It took an hour and ten minutes to drive from mom's house in Rocky Point to Dr. Kim's office in Medford. Two hours and twenty minutes of drive time for a half-hour appointment! I'd better not think like that...time efficiency is not the goal here! Beautiful scenery on our way over the mountain!
We left the house at 9:45am, and while we were driving mom had a spell at 10:05, and another at 10:08, and another at 10:18. I was keeping track of the times so I would remember to write those down on her log for the Holter monitor. After the 10:18 spell, mom commented that it was a strong one, and almost immediately she became nauseated and got out a plastic bag and began vomiting. (This time she was prepared with extra plastic bags since she had vomited last Friday on our way into town.)
We got to Dr. Kim's office and checked in, and only had to wait a few minutes before they called her. In the exam room, the nurse weighed her (111 pounds), and then took her blood pressure (108/54...low). A minute after the nurse removed the blood pressure cuff, mom asked for an emesis basin and no sooner had the nurse gotten one for her than she began vomiting again.
Dr. Kim came in and chatted with us. He didn't have the blood test results from last Friday and it almost seemed like he wasn't going to get them, so I asked if he would mind having his assistant get them from KFalls. A little while later she came back with a form that mom had to fill out to allow KF to send her records to Dr. Kim. Then a little later again, the assistant came back with her blood work. Dr. Kim said everything looked more or less normal ("for her" he emphasized, not really normal but not out of bounds for mom) except that her creatinine was elevated (that's the one that tells how the kidneys are doing). He said that mom's typical creatinine over the past year was usually around 1.5 - 1.6. When she went into the ER last month it had spiked to 2.19. Friday's blood work showed it at 1.9, still elevated but not in the "kidney failure" category.
I told him all about the spells and he thinks they are caused by low blood pressure. He described it as "almost like fainting." Dr. Kim said that when the kidneys are not working well, they are not able to excrete potassium, and excess potassium in the body causes the heart rate to slow down. I asked if excess potassium could cause nausea and he replied that kidney failure can cause nausea.
Mom said that she just wants to KNOW for sure what is causing these spells, and that once she knows for sure she has no problem accepting it. Dr. Kim replied in a very quiet gentle voice "heart failure." He said mom's primary problem is the heart, and that meds "can only try to support" the heart. He deferred to Dr. Kubac, since he's the cardiologist, but Dr. Kim was gently giving the message that mom needs to accept the fact that her heart is failing.
Dr. Kim then went through the standard list of questions: how's your diet, are you still taking x medicine, how's your colitis, are you still using Natural Grecian patch...HUH??? Natural Grecian patch??? Turns out that's how you pronounce "nitroglycerin" with a Korean accent.
We left Dr. Kim's and headed to Costco, where of course there were NO handicapped parking places, so mom had to walk quite a ways. When we got inside she made a beeline for the wheelchairs and collapsed into one with a big sigh of relief. Then we invented our own "motorized" handicapped cart: mom sat in the wheelchair behind a regular cart, holding on with both arms, while I pulled the cart from the front. We had our own train, and it worked fine!! I pulled her all through the store and she collected whatever she wanted. We checked out and I pulled her across the parking lot to the car, packed mom and the groceries into the car, then delivered both the cart and the wheelchair back to the store.
Next stop was the Army Surplus store on Crater Lake Highway, where she wanted to get a new American flag to replace her old tattered one. She found such a good deal that she bought TWO and told me that she got both of them for less than some place in KFalls charges for one.
We got home about 2pm and I carried all the groceries down to the kitchen, because she wanted to sort things and re-pack some things into single servings. I left her to her sorting and went up to join my conference call. When it was over at 3pm I came back downstairs and she was still puttering, but she said she was about to take a nap. I added the info about this morning's spells to the tracking sheet for the Holter monitor, and included the fact that she had a BP of 108/54 and then immediately became nauseated and vomited. Then Fritz and I headed into KF to take the Holter monitor back to Kubac's office so they could download the heart data prior to her appt on Friday.
We got back to RP about 5:30pm, and she had already taken the stuff downstairs to the freezer, and she said that she even did some sorting of the freezer "so I can actually find things again!" She had built a fire and was puttering around preparing dinner. I think she is right that she does better when she's moving around. She says she never has spells when she is actively moving.
Tomorrow is actually a "day off." No doctor appointments, no reason to go into town. I have a 2-hour conf call, and a ton of work to catch up on. Oh yeah, and three cords of wood to stack! When we got back from Medford, we discovered that Carl had apparently been here, because there is now a big pile of firewood at the front of mom's parking area.
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