Atrial fibrillation and Coumadin

Fri 5/31: Received phone message from SLV, having a phone meeting with Diedre (nurse at SLV), mom, and Dr Antonucci of Kaiser. Dr A said to call Mom and then call him.

 Fri 5/31: Talked to Mom, issue is that the doctor could prescribe either aspirin or Coumadin. Mom very much does NOT want Coumadin because of the risks of excessive bleeding. She "doesn't have enough blood" and "they're always taking my blood" were comment responses. Mom could not answer why the doctor wanted to prescribe Coumadin, or what good it would do.

 Fri 5/31: Left message for Dr Antonucci, no response

 Mon 6/3: Spoke to Dr Antonucci.

• Mom came to the emergency room from SLV complaining of shortness of breath.  Diagnosed with atrial fibrillation, which is a particular type of arhythmia.  The A-Fib is OK, but one possible problem is that clots can form in the vessels around the heart, and those clots can be dislodged and go to the brain, which is a stroke.
• In order to prevent stroke in A-Fib patients, normally prescribe either aspirin (a mild blood thinner) or Coumadin (a stronger blood thinner).  In patients below 80, normally go with Coumadin because it is better at preventing stroke.  Above 80, the bleeding risks associated with Coumadin start to outweigh the benefits, and aspirin is appropriate.
• After discussion, although Mom is healthy and could probably take Coumadin, she does not want to and therefore aspirin is OK.

Other notes:

• Dr Antonucci has other SLV patients.  He described the nursing staff at SLV as "very good."
• Dr A mentioned that Mom was considering a higher level of care at SLV.
• Dr A mentioned that Mom has some symptoms of age-related decline or dementia; she seems to be quite forgetful.

Contact numbers: Peters, Serotte

Thurs 5/9/2013:  Andrew came through with contact info:

Gary W Peters
P.O. Box 2782
Guerneville, CA   95406
707-529-7997
garypeters@comcast.net
bryanthatch@comcast.net


Elaina Serrotte
415-743-1010

Spoke to Bryant Hatch who works for Gary Peters.  He recommended that  write Gary to request executed copy of trust, will, POAs, etc.  I sent that yesterday (Th 5/9).

Update Mon 6/3: Mom's Kaiser doctor is Dr. Antonucci: 707-393-4044

Phone call from Diedre Tue May 7

Diedre called last night to say that Mom had come to the outpatient department complaining of rapid hearbeat, diagnosed as atrial fibrilation.  Got her to Kaiser, doctor examined her, changed her meds, enrolling her in class about atrial fibrilation.

From Wikipedia:

Atrial fibrillation (AF or A-fib) is the most common cardiac arrhythmia (irregular heart beat). It may cause no symptoms, but it is often associated with palpitations, fainting,chest pain, or congestive heart failure. However, in some people atrial fibrillation is caused by otherwise idiopathic or benign conditions.

AF increases the risk of stroke; the degree of stroke risk can be up to seven times that of the average population, depending on the presence of additional risk factors (such ashigh blood pressure). It may be identified clinically when taking a pulse, and the presence of AF can be confirmed with an electrocardiogram (ECG or EKG) which demonstrates the absence of P waves together with an irregular ventricular rate.

May 3 - May 6, 2013 -- My visit to Spring Lake Village

May 3 - May 6, 2013. Visited my Mom out in Santa Rosa at Spring Lake Village. Flew out Fri May 3 via SLC to Oakland, rented a cool little Fiat, and drove 75 miles.

 My Mom's place is a mess. She has a little studio apartment, but it's actually pretty spacious and she used to have all her shelves and drawers neatly arranged. Now there are clothes everywhere: on the bed, over the back and seats of the coach, on all the chairs, etc. There are boxes on the floor, much of the contents of the closets are out on the floor, etc.

 Mom pretty much blames everyone else for the state of things. Apparently a woman named Celeste came over to help her organize. Celeste folded and put away all of Mom's clothes, but Mom feels that they were put away dirty, arranged by color rather than how my Mom arranges them, etc. My Mom has these long, complicated explanations of how she is going to gradually work through them all, washing them and folding them and putting them away. But it's clear that she cannot really handle living like this.

 Food is a problem; my Mom likes to bring bits of food back from the dining hall in case she gets hungry at night or whatever. So there are cups, spoons, odd pieces of bread etc. around.

 She's tottery.

 Mom doesn't want to know any details -- she can't find a phone number, doesn't know where her money is, etc. The simplest things are a problem because every detail can potentially stop Mom -- she can't find her underwear, her socks, her pants, her shirt, her jacket, her scarf, her purse, keys, shoes, etc. This frustrates and exhausts her. Oh boy.