You know sometimes when you're "living with Mac" you learn a lot. One of the things I have learned is you have to be careful when it comes to Dad's medication. Over the last few months, when it comes to Dad's medication, the pharmacy has make mistakes and the Doctors have made mistakes. I know, I know, we all make mistakes, we are all human ... but it is scarey because when a mistake is made the medication can affect Dad's life. You know I have no idea how seniors living on their own can track and keep tabs on what they are taking and why. I am sure the majority of them put their trust in "the system". Anyway, I digress .... I bring this "medication issue" up because over the last few days the following has happened:
Dad is on blood thinners. He is on blood thinners (Warafin) because of his congenital heart failure (did I mention that before?) and to reduce the risk of stroke. You may know, or not know, Warafin is rat poison, but they call it Warafin, well, because "rat poison" doesn't sound very good, does it. I believe Dad has been on blood thinners for at least 6-7 years, maybe more.
As a result of being on Warafin, Dad needs an INR test every two weeks. This is a blood test that shows if his blood is too thin or too thick. If it is too thin he could bleed to death internally. If it is too thick he could have a stroke. Anyway, Dad has been getting his INR checked every two weeks for quite awhile. He has taken 2 or 2 1/2 milligrams of Warafin per day pretty consistently for some time. Last Thursday (Aug. 26) we had a call from the "Unattached Patient Clinic" advising to increase Dad's warafin from 2 milligrams to 3.5 milligrams. I thought that was quite an increase and was going to question it but did not (lesson learned). Today we were told his blood is much too thin to and quit taking the Warafin. That is not good.
I will be talking to the Geriatric Specialist and the Unattached Patient Clinic tomorrow to find out what happened. Something was missed somewhere. Just thought I would share this and for your information you should always check the medication prescribed and dispensed whether it is for you or your loved one!
Tuesday, August 31, 2010
Saturday, August 28, 2010
The "Decisions"
Well .... Dad has a few decisions to make.
The First Decision - Cataract Surgery
The first decision is to decide if he wants cataract surgery on his left eye. An eye specialist here in Prince George advised Dad he only had 20% vision in his left eye due to cataracts. You would assume this is an easy decision to make ... get the cataract surgery! But, alas ... it is not that simple a deicision to make. When Dad had cataract surgery on his right eye about 8-10 years ago he said it made his eye sight worse. I advised Dad that technology has improved since then. Now he has a decision to make.
The Second Decision - Hip Replacement Surgery
As some of you may know, it is very hard for Dad to get around. He has very bad osteoporoporis and osteoarthritis in all his bones and joints. In early 2009 Dad also fractured two vertabrae in his back. Dad's hips are very bad and very painful and so, as a result, it is hard for Dad to get around. Having said that when he first came to live with us he could only use his wheelchair (for long distances) and his walker (for short distances), now he is back to using a cane in the house. This is as a result of going to physio and the Geriatric Day Hospital.
Anyway, the Geriatric Specialist recommended Dad get him replacement surgery right away. I was concerned about Dad having major surgery at his age (82). Below are some questions I asked the Doctor and the responses:
- Can Dad's heart handle major surgery? - before the operation Dad will be assessed by a cardiologist. Currently Dad's heart status is stable.
- Because Dad is on blood thinners, how will this affect the surgery? - you go off the warafin before surgery and you get shots of blood thinner for a few days then you restart the blood thinner.
- Isn't there a risk Dad could catch pneumonia while in the hospital? - sure, it is possible but not common. The best protection from pneumonia is to get moving as soon as possible after surgery.
- What town/city will the operation take place? - it will take place here but if you would rather go elsewhere such as Kelowna or Vancouver where the wait list is shorter we can look into referring you there.
- Will there be home support after the operation? - yes. You might need home support (i.e. assistance with dressing or bathing) for awhile after surgery. You would also likely attend the Day Hospital again to help with rehab.
- What other risks are there? - other risks are infections in the wound or the artificial joint, stroke, heart attacks, blood clots, pneumonia, etc.
The Geriatric Specialist advised Dad that he will only get worse as time goes on, and there will be a point when the only way he will be able to get around will be in a wheelchair. Also, if Dad waits too long to get the surgery there will be a point where it will be too late, where the surgery won't help him - they won't be able to fix the hip.
There is a one year wait list so Dad has some time to make a decision. Having said that we meet with the surgeon on September 28th!
This is a decision Dad has to make - a scarey decision. Maybe it is better he doesn't get the surgery but only Dad can decide if he wants to be in a wheelchair 24/7.
The First Decision - Cataract Surgery
The first decision is to decide if he wants cataract surgery on his left eye. An eye specialist here in Prince George advised Dad he only had 20% vision in his left eye due to cataracts. You would assume this is an easy decision to make ... get the cataract surgery! But, alas ... it is not that simple a deicision to make. When Dad had cataract surgery on his right eye about 8-10 years ago he said it made his eye sight worse. I advised Dad that technology has improved since then. Now he has a decision to make.
The Second Decision - Hip Replacement Surgery
As some of you may know, it is very hard for Dad to get around. He has very bad osteoporoporis and osteoarthritis in all his bones and joints. In early 2009 Dad also fractured two vertabrae in his back. Dad's hips are very bad and very painful and so, as a result, it is hard for Dad to get around. Having said that when he first came to live with us he could only use his wheelchair (for long distances) and his walker (for short distances), now he is back to using a cane in the house. This is as a result of going to physio and the Geriatric Day Hospital.
Anyway, the Geriatric Specialist recommended Dad get him replacement surgery right away. I was concerned about Dad having major surgery at his age (82). Below are some questions I asked the Doctor and the responses:
- Can Dad's heart handle major surgery? - before the operation Dad will be assessed by a cardiologist. Currently Dad's heart status is stable.
- Because Dad is on blood thinners, how will this affect the surgery? - you go off the warafin before surgery and you get shots of blood thinner for a few days then you restart the blood thinner.
- Isn't there a risk Dad could catch pneumonia while in the hospital? - sure, it is possible but not common. The best protection from pneumonia is to get moving as soon as possible after surgery.
- What town/city will the operation take place? - it will take place here but if you would rather go elsewhere such as Kelowna or Vancouver where the wait list is shorter we can look into referring you there.
- Will there be home support after the operation? - yes. You might need home support (i.e. assistance with dressing or bathing) for awhile after surgery. You would also likely attend the Day Hospital again to help with rehab.
- What other risks are there? - other risks are infections in the wound or the artificial joint, stroke, heart attacks, blood clots, pneumonia, etc.
The Geriatric Specialist advised Dad that he will only get worse as time goes on, and there will be a point when the only way he will be able to get around will be in a wheelchair. Also, if Dad waits too long to get the surgery there will be a point where it will be too late, where the surgery won't help him - they won't be able to fix the hip.
There is a one year wait list so Dad has some time to make a decision. Having said that we meet with the surgeon on September 28th!
This is a decision Dad has to make - a scarey decision. Maybe it is better he doesn't get the surgery but only Dad can decide if he wants to be in a wheelchair 24/7.
Fishing
On August 10, 2010 Brian and I took Dad fishing to Stuart Lake. We stayed in a 2 bedroom motel at the Pitka Bay Resort. We had wonderful weather for the 4 days we were there. There was only one problem though, the lake was too rough to go out on for the first 3 days.
Getting Dad on the Boat
Well ... it was interesting getting Dad on our 24 foot Bayliner. You have to give Dad credit, he put his trust in Brian and I to get him on the boat. He was very brave. We took Dad down to the dock in the wheelchair. To get him down a 2 foot drop to the lower dock we had a "two-step" step stool with us. Once we got Dad by the boat he had to get on the boat! With the dock and the boat moving it was interesting but he did it!
Brian was able to take Dad out for a few hours on the Thursday night and Dad caught two baby fish so he let them go (thanks, Dad).
On the Friday all three of us went fishing for 5 hours! Brian was the only one to catch a fish on Friday but it was fun nonetheless. We plan to go fishing on the September long weekend, maybe we will all catch a fish then!
Oh yeah, when we were out on the Friday, Dad just about got sun stroke thanks to Brian and I. We will be more careful next time! Sorry Dad!
Getting Dad on the Boat
Well ... it was interesting getting Dad on our 24 foot Bayliner. You have to give Dad credit, he put his trust in Brian and I to get him on the boat. He was very brave. We took Dad down to the dock in the wheelchair. To get him down a 2 foot drop to the lower dock we had a "two-step" step stool with us. Once we got Dad by the boat he had to get on the boat! With the dock and the boat moving it was interesting but he did it!
Brian was able to take Dad out for a few hours on the Thursday night and Dad caught two baby fish so he let them go (thanks, Dad).
On the Friday all three of us went fishing for 5 hours! Brian was the only one to catch a fish on Friday but it was fun nonetheless. We plan to go fishing on the September long weekend, maybe we will all catch a fish then!
Oh yeah, when we were out on the Friday, Dad just about got sun stroke thanks to Brian and I. We will be more careful next time! Sorry Dad!
Monday, August 16, 2010
Geriatric Day Hospital
About four weeks ago, Dad and I went to go see a "Geriatric Specialist". I never even knew these existed! Anyway, after a 2 1/2 hour visit and two weeks later Dad was asked to attend a Geriatric Day Hospital twice a week (on Tuesdays and Thursdays from 9:30 am to 2:00 pm).
This Day Hospital has a team consisting of: Geriatric Doctor, Charge Nurse, Practical Nurse, Occupational Therapist, Recreational Therapist, Physio Therapist, Rehab Assistant, and Social Worker. They are a team that focus on improving Dad's physical and mental health. They work on improving his mobility and overall health. He will be attending this day hospital for 6-10 weeks. To date, they have modified his medication so he only has to take his many, many pills twice a day instead of three times a day and he seems to be getting around a bit better (using a cane in the house instead of his walker).
Each day (Tues and Thurs) all the "old folks" meet with the different therapists, are weighed, and have blood pressure and pulse taken, and do an exercise circuit, They also have different events each day such as: Food Safety Facts, 50's sing along, brain games, baking, etc. Dad seems to enjoy going here. It is a great opportunity to get out and socialize with other "old folks".
With Brian and myself working, it has been a challenge at times to get Dad to the Day Hospital and back. Handi-dart will not pick up Dad because we are outside of city limits. We can't get a taxi as Dad needs help getting up and down our stairs. We are very thankful, and grateful, to Sarah (Mac's granddaugher and my daughter). When she can, she comes to pick up Dad, help him down the stairs and out to the car. She drops him off at 9:30 and then picks him up at 2:00 and brings him back home. There has been a few times when she couldn't do it and we were very thankful, once again, to have Christine (Brian's niece) to be Dad's Chauffer for the day!
This Day Hospital has a team consisting of: Geriatric Doctor, Charge Nurse, Practical Nurse, Occupational Therapist, Recreational Therapist, Physio Therapist, Rehab Assistant, and Social Worker. They are a team that focus on improving Dad's physical and mental health. They work on improving his mobility and overall health. He will be attending this day hospital for 6-10 weeks. To date, they have modified his medication so he only has to take his many, many pills twice a day instead of three times a day and he seems to be getting around a bit better (using a cane in the house instead of his walker).
Each day (Tues and Thurs) all the "old folks" meet with the different therapists, are weighed, and have blood pressure and pulse taken, and do an exercise circuit, They also have different events each day such as: Food Safety Facts, 50's sing along, brain games, baking, etc. Dad seems to enjoy going here. It is a great opportunity to get out and socialize with other "old folks".
With Brian and myself working, it has been a challenge at times to get Dad to the Day Hospital and back. Handi-dart will not pick up Dad because we are outside of city limits. We can't get a taxi as Dad needs help getting up and down our stairs. We are very thankful, and grateful, to Sarah (Mac's granddaugher and my daughter). When she can, she comes to pick up Dad, help him down the stairs and out to the car. She drops him off at 9:30 and then picks him up at 2:00 and brings him back home. There has been a few times when she couldn't do it and we were very thankful, once again, to have Christine (Brian's niece) to be Dad's Chauffer for the day!
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