A Visit to the Specialist

Tuesday finished on a quiet note with Margaret and I on speaking terms except that Margaret didn't want a cooked dinner. I like to have a barbecue once a week so I can have a good steak and a couple of glasses of red wine, these days out of a cask. Margaret has been having pork sausages with salad but now didn't want them. She decided to have a tin of hearty beef soup and vegetables with a couple of slices of bread. She had a full 505 gm can and afterwards did an Oliver Twist on me and asked for more. There were two things wrong with this. One, I didn't have any more beef and she didn't want chicken and, two, the soup counts in her fluid intake which she was already exceeding. She became quite huffy about it but settled for a hearty beef Cup-of-Soup instead.

Wednesday morning passed without any problems but after lunch Margaret didn't want to get dressed to go and see her specialist. She had some pain in her abdomen so I gave her two paracetamol tablets which settled her down. I like to allow about 45 minutes to get her in the car, drive to the hospital, find a parking spot (sometimes a near impossibility), get her out of the car and wheel her to the specialist's office. The appointment was at 1.50 pm and at 1.05 pm she was not dressed. I found some suitable clothes and dressed her and we got out at about 1.20 pm We had a really quick and easy drive the hospital and found a vacant disabled car park right outside the door. We were in the rooms by just after 1.35 pm. Margaret then complained that we were much too early – which, of course ,we were! Some days I have had to park in a side street and walk several hundred metres to get to the hospital.

The specialist's report was both good and bad. The good news was that her sodium levels were now normal and her two kilogram weight loss had resulted in some reduction in the swelling around her ankles. The bad news was that the swelling was still too much and was causing concern plus her kidney function, eGFR, had dropped from 30 ml/L to 25 ml/l which is also causing concern. In spite of this the specialist increased her frusimide/lasics to 80 mg/day, up from 60, in an attempt to reduce the swelling. Coupled with this he ordered more blood tests in ten days time. He would phone the result through to us as soon as they were available. Margaret has to continue on reduced fluid intake for another eight weeks by which time it is hoped that her weight will have reduced by another 4 kg and the swelling gone. Of course if her kidney function continues to decline all bets are off.

Margaret had a rest until dinner time and sat up and watched some TV with me afterwards. She asked what her new medication was to be from now on and I explained that instead of having half a 40 mg lasics tablet three times a day she would have two whole 40 mg tablets twice a day. At bedtime I gave her her one night time tablet, Ducene/Valium, to help her relax and sleep. She immediately went into a rage (sorry but this is a correct description), saying that she always had another large round tablet without which she could not sleep. I rather stupidly tried to explain that she had no more tablets to take. She continued to rage and wouldn't go to bed. Instead she switched on her computer and after a while I went to bed leaving her up. I dropped off about 12.00 midnight and she was still up. I was wakened at 4.45 am by a large banging from her bedroom. I think she was deliberately running her wheely walker into her bathroom door. She was still in a rage. She claimed that, because I hadn't given her her tablet, she hadn't slept all night and she was in pain. I did what I should have done last night and gave her some more paracetamol which calmed her down. She continued to be mad at me for several hours but appears to have calmed down by now.