General Medical issues thread

[love_the_life]

I can empathise Seat08! My mum's Services Australia form for calculation of residential fees was a nightmare - she had bits of money stashed in odd accounts, quite a few share holdings and other odd investments. She hadn't actually told anyone exactly her financial situation so that when she was admitted to resi after hospital discharge it was a mad scramble as she really didn't remember where her accounts etc were. Middle of Covid lockdown, no family close to her in country Victoria, so I did what I could then forwarded to brother in BNE. From memory it had just be sent in when she passed away. We were lucky though as she had a stack of respite (DVA), a 2 week "try before you buy" offer from the home and I think we only paid 2 weeks in the end (and only really about $700 pw).

 

[drron]

I did some PD when a brand new Geriatrics Consultant in London. Shared the clinic with one of the top ten PD Neurologists in the world. Did feel that maybe my older patients were missing out but he did say that the combination of PD and cognitive impairment even he found hard.

In general, though the slowness and stiffness usually responds well to treatment (usually for many years), tremor is variable in response and "non-motor" symptoms usually don't respond to the dopamine drugs and need different approaches

But in the future you may find that retired physicians aren’t your average patient. I had my cerebral embolism 3 months after starting. Xarelto.
After starting PD medication my swallowing improved first. Then my usually loose bowels became constipated How do you explain that one?
So I just go with the flow.

 

[Quickstatus]

she had bits of money stashed in odd accounts

Mum had bank accounts overseas that she had no memory of It was worth clawing it back.

 

[andye]

But in the future you may find that retired physicians aren’t your average patient. I had my cerebral embolism 3 months after starting. Xarelto.
After starting PD medication my swallowing improved first. Then my usually loose bowels became constipated How do you explain that one?
So I just go with the flow.

As we know patients (especially medical ones) don't always follow the textbooks

 

[Pushka]

Now I can't take simple anti inflammatory drugs being on a blood thinner.

I do. Not very often and always with a meal. I'm on Xarelto and have been for over 10 years now.

 

[zig]

Breakthrough!

That rumour of a bed at Mum's preferred nursing home became a reality and last night a formal offer eventuated. Contracts signed today. She will move in there tomorrow, which was her discharge date until the "medication review". Talk about cutting it fine. There has been a lot of hurry up and wait in this process.

We are still not finished though - cannot finalise financial details until Services Australia does their review which has a service timeframe of 4-6 weeks from lodgement. We started work on the forms as soon as we knew she had to leave hospital (so 2 weeks ago) but the level of detail and documentation needed took some time to pin down - this for a lady of modest means who is a part pensioner, which means her details are in their damn system anyway.

After that experience, the family hold outs have agreed to getting aged care specific financial advice, and that is booked for tomorrow, which is also our day to collect granddaughter, take her to swimming and then give her dinner. Talk about the sandwich generation! We think the money spent on that will be worthwhile and could save us many thousands down the track if a poor decision about RAD/DAP and the various means tests (for care, for pension etc) is made.

I do feel relieved, but not yet able to sit back and breathe.

An available bed in her preferred nursing home is wonderful news. I'm so pleased for you and you must be feeling a slight lifting of stress and tension.

 

[Quickstatus]

part pensioner,

Correct. Serv Aus should have the information already.

So glad your mum got a resi spot in the preferred place as well!.

The medication polypharmacy review should still happen though as it is always a good idea.

Can you not, with food?

Different side effect
The food part is to mitigate against stomach ukcers
Separately, it (to varying degrees) can be a "blood thinner" by interfering with the platelet function.
The combo of NSAIDS + blood thinner (like aspirin, eliquis, xarelto, warfarin,) can significantly increase bleeding.
It does not mean that combo can never be taken together, just means being aware of the potential complications and use the NSAiD for the shortest period possible.

 

[Pushka]

Correct. Serv Aus should have the information already.

So glad your mum got a resi spot in the preferred place as well!.

The medication polypharmacy review should still happen though as it is always a good idea.


Different side effect
The food part is to mitigate against stomach ukcers
Separately, it (to varying degrees) can be a "blood thinner" by interfering with the platelet function.
The combo of NSAIDS + blood thinner (like aspirin, eliquis, xarelto, warfarin,) can significantly increase bleeding.
It does not mean that combo can never be taken together, just means being aware of the potential complications and use the NSAiD for the shortest period possible.

Yes. Just like I'd like to take daily curcumin to reduce inflammation but it also 'thins the blood'. I don't take that one as a result. But sporadic pain that isn't relieved by Panadol or sometimes the headaches - that I used to get but not now so much (except during PMR which has thankfully left the building) then I will take that risk. I have some oesophageal scleroderma which is why I am always eating something as I take the tablets. Because that combined with blood thinners isn't ideal.

 

[RooFlyer]

use the NSAiD for the shortest period possible.

For sure. No more than 5 doses of Celecoxib/month is what I worked on (usually consecutively); but I rarely take it now. Arthritis evolves.