Cmeyers, why is she in an adult foster care home? Is she incapable of caring for herself now? I would suspect that is whats going on. Anyway, if she has been stable for 31/2 months that is good. Her sodium levels may be able to be controlled to some degree but it is difficult for me to give you an honest answer since I don't know the details, labs, etc. So everything is an educated guess. She is most probably in a state of mild to severe confusion on a regular basis. Not just from the sodium levels but in addition to her levels she must have some episodes of encephalopathy. When they gave you her anticipated life expectancy it was just a guess on their part. There is no sure fire method to determine that. Sometimes they say 6 months and it is 2 years, other times they say 6 months and it's 3 days. You just never know for sure. You asked if the sodium levels were heading toward more severe problems right? I would suspect that it is just the beginning of more serious health issues. At least that is what usually happens. They will more than likely just treat each issue as it occurs. Pain is the most difficult to treat long term and unfortunately it is very common in end stage. My mother suffered so much that it literally made us all cry for her just watching her suffer. I don't want to upset you but I want you to be prepared as much as possible. It is heartbreaking to watch. There were days that I prayed GOD would just take her then there were days I prayed she would live. It is a roller coaster ride for everyone. There is no way to sugar coat any of this and the truth is very difficult to swallow I know. The one thing you can do is keep your hope alive and never give up. Stay on top of her condition as much as possible. And above all let her know how much you love her. My thoughts are with you and we are all here for you.
Thank you all for your nice words and thoughts. Butterflythree..sending thoughts to you and your husband.
Shelly, yes, she is in adult foster home as she is unable to completely care for herself. I would say at this point in time she is suffering mild confusion on a regular basis, otherwise her wits are about her. It seems alot of her short term memory is what is affected.
You don't know how much I appreciate your honesty. The one thing that I was not aware of was the pain factor.... That is (obviously) good to know and keep a watch out for.
The Dr. has informed me that her sodium is running 125 (not sure how high that is) they have cut back on her Bumex (Diuretic) in order to control the sodium, however, now she is retaining more fluid in her abdomen which is causing the discomfort and the increased blood pressure. It really does seem to be quite a balancing act.
Shelly We just returned from the hospital for Jerry to be drained. I requested they take blood because he seems so weak and he's really shaking a lot. Two weeks ago his ammonia was in the 80's last week in the 60's and today it was 98. Also his dreatinine was 1.42 , sodium 129 (it has been worse). Ion balance 4, BUN 33 and GFR 51. I looked up the ranges. I'm concerned about his kidney function. Do you think its serious. He has a Dr. appt tomorrow. I'm a little concerned.
Rainbeau What a dear you are. I just have my moments. I've even had a mini-meltdown with the Dr. When I get scared I want results RIGHT NOW. Things just don't happen that way. As far as Vandy I have wanted to leave them but Jerry won't budge. It has taken so long for a couple of reasons. The Drs here didn't beleive Jerry was so bad at first. His numbers were good. Problem is, which does happen occasionally he is much worse then his numbers. There are no liver specialists here. We only see the Gastrologists. Once they decided he was going down hill fast they scheduled an appt with a liver specialists at Vandy. Jerry has someone working for him that his wife is a head hunter for hospitals so she researched the Dr. at Vanderbilt for us. The surgeon has very good cridentials. Also Vanderbilt is extremely busy. It took three months to get the first appt and another two months for the second appt. All the tests are done now its just that WOMAN. I got news for her we are just about done with ALL of her requirements. We go back next week to see the liver specialist. Don't have an appt with her. I'm not going to make on either. Right now Jerry needs to get stabilized. I think he will probably go in the hospital tomorrow. I will keep you posted how it goes. Say a prayer for Jerry tonight.
JoAnn, hi sweetie. I am concerned with his lab values. Creatinine (kree-AT-uh-nin)= the normal range is 0.6 to 1.2 mg/dL. Higher levels may be a sign that the kidneys are not working properly. As his kidneys struggle right now his level of creatinine in the blood increases. Creatinine comes from protein in the diet (mainly meat) and from muscles. Blood Urea Nitrogen (BUN) levels are between 7-20 and is also from the breakdown of protein. Both levels indicate kidney function and as you can see his BUN is 33 which is high. His creatinine level is only slightly elevated at 1.42 (I've seen much higher levels of both tho). They are both waste products. I think that with liver disease that is advanced the kidneys are often affected too. Normal amonia levels vary (as do most lab values) from hospital to hospital or lab to lab) but generally amonia levels are between 20-40. The amonia in the body forms when the protein is broken down by bacteria in the intestines. Normally the liver converts ammonia into urea and then eliminates it in the urine. But because of his liver disease his liver is sick so it can't convert the amonia into urea. What amonia is converted is not being excreted thru the kidneys properly because now his kidneys are sick too. What does it all mean? Well, his disease process is advancing. He is not eating and drinking water much either I would suspect. Often times they do NOT have any appetite and have to force themselves to eat and drink.There are appetite stimulants the Dr can RX which do help quite a bit. He probably has some muscle wasting too. His weakness will increase as well. Confusion increases with the elevated amonia levels as you know. Lethargy is common and can become worse as well. Most of this you already know but I was hoping if I explained the process a little it may help you to understand what's happening. PLEASE ask the Dr to give him something to increase his appetite. It will help a little. One drug I am aware of is Magace ES. There are probably others but I know that Megace is utilized fairly often. Ultimately it is up to the Dr but at least ask OK?