Monday, September 29, 2008
The Furosemide May Have Been Too Much
Movement for 9/29/08:
- Mom wasn't interested or ready to try walking, today, until after breakfast and the RN's visit, when she was ready to retire for her nap. She did pretty well: She walked all the way from the dinette table into the bathroom, then walked from the bathroom to her bed, at her insistence. She was slow and deliberate, but not wobbly. After her nap, though, she had significant difficulty even trying to remember how to stand. She seemed unable to grasp the concept of throwing her weight forward onto her legs, both when sitting in preparation for standing and when standing. Transfers were very difficult. From the bed to the wheelchair she claimed she was unable to move her legs and remained standing only with my strength. I took her weight on me and swung her to the chair. In the bathroom she managed standing and moving a bit better, but only a bit. I expect the rest of the evening to be spent in the wheelchair.
- An informative and pertinent lecture by the RN about furosemide (which I don't like to give my mother, anyway, but, it seems, have probably been relying on more than I should, for the little I use it) signaled me that the difficulty she's having this evening may very well be due to the "innocent" "whiff" of 10 mg I gave her last night. Although I've known its powerful stuff, which is wy I don't use it, the nurse gave me a thorough rundown of how it works on the body chemically and systemically, what it's half life is and how severely even a little bit can deplete the body of a variety of electrolytes and other things and how this process happens. He recommends using it only when swelling reaching the "pitted" stage. For the swelling Mom exhibited, even, he suggested the edema that led to the 20 mg dose, elevation of feet, walking and the stuff I usually do (rubbing down her legs, having her rotate her ankles in the air three times now and then). Elevation is a little different than usual because my mother doesn't like to sit with her legs elevated, which is why we don't have a recliner; but, I figure, when she's laying down, her legs are well elevated, and she spends lots of time in a prone position. It hurts her back. Mom's did reach that stage last week, quickly, just prior to her beginning "empirical" treatment for pneumonia. At that time 20 mg was probably justified. The 10 mg last night, I figured out, was not. As well as not having worked very well, it probably drained the recovery of strength she was exhibiting yesterday from her. Oh well. Live and learn. I have no idea how she'll do this evening on the way to bed, or tomorrow. I'll let her surprise me.
- Mom's evening was wheeled out in style. She had some difficulty with transfers, specically balancing her weight, and so much difficulty raising herself from the rocker for slacks pulling in order to rub down her legs that we abandoned that for the night, although I rubbed lotion into her feet and up to her calves. "It's better the other way [meaning full leg rubs]," she said. I agree.
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