What Just Went Down:
On Friday, Feb 17, Beatrice got up here to the cabin. A week was in store for us and the doggies. It tuned into a 13-day family medical intervention. Here are the high points.
By Sunday, shit was looking grim. Her mom, mid-80s, with a non aggressive form of lymphoma that had been acting up, was under care and plan to deal with it. A low-dose chemo, pill form.
But, they thought some measures were called for before going on the regimen, and so there were additional prescriptions.
…And within two days, she became so demented she knew not her age, nor how many children she bore (six, is the correct answer), was in chronic pain, and other bad shit.
So, we headed out early Tuesday morning, intending to be back by Sunday, and Bea could get back to school Monday, as scheduled.
The next day, once set up in the AirBNB, I was casually exchanging email on current political events with my buddy Mike Eades, and with no intention whatsoever to ask for help, either I mentioned or he asked if she’s on a diuretic.
Yep.
“She’s dehydrated,” Mike says, and adds that there are three classes of human that can get really dehydrated easy: old, young, sick.
It’s not all he wrote to me, but he gave me enough that within 2 hours, Bea’s mom was admitted to emergency with a husband imperative she be put on IV fluids immediately. She began to improve soon.
It’s so damn easy to understand, once you’re just given a clue into the essentials. She had a bit of leg edema. That’s why the diuretic. But it wasn’t managed. It fixed that, and overshot big.
Most infuriating to me was that the med staff did the tests and lied to Bea and the family. Did it come back as dehydration? Nope, of corse it didn’t. Came back as hypercalcaemia, which in addition to aligning with the onset dementia perfectly, is also chiefly caused by dehydration. Get it? So, “that’s her problem,” and not that they overshot and dehydrated her with a diuretic drug.
You can easily Google all this stuff. Dehydration can easily cause high calcium (any cook who reduced sauces ought understand this), and high calcium can cause your brain to screw up. Don’t know what units of measure, but she was at 14, where 8-10 is normal range. When hydrated enough to dilute calcium to 9, she began making sense again. At 8.1, we had mom back.
…The problem was that the process took a huge physical toll, and once out of the woods, she had to spend about a week in a rehabilitation center where she was too weak to do much of anything.
She’s back home, better, but still not where she was a couple of weeks ago. Do not get old people dehydrated. What in the hell, put an 85-yr-old on a diuretic?
…Bea’s dad bought me shoes. I sent a thank you.
So there you go.
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Godspeed.. and I hope Bea’s Mom a complete recovery.
God Bless you all..!
I hope I go out choking on a potato and not as an oldster in ICU.
Potato deaths are horrible…….cruel and unusual.
Lived and died by the potato. I guess that’s not a bad way to go. 😉
Glad she’s improving. Gotta take care of the parents.
Never underestimate the power of Eades.
Glad to hear Bea’s mom is doing better. Amazing how something so simple, so so essential, can get overlooked. Nice wirk Dr. Eades.
Good job!
Sometimes you have to take the 10,000 foot view to get things under control. Doctors don’t know what they’re doing sometimes even when they mean well. They’re focused too close up. Glad Eades advice was of help.
It should be emphasized that while Mike did indeed provide a critical piece, that Bea, my wife, was on scene day and night for 13 days, as were other members of the family. Her mom was rarely ever alone, which surely helped the recovery.
Can completely relate to this. My father in law thought I was a bit over protective when I insisted on staying with him overnight after his hip replacement. Did I really do anything? No. But I felt the nursing staff was a little more “attentive” than if he had been alone. Thankfully, he didn’t have any issues, but if he had, I would have been there to remind then next shift of his medical history, contact any family members that needed to know, etc. Just because we are paying hospital staff to provide medical care doesn’t mean we are free to absolve ourselves of responsibility for our loved ones.
HI Richard,
Just wanted to say that you and your family are in our thoughts. Kudos to your amazing wife and you for powering through. I always knew Dr. Eades was a good guy even from just reading his books and watching him on TV back in the day.
Geriatrics 101….if an older person shows up with disorientation or other cognitive decline, generally acute (and stable cardiovascular…ie not crashing), then the first ten things you deal with are the meds. that all has to be sorted out immediately because it’s so common. then you can go on to the other stuff, starting with no brainers like hydration status, electrolytes, in fections, glucose, stroke , MI , arrrhythmia…..etc.
Very helpful to you to have a generalist like Eades in your skybox to help navigate.
Hoping that Bea and your mother in law….are both doing fine, now.
You really have to be vigilant and ask alot of questions when you family or yourself are in the medical care of doctors. Glad to hear she’s doing better.
Occam’s razor.
My wife is a 3rd year med student on her pediatric rotation right now. I’m paraphrasing here, but a kiddo, who was of sexual maturity (15 years old), but not sexually active (based on history), presented with lower right abdominal pain. Some initial diagnostic tests were ordered including an ultrasound. When it came time for everyone to give their diagnosis, (they didn’t have the images in front of them nor an official read) my wife said it was a no-brainer based on symptoms and location, perforated appendicitis is the most obvious/likely and has to be ruled out first with presentation. Everyone dismissed it with a wave of the hand, “no, that can’t be it, the ultrasound didn’t really show that (even though the appendix couldn’t be seen on the ultrasound),” or “the one ovary looked bigger than the other and it had intermittent good blood flow.” So, instead everyone was focused on her having this ovarian torsion, which I’m told is more likely in sexually active individuals, which are kiddo here denied. Turns out it was indeed appendicitis based on the CT the surgery staff demanded before going in.
Always rule out the easy, most likely shit first.