Tuesday, March 30, 2010

Daily notes

Don't have much time for anything else in life right now other than charting his food/meds/stats and keeping notes. Thought I would post this mornings notes here. I like to write things down before I/he calls a doctor just so we don't forget something in the conversation.

Wed - 4 sugar lows
Thurs 6 sugar lows
Fri 3 sugar lows, saw endo, changed humulin
Sat ok
Sun 1 low
Mon 1 low

Possibly too much OJ to resolve the lows, too much citric acid, thinks his gout has flared up.

Infection in l hand/wrist and l knee.

started colchicine on Saturday, took until he got nauseated (per instructions)

Has not been taking diladid as he is still constipated somewhat. Had hard BM yesterday, still taking stool softeners.

In pain since last Friday, not improving.
Awake at 3 am today.
4 extra strength tylenol at 6 am
1 diladid at 8 am
Zero relief from pain.

Overall pain level 7, spikes to 9 are random
Left writs pain 10 to touch or move
So much pain he is now nauseated from the pain

Backpain with no movement is 5
hip to knee pain 0-7 in cycles
He has had hot searing pain from outside left hip to knee since he got home from surgery, had associated it with healing, but that pain has intensified since Friday.

Called surgeon's office. In surgery til 3 pm today. Nurse does not think this is gout due to location of infections, wants him to see a physician today.

Called the doctor's office and his GP is out today.

Cardiac Rehab assessment at 9:15 am.
1 hour assessment of his physical condition.
Do not want to start PT until next week due to pain levels today.
Nurse ret'd call, go from there to doctor's office, get labs first.

Labs done, then waiting
GP: only way to know if it's gout is to do a needle biopsy, but he doesn't see enough fluid to do that. Uric acid level won't tell anything - usually goes down during an attack.
While not typical joints for gout to attack, agree he has had gout there in the past. Atypical in how it started, but that doesn't matter now either.
Treat with prednisone for presumed gout, a lower dose. There should be clear progress by Thursday. If not, or if it's worse tomorrow, call back in.

Prednisone increases blood sugars, contact endocrinology to adjust Humulin levels.

At the clinic from 9 am - noon. Home. Fixed lunch. Basically skipped entire morning routines, no glucose levels, etc.

Called cardiac surgeon's office to insure ok to take prednisone this soon after surgery. (She called back, it's ok)

Called endo office. Doctor is out ill today, but taking messages Nurse not sure how to adjust humulin, wants to consult with physician.

1 pm. First dose of prednisone. And doubled the dilaudid.

Sound asleep at 1:30 pm.

I wish someone who has been down this road would post and let me know what to expect next! Maybe it's not possible.

It's now almost 2pm. And I have been providing him care since 6 am - non stop. Probably not a good day for me to make any decisions. But I have to wonder what I'm doing still here. How much can love endure? He has absolutely no quality of life at the moment. I'm trying hard to see any kind of light at the end of the tunnel, but at the moment, it looks like one huge black hole. I do know it's there.....it's just not visible at all today. I am in my one minute at a time mode. If I even stop to think how much of my life is currently being consumed by HIS disease I will get depressed. I thank God daily that I am healthy. Because I know that no one else in his life is going to take care of him.


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