INSOMNIACS place to talk in the wee hours

Nettie1964

What next, woke up this morning with no back pain, but now my bc boob is itching like crazy and it's an itch that I can't seem to scratch!!  It's driving me nuts!!  I think I'm going insane!

Holeinone

Nettie, 

Benedrayl, worth a try....

sas-schatzi

3rd Littlegoats gave you such great advice. You can do this GIRL You're almost done. In regard to the memory thing, we pretend allot LOL. Also, you have been assaulted mentally and physically since this started. PTSD is a huge problem with all the shit we are subjected too. Check with your cancer center to see if they have a counselor. Counseling is a gift you give to yourself. 

Blessings WAVING

Blondie, you sound better. Sorry all the awful stuff is happening

Enerva thanks for posting the bluebird pic. Kristine loved bluebirds so much, if you didn't catch that the name of her home was Bluebird Farm.

2TA, sorry Mom is having such a bad time. Sorry that you and Dad have to see it. It's very hard to explain, but an alternate explanation for her in the unit she's in, could be that the policy is to let the patients do what they want as long  they don't hurt themselves or others. Alzhiemers takes the patient in the reverse order of mental growth. She's in the toddler phase. Think about trying to get a toddler to do anything they don't want too. Mom had clothes on wrong, but she may have done this herself or insisted on as the staff was dressing her. It's not an unusual behavior in the late stages.Some late stagers, it's very difficult to keep clothes on them at all. Sitting on the floor is a common behavior. Again, as long as a it's not the result of a fall and they are happy let them be. In regard to the head wound. Yes they should have notified you right away. 

The public assumes it is b/c of neglect. She's in an end stage unit. The goal in an end stage unit. is to have them mobile and minimally drugged. Take a closer look at the environment, it's set up like a toddlers room. Beds on the floor, next to the beds. Foods are chosen to reduce choking risk. Silverware is plastic to prevent injury. Doors are locked and monitoring bracelets are used.

In a previous unenlightened time, patients were drugged into oblivion and restrained with wrist, vest, and leg restraints. Sure it was easy on the staff and families. The risks of problems  reduced. BUT it wasn't humane. The problem with the concept is how do we protect from all harm. Accidents happen in milliseconds. Use of protective equipment like a helmet could be considered. Even protective equipment as a skateboarder wears is appropriately of value with some. BUT with the alzhiemers or dementia patients keeping anything on them is difficult.

As far as incontinence, again when you find a patient in a soiled diaper the assumption by the public is that the staff isn't doing their job. The staff may have just changed a diaper a few minutes before a family member found them in a soiled diaper. There are things you can ask 1. what is the policy about how frequently are the diapers checked. A reasonable policy is 1-2 times an hour. This is done more frequently if the patient has diarrhea. 2. there are signs that a patient has not been changed in an overlong period. The sheets that haven't been changed that have old urine on them, will have multiple brown edges. The diaper is very very soaked and heavy.This indicates that there was repeated urinating without changing. Stool may be dry and caked. I have been involved with getting people disciplined or fired b/c these signs were present. 3. Diaper rash can be b/c of improper care, but is not absolutely b/c of improper care. Ask what the usual skin care routine is. There should be a written policy. Each patient should have their own skin protectant creams/ointments at their locked bedside cupboard to prevent cross-contamination.

All hospitals and tertiary facilities(nursing homes) are under government or accrediting inspection rules, if you feel the care is substandard ask to see the inspection reports. Complaints to the accrediting agency can be made. They are required to have the 800 number posted. This is also discussed at admission.

I've said for decades whomever invents the bubble will be a millionaire. With inflation I suppose it's a billionaire.

There is nothing harder then taking care of a patient that has an altered mental status in any setting. Nothing.

sas-schatzi

Nettie- see your doc

Nettie1964

Have appointment next week!  Wouldn't get in any faster if I called!  So, I'll wait til then!

sas-schatzi

2TA and all--For decades, I used to routinely teach families to do a "Head toToe" exam at each visit inclusive of the butt and vulva.  This identifies how intact the skin is, if there are any problems starting like diaper rash etc. Something like simple dry skin of the limbs can be addressed by asking for lotion to be applied. Reviewing elimination record and dietary/ fluid record. I wrote something similar to this before. It can be done. 

Don't forget to check the feet well. Fingernail and toenail care is not good. There are rules that they can't clip them. See how you can work out what needs to be done. Usually they tell families they can do it. With the feet, if you can get her to put her feet in a soaking basin and then rub in lotion, that would be very good. If a patient can have Manis/Pedis done that's great. Generally, all NH's will have a podiatrist come for foot care that can be signed up for once a month. May need the NH doc's order for this to get insurance to cover it. Usually not a problem to get this order.

When I have had the responsibility of the care of family this is exactly what I have done. It shouldn't make the staff uncooperative or hostile, but if they don't like it tough. There was a landmark study published around 2009-2010, supporting my approach  Study conclusion: patients that have an involved family member(s) or advocate live longer.

tangandchris

Oh man, I hadn't even considered the lymphodema thing!! I don't have compression garments and don't have the money to get one right now. I think I need to just not hold off on this trip for now...too much stuff happening.

Sass-just wanted to say how wonderful it is how you take time to answer people in such a thourogh way. I know I'm spelling that wrong lol

((hugs))

gardengumby

Hi Nettie - first Happy Birthday - sorry I missed the actual day, but it does sound like you had a great one.  About the itching boob thing, that happens with me on occasion.  when I asked about it my doctor said it was my nerves trying to "find" new routes.  It still happens once in awhile for me, not often.  Please let me know if that's what your doc says too - it's always nice to hear something from more than one source.  I had a DIEP recon following mastectomy, so don't know if we had the same kind of procedure....  

tangandchris

Oh crap...Nettie I keep meaning to say Happy Birthday!! So here goes............HAPPY BIRTHDAY!!!

luvmygoats

Tang - HI1 bring up a good point about LE. That might be more important that doc note, job improvement etc. I would seriously get on the LE thread if you decide to go and ask. That's a whole lotta nodes and LE you don't want at your age. Better when you do fly you are well prepared with sleeve etc.

Nettie - It wounds like a wonderful birthday and those earrings will be beautiful on you with your coloring. My boob variously itches - inside/outside, aches, peels (again for how many times). I'm a bad girl and don't wear a bra (42C) which I know would help ache. The others I accept. It had the electric zingers too but I was on Celebrex then Mobic last summer. That helped those not the shoulder so much. Zingers back some but not as bad. I just think our bodies have no clue what we have done to them so they rebel in multitudes of ways. Plus nerves from other parts of the body can "refer" pain/sensation. Ever scratch your tummy and feel it in your shoulder? Maybe try some soothing cooling lotion or cooling powder underneath. Might fool sensation enough to get it to quit. How about a cool quick shower? Just the step in wet down type.

Blessings - great news you have a brain and it is all your's and normal. How is the processing going? I'm with whoever wrote yesterday that we hope you are continuing to rest, not clean, not clean out other people's homes, not cook. Rest.

Sassy - I think HI1 meant the antibiotic infusion came out of the port, not the whole PICC line came out. PICCs are a special breed, aren't they. HI1 - this is going to wound whacky. Did they give you the tips that clamp onto the PICC line port - kind like how you put on a clothespin? Sassy can probably supply a better name. I can't seem to find a picture.

2TA - skin care is a science and sometimes it's a seat of the pants kinda instinct. What works on some behinds doesn't on others. Sometimes the caregiver uses so much force to wash off the skin protectant that harms the skin more. Your geriatric spec. may have his favorite.

Nettie1964

 

this is how I feel most days, but since I have to work, it is not an option!  Not sure if I've ever mentioned this here, but at one point during my rads, the RO came in and said for me to NOT wear a bra so that the boob could air out, well I told him, I work in a place with ALL men and me, he quickly and comically turned and said, Oh, then you wear bra at work, but take off as soon as possible!  I can't mimick how he said it, he has an accent, he is Indian, but I nearly rolled off the table laughing!

 

Edited to say:  When I hit submit, I can no longer see the pic I posted, I hope you ladies can see it!

sas-schatzi

LMG  the caps are all screw on  that I have used. It's been so long for a needleless system, I don't remember what we used to use other than tape. You're probably right about the antibiotic detaching versus the picc coming out. I suppose we go where  the memory is triggered LOL. 

HI1--piccs aren't secured with a stitch like other external lines. They can be difficult to make sure they don't move. They also can come out for that reason too. For the patient the difficulty showering is a problem.  You likely have a bench, but use of a hand held system is a good thing to do.

Nettie, Gumby and LMG are right, but it could be something else too. That's why the doc suggestion. BTW, If it's on the BOOB, I would have the breast surgeon look at it -- not a PCP or Derm doc.

Tang thanks. I'll link to some questions answered for me by BINEY4 and KIRA re: flying and LE. They are the most knowledgeable about LE. Others have knowledge, but they are to LE as Whippetmoms is to implants.

https://community.breastcancer.org/forum/64/topic/...

luvmygoats

2TA - You probably have to see social worker to get on podiatrist list. Should be reimbursed at some interval, maybe not monthly but I would think at least every other month. Again good she has a geri specialist.  When your mom spends more time in bed be sure to check her heels and tops of her toes. They get more pressure and esp as most elderly don't roll over as much. Do they have low beds or is it a twin from home? Being assisted living the record keeping for elimination may be non-existent. I had patients in locked units and they were a bit better. Even in a dedicated memory care facility it was hard to get anything exact.

Nope no picture Nettie.

I don't really have unexpected visitors so the braless look is OK. DH doesn't care a hoot. Just I think the support would help my aches but the sticky itchy underneath not so much. I have some I bought last summer over the head kinds from WallyWorld. Shoulders will not put up with those. Bad girl needs to get back to doing her shoulder exercises.

http://comicskingdom.com/shoe/2014-08-02

This is the "Shoe" comic from Saturday's paper. The way I feel somedays.

Sassy - I can't remember what those are called. Yes the PICC line caps themselves are screw on but with the needleless systems these plug in the caps then clamp over them. Not that dislodging them is impossible but very hard to do accidentally.

  The bottom yellow thingy. The antibiotic line screws into the opening in the middle.

sas-schatzi

LMG LOL, Yes I remember those. I was kind of envisioning the bottom one as I was writing. But thought I was wrong. LOL. 

See 3rd we don't remeber everything LOL

sas-schatzi

2TA and all I started as a nursing assistant in 1969. I wanted to check out nursing from the bottom up so to speak. It was an eye opener. It was an entirely (maybe that's an exaggeration) unenlightened time. So many nurses don't have that experience. While nursing can be accomplished without being an aide, I wouldn't have been the same nurse without it. There's a phrase we used to use about nurses that wouldn't jump in and help clean a patient up for any reason from pee, vomit, to blood. "They don't like to get their shirt dirty". It was an insiders joke/derogatory. As a young new nurse, I emptied urinals and bedpans as I did rounds. I had an aide who happened to be a nursing student  expressed that was__________(forget) b/c none of the other nurses did it. Told her to remember this discussion when she became a nurse. Nothing gets greater cooperation of the nursing assistants when they know they can depend on your help. Versus the nurse that will walk down the hall to find an aide to clean up room 101.

luvmygoats

I got out of nursing school just as the "all nurse" staff was coming about in1983. We had no techs and no unit secretary on 3-11 much less on 11-7. Did everything - transport, pick up menus, read menus to pt, any/all pt cleanup, distribute/pick up trays. When I went back to hosp. nursing in 2009 it was different. OK amount of support staff, at least from what I had b4. But of course patients were much sicker, complicated teaching, documentation out the wazoo.  I worked in several clinical labs, for a psychiatrist, in pharmacy and in med. records b4 nursing school. I saw many sides of the business.

sas-schatzi

LMG OMG wasn't The "ALL NURSE" concept just the stupidest concept. I'd forgotten about it. What a total misuse of personnel. The ones that came up with it were the "Won't get their shirts dirty" administrators LOL. They had no clue what it meant to try and wear all the hats. NONE. With all the other things in nursing and outside of nursing, you were a boon to patients trying to navigate the system. 

Every few years a new trend comes about, just like in education. Remember Sight Reading and no Phonix. What a friggen disaster.

Off on errands BBL

sas-schatzi

3rd- memory Lol. I had six places to go and forgot three, Even stopped before i left grocery parking lot and said HMMM did I cover everything? Forgot mail drop, vet's office, and to grab a Mc Donalds. 

Holeinone

Good afternoon, 

Smaarty, so true, Insurance Co. Are aggravating. They do not want to tell you the facts, they want you to be totally confused. 

LMG, you were right, the line came undone, the pic line was stable. I did not remove the little white cap, but was able to screw the antibiotic ball into it. The home health nurse said no one has done that before.

While I was at the IV pharmacy today, they had compression sleeves. I am going to get fitted for one next week. Planning on going to NYC & Wash. DC the end of Aug. that is if DH is much better. I got the insurance on the flight, but I already paid for the hotel in Wash. DC....

Enerva, that bird is gorgeous. Ok, this might sound out there....I found a card today in my junk drawer. It has the mountain blue bird on it. So of course I think of Blue Bird. I think, someone must of sent me that when I was going through tx. I look, the card is blank, has not been used. I do not remember seeing this before. It has a book mark attached and the Card. Inside the card are the words....

Being happy in your skin

That's what it's all about.   By. Koo Stark

Seems odd, but it is a hiking Idaho card, so I must of picked it up somewhere. 

tangandchris

Hole-how much do those sleeves run?

When I was on IV antibiotics it was all sent to the ID doctor and I picked it up there. Interesting how things can be different. ((hugs))

mostlymom

Holeinone

I think it will be around $100. That would be with the hand part. She wanted to fit me today, but DH was home & we were still trying to figure out what went wrong. The screw up cost him 24 hours of antibiotics. 

I hope I did not scare you into staying home. Not my intent, I have been concerned about lymphdema, do not need another thing to go wrong. 

My nurses & MO have been very relaxed about needing a sleeve or worrying about flying. I would rather spend the $ then tempt fate. 

tangandchris

Hole-you didn't scare me, it is something that I need to consider. I started a thread about it and am already getting mixed info. I think I'd rather be safe than sorry as well. I've had enough go wrong that is for sure.

I really hope dh gets all of this straightened out!

3rdtimenow

Thanks, Sas, I am going to see the counselor again next week. Stephanie

sas-schatzi

3rd . I still see my counselor, but not near as frequent. It's 5 years last month. I have him scheduled until Jan. 2015. I do block scheduling b/c he's so hard to get into. Each must determine their own need and length. You likely don't know it, but My Dh was dx with lymphoma 3 months after my BC dx. The next 16 months were hell. Then he passed. Then I had a brain tumor that decided to not behave and grew. Then a crainotomy. Then life stuff. Then the thyroid cancer earlier this year. I keep him as my safety net. LOL... Great guy. 

The above hx is real short, but it is why I believe strongly that a counselor is involved as soon after the dx of any life threatening occurrence. It didn't hit me until 6 months after my dx. I was reading a book called "For the Love of a Dog". Reading the chapter on happiness, I sat straight up in bed and said "OH SHIT" we're both depressed. I was lucky I already had a great referral name and #, that I had obtained for a neighbor.

Not a single health practioner involved in that time explored or suggested counseling as a useful tool. Sad, but true.

It is a gift you give yourself.  Hugs.

sas-schatzi

Good Lord, you all are quiet tonight. I just talked with Phyllyinhouston. She sees the RO tomorrow about treatment plan.

I literally poured her a glass of wine and clinked glasses a couple of times    

sas-schatzi

Don't tell her I drank her wine when we hung up SHush.........

sas-schatzi

HI1 why am I writing this---1. I missed the insurance post thingy sorry. 2 OH found it! The card. I so believe in the "Thiness" The Celts that are most associated with the Irish.  Believed in the Thiness----between this world and the spiritual world. When St. Patrick went to Ireland to spread Christianty, one of the posited reasons that the Irish accepted the religion was b/c of the idea that Saints and God, Mary, Jesus, and Joseph WERE accessible by prayer and thought.  I know people thought I was crazy when I talked about the birds flying around in the topic box.  But when I put Chevy's quote in there and hit submit. FBB's bird jumped on top of the other owl. The message for me was, Chevy's quote was just right and this part I didn't say before, that bird which btw will never leave the box, was looking me directly in the eye and saying  "Don't you forget that".  To me it was just like your thoughts finding the card. She's here.

susan3

sas..have a glass for me too?.lol

dutchiris

 I won't tell phyllithewineless a thing about how her glass came to be empty.