OK, my grandma has had sick sinus syndrome for a long time, had a pacer placed about 5 years ago. Last week, she went into a fib, and stayed in it. Her cardiologist, whom I love, put her on coumadin. I'm in agreement w that. So, what's the problem? Grandma is freaking out b/c she does not understand the directions for the medication change in response to the labs.
She was soooooo anxious, I had to make her take a xanax on her first day home. I filled up a seven day mediplanner for her, and put in the alternate day coumadin doses, etc... She must have called me 3 times every day since to question how I put the medicine in? I found out why, b/c she didn't think I did it right, so she took it all out, and totally screwed up her doses!!!
Last INR was 3.9, so doc said to hold x 3 days, then take 2.5 mg Sat and Sun, lab on Monday. I told her 3 x thursday, 2 x Friday, and 2 x Saturday we were going for lab work on Monday. I called her this am, and said, are you ready to go to the lab? Today? She says.
I even wrote this down so she would remember. I asked her how she took her meds, and she said one pink one last night. I said, you are only supposed to take half a pink one (half of a 5 mg coumadin), so she says Oh yeah, that's what I did. Huh??? That was how I poured it in her mediplanner. She kept calling me and I kept saying, grandmom, I don't remember what white pill is which, please just take them from your box the way I put them in there. But apparently, she doesn't trust me. She never has. It is a cultural thing.
I have been trying to get her to see my primary doctor for 2 years. She has only been seeing a cardiologist, b/c she refused. Her other doctor was a crook you know. So, I made about 3 appointments and she cancelled every one. Fortunately, my doc is a very patient man, and agreed to try again. My grandmother says, well, I talked to a few of my friends (yes, please take their advice over mine, I am only a nurse) and they really like this doctor, so I think I want to go to him. I made the appointment, wrote it on her calender, and on a paper for her. She has called me four times to ask when the appointment is. No, she is not going senile, she is as sharp as a tack, this is how she gets when she is anxious. She refuses to take the paxil.
Today, I told her, I am not going to pour her pills for her (she doesn't take them anyway the way I put them in there, with her input I might add,) and I asked the doc to call her w the change in coumadin. I also asked them to call me, so I can be sure she understood the directions. I don't know what to do with her. I am rapidly losing my patience!!! And believe me, I am a really super patient person, but when she gets herself all worked up like this, there is no reasoning w her, everyone is against her, poor her, no one wants to help, her...
God, please give me strength!!!
Well, not sure what I wanted from anyone, just needed to vent. Thanks for listening!
Jul 1, '02
I don't get why we can be so great as far as our families are concerned--- and then one of them
gets sick. Suddenly, we alone
are expected to "make" them get better (no input or cooperation from them; medicine is still voodoo to their generation); perfect English is gibberish (we're secretly trying to cleverly "lock them away and throw away the key"and they still have enough brains to stop that trick, by golly!), and the mystique of the practice of medicine suddenly takes on enormous proportions --"oh no, honey, I can 't call the DOCTOR over how much atenolol to take; he's busy" while I'm only 1500 miles away and have to pull answers out like they were diamonds in a bank heist!
I hear ya!
My 86-yo relative "cut down on" her atenolol, coumadin, and zocor rather than call the doc about her "A-trib" problem a few months ago, for instance. I could no more accurately tell her doc what she's taking than I can determine the numeric equivalent of pi
I can only step back a little and add to my arsenal of knowledge-- a lot of elders are probably doing the exact same dance.
(My mom for instance: her back itched. Dad, a tad myopic himself, scratched it. This went on for about 3 days before she noticed a generalized rash over her entire body and --gee whiz! her face was kinda swollen too
-- oh by the way, she'd been taking Bactrim. They send her to the ER as a direct admit and give her some Benadryl. I call to talk to her in her room about 8 hours later, and she says, "Hold on a sec, okay?" and she comes back to the phone. Knowing her as I do, I said, "What did you do, Mom?" and she says (garbled because her face was so swollen by now she looked like a freak), "Well, I just felt so itchy, and I don't wanna bother the nurse, so I had a couple of Benadryl in my purse, so I took one."
My response? I chatted her up til her nurse came into the room, and ratted her out.
Oh, of course, she had already had one IV dose in the ER and another when she got to the floor.
Ok, so that was about a year ago...
Last edit by Sleepyeyes on Jul 1, '02