I had intended to carry out a bit of external house cleaning. We have a multitude of spiders and other creatures living around our windows and stuck to the walls. When the time came I decided it was much too hot and humid for outside work and anyway the spiders kept the other bugs under control.
Margaret was feeling quite well so about 10.30 am I got her dressed and took her out to the shops for morning tea and a little shopping. Margaret wanted to buy some cosmetics. One of the side effects of continuous treatment with steroids is that her, once, flawless pale British facial skin has now a fine network of veins across it. Margaret bought herself some foundation makeup which would cover these up. After morning tea and dough nuts for Margaret and coffee and dough nuts for me we looked around some other shops and came home in time for lunch.
Margaret was very tired and I helped her to get undressed and put on a clean nightie so she could rest. Unfortunately one of the other little features of Margaret's confusion returning is her obsession with time and appointments. She got up several times to check her next medical appointments. These are blood tests on 4th Jan, specialist appointment 6th Jan and GP appointment 7th Jan. All these are clearly written on our new 2010 calendar but she checks it every couple of hours and then checks with me that they are accurate.
Margaret went to bed at 9.30 pm and had a good night's sleep. When she woke up this morning she was quite breathless but now appears to be OK. We have a long weekend ahead when the only medical support is the hospital emergency centre so I hope she lasts out to Monday without any crisis. Her feet are quite swollen in spite of the restricted fluid intake and this is not a good sign.
K in South Australia tells me that he is not running a restaurant.
Wednesday, December 30, 2009
Tuesday, December 29, 2009
Still Quiet
When I got back from shopping yesterday Margaret said she felt better and was breathing more easily. I think that she builds up fluid on her chest (a totally unsubstantiated assumption by me!) which makes her early morning breathing more laboured. Anyway the rest of the day was nice and peaceful. Margaret rested most of the day in her bedroom and got up for dinner before watching TV until about 9.30 pm.
Before her most recent visit to hospital she was quite confused and having, I think, hallucinations which formed part of her conscious life. These decreased markedly while in hospital leaving only her dementia where her short term memory is shot. Last night her hallucinations made a reappearance. She told me that she missed getting e-mails from her friend K in South Australia but then he must be very busy since he started his restaurant!.. K is 72 and well retired. Perhaps he can explain this?
Margaret was puffing a lot this morning but is settling down now.
Before her most recent visit to hospital she was quite confused and having, I think, hallucinations which formed part of her conscious life. These decreased markedly while in hospital leaving only her dementia where her short term memory is shot. Last night her hallucinations made a reappearance. She told me that she missed getting e-mails from her friend K in South Australia but then he must be very busy since he started his restaurant!.. K is 72 and well retired. Perhaps he can explain this?
Margaret was puffing a lot this morning but is settling down now.
Monday, December 28, 2009
A Quiet Period
The last couple of days, Boxing Day Saturday and Sunday, have both been very quiet. I have been feeling a bit flat and apart from a little shopping, tidying up around the house, cooking and walking Louis have mainly watched the cricket on TV. Margaret is pretty well bed bound as she hasn't got the "moon boot" to support her injured Achilles Tendon. She is also getting very "chesty" and short of breath if she moves around too much. With her reduced fluid intake she is not on any diuretics and I am a little worried about fluid on the lungs - one of Margaret's chronic problems. Unfortunately our local GPs are not available until tomorrow and Margaret doesn't fancy a four hour wait in our local emergency dept and she in not ill enough, yet, to call an ambulance.
Her specialist is not available until 4th January and she is seeing him on the 6th after more blood tests on the 4th.
I think that the specialist treats the blood mineral deficiency problems and her chronic kidney failure and cancels any medications likely to exacerbate them while her GP treats her cardiovascular problems and pulmonary oedema and re-prescribes them. I would like to get somebody controlling the overall situation. We do have a geriatric specialist in Noosa who could be the answer.
I shall be going shopping in a little while while Margaret stays in bed with Louis lying next to her. She will be on her own for about two hours but she can contact me on my mobile phone in an emergency providing she remembers to just press 2 on her mobile!
Her specialist is not available until 4th January and she is seeing him on the 6th after more blood tests on the 4th.
I think that the specialist treats the blood mineral deficiency problems and her chronic kidney failure and cancels any medications likely to exacerbate them while her GP treats her cardiovascular problems and pulmonary oedema and re-prescribes them. I would like to get somebody controlling the overall situation. We do have a geriatric specialist in Noosa who could be the answer.
I shall be going shopping in a little while while Margaret stays in bed with Louis lying next to her. She will be on her own for about two hours but she can contact me on my mobile phone in an emergency providing she remembers to just press 2 on her mobile!
Saturday, December 26, 2009
A Quiet Christmas Day
Christmas lunch at the Reef Hotel Noosa was a great success. I had managed to get Margaret dressed in a colourful kaftan instead of her normal blouse and pants. Lunch was due to start at 11.30 am so I got there early to maneuver her wheelchair into position. Unfortunately the access from the car park to the restaurant was locked and the only other access was up a steep flight of stairs. I had the Hotel's phone number and after a couple of minutes we were let in.
We had a nice central table with just enough space for the wheel chair protected by a rail which meant that Margaret could see everything that was going on but was out of the way of passing diners and of course playing kids.
We started with a selection of nuts and fruits accompanied by a crusty wholemeal loaf and herb butter. Next was a huge seafood platter with prawns, oysters, sushi rolls, smoked salmon and some lobster. It was a meal on its own. I ate the oysters and Margaret most of the prawns and we made inroads into the salmon, sushi and lobster but were couldn't eat it all. I saved six large tiger prawns for later along with some beautiful peaches and plums.
We had a good half an hour's break until the main course of cooked honey glazed ham, roast chicken, roast potatoes etc. We managed to eat some of this.
During dinner we had a visit from Father Christmas - not just the kids. We were given little presents and sweets etc as gifts. Margaret really enjoyed it, especially a cuddle from Santa!
We finished off with Christmas Pudding, custard and ice cream. Margaret had two glasses of sparkling white wine and I had two diet cokes but caught up at home later with beer. We left about 2.00 pm and Margaret was very tired so I got her in a nightie and put her to bed.
I snoozed in the lounge for while before taking Louis, who had been sleeping of a massive Christmas bone, for a walk.
Margaret got up about 7.00 pm and had her prawns with bread and butter for tea while I just had some Christmas Cake.
We watched a movie together before getting Margaret to bed about 10.00 pm.
This morning Margaret is a little breathless and needs watching as she also says she has a sore throat. She had a good night's sleep in spite of it being a warm humid night.
Margaret resting after the Sea Food Platter
We had a nice central table with just enough space for the wheel chair protected by a rail which meant that Margaret could see everything that was going on but was out of the way of passing diners and of course playing kids.
We started with a selection of nuts and fruits accompanied by a crusty wholemeal loaf and herb butter. Next was a huge seafood platter with prawns, oysters, sushi rolls, smoked salmon and some lobster. It was a meal on its own. I ate the oysters and Margaret most of the prawns and we made inroads into the salmon, sushi and lobster but were couldn't eat it all. I saved six large tiger prawns for later along with some beautiful peaches and plums.
We had a good half an hour's break until the main course of cooked honey glazed ham, roast chicken, roast potatoes etc. We managed to eat some of this.
During dinner we had a visit from Father Christmas - not just the kids. We were given little presents and sweets etc as gifts. Margaret really enjoyed it, especially a cuddle from Santa!
We finished off with Christmas Pudding, custard and ice cream. Margaret had two glasses of sparkling white wine and I had two diet cokes but caught up at home later with beer. We left about 2.00 pm and Margaret was very tired so I got her in a nightie and put her to bed.
I snoozed in the lounge for while before taking Louis, who had been sleeping of a massive Christmas bone, for a walk.
Margaret got up about 7.00 pm and had her prawns with bread and butter for tea while I just had some Christmas Cake.
We watched a movie together before getting Margaret to bed about 10.00 pm.
This morning Margaret is a little breathless and needs watching as she also says she has a sore throat. She had a good night's sleep in spite of it being a warm humid night.
Margaret resting after the Sea Food Platter
Your's truly doing the same
Margaret getting into the spirit of things.
Good old Santa
Margaret getting into the spirit of things.
Good old SantaFriday, December 25, 2009
Margaret is Home
Yesterday morning I was at the hospital by 9.30 pm. Margaret was sitting in a chair occupying the space where her bed used to be. Her room mate, also Margaret, was quite ill during the night and they had moved our Margaret to another room for the night to get some sleep. After her shower it was decided that she could sit up until it was decided whether the came home or not. She had had another blood test at 8.00 am and the results were being rushed through.
G Pavilion was in chaos. Those patients who were not going home were all being moved to D Pavilion as there were so few that it was not worth keeping the ward open. The other Margaret disappeared at about 10.30 am and by 11.00 am there were only two other patients on the ward also awaiting discharge. Finally at 11.30 am the specialist dropped by with the test results. They were not too great as her sodium levels had stabilized at 127 mmol/L, still well below the 140 normal low. The specialist said that he thought Margaret would be better of at home for a few days on certain conditions. One was that she went on a restricted fluid intake of 1.2 L per day - that's everything tea, water and alcohol. This is equivalent of 6 cups of tea a day Margaret's normal tea intake! The next is restricted walking as her boot hasn't arrived yet and finally not to over tire herself.
I queried her kidney function and he said it was normal for Margaret and above the level requiring dialysis! Her kidneys are shot and a eGFT of 30 is good for her. As I have said before above 90 is good below 60 is some kidney failure ,below 30 chronic failure, below 20 acute failure and below 10 dialysis is required. Margaret's were below 20 on admission and had clawed their way up to 30 on discharge. He was more worried about her sodium levels. She will have more blood tests on Jan 4 and a follow up visit to the specialist on Jan 6. If there are any signs of increased confusion it's back to emergency and on a saline drip. Happy Christmas!
We got home at 12.30 pm to a rapturous welcome from Louis. He wouldn't let me wheel Margaret in her chair from the garage and just stood there with his paws in Margaret's lap licking her face. Margaret has been resting up as much as possible and watched the Carols by Candle Light on TV before going to bed.
Today she is quite bright but has had two cups of tea before 8.00 am! I will help her get showered and wash and set her hair (it's very short) before going out to Christmas Lunch at the Reef Hotel at 11.30 am. I will take my camera and try and get some photos.
G Pavilion was in chaos. Those patients who were not going home were all being moved to D Pavilion as there were so few that it was not worth keeping the ward open. The other Margaret disappeared at about 10.30 am and by 11.00 am there were only two other patients on the ward also awaiting discharge. Finally at 11.30 am the specialist dropped by with the test results. They were not too great as her sodium levels had stabilized at 127 mmol/L, still well below the 140 normal low. The specialist said that he thought Margaret would be better of at home for a few days on certain conditions. One was that she went on a restricted fluid intake of 1.2 L per day - that's everything tea, water and alcohol. This is equivalent of 6 cups of tea a day Margaret's normal tea intake! The next is restricted walking as her boot hasn't arrived yet and finally not to over tire herself.
I queried her kidney function and he said it was normal for Margaret and above the level requiring dialysis! Her kidneys are shot and a eGFT of 30 is good for her. As I have said before above 90 is good below 60 is some kidney failure ,below 30 chronic failure, below 20 acute failure and below 10 dialysis is required. Margaret's were below 20 on admission and had clawed their way up to 30 on discharge. He was more worried about her sodium levels. She will have more blood tests on Jan 4 and a follow up visit to the specialist on Jan 6. If there are any signs of increased confusion it's back to emergency and on a saline drip. Happy Christmas!
We got home at 12.30 pm to a rapturous welcome from Louis. He wouldn't let me wheel Margaret in her chair from the garage and just stood there with his paws in Margaret's lap licking her face. Margaret has been resting up as much as possible and watched the Carols by Candle Light on TV before going to bed.
Today she is quite bright but has had two cups of tea before 8.00 am! I will help her get showered and wash and set her hair (it's very short) before going out to Christmas Lunch at the Reef Hotel at 11.30 am. I will take my camera and try and get some photos.
Thursday, December 24, 2009
She is Still in Hospital
Yesterday I went to the hospital at 9.00 am so as not to miss Margaret's specialist. I got a funny look from the Unit Manager (Senior Nurse) so I asked if it was true that Margaret was to be allowed home later in the morning as the nurse has said on the previous night. She said that was so provided her blood tests came back OK. This confused me as Margaret had not had any more tests since Tuesday and those results were why she was still in hospital!
I went and sat with Margaret who, like yesterday, was sure that she was coming home although she had very sore arms from the cannulas and failed drip from the day before. At about 10.15 am the pathology lab's blood collector came by and took more blood from Margaret and I knew that she wasn't coming home that day. I left her for a while to get a coffee and on the way met her specialist. He asked how Margaret was and I told him that she was upset because she thought that she was going home. He was surprised and told me that he not told anyone that and the nursing stall were making assumptions. He was to say the least "not amused".
He explained that following Margaret's problems with cannulas and drips he had decided to postpone the saline drip until she had more blood tests that day. He said that another patient had had anomalous results similar to Margaret and it could be a testing error.
After coffee I returned to Margaret and her specialist dropped in to see her and apologize for keeping her in for at least another day and assured her that, come what may, she would get out for her Christmas Lunch even if she has to return afterwards.
At 5.00 pm I visited Margaret once again and she had just seen her specialist. He had chased up her blood test Sodium levels results and they were still low but rising. The normal lower pass level is 137 mmol/l and Margaret's were now 127 from a low of 120 a couple of days earlier. On this he would release Margaret over Christmas but further blood tests would be required to check that the trend continues. Low Sodium is not a life threatening condition but does affect the brain function and hence Margaret's hallucinations. If left untreated and it falls too low the brain can swell and the patient die so it has to be watched.
On the down side the results showed that Margaret's kidney function is still in the chronic failure mode. For example the lower level for normal eGFT is 59 ml/min hers is 31 and the Urea maximum level for normal is 7.5 umol/L while her is, at best this week, 11.4 and has been as high as 26.5. I think that you and I would be in hospital with these readings but they are just "normal" for Margaret and part of the chronic state of poor health.
I am off to pick up Margaret at 10.00 am.
I went and sat with Margaret who, like yesterday, was sure that she was coming home although she had very sore arms from the cannulas and failed drip from the day before. At about 10.15 am the pathology lab's blood collector came by and took more blood from Margaret and I knew that she wasn't coming home that day. I left her for a while to get a coffee and on the way met her specialist. He asked how Margaret was and I told him that she was upset because she thought that she was going home. He was surprised and told me that he not told anyone that and the nursing stall were making assumptions. He was to say the least "not amused".
He explained that following Margaret's problems with cannulas and drips he had decided to postpone the saline drip until she had more blood tests that day. He said that another patient had had anomalous results similar to Margaret and it could be a testing error.
After coffee I returned to Margaret and her specialist dropped in to see her and apologize for keeping her in for at least another day and assured her that, come what may, she would get out for her Christmas Lunch even if she has to return afterwards.
At 5.00 pm I visited Margaret once again and she had just seen her specialist. He had chased up her blood test Sodium levels results and they were still low but rising. The normal lower pass level is 137 mmol/l and Margaret's were now 127 from a low of 120 a couple of days earlier. On this he would release Margaret over Christmas but further blood tests would be required to check that the trend continues. Low Sodium is not a life threatening condition but does affect the brain function and hence Margaret's hallucinations. If left untreated and it falls too low the brain can swell and the patient die so it has to be watched.
On the down side the results showed that Margaret's kidney function is still in the chronic failure mode. For example the lower level for normal eGFT is 59 ml/min hers is 31 and the Urea maximum level for normal is 7.5 umol/L while her is, at best this week, 11.4 and has been as high as 26.5. I think that you and I would be in hospital with these readings but they are just "normal" for Margaret and part of the chronic state of poor health.
I am off to pick up Margaret at 10.00 am.
Wednesday, December 23, 2009
A Confusing Situation
On Monday I met Margaret's specialist who said that her sodium levels were not serious and that she could come home yesterday (Tuesday) after the results of her latest blood tests were back.
So yesterday morning I quickly dusted and vacuumed the house and did some last minute shopping before going to hospital to pick up Margaret at 10.00 am. She was already to go. Her medications were being documented by the hospital pharmacy so we just needed the specialist's "off you go" signal and Margaret was coming home.
At about 11.00 am the specialist arrived and said "No!"... Margaret's sodium levels had continued to fall and she could get quite sick if she didn't have an intravenous saline drip. This should put her right to be home for Christmas. Margaret was very upset so I popped out to the car and brought in some flowers that I had bought her as a welcome home gift. This cheered her up somewhat.
Just before 12.00 noon, after three goes, they go a cannula inserted and the drip started so I went home to lunch. When I returned at 5.00 pm there was the drip disconnected and the cannula removed but the saline bag was still full. The drip had failed and no other suitable veins were available. A passing nurse said that Margaret was going home today (Wednesday) and the drip didn't matter. I am now very confused and unless I can see the specialist and get a satisfactory explanation for how she was likely to be seriously ill in the morning without the drip and OK to go home in the evening when it had not been administered.
Stay tuned!
So yesterday morning I quickly dusted and vacuumed the house and did some last minute shopping before going to hospital to pick up Margaret at 10.00 am. She was already to go. Her medications were being documented by the hospital pharmacy so we just needed the specialist's "off you go" signal and Margaret was coming home.
At about 11.00 am the specialist arrived and said "No!"... Margaret's sodium levels had continued to fall and she could get quite sick if she didn't have an intravenous saline drip. This should put her right to be home for Christmas. Margaret was very upset so I popped out to the car and brought in some flowers that I had bought her as a welcome home gift. This cheered her up somewhat.
Just before 12.00 noon, after three goes, they go a cannula inserted and the drip started so I went home to lunch. When I returned at 5.00 pm there was the drip disconnected and the cannula removed but the saline bag was still full. The drip had failed and no other suitable veins were available. A passing nurse said that Margaret was going home today (Wednesday) and the drip didn't matter. I am now very confused and unless I can see the specialist and get a satisfactory explanation for how she was likely to be seriously ill in the morning without the drip and OK to go home in the evening when it had not been administered.
Stay tuned!
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