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Friday, 08 May 2009

Rats in the Health Care System

So, I never got the chance to update you on what happened with my Mom and that whole Heath Care ordeal.
On Wednesday we met up with her primary care doctor. Shes a nice lady I remember her 7 years ago when I went to translate, this was before I left for college. During that age I was pretty oblivious to my Mom's actual health. I always imagined she was only taking Novolin 70/30 shots and painkillers for her legs and a single pill does of Diabetes meds (all of which was true)

It was only December of last year when I went to the pharmacy to pick up my Mom's courtesy refills when my entire world fell apart. Holding at least 14 baggies in my hand I cried for the pharmacist, "All these???? For how long"

There was a shrug on his face, and he later told me to do the right thing and consult with a doctor.

So here is the list, and I am not afraid to show you, nor do I think I am breaking any laws by disclosing this

• Hydrocodone - 500 mg | As needed
• Naprosyn - 500 mg | As needed
• Glipizide - 10 mg | twice a day before meals
• Metformin 1,000 mg | twice a day before meals
• Lantus Insulin - 70 units subcutaneously daily
• Novolin R 100 unit (5 units before dinner)
• Ditropan XL - 10mg | once a day
• Levothyroxine - 75 mcg | once a day
• Lisinopril - 20 mg | once a day
• Simvastatin - 40 mg once a day before bed
• Trazodon - 50 mg 3 times a day after meals.
• Albuterol Sulfate HFA - 90 mcg inhaler
• Patanol 0.1% eye drops
• Claritin 10mg

Its been 2 months since we saw urgent care for her some symptoms that were acting up. We were seen by a secondary doctor (whom obviusly, didn't really want to serve us because she refuse to prescribe my mother allergy medication) that day and took some labs. The results are below.

• HGBA1C 11.5 %

The Hgb A1C or Hemoglobin A1c is an estimate of your average blood sugars over 3 months. Blood sugars that are higher than normal can cause damage to the eyes, the kidneys and the nerves. The ADA recommends that you maintain an A1C value less than 7.0 or as close to 6.0 as possible (without severe low blood sugars) to reduce the damage to the eyes, kidneys, and nerves.

• Recent test results: 10.00 in 04/26/07 | 10.03 in 11/14/06
• her lipid panel: LDLC - 80mg | TRIG - 608 | HDL - 30

ADA recommends keeping LDL less than 100 mg/dl or optimally less than 70 mg/dl, Triglycerides less than 150 mg/dl and HDL more than 40 mg/dl to prevent heat attacks, stroke, circulation problems and amputations.

• BP readings 112/67 | Pulse 93 | Resp 15

~So, WOW ~right?
If we get lucky and we can reduce to blood sugars to a 230 (instead of a 274 which is where it is at now) the only medications we can take off are Glipizide which is a diabetes medication that has very little effect on her at this point. Diagnosis that day were Allergic Rhinitis, cause unspecified, DM w/o Complication Type 2 (no idea...) Unspecified Hypothyroidism, Tinnitis, Pain in joint, multiple sites.

That was on Wed....

Yesterday I was also at the hospital with her this time to see her retinopathy Doctor who performed Laser on her eyes for bleeding/blood vessel blockage within the retina's in both eyes in 2005.

We were hoping to seek good news but as it turns out, my mother has a new hemorrhaging in her right eyes and fluid build up in her left. In June we will be doing a Flourescein angiography and if needed focal macular laser for PDR (Proliferative Diabetic Retinopathy).

~As soon as we were done, my mom is in a minor discomfort from her eyes being dialated. Because of that she was having one of those cursing storms. And I'm under a ton of stress from this: "my time with Hope", as well as having a baby brother with his own health issues. We are all treading on thin waters here, and the only thing that made me laugh was hearing the joking voice of my XC's teasing about all these health related issues, "you are allergic to the world aren't you?" brings only one smile to my face.

"I just didn't like the fact that they had all those computers on! I swear what are they trying to prove by recording us or anything?" My mom said, her voice in so much pain, masking over her own hurt ego.

Technically I didn't think they were recording us...They would have told me so, out of courtesy. And well, during my ongoing health related issues I can understand her. She saw 3 specialists and 4 assistants today, shes tired from being pricked and prodded. And well I feel her. I am too.

"Mom, you know they are doing what they can. You know this is a manageable disease, its not curable, you can't wave a magic wand....and Ma? You honestly haven't done such a great job either you know?" I said. Necessarily it wasn't entirely her fault for that, English is a hard language to learn if you've never ever went to school on your home country. But too many times, my mom makes a lot of excuses....and she doesn't tell the doctors...so the Doctor's doesn't side with her or on her behalf. Which sucks for her because my Mom has an incredible doctor for at least 10 years how. Mind you she may be busy ALL the TIME...but shes great. Why? because she hears you out.

"I don't see a point (not entirely sure if that was a sarcastic joke)" she says walking slowly.

**flashes to a moment in the Primary Care doctor's office**
And that day I had to explain, "You know...she refuses to check her blood sugars because the needles just hurt."

"OH well we got this new machine that checks on the wrist, so it eases the pain from being pricked in the fingers, you should have told me...I would of gave you that one!" she says, shes always got this cheery voice. And she always gives people chances (I can tell).
**Flash ends**

I then told my Mom, "You have a disease, that the entire world is still researching on. It was make life a whole lot better for you and everyone is you really said what was on your mind, and what you don't like, instead of always listing symptoms. Also...you should follow the prescribe directions once in a while....MA...this bring results you know...there are some results you can't hid from (referencing the HGBH1C)"

And I should have known this was coming, "What am I a Rat?" she commandingly asks.

"Ma, don't you think that if you make progress, this will save others?" I say.

"Save who, now who's gonna save me?" she says, a thought raised in my mind, 'You can save yourself, you know?'

"Mom, since I was in the womb, you've had diabetes, that leaves Hieu and Me at a 90% chance of having this (if we haven't already). You don't think this would save our lives? --The pain --The Sacrifice -- The Hurt? I said. And to that, the rest of the car ride home was quiet.

Here's My 2-5 Cents on this...

1. I understand her, its been a long battle, a hard battle, but shes at the last stage of this disease.
2. There are no more meds to give, its all diet and control now(that's hows its always been).
3. I just want her to put her Ego back into that Box of Eggo Waffles (thanks Amanda <3)
4. We're all Lab Mouse/Mice when it comes to these things. But for the sake of Medicine sometimes we have to make that strive, not just for US, ~you know?
5. If there was any proper way to fight genetics or anything else, I pray for the day that this is a resolved and controlled issue, especially for Type 2 patients.

Life tears you down, causes boils in the veins of your blood. So many times, we take fore granted of the people trying to save us. I know I HAVE. I ran across the borderlines of my sanity praying for the dim lights to be turned on bright. Running through the endless tunnels of "What if's" and "Let's Try" and you know...when it all comes down to it, every effort helps, even if its just a test.

These things I know I've realized a while ago, but fail to admit, because admitting it would be a blow to the Ego. And "Pride" can't be shut off. Self-fish acts of protecting a dignity can only go so far. Its easy for someone to say "be responsible for your health" But are we ever? And How do we?

I applaud the efforts of UC Davis Medical Center and all their research groups for their efforts, even if they are unpleasant at times.

------------
This long post is directly related to me, my thoughts on this and my reminder to myself to keep striving even IF they don't know whats wrong with my brain...
If you can relate to this, just know, "I don't know exactly what you are going through, but I understand ~which is the best I can do"
--If I offended animal rights activists or scientist, by referring to Lab Mouse/Mice as Rats, its only because in Conversational Vietnamese, it honestly sounds better to speak the word "Rat" rather than "Mouse/Mice", My apologies are dully noted.

IF have any relation to Diabetes in your life, what I have provided at the top of the post are her labs tests and After-Doctor-Visit Summary reports on diagnosis.
I hope it helps anyone relating to this issue.

---Heads up, not because this is related to my Attention-Whoring issue, I want you to know I will Time Stamp this every morning all weekend.
Because...well...~when I have a good reason, I'll let you know...
Til then, Happy Blogging.