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.

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.

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.

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.

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..

August 26, 2010 - Blood results

Dr. Waldrop's office called to say that Mom's sodium is low. There were some other figures she gave me but she had already sent them over to Ryan Cantwell as well as called him. Most concerning is her white count which is elevated to 17.2. The upper normal is 10. So I have already called Cantwell to find out what to do next. They could simply call in a prescription for an antibiotic or they could make an appointment. All the other doctor reports from this week and the previous week will be in Cantwell's office by Tuesday latest. Tuesday we are meeting with Waldrop (neurologist) to get a summary of Mom's head and carotids.