Blood Test Results and Specialist's Visit

After a quiet Tuesday and Wednesday morning I took Margaret to see her Specialist Physician in the afternoon.

First the blood test results show that Margaret's sodium levels have crept up to normal - actually the lower limit of normal 137 mmol/L. This is why Margaret has been reasonably normal for the last few days. Most of her confusion has gone away and we are left with dementia but no hallucinations so our conversations are sensible again. The improvement is put down to the reduced fluid intake which she is to stick for the foreseeable future. Her kidney function is still holding at an eGFR of 30 ml/min - chronic failure level which is now accepted as normal for Margaret.

The main concern is Margaret's fluid retention which is most obvious with her swollen ankles and lower legs. If not controlled the specialist agrees that she is in danger of developing pulmonary oedema and possibly congestive heart failure. The big problem is that she is already on a low fluid intake and diuretics could cause other problems not the least is the leaching of sodium from her system. The specialist estimates that over her complete body she has accumulated about 10kg of retained fluid. To combat this he has put her on a low dose of Frusimide - 60mg a day. She must have fortnightly blood tests and see him soon afterwards for a review of the situation. If her confusion returns I am to stop the frusimide and take her to see him asap.

So her health situation is now in a closed loop. Give her diuretics to prevent fluid retention and possible heart failure which leaches out her sodium which causes confusion and ultimately death. The solution stop the diuretics and start again. I thinks the cycle takes about 6 to 8 weeks - we shall see.

While she is on diuretics I am to monitor Margaret's weight which should reduce at about 1kg/fortnight. During the hot weather I am also to check her for possible dehydration and to regulate her fluids to combat it if necessary.

While all this was going on I missed watching Australia actually bringing off the greatest recovery in a cricket match in the last few years beating Pakistan by 30 0dd runs in the second test.

This morning Margaret has a GP's visit to renew some prescriptions I shall discuss her situation with him - her health not the cricket.