.wikipedia.org/wiki/Zenker) which catches particles of food and could be causing the inhalation of food particles. Anyhow, Dr. I says that if she has another bout of chest congestion that isn't caused by obvious factors (cold, bronchitis etc.), then we need to see a speech pathologist who will teach Mom to swallow more efficiently to minimize the adverse effects of a ZD. (I see I didn't mention this in my October posting... The result of the 3 tiered barium swallow was that Mom had the Zenker's Diverticulum. Somewhere in here she was also assessed by a speech pathologist but at this point I can't remember when. Dr. I has a report from the pathologist, however.)
We will be starting a regular regimen of exercise at LA Fitness starting next week. We will do Tuesday and Thursday like we did at Midtown before all this brouhaha started. We plan on doing water exercises and, if I have my way...a bit of weight lifting to augment her strength.
What's left? Mom still fatigues easily. I think, now that the bronchitis is over, time, beautiful weather, and exercise will remedy this situation. She also needs to improve her overall strength and that we can remedy with exercise at home and at the club.
March 9 - the yeast infections are over. I don't know about her mouth but the diarrhea and v. itch are gone.
Thursday, February 26, 2009
Feb 25, 2009
Mom went to see Dr. Iatredes today because she wasn't getting over her cold and she was short of breath. He measured her lung capacity and took an X-ray. Her capacity was fine, and her Oxygen saturation was fine. Looking at the X-ray the right lung was fine. There was a little bit of scaring from the pneumonia in the lower right side but nothing to be concerned with. On the left side there was a little bit of blurryness on the lower left side where is should have had a clear line of demarkation but the area was small. He determined that this was bronchitis and has put Mom on an antibiotic (Amox) for the next 7 days. We return on March 4th for a follow up. In the meantime, I will check her coumadin levels tomorrow before Dr. Cohen leaves his office as antibiotics impact the thinness of the blood.
Tuesday, February 17, 2009
Feb 17, 2009
Mom started the two Toporol at night following our visit with Dr. Cohen last week. It is too soon to tell how this is working re: her fatigue level as she caught a cold over the weekend and feels terrible. She's doing fluids, chicken soup and Zicam....and prayer.
Her shoulder's seem to be improved with the more focused physical therapy.
Her shoulder's seem to be improved with the more focused physical therapy.
Thursday, February 12, 2009
February 11, 2009
Yesterday was a flurry... We went to Dr. Cohen in the morning and her EKG and Pacemaker are doing fine. He said the pacemaker would need replacement in 7 years - that would be at its present utilization of 30% of the time. Her heart chart (beats/min) was lovely according to Cohen - between 70bpm and 90bpm with a small blip in the 100's.
Because of Mom's fatigue we are going to try taking her 2 Toporol as a "group". She will take then at night and see if her fatigue level improves after two weeks. If this doesn't work she'll reverse the dosage and take two in the morning. Re: changing the medication, this wasn't advised. Dr. Cohen says that Toporol is one of the best for controlling the rate at which her heart beats and that it would be a matter of test this, adjust that, and lots of office calls if we were to change her meds.
RE: her swollen feet, he suggested that she wear surgical stockings, particularly as it is erratic rather than a continual problem. Also, she should not drink lots of water/liquids as this would contribute to the problem. Moderation is the by-word.
Mom's physical therapy routine has shifted to focusing on her shoulders rather than her legs. She has done well and needs to develop more strength in her limbs to offset the fatigue/weakness she experiences. She is to use 2 pound weights on her legs (she has these at home) for her leg lifts and 4 pound weights for her arms.
Coumadin levels have remained within range since Dec. 2.4 - 2.7.
Because of Mom's fatigue we are going to try taking her 2 Toporol as a "group". She will take then at night and see if her fatigue level improves after two weeks. If this doesn't work she'll reverse the dosage and take two in the morning. Re: changing the medication, this wasn't advised. Dr. Cohen says that Toporol is one of the best for controlling the rate at which her heart beats and that it would be a matter of test this, adjust that, and lots of office calls if we were to change her meds.
RE: her swollen feet, he suggested that she wear surgical stockings, particularly as it is erratic rather than a continual problem. Also, she should not drink lots of water/liquids as this would contribute to the problem. Moderation is the by-word.
Mom's physical therapy routine has shifted to focusing on her shoulders rather than her legs. She has done well and needs to develop more strength in her limbs to offset the fatigue/weakness she experiences. She is to use 2 pound weights on her legs (she has these at home) for her leg lifts and 4 pound weights for her arms.
Coumadin levels have remained within range since Dec. 2.4 - 2.7.
Thursday, February 5, 2009
February 5, 2009
Well, I am almost home. Mom has progressed beautifully and now is a good time for her to fly under her own power. Yesterday I left for the afternoon and had Mom make dinner. Today, I left for the afternoon - will arrive for dinner -- and will come to my own house for sleeping. Tomorrow I work and Mom will be on her own except for cat medications. Saturday we will go shopping together and then she's on her own again.
I have left ample food in the house with lists of meats/fish and vegetables so Mom won't be wondering what's available. This is because I have been doing the shopping and it is always hard to pick up in "some-elses kitchen". I expect that she should make balanced meals however, if that isn't the case "the team" will undertake meal prep's. Inge and I had talked about cooking for 3 and delivering to Mom. Karen and Karley have also volunteered so I am sure this won't be a problem. Mom's appetite is good
.
Mom's INR (coumadin levels) have been staying right in place these days (2.4-2.7) I will take them on Monday, call them in to Cohen's office and probably get a new schedule for 3 weeks out assuming they stay within bounds. Blood pressure is good as well 118/64 with pulse between 70-85.
Her pill requirements these days are as follows: Morning: Toporol and a diuretic. Evening: Toporol, Neuronton, Advil and Coumadin (4mg. on M,W,F; 2mg on T,TH,S,S) In addition, Mom has her regular vitamin regimine.
Mom continues to go to physical therapy twice a week and has driven there herself. Inge and I have independently tested her driving skills and they appear to be perfectly fine.
The Physical Therapist thinks she is good to go. And, Monday of this week the Social Worker came and also thinks that Mom is ready to go. This makes me feel confident in my own thought that she is ready to be independent again. In fact, I think without the additional help she will get stronger from the extra effort required. Too, she can get back into her social groove and be the vibrant Mom we all know and love.
I have left ample food in the house with lists of meats/fish and vegetables so Mom won't be wondering what's available. This is because I have been doing the shopping and it is always hard to pick up in "some-elses kitchen". I expect that she should make balanced meals however, if that isn't the case "the team" will undertake meal prep's. Inge and I had talked about cooking for 3 and delivering to Mom. Karen and Karley have also volunteered so I am sure this won't be a problem. Mom's appetite is good
.
Mom's INR (coumadin levels) have been staying right in place these days (2.4-2.7) I will take them on Monday, call them in to Cohen's office and probably get a new schedule for 3 weeks out assuming they stay within bounds. Blood pressure is good as well 118/64 with pulse between 70-85.
Her pill requirements these days are as follows: Morning: Toporol and a diuretic. Evening: Toporol, Neuronton, Advil and Coumadin (4mg. on M,W,F; 2mg on T,TH,S,S) In addition, Mom has her regular vitamin regimine.
Mom continues to go to physical therapy twice a week and has driven there herself. Inge and I have independently tested her driving skills and they appear to be perfectly fine.
The Physical Therapist thinks she is good to go. And, Monday of this week the Social Worker came and also thinks that Mom is ready to go. This makes me feel confident in my own thought that she is ready to be independent again. In fact, I think without the additional help she will get stronger from the extra effort required. Too, she can get back into her social groove and be the vibrant Mom we all know and love.
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