Mom & Me Four Archive

...The Dailies through yesterday. I was afraid if I didn't get all the stats in and publish the notes I'd been keeping in draft form, I'd begin to lose BP stats: The cuff only retains 20 readings. Nothing earth shattering over there. During the "As Draft Only" period we had two days of unusual dehydration, one instigated by me when I administered 20 mg of furosemide instead of the usual 10. I did it intentionally (brief explanation over there) and it was a mistake. I'll never do that again. It pulls fluid off her way too fast. I'm not sure what instigated the second dehydration episode, but I recognized the problem immediately in the morning and began treating it even before her bath.
    The curious aspect of giving Mom 20 mg of furosemide and having that backfire on me: The lowest prescribed dosage is 20 mg, as far as I can determine. I almost never give her 20 mg. Usually, if she needs to shed fluid, I give her 10 mg, then another 10 mg in 12 hours if she's exhibiting stubborn retention. Even this type of administration takes her breath away, so to speak, and I can count on the following day being slow and sleep-ridden while she rehydrates herself. On the day that I gave her 20 mg at one clip its effect was almost immediate and she "felt bad all over" most of the day, as she usually does when she's severely dehydrated. As well, because of the medication floating around in her system combined with her typical lack of thirst and the battle I have getting her to drink fluids, it takes a few hours to get her out of this state. She also looks and acts like she feels "bad all over": Her footing is much less sure, she tends to weave and needs a lot of help moving around; what mental acuity she retains is obviously impaired; she has no energy and her body looks like she's feeling under the weather. Interestingly, the way I administer furosemide (once in a great while, only when absolutely necessary and in 10 mg doses) isn't at all the way it's typically prescribed and taken. Most people who are on this stuff take it daily. I can imagine some circumstances wherein this would be necessary: The later stages of Chronic Renal Failure, for instance, and/or frequent episodes of high blood pressure definitely linked to unusual and frequent fluid retention. The problem is that the prescribed "method" is the way it is prescribed for my mother. If I had never gotten involved in my mother's medications in a micro-management way and if I had never had friends who identified what that "TIA" in September of 2002 actually was I would never have questioned the administration of this medication and my mother would be on it daily, just as most people who take it are. I would, thus, be fighting her "feeling bad all over" all the time and wondering why, or maybe chalking it up to old age. I probably would also be fighting this "feeling" ineffectively. I wondered, today, when reviewing all this, how many Ancient Ones "out there" would be feeling and doing a lot better if their medication regimens were scrutinized and manipulated by their caregivers. The 'moral' is, people who care for the Ancient and Infirm absolutely need to educate themselves about the medications they administer. My mother's and my life together is a painfully detailed demonstration that doctors don't think as much as they should, don't communicate among themselves, aren't on the scene intimately in order to note what's happening and think about why, don't communicate well with their patients and those patients' caregivers, thus they often aren't in a position to understand when medications are not only unnecessary but need to be dispensed (both by the pharmacy and by the medication manager, who is usually the caregiver) in a way other than the prescribed/accepted manner. This, readers, is a big fucking deal. If you're a caregiver and you are dealing with someone who feels "bad all over" a lot, you need to be doing your own research, observation and figuring regarding your care recipient's medications. You can't, you absolutely can't leave it all up to the doctors. It is important to inform the doctors with whom you're dealing of your discoveries and permutations concerning your care recipient's prescriptions. It is also important, though, in the face of disagreement, to trust your research, observations and instincts and to be "fearless" [as per Caregiver.com] when it comes to meddling with prescribed medications and their regimens: Trust your observations first and the doctors' recommendations second. Too little is known, at this time, about medicating the elderly (and often medicating others). Lay medication administrators must be extremely active in making observations, thinking about what they learn and observe and applying all this information in making decisions about medication management and dispersal. Yes, you may very well make enemies of physicians. You might even get your care recipient bounced by a few doctors. But, believe me, I can tell you from experience, this is not the worst that can happen.
    Today seems to be a pronounced sleep day for her. We've been having more of those lately. I'm not worried about it, just noting it. Otherwise, Mom's doing good, maintaining "her own", as 'they' say.
    I think I'm beginning to emerge from my den.
    Later.