Under Pressure

My last update on Mom was a short note at the top of the June 6 post where I said she had seen a doctor about the bump on her abdomen that flared up, ruptured, oozed, and then seemed to calm down. At that time the plan was to leave it alone for now unless something happened. So let's see if anything happened . . .

June 3, 2013 (Monday): During dialysis today, about two hours after they got Mom started, a nurse came over to make some adjustments with the needles in Mom's arm for some reason and she did something that caused Mom to scream out in pain. That nurse called Rick, who is sort of a lead tech and Mom's favorite tech, to come over. He tried for awhile without success, also causing Mom some pain once or twice. Rick eventually gave up and announced that the access they were using that day was done. So she only had two hours of dialysis for that session.

When I spoke to Mom at 2:25 PM she did not sound too good. She said she had a headache that would no go away, and she was feeling a little nauseous. She said her arm was not bruised too badly from the dialysis incident, which surprised me given her description of the pain and how long they tried adjusting the needles. I suggested she check her blood pressure with her home machine. My sister Laura called me a little later and said Mom's blood pressure was 194/99, pulse 97. She is on a daily blood pressure medication (valsartan) but she is also supposed to take a clonidine tablet when the top number (systolic) is over 160. She can take one of those every six hours. So she took a clonidine tablet and planned to rest and check her blood pressure again in about an hour. At 4:15 PM her blood pressure was 186/96, pulse 90. At 5:45 PM it was 180/89, pulse 92. At 8:00 PM it was 177/88, pulse 91. So the blood pressure was heading in the right direction and she was due to take another clonidine tablet, which should help it go down some more. I talked to her shortly after 8:30 PM and she sounded much better than she did earlier in the day, with no headache and no nausea.

(Note: While writing this blog post I did a little research on blood pressure and found a site that recommended emergency care if the top number (systolic) is over 180, or if the bottom number (diastolic) is over 110.)

June 4: Mom's blood pressure this morning was 184/94, so she put a call in for her nephrologist at the dialysis clinic, Dr. N. Her blood pressure was 184/84, pulse 85 just before noon. I talked to Mom right after noon and she sounded tired. She still had not heard from Dr. N so I suggested she call his office again and give them some exact numbers on what her most recent blood pressure readings have been.

We all had a 2:00 PM funeral to attend, and Mom had a hard time staying awake during the service. After the funeral we all went to a gathering at the house of my great aunt who had passed away, and Mom seemed more or less ok there. My sisters took Mom home and I stayed behind and got a ride home with my uncle. On my way home my sisters said Mom was not doing well and was slurring her words. My sister Amy said it reminded her of the day last October when she took Mom for her last attempt at peritoneal dialysis training, right before she was hospitalized to start hemodialysis. Mom took her blood pressure when they got to her house and it was 172/77, pulse 81, which I think was the best reading since Monday afternoon. My sister Laura then called me and said she read about the side effects of clonidine, one of which is drowsiness. Mom had taken one clonidine in the morning and then another one around noon, so at that point we were comfortable that Mom's drowsiness could be attributed to the clonidine. She has dialysis tomorrow, and Dr. N should be there so if her blood pressure is still too high he can decide what needs to be done.

June 5 (Wednesday): Well, Dr. N is on vacation starting today. He was at the dialysis clinic on Monday and Tuesday, but he missed seeing Mom on Monday because her session was cut short due to the issue with the needles. I guess he was too busy getting ready for vacation to call Mom back yesterday. Anyway, they routinely check the patient's blood pressure before and after dialysis, and they were not overly alarmed about it. I do not know what the numbers were.

June 6: Mom's blood pressure was still high today. (Incidentally, she has two blood pressure machines at home and they were both giving essentially the same readings.) She called her internist, Dr. M, who wrote her a prescription for six clonidine per day (3 AM and 3 PM). So her first dose of three clonidine tablets was Thursday evening.

June 7: Dialysis went fine today. Mom told them about her blood pressure issues and her increased dosage of clonidine.

June 8 (Saturday): Mom called me at 9:40 this morning and . . . I should probably end this blog post here. It seems long enough.