Saturday, September 9, 2006

 

The Importance of the "Trivial Detail" I Collect on My Mother

    People often kid me about the amount of trivia I collect and post about my mother, especially at The Dailies. My mother is one of the most active of these kidders. I've never understood why I was driven to collect it, but when I take vacations from collecting and posting it I feel as though I've missed something I'll later wish I'd posted.
    Today (actually, yesterday) I realized that at least some of that trivial data will come in very handy as my mother's physician and I decide whether it's time to change her oral type 2 diabetic meds. This morning I was stressing about how to present my observations to her doctor in a way that would be more than "sensing", or short term observations, both of which are usually waved away by almost all physicians (although not necessarily or usually her PCP). Suddenly I realized, all that meal data I've got over at The Dailies, combined with the BG readings, might give both me and her PCP a better idea of how her glipizide is operating, now, and whether she could use a change of med. It occurred to me that if I searched each dinner meal we'll be having from Friday through Monday (since her breakfast and lunch meals usually remain the same) through all the data I've collected since September, 2004 [when she was officially off Glucophage and put on her present med and dosage regimen], listed her morning BG's after each incident of each meal, I'd be able to tell whether her BG has really become less responsive to her medication. Since I've been recording Mom's daily meals and BG's doggedly for at least three years I've got everything I need.
    Turns out, her A.M. BG's are showing a steep upward trend through August and September of this year. I've already compiled the one for the dinner we had last night, Cobb salad. The one for tonight's dinner, More Than Mac & Cheese, is ready except for "tomorrow morning's" reading. I've also listed the Assumptions that can be made about circumstances surrounding the dinners, as well as of exactly what each dinner consists. I chose her four day dinner menu by searching through the The Dailies site to determine what meals she most often wants and in which she indulges, as well as keeping in mind those meals which she is most likely to eat during the upcoming fall and winter months.
    Often, when I think something in her medical routine needs to be changed, I am greeted with a "wait and see" attitude, primarily because of the medical assumption that patients and their medical advocates don't have the hard data to which to point to back up their considerations. This is frustrating, especially since I'm usually right but it takes a long time to wait for medical professionals to compile enough data, over occasional appointments and tests, for them to observe the same thing I've been observing. Sometimes, even when I have the data and compile it to a particular observation, it's ignored. My mother's PCP, though, usually pays attention to the data I've collected and compiled, thus, appropriate decisions are made in appropriate time.
    I've got to say, I never thought I'd be quite this thrilled about being so meticulous and detail oriented. Although I usually have my head too far up my ass to realize that it has made my job as my mother's medical advocate much easier than it could have been, this morning (actually, yesterday morning), when I thought of compiling her meal-to-BG comparisons, I got it. All that Trivial Detail Collecting renders me much more effective and assures that medical management of my mother, by me, by medical professionals, by anyone, will be as timely and appropriate as possible.
    Let's hear it for geeks and nerds, for people equipped with pocket protector pen sets (I have one filled with several colors of my favorite type of pen, although I never have a pocket in which to wear it) and lovers of cocktail party facts whose minds obsessively collect infinite bits of data! Those of us who do this are often chided for not being able to see the forest for the trees. Funny, though, we're the ones who not only make it through the forest easily and safely, but usually lead the lost through it, as well.
    Later.

Comments:
originally posted by Mona Johnson: Sun Sep 10, 11:09:00 AM 2006

Gail,

Of course you're right that this detailed information is important! I remember that when we were trying to figure out whether Aricept was causing Dad's heart rate to slow down, we found out even his doctors had never recorded his heart rate. Because we didn't have the data, it was impossible to know what was causing the problem. Keep it up!
 
originally posted by Kim: Thu Sep 14, 12:26:00 AM 2006

Hey, in nursing, documentation is everything. You can never have too much data or too much information.

And your understanding that an MD will respond to facts more than a sense or "feeling" is right on!

Although with the amount of time you spend with your mom, I'd be pretty apt to believe any "feeling" you have.
 
originally posted by Kim: Thu Sep 14, 12:35:00 AM 2006

BTW, is the audio intro new? Am I dense and just didn't see it before?
It's a great summary!
 
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