Wednesday, September 22, 2010
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.
Thursday, September 16, 2010
More on Mom's eye condition - sept 16
This article from the national institutes of health does an excellent job describing exactly everything we know and experienced at the doctors office today. http://www.nei.nih.gov/health/maculardegen/armd_facts.asp
Mom had the 3 initial tests listed and then had the fluorescein angiogram test which is the one where they took all the pictures of her macula. On the right eye we could see the drusen with one on the edge of the macula - the doctor did not say what stage Mom's right eye is in but I'm guessing, based on this article that it is intermediate AMD.
Left eye: She has a drusen on the macula with the leak and 3 blood spots in her left wet AMD eye. That means she has advanced AMD on that side.
From this article I have the impression that Mom could lose her sight in the left eye at anytime which doesn't mean we shouldn't monitor it. Mom can check her "wiggly lines" every day as we have the eye chart seen in the article on the kitchen pantry door.
We already have the vitamins - the doctor gave her a sample (I took an extra when no one was looking ) and this evening I went and bought a jar of them which I'll give Mom in the morning. These vitamins are from Bauch and Lomb PreserVision for AREDS. She will take two a day.
Lucentis is the drug that was going to be injected in to Mom's eye.
Visudyne therapy was a secondary drug but not as effective that could be used...also injected.
This doctor recommended lucentis and then does lazer as a follow-up for the wet AMD. We told him we would get back to him if Mom changes her mind.
This article from the national institutes of health does an excellent job describing exactly everything we know and experienced at the doctors office today. http://www.nei.nih.gov/health/maculardegen/armd_facts.asp
Mom had the 3 initial tests listed and then had the fluorescein angiogram test which is the one where they took all the pictures of her macula. On the right eye we could see the drusen with one on the edge of the macula - the doctor did not say what stage Mom's right eye is in but I'm guessing, based on this article that it is intermediate AMD.
Left eye: She has a drusen on the macula with the leak and 3 blood spots in her left wet AMD eye. That means she has advanced AMD on that side.
From this article I have the impression that Mom could lose her sight in the left eye at anytime which doesn't mean we shouldn't monitor it. Mom can check her "wiggly lines" every day as we have the eye chart seen in the article on the kitchen pantry door.
We already have the vitamins - the doctor gave her a sample (I took an extra when no one was looking ) and this evening I went and bought a jar of them which I'll give Mom in the morning. These vitamins are from Bauch and Lomb PreserVision for AREDS. She will take two a day.
Lucentis is the drug that was going to be injected in to Mom's eye.
Visudyne therapy was a secondary drug but not as effective that could be used...also injected.
This doctor recommended lucentis and then does lazer as a follow-up for the wet AMD. We told him we would get back to him if Mom changes her mind.This article from the national institutes of health does an excellent job describing exactly everything we know and experienced at the doctors office today. http://www.nei.nih.gov/health/maculardegen/armd_facts.asp
Mom had the 3 initial tests listed and then had the fluorescein angiogram test which is the one where they took all the pictures of her macula. On the right eye we could see the drusen with one on the edge of the macula - the doctor did not say what stage Mom's right eye is in but I'm guessing, based on this article that it is intermediate AMD.
Left eye: She has a drusen on the macula with the leak and 3 blood spots in her left wet AMD eye. That means she has advanced AMD on that side.
From this article I have the impression that Mom could lose her sight in the left eye at anytime which doesn't mean we shouldn't monitor it. Mom can check her "wiggly lines" every day as we have the eye chart seen in the article on the kitchen pantry door.
We already have the vitamins - the doctor gave her a sample (I took an extra when no one was looking ) and this evening I went and bought a jar of them which I'll give Mom in the morning. These vitamins are from Bauch and Lomb PreserVision for AREDS. She will take two a day.
Lucentis is the drug that was going to be injected in to Mom's eye.
Visudyne therapy was a secondary drug but not as effective that could be used...also injected.
This doctor recommended lucentis and then does lazer as a follow-up for the wet AMD. We told him we would get back to him if Mom changes her mind.
This article from the national institutes of health does an excellent job describing exactly everything we know and experienced at the doctors office today. http://www.nei.nih.gov/health/maculardegen/armd_facts.asp
Mom had the 3 initial tests listed and then had the fluorescein angiogram test which is the one where they took all the pictures of her macula. On the right eye we could see the drusen with one on the edge of the macula - the doctor did not say what stage Mom's right eye is in but I'm guessing, based on this article that it is intermediate AMD.
Left eye: She has a drusen on the macula with the leak and 3 blood spots in her left wet AMD eye. That means she has advanced AMD on that side.
From this article I have the impression that Mom could lose her sight in the left eye at anytime which doesn't mean we shouldn't monitor it. Mom can check her "wiggly lines" every day as we have the eye chart seen in the article on the kitchen pantry door.
We already have the vitamins - the doctor gave her a sample (I took an extra when no one was looking ) and this evening I went and bought a jar of them which I'll give Mom in the morning. These vitamins are from Bauch and Lomb PreserVision for AREDS. She will take two a day.
Lucentis is the drug that was going to be injected in to Mom's eye.
Visudyne therapy was a secondary drug but not as effective that could be used...also injected.
This doctor recommended lucentis and then does lazer as a follow-up for the wet AMD. We told him we would get back to him if Mom changes her mind.
Mom had the 3 initial tests listed and then had the fluorescein angiogram test which is the one where they took all the pictures of her macula. On the right eye we could see the drusen with one on the edge of the macula - the doctor did not say what stage Mom's right eye is in but I'm guessing, based on this article that it is intermediate AMD.
Left eye: She has a drusen on the macula with the leak and 3 blood spots in her left wet AMD eye. That means she has advanced AMD on that side.
From this article I have the impression that Mom could lose her sight in the left eye at anytime which doesn't mean we shouldn't monitor it. Mom can check her "wiggly lines" every day as we have the eye chart seen in the article on the kitchen pantry door.
We already have the vitamins - the doctor gave her a sample (I took an extra when no one was looking ) and this evening I went and bought a jar of them which I'll give Mom in the morning. These vitamins are from Bauch and Lomb PreserVision for AREDS. She will take two a day.
Lucentis is the drug that was going to be injected in to Mom's eye.
Visudyne therapy was a secondary drug but not as effective that could be used...also injected.
This doctor recommended lucentis and then does lazer as a follow-up for the wet AMD. We told him we would get back to him if Mom changes her mind.
This article from the national institutes of health does an excellent job describing exactly everything we know and experienced at the doctors office today. http://www.nei.nih.gov/health/maculardegen/armd_facts.asp
Mom had the 3 initial tests listed and then had the fluorescein angiogram test which is the one where they took all the pictures of her macula. On the right eye we could see the drusen with one on the edge of the macula - the doctor did not say what stage Mom's right eye is in but I'm guessing, based on this article that it is intermediate AMD.
Left eye: She has a drusen on the macula with the leak and 3 blood spots in her left wet AMD eye. That means she has advanced AMD on that side.
From this article I have the impression that Mom could lose her sight in the left eye at anytime which doesn't mean we shouldn't monitor it. Mom can check her "wiggly lines" every day as we have the eye chart seen in the article on the kitchen pantry door.
We already have the vitamins - the doctor gave her a sample (I took an extra when no one was looking ) and this evening I went and bought a jar of them which I'll give Mom in the morning. These vitamins are from Bauch and Lomb PreserVision for AREDS. She will take two a day.
Lucentis is the drug that was going to be injected in to Mom's eye.
Visudyne therapy was a secondary drug but not as effective that could be used...also injected.
This doctor recommended lucentis and then does lazer as a follow-up for the wet AMD. We told him we would get back to him if Mom changes her mind.This article from the national institutes of health does an excellent job describing exactly everything we know and experienced at the doctors office today. http://www.nei.nih.gov/health/maculardegen/armd_facts.asp
Mom had the 3 initial tests listed and then had the fluorescein angiogram test which is the one where they took all the pictures of her macula. On the right eye we could see the drusen with one on the edge of the macula - the doctor did not say what stage Mom's right eye is in but I'm guessing, based on this article that it is intermediate AMD.
Left eye: She has a drusen on the macula with the leak and 3 blood spots in her left wet AMD eye. That means she has advanced AMD on that side.
From this article I have the impression that Mom could lose her sight in the left eye at anytime which doesn't mean we shouldn't monitor it. Mom can check her "wiggly lines" every day as we have the eye chart seen in the article on the kitchen pantry door.
We already have the vitamins - the doctor gave her a sample (I took an extra when no one was looking ) and this evening I went and bought a jar of them which I'll give Mom in the morning. These vitamins are from Bauch and Lomb PreserVision for AREDS. She will take two a day.
Lucentis is the drug that was going to be injected in to Mom's eye.
Visudyne therapy was a secondary drug but not as effective that could be used...also injected.
This doctor recommended lucentis and then does lazer as a follow-up for the wet AMD. We told him we would get back to him if Mom changes her mind.
This article from the national institutes of health does an excellent job describing exactly everything we know and experienced at the doctors office today. http://www.nei.nih.gov/health/maculardegen/armd_facts.asp
Mom had the 3 initial tests listed and then had the fluorescein angiogram test which is the one where they took all the pictures of her macula. On the right eye we could see the drusen with one on the edge of the macula - the doctor did not say what stage Mom's right eye is in but I'm guessing, based on this article that it is intermediate AMD.
Left eye: She has a drusen on the macula with the leak and 3 blood spots in her left wet AMD eye. That means she has advanced AMD on that side.
From this article I have the impression that Mom could lose her sight in the left eye at anytime which doesn't mean we shouldn't monitor it. Mom can check her "wiggly lines" every day as we have the eye chart seen in the article on the kitchen pantry door.
We already have the vitamins - the doctor gave her a sample (I took an extra when no one was looking ) and this evening I went and bought a jar of them which I'll give Mom in the morning. These vitamins are from Bauch and Lomb PreserVision for AREDS. She will take two a day.
Lucentis is the drug that was going to be injected in to Mom's eye.
Visudyne therapy was a secondary drug but not as effective that could be used...also injected.
This doctor recommended lucentis and then does lazer as a follow-up for the wet AMD. We told him we would get back to him if Mom changes her mind.
September 16, Dr. Kooragayala - eyes
Mom visited Dr. K today re: her dry and wet macular degeneration. The doctor shows that she has "leaky" type wet AMD (age-related MD). He was going to give her a shot in the eye which in 95% of the cases stops the leak and in 50% of of those 95% improves vision. There are some potential side effects none of which bothered Mom until the word Stroke came up. We were going to have this shot and were prepared but called the doctor back. We asked how often does this stroke thing happen. He said that research on the drug (name will come later) does not bear it out that stroke happens as a result of this medice HOWEVER, given mother's age you can't rule it out. Well, that was enough so Mom and I were going to call a family gathering to discuss the subject. NOT
Mom has made up her mind. Here I paraphrase: She has made it to 92 and didn't think she had an eye problem until she went in to see the eye doctor for new glasses. She prefers blind to stroke and its unpleasant possibilities. Presently her right eye - unbeknownst to her has taken over for the sight limitations of her left eye.
I am going to check up to see if blind means blackness or only light coming in the periphery or what "blind" means. Also, I will check to see if this situation can be monitored every quarter with new photo's of the macula to see how things are going. Also, I will check to see if one goes blind instantly or gradually.
There are two other treatments: another kind of shot which is less effective - the shots go into the eye.... and laser which is used with the shot. Without the shot it isn't as effective or effective at all without the shot.
Mom has made up her mind. Here I paraphrase: She has made it to 92 and didn't think she had an eye problem until she went in to see the eye doctor for new glasses. She prefers blind to stroke and its unpleasant possibilities. Presently her right eye - unbeknownst to her has taken over for the sight limitations of her left eye.
I am going to check up to see if blind means blackness or only light coming in the periphery or what "blind" means. Also, I will check to see if this situation can be monitored every quarter with new photo's of the macula to see how things are going. Also, I will check to see if one goes blind instantly or gradually.
There are two other treatments: another kind of shot which is less effective - the shots go into the eye.... and laser which is used with the shot. Without the shot it isn't as effective or effective at all without the shot.
Wednesday, September 15, 2010
Sept. 15 Dr. McCune - hemotology/oncology
A blood specimen was taken and immediately taken to Dr. McCune's lab where the results were that Mom has CLL - Chronic Leukemia. This is nothing to be disturbed over as it turns out. She has probably had it for at least the past 2 years. I asked why they didn't tell me back when she had the stroke and he said she had multiple things going on so the elevated white cells could have been attributed to that. McCune said that this doesn't cause Mom's fatigue or her dizziness.. apparently it doesn't do anything at all if I understood him correctly. After the blood test he went and looked at the slide that had been prepared of Mom's white cells...they were broken up which is a clear indicator of CLL. The white blood cells are "fragile" with CLL. I asked if it would kill her. He said no. I asked if it was hereditary. He said not. He said if she had enlarged lymph nodes or something more symptomatic he could give her medicine but he said presently there is no need. I asked if this was no-med's was age - related and he said no. "So if she was 30 you still wouldn't prescribe meds". Again he said no.
Finally he asked if anyone had done a thyroid or B12 test yet. I said no. He said this could also be a contributor to fatigue or dizzy. So he drew more blood and we will know tomorrow if everything else is Okay.
Finally he asked if anyone had done a thyroid or B12 test yet. I said no. He said this could also be a contributor to fatigue or dizzy. So he drew more blood and we will know tomorrow if everything else is Okay.
Tuesday, September 14, 2010
Sept. 14 Dr. Bhansali - Ear specialist
Doctor Bhansali said that Mom's ears are functioning as they were designed - no physical anomolies in her vestibule which would cause imbalance. Three things go into balance, sight, ears, and feeling. Two of these are compromised. Mom's eyes and her feeling (neuropathy and reduced reflexes in her legs and feet). This contributes to her lack of balance.
As for her dizziness, Dr. BH said that it could be that the atrophy of her cerebral/cerebellar area could contribute to the dizziness and loss of balance and perhaps the high white blood cell count.
He has written a prescription for Mom to go to a physical therapist for an assessment. We will do that after we do the blood doctor tomorrow and the eye doctor on Thursday. If the PT exercises we already have from the first physical therapist are good we should continue them. If the PT recommends medication of some sort or other PT, he will write it the prescrition for us.
Mom has also lost her high end hearing - not completely but it could be improved with hearing-aids. She does not want them although she says her friend Gertrude should also have HA's. So who knows. We should make an appointment to follow up with Dr. Bhansali in one year. The exception is if Mom feels the room spinning and extraordinary dizziness we should call immediately and see him as he likes to see a patient as close to an episode as possible.
As for her dizziness, Dr. BH said that it could be that the atrophy of her cerebral/cerebellar area could contribute to the dizziness and loss of balance and perhaps the high white blood cell count.
He has written a prescription for Mom to go to a physical therapist for an assessment. We will do that after we do the blood doctor tomorrow and the eye doctor on Thursday. If the PT exercises we already have from the first physical therapist are good we should continue them. If the PT recommends medication of some sort or other PT, he will write it the prescrition for us.
Mom has also lost her high end hearing - not completely but it could be improved with hearing-aids. She does not want them although she says her friend Gertrude should also have HA's. So who knows. We should make an appointment to follow up with Dr. Bhansali in one year. The exception is if Mom feels the room spinning and extraordinary dizziness we should call immediately and see him as he likes to see a patient as close to an episode as possible.
Saturday, September 11, 2010
Sept 11 follow-up remarks
So I looked up dizziness in the elderly and this article from the Merk manual ( http://www.merck.com/mkgr/mmg/sec2/ch19/ch19a.jsp) describes everything we have been through up to and including the physical therapy. Mom does not have vestibular problems (ie. ear)... we just finished all of those tests. She doesn't appear to have circulatory problems, at least not in her carotids. We do know that she has some cerebral and cerebellar atrophy which could be a contributing factor but who knows. I must remember to ask the ENT. Her eyes are fine except for the macular degeneration. The physical therapy discussed at the end of the paper is just exactly what we did for 6 weeks and I think we should resume at home because it says that in weeks or months it could help the situation. I have all the exercises listed on a sheet of paper - one from the PT and one that I wrote as notations when we did PT. So, my plan now is to start doing the ambulator part of the PT. Mom does the eye and head motion exercises.
Sept. 10 -ENT test
Mom had a complete ENT test for dizziness/balance. This included air in her ears, twisting of the head, pulling her head up from a prone position, following a moving light, hearing sounds and wearing electrodes that measured how her eyes were functioning. The end result was that she has all her faculties and that for her age she is in great shape. That was what the audiologist said who ran these tests. We have a meeting with the ENT specialist on Tuesday and he has all the reports from all the other tests that we have undertaken over the last month.
Wednesday, September 8, 2010
Sept. 7 - eye test results
We went to the Atlanta Eye Clinic and saw Dr. Thrushwell. He diagnosed Mom with dry macular degeneration in the right eye and wet macular degeneration in the left eye. Also, there is a "blister" at the back of Mom's left eye that has fluid and blood in it. We now have an appointment (Sept 16) with Dr. K at the Kennestone Hospital location of the Atlanta Eye Clinic. He is a surgeon who specializes in such things. A question to ask is whether this could be causing Mom's elevated blood count when we see the hematologist on Wed. Sept. 15.
Thursday, September 2, 2010
Sept. 2 - Dr. Bhansali
We met with Dr. Bhansali today and he was very thorough with his questions and assessments. After gettng a medical run-down he put some "glasses" on Mom and looked through them into her eyes. Then, he had her close her eyes and he twisted her head back and forth about a dozen times and then he peered back into Mom's eyes to see what was happening. His initial assessment is that the problem is on the left side not the right side. He also had his audiologist assess Mom's hearing. She has some hearing loss, particularly of the high tones but nothing to be concerned with at this time. He also looked into her ears and her mouth.
He has asked that we get the CT Scan results to him and the other ENT test results to him. On Sept. 10th he is going to re-run the ENT tests that Mom had previously to see what his assessment is. He wants to know if Mom has had an MRI in the last three years and I will call Cantwell tomorrow and see if she's had such a thing. I know for certain that she hasn't had one since she had the pacemaker... can't do MRI's with pacemakers. So, if she did have one it would have had to be in 2007 or early 2008. Anyhow, if she's had an MRI then he wants to see that as well.
Mom and I are going to postpone the Boniva shot until the week following the hematologist appt. We can cancel it if necessary but as I said earlier....better not to impede anything the H man needs with an added dose of something.
BTW Mom's INR for coumadin has gone back down to 2.8. For the past two weeks it has been at 3.1 which is a bit thin although nothing to be alarmed about. I'm glad it is back between 2 and 3 which is where it is supposed to be.
He has asked that we get the CT Scan results to him and the other ENT test results to him. On Sept. 10th he is going to re-run the ENT tests that Mom had previously to see what his assessment is. He wants to know if Mom has had an MRI in the last three years and I will call Cantwell tomorrow and see if she's had such a thing. I know for certain that she hasn't had one since she had the pacemaker... can't do MRI's with pacemakers. So, if she did have one it would have had to be in 2007 or early 2008. Anyhow, if she's had an MRI then he wants to see that as well.
Mom and I are going to postpone the Boniva shot until the week following the hematologist appt. We can cancel it if necessary but as I said earlier....better not to impede anything the H man needs with an added dose of something.
BTW Mom's INR for coumadin has gone back down to 2.8. For the past two weeks it has been at 3.1 which is a bit thin although nothing to be alarmed about. I'm glad it is back between 2 and 3 which is where it is supposed to be.
Wednesday, September 1, 2010
Sept. 1 - blood results
Went to see Dr. Cantwell on or about August 25 regarding the call from Dr. Waldrop and Mom's elevated blood count. Dr. Cantwell wanted to run all the tests again to check out Mom. He ran more Blood tests, took an X-ray and did her urine. Today, we had a call regarding the results.
Sharon, Dr. Cantwell's nurse called to say that Mom's white blood count was still elevated but not quite as high as previously. It was at 16 something with some cells that need further identification. That being the case Sharon had their office set an appointment with a hematologist, Dr. McClune, for Sept. 15...couldn't be sooner for a new patient.
I contacted Mark Cohen for a referal on an ENT at the recommendation of Dr. Waldrop and reiterated by Dr. Cantwell. I also asked if he knew a hematologist in case we didn't like the one provided by Wellstar (Cantwell's system). He gave me the name of his own ENT, Dr. Sanjay Bhansali, over near St. Joseph Hosp. He said that a 2 week wait for a new patient was what to expect no matter who the hematologist was so we are going along with Dr. McCune for the moment.
I got an appointment with Dr. Bhansali on Sept. 2, and re-organized Mom's eye appointment for next Tuesday along with her blood work for the Boniva shot. I am thinking that the blood work just received from Dr. Cantwell should work just fine for Dr. Meyerson. I'll check on that tomorrow. Boniva is scheduled for Sept. 15 so I need to see if it conflicts with Dr. McClune. Actually, I think I will reschedule the Boniva...until we've met with Dr. McCune..
Sharon, Dr. Cantwell's nurse called to say that Mom's white blood count was still elevated but not quite as high as previously. It was at 16 something with some cells that need further identification. That being the case Sharon had their office set an appointment with a hematologist, Dr. McClune, for Sept. 15...couldn't be sooner for a new patient.
I contacted Mark Cohen for a referal on an ENT at the recommendation of Dr. Waldrop and reiterated by Dr. Cantwell. I also asked if he knew a hematologist in case we didn't like the one provided by Wellstar (Cantwell's system). He gave me the name of his own ENT, Dr. Sanjay Bhansali, over near St. Joseph Hosp. He said that a 2 week wait for a new patient was what to expect no matter who the hematologist was so we are going along with Dr. McCune for the moment.
I got an appointment with Dr. Bhansali on Sept. 2, and re-organized Mom's eye appointment for next Tuesday along with her blood work for the Boniva shot. I am thinking that the blood work just received from Dr. Cantwell should work just fine for Dr. Meyerson. I'll check on that tomorrow. Boniva is scheduled for Sept. 15 so I need to see if it conflicts with Dr. McClune. Actually, I think I will reschedule the Boniva...until we've met with Dr. McCune..
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