Betty Updates

Sunday September 3, 2006
Got an early morning call from Trinity saying Mother was still throwing up and now has abdominal pain. Dr. Hankwitz wants her to go to the ER at Columbia.

9:30
Met the ambulance at Columbia. Dr. Mays (surgeon) ordered a catscan and redressed her legs himself. He found the dressings to be poorly done and leaking. Catscan inconclusive but best guess is colitis since she believes her appendix was taken out with her gall bladder. Admitted to the 5th floor. Followed by Dr. Lee and then Dr. Kastopolous(sic?). Discovered a previous culture for an infection called Mersa which was done by Dr. Altman. Recultured and still waiting for results. Takes 72 hours. Isolation procedures in place (gowns and gloves for staff). Antibiotics begun.

Saturday September 9, 2006
Discharged to St. Anne's Home for the Elderly. Passed on a 2 inch thick file of paperwork from Columbia Hospital. New doctor is Dr. Hawes. Colleen will meet with her on Monday 9-11. Watch for her update. OT and PT services to start Monday as well. Mom is in Room 215 and her phone number is 527-6787.

Wednesday September 13, 2006
Bridget took Mom to her appointment with the Wound Healing Clinic at Columbia Hospital. They still are unsure of the Mersa culture but proceeding with antibiotics directly applied to the wound , Bactriban. Her legs were significantly swollen (tree trunk sized), especially above the knees. Her slacks had to be taken off because the swelling was too much to slide them up. Bridge happened upon the discovery that Mom has not had any Synthroid for her thyroid condition for at least 11 days, since she entered Columbia Hospital. We'll have to check on the Trinity records to determine whether or not it has been longer. The nurses are contacting Dr. Hawes and she has started her on a "ramp up dosage" - 50mg. for 5 days, 100 mg. for 5 days and then 150 mg. daily. The synthroid began Thursday. Mom saw the wound nurse, Sue, who wrote detailed notes on the dressings to be used and the antibiotics necessary. The dressings from St. Anne's included the use of an Ace bandage and Sue prefers that not be used because of the compression and the tendency for it to slide off. That was communicated in her notes.

Thursday September 14, 2006
Received a report that Mom was vomiting and her stomach was upset. Brendan and I visited after dinner. She looked as bad as I have seen her. Very lethargic, hardly able to lift a glass to her lips, shallow, quick breathing and continued extreme swelling of her legs. She was running a low grade fever (100 degrees) and had some wheezing from her lungs. The nurses tried putting her on oxygen and offered her albuterol inhaler. She ate little for dinner and had been in her room most of the day. She needed much help to get to the wheelchair and when she was taken to the bathroom to get dressed for the night, she had a bout of diarrhea. She was very weak. She was given Tylenol for the fever and Tums for the stomach upset and put to bed. She says she slept soundly. The nurses reported that her fever was still 99 degrees during the night.

Michelle the nurse manager, came in to check her over and listen to her lungs before we left. I questioned the effects of missing Synthroid for longer than 10 days and she had me and mother sign a release of records form for Trinity. When they arrive, we should know how long it really has been.

Friday September 15, 2006
Called early to check on Mom and was told she was in bed. I was put through to Georgie Rosio who is the wound care specialist at St. Anne's. She has called me 2X previously, wanting us to transfer Mom's wound care to St. Anne's rather than taking her to Columbia. I explained that we were very happy with the progess she is making with Dr. Altman and do not believe that another change of doctors is in her best interests. She is very assertive and really pushed for us to do it her way. She insisted that the Bactriban that was prescribed was very expensive ($180) and would not be covered by her Medicare, T-19 or insurance. I told her I would check with Dr. Altman and get back to her.

I spoke to Sue at the Columbia Wound Clinic and she assured me that Bactriban should be covered. She even checked with the Newport Pharmacy in the hospital and they agreed and told her that there was a generic available. She feels that even if it was called into question, it could be challenged since the Mersa has been very resistant to other antibiotics. They are prescribing the use of both the Acuzime (to help to dissolve the dead tissue) and Bactriban (antibiotic) daily with a full leg dressing of Kerlix and Coban . She had OK'd the ace bandage over the phone if it was checked and repositioned at least 2X a day.

I went to visit over the lunch hour and Mother sounded a little better. Confused about where she is. Scott had been to visit and she wasn't sure when that was. She was in bed with her legs up. Her legs are still huge but her breathing is better and she was much more alert than last night.

Stacy met me there and we spoke to Pat Rosensteter the nurse about the medication and dressings. Pat even spoke on the phone herself with Sue from Columbia ( a personal friend of hers) and with Csilla. Csilla spoke to her about the antibacterial dressing that she has been suggesting and since Family Care will pay for it, they will order that as well. Stacy stayed and met with the PT people about her treatment plan and the diabetic shoes. I will update after she emails me.