Saturday, September 19, 2009

What is Wrong With People?!

Okay, so that's a rhetorical question, in case you haven't guessed. I told a dear friend of mine, "This is why I need Timmy!" Another friend referred to the baby as my "balance."

Tuesday, I got Timmy down for a nap, and my phone rang - Mam-ma Polly. She sounded AWFUL and said, "The nurse just left to go get me some pain medicine... this Ibuprofen is not doing enough." I asked what nurse... and she said Home Health. I asked WHAT medicine, and she said, "Darvocet." I then reminded her that about a month ago, Dr. B said "No more Darvocet," and I removed it from her house - so who prescribed this? She didn't know... but the nurse was headed to the pharmacy. So I called the drugstore, and the clerk asked the pharmacist, and he said, "That prescription has been sitting here for 5 days."

Meanwhile, the nurse arrived at the pharmacy (the clerk said "I think she's standing here at the counter.") and I explained that my grandmother wasn't supposed to have Darvocet, and this was all news to me, and I needed to talk to Dr. B. So the pharmacy people told the nurse there was nothing to pick up, and if there was something later, I would get it. The pharmacy clerk also told me that Calamine lotion had been ordered. I told her I had a bottle of Caladryl in my purse already to take to Mam-ma, and she said, "Well, you certainly don't need the Calamine, then... I'll tell the nurse there is nothing to pick up."

So... I called the clinic, and I talked to the receptionist, who happens to be the doctor's wife. That was before 2:30 p.m. She looked at Mam-ma's chart and said, "Last Thursday, the Home Health nurse called and reported you had had Polly to the ER on Wednesday and she was disoriented and vomiting. She is not disoriented today, but she is in pain. The doctor personally called in a prescription for Darvocet."

Nobody ever let me know about it - and nobody picked it up. I also told the doctor's wife that Polly was INDEED disoriented on Thursday, which is why my sister spent the night with her. So I don't know what story Mam-ma gave the nurse or how she acted. The doctor's wife acted very sympathetic and understood Mam-ma could not take Darvocet with Ativan, and she said she would talk to the doctor herself and call me back. No one ever called back, so at 5:00, I called the clinic again and was put through to a nurse. She said, "Well, we told the doctor you called, and I guess we assumed you were just wanting us to know you weren't going to pick up the Darvocet." I told her no... that the doctor's wife had said she would talk to him and call me back. The nurse started in about how Darvocet was the ONLY thing that would cut the pain of shingles, and "I can tell you, if she has shingles, she is in pain."

I told her I was really upset that Dr. B told us recently she was NOT to take Darvocet, and then last week he called in a prescription for it... and on top of that, nobody told me! So if she made it all weekend without the Darvocet, how bad did she really need it? The nurse repeated for the umpteenth time "All I can tell you is if she has shingles, she is in pain, and Ibuprofen won't cut it... she needs Darvocet." So finally I asked if there was anything in between Ibuprofen and Darvocet, and she said, "Motrin is not going to cut the pain." I reminded the nurse that my grandmother takes Ativan, and Darvocet and old people doesn't go well (much less with Ativan), and we couldn't risk a fall, and she said, "Okay, let me ask you this... do you live in town?" I told her yes, and that Mam-ma lives in town, but we don't live together. She said, "Well, why couldn't you go stay with her for a week or so while she takes the Darvocet?" I told her, "You just don't understand... there are extenuating circumstances, and no, I can't go stay and neither can anyone else. Besides, she doesn't want us there." The nurse said, "Well, then, couldn't you bring her to your house?" I told her again, that no, there were extenuating circumstances, like I live in a 2-story house (not to mention that I keep a 4-month-old baby that can't be exposed to shingles!). She said, "Believe me, I understand, but you have two choices - she can take the Darvocet or be in pain."

Finally I told her I would talk to Mam-ma and if we needed the Darvocet, I'd go get it. I called my mom, who had just gotten home from a trip to Branson, and we talked it over, and we agreed that Mam-ma's body is under stress from the pain, so I should go get the Darvocet. I did, and get this - her Medicare Part D wouldn't cover it, because Darvocet is not authorized by Medicare for coverage for anyone over age 64! So I paid the $13.80, and the girls in the pharmacy told me how shingles REALLY DOES hurt, but they were nervous about the Darvocet... although one of them pointed out it was Darvocet N100 and "very mild." Yeah, whatever... it's still Darvocet!

So I get to Mam-ma's with the Darvocet, and she says, "Well, I'm not takin' that!" So... tell me... why did I get it?*lol* I explained that her insurance would not authorize payment since she is 97, and she said, "I've never taken a whole one - if I get desperate, I might take a half, but I'm taking Ibuprofen every 3 hours instead of 4 and doing just fine." So what was the deal at 2:00, I wonder? I put Caladryl on her shingles and left. Her shingles have broken open and even scabbed over some, so they are moving right along.

So I went to Mom's to tell her this, and she asked me again if I thought Mam-ma could take TWO Ibuprofen at a time. I called my sister-in-law (who is a pharmacist) and asked her, and she said yes - every 4-5 hours, but not every 3. I told Mam-ma that, and she said she would do this if she needed them. I know her BP is up and this is hard on her heart to hurt, but I pointed out to the nurse that we didn't have that Darvocet all weekend because I didn't even know it was at the drugstore, and she made it just fine without it, and the nurse said, "Well, I can guarantee you, if all she had was Ibuprofen, she was hurting." In other words, we are all big heels for being so mean to Mam-ma! I don't think so!

So... Mam-ma has the Darvocets, but so far she has not taken any. My sister-in-law agreed that if Mam-ma isn't remembering to take Ibuprofen every 4 hours, she can't be hurting THAT much... not enough to need Darvocet. AND... she said there are 400, 600, and 800mg prescription strengths of Ibuprofen... so there IS something besides Darvocet! I'm still upset with Dr. B for not paying closer attention to this - and it bothers me that the Home Health nurses can go get medicine for Mam-ma without me knowing about it. Funny they can do that, but they can't take her to the clinic for a dr.'s appointment!

Wednesday, Mam-ma said she took 2 Ibuprofen the night before at bedtime and got a really good night's rest. Wednesday, she only took 1 tablet at a time, but said she would take 2 again at bedtime. However, she said her legs were wobbly - and she blamed it on the 2 Ibuprofen (more likely it was the whole Ativan tablet she took during the day on Tuesday after a half tablet the night before!). I said, "Imagine if you took the Darvocet!" She said, "Now that Darvocet doesn't bother me... and I only take a half a tablet..." But she assured me she would NOT take it.

It is so frustrating dealing with doctors. And I did not need a lecture from that nurse. I think it was a CYA thing, but nonetheless, I was not a happy camper. It just blows my mind the messes doctors can create... and I feel like Dr. B is avoiding me and giving me the runaround... and clearly he is not paying attention. But trying to change doctors at this late stage would be an ordeal, too... and I am not sure it would make any difference. I should have changed Mam-ma to my doctor years ago, and I can't remember for sure why I didn't, but I think she and Mom were not on board with it. Maybe my doctor didn't do rounds at our preferred nursing home. Such complications! Oh, well... If I am sort of on top of this and this much chaos occurs, can you imagine what happens with little old people who have no advocate? Sheesh!

Meanwhile, I did get my grandmother to the beauty shop yesterday, and she had made a grocery list... milk, buttermilk, orange juice, a big bag of Three Musketeers bars, corn meal, apples, and Cokes! I was surprised her Chips Ahoy Chewy Chocolate Chip Cookies were not on the list... hopefully she still has a stash! I dispensed her medicine for the next 2 weeks and noticed that it doesn't appear she has taken the doses correctly for the last week, but I'm not totally surprised by that. Anyway, she told me, "Before you leave, you can doctor my places again." So I donned a glove and applied a layer of Caladryl. And the shingles look amazingly better than even 3 days earlier. The red welts are gone, and all that is left is a little patch of scabbed places.

I asked Mam-ma if she was taking her Ibuprofen, and she said no - that she had not needed any all day! She said she was going to take some at bedtime, along with a whole Ativan. I questioned this, and she said, "Well maybe I will take a half a tablet, and if I wake up in the night and can't sleep, I'll get up and take the other half." My thought was, if you have to wake up in order to know you need another, do you really need it? Oh, well... she will do what she will do - even with us standing right over her - so I left her to her own devices. Hopefully she truly is on the mend, and things will start to look up from here. All I can do is try to keep tabs on her medication and pray that nobody does another "end-around" that results in a fall.

1 comment:

Mark said...

What an ordeal. Maybe the most painful part of her shingles is over. Kind of sounds like it. 97. Just amazing.