I'm really pissed off. In general, that's not my natural state these days. I'm pleasantly mellow. Most people don't even recognize me. But what's with the whole "I'm a specialist, I won't talk to another specialist who treats your mother" schtick? Doctors of the universe: this ain't winning you friend among the foilfriendly. Call other doctors who treat your patient. Talk to them. Come up with a plan of attack on ailments that is coordinated. Don't make your elderly patient or her increasingly annoyed daughter run interference for you, communicate for you, and do your fucking job. If your treatment, for example, gives my mother other ailments own up, man up, and work on fixing those other ailments as well as the original ailment that treatment of which caused the secondary ailments.
Specifically: Hematologists, you know that Hydroxyurea is used to treat essential thrombocytosis and other ailments involving excessive platelet prodcutions. You also know (since it's all over the Internet as a side effect) that long-term Hydroxyurea use can cause unhealable skin ulcers, especially on the ankle (which hurt like a sonofabitch). Unhealable skin ulcers are not a good thing. So get on the fucking phone with the wound care specialists and come up with a workable plan of treatment for painful skin ulcers. Thank you.
February 29, 2012
February 25, 2012
The Year There Was No Winter
Okay, I know those of you in the antipodes are at the end of summer, but here, it's winter, and for the last few years we have had boatloads o' snow. This year, nothing. There's still a chance, of course, but it's increasingly unlikely that the capital area will have a significant snowfall with March just a few days away. And that's just fine.
But right now I'm up in Maine, checking up on an ailing Foilmormor, and there's no snow here either. That's just wrong. Wrong, wrong, wrong.
Now, I wasn't going to get to ski anyway, because Foilmormor's ailment is as follows: for the last six years Foilmormor has had a blood disorder that causes her to produce too many platelets. It's either polycythimia vera or essential thrombocytosis (who makes up these names? The department of incomprehensible disease nomenclature?) for which she has been taking hydroxyurea and been doing fine until this fall. And by fine, I mean, swimming in the ocean in Maine, swimming 100 laps a day (okay, the pool is small, but still) in the condo pool, walking 2-5 miles a few times a week, biking 10-20 miles on bike trails twice a week or so, visiting children and grandchildren, and generally keeping busy. The only sign of her age (75) has been excessive writing letters to the editors of publications with which she disagrees. However, this fall, Foilmormor got a wound on her ankle which would not heal. It swelled up. It showed the ankle bone. It was painful. It was gross. It wouldn't heal.
Finally, after several rounds with antibiotics, Foilmormor went to the wound care clinic at Mercy Hospital in Portland and the wound care doctor, upon hearing that my mom took hydroxyurea for her excess of platelets, told her that the wound was an ulcer caused by the hydroxyurea. After stopping that medicine, the ulcer started to heal, but this last month Foilmormor's hematologist told her that her platelet counts were just too darn high and she went on another medicine, but that medicine didn't work. Her platelet count is now about 1200 (400 is the top range of normal). She has started back on the hydroxyurea and says she can feel the prickling sensation which means that the ulcer is coming back.
Why not just remove the platelets via apheresis? I mean, living with open sores is no fun. The Red Cross takes my platelets every 2-4 weeks and gives them to people with myelofibrosis (what the Second Mate died of). Since Foilmormor has a blood disease, I'll understand if they toss her platelets, but since she has too many and you can remove them by apheresis, why not do that rather than give her a medicine that gives her open wounds, huh?
Does anyone have any experience with this? Anyway, Foilmormor can't wear shoes or boots now because they aggravate the ankle, so she just wears clogs. Fortunately, she lives in Maine where lots of people wear clogs (looks a bit hippy, but that's ok). Today, we went for a walk and Foilmormor apologizes for moving slowly, etc. My ailing 75-year old mother with a wound on her leg still managed a 1.5 to 2 mile walk over off-road trails in the woods. I was the one walking more carefully, since the last few times I've slipped and fallen I have dislocated my shoulder (left). Maybe it's the left side of our bodies' that's weak?
My ailing 75-year old mother could only walk 2 miles (actually, she could have gone farther, we just got to the end of the trail and were hungry and wanted lunch) and now she's napping. I do want that wound healed, but she's not at death's door yet.
But right now I'm up in Maine, checking up on an ailing Foilmormor, and there's no snow here either. That's just wrong. Wrong, wrong, wrong.
Now, I wasn't going to get to ski anyway, because Foilmormor's ailment is as follows: for the last six years Foilmormor has had a blood disorder that causes her to produce too many platelets. It's either polycythimia vera or essential thrombocytosis (who makes up these names? The department of incomprehensible disease nomenclature?) for which she has been taking hydroxyurea and been doing fine until this fall. And by fine, I mean, swimming in the ocean in Maine, swimming 100 laps a day (okay, the pool is small, but still) in the condo pool, walking 2-5 miles a few times a week, biking 10-20 miles on bike trails twice a week or so, visiting children and grandchildren, and generally keeping busy. The only sign of her age (75) has been excessive writing letters to the editors of publications with which she disagrees. However, this fall, Foilmormor got a wound on her ankle which would not heal. It swelled up. It showed the ankle bone. It was painful. It was gross. It wouldn't heal.
Finally, after several rounds with antibiotics, Foilmormor went to the wound care clinic at Mercy Hospital in Portland and the wound care doctor, upon hearing that my mom took hydroxyurea for her excess of platelets, told her that the wound was an ulcer caused by the hydroxyurea. After stopping that medicine, the ulcer started to heal, but this last month Foilmormor's hematologist told her that her platelet counts were just too darn high and she went on another medicine, but that medicine didn't work. Her platelet count is now about 1200 (400 is the top range of normal). She has started back on the hydroxyurea and says she can feel the prickling sensation which means that the ulcer is coming back.
Why not just remove the platelets via apheresis? I mean, living with open sores is no fun. The Red Cross takes my platelets every 2-4 weeks and gives them to people with myelofibrosis (what the Second Mate died of). Since Foilmormor has a blood disease, I'll understand if they toss her platelets, but since she has too many and you can remove them by apheresis, why not do that rather than give her a medicine that gives her open wounds, huh?
Does anyone have any experience with this? Anyway, Foilmormor can't wear shoes or boots now because they aggravate the ankle, so she just wears clogs. Fortunately, she lives in Maine where lots of people wear clogs (looks a bit hippy, but that's ok). Today, we went for a walk and Foilmormor apologizes for moving slowly, etc. My ailing 75-year old mother with a wound on her leg still managed a 1.5 to 2 mile walk over off-road trails in the woods. I was the one walking more carefully, since the last few times I've slipped and fallen I have dislocated my shoulder (left). Maybe it's the left side of our bodies' that's weak?
My ailing 75-year old mother could only walk 2 miles (actually, she could have gone farther, we just got to the end of the trail and were hungry and wanted lunch) and now she's napping. I do want that wound healed, but she's not at death's door yet.
Subscribe to:
Posts (Atom)
Posts
