An apology in advance for a whiny post

Now that we’ve got the O2 monitor, and I’ve got a spreadsheet of her levels and rescue, either by MDI or nebulizer, I was able to see that Mariella has needed 7 albuterol or Xop doses in 7 days. Not one a day, so there have been days that she needs more than one.

So, now that I have it in black and white…it’s a bit easier to say…”wow, it’s time to implement the sick plan…for some reason, her lungs are PISSED.” It’s also just HARDER to see it in black and white. I know I “forget” how many treatments we really do…when we do them so often.
So, my spreadsheet has her pre and post treatment (if needed) O2 levels, as well as a notation as to why she needed a treatment. I am basically giving a rescue treatment for any O2 level of 93% or below. It’s not the protocol I’ve been given…her doc didn’t really give me one…She’s never really had low O2 in the office when we’re there. Even when she was completely occluded, she was satting at 99 or 100%. I don’t think he really expected to see low readings. We see nice high ones too…98, 99, 100%. Sometimes, she’s got a nice high O2 reading, but she’s feeling short of breath, or her chest hurts, or she’s coughing…and those get a notation. I always check her O2 after a treatment as well.
We started “sick plan” tonight. Her cough has gotten steadily worse since Tuesday, when she ended up in the nurses office for her Xop. At that point, she was just tight, according to the nurse. She was not coughing over night, but did start as soon as she woke up, and asked for a treatment on Wednesday. By today, her cough is junky and gross…she is bringing up grossness after her acapella. (which of course is good, that’s the point of airway clearance) It’s not colored…just gross. I don’t want to, but I might just keep her home tomorrow. She’s coughing in her sleep, which means she won’t be well rested, and they already complain about her distractedness…which will be worse if she’s tired.
Tomorrow we’re heading to the financial counselor at the hospital, to see what Mariella qualifies for, regarding MassHealth. It’s just so expensive keeping her in medication.
I’ll also be calling her pulmonologist, to let him know we’ve started sick plan, and to see if he thinks he needs to see her. He usually does not, though…he trusts me to administer the medication, and to call if she goes south.

7 Responses to “An apology in advance for a whiny post”

  1. 1 kerri May 21, 2010 at 4:08 am

    Here’s hoping the sick plan does the trick and she improves soon, and that that her doc can make something of the low O2 sats.

  2. 2 Tash May 21, 2010 at 7:22 am

    You know, that was the least whiny, whiny post I ever read!

    Your post really confirmed what I also have been thinking about this week – putting things down in black and white makes a big difference how you see things. I really hope it helps you find some patterns in what’s happening, and get the flares cleared up more quickly.

    Hugs to you both!

  3. 3 Amy May 21, 2010 at 6:35 pm

    Yeah, that really was spectacularly unwhiny. I hope you got some good news re: finances today and that the sick plan gets her breathing better again.

    How long will you track her O2 before it’s useful for the doctors? Or is it a matter of undefined time & waiting for a pattern to emerge?

  4. 4 Sara C. May 21, 2010 at 7:08 pm

    We will almost definitely qualify…and as a FAMILY…which means all our co-pays should be taken care of, AND if “they” decide what we pay in premiums is too high for our income, they will reimburse us…I said to Rob, it would be like winning the lottery.

    I’m not sure about the O2…We might just keep using it but not so often…especially if she still has times that she goes really low.

    The pulmicort tends to work really fast.

  5. 5 Sarah May 21, 2010 at 7:19 pm

    I hope you get into that program! I know how bad medical copays can be: A third of my income goes for my asthma meds (and that’s after insurance takes care of 80% of the prescription drugs). It would be awesome if you could get some of the money back.

  6. 6 Breathinstephen May 22, 2010 at 12:07 am

    O2 saturation is rarely effected by an asthma flare up, unless the patient is critically ill.

    It’s much better to assess the patients breath sounds, listen for audible wheezing, coughing , accessory muscles use, skin color, etc. to determine if she needs a neb treatment.

    Just my 2 cents.

  7. 7 Sara C. May 22, 2010 at 12:34 am

    Stephen…she is definitely flaring at the moment…the O2 monitor is because she has episodes where she gets dusky lips and fingernails. I probably shouldn’t check her so often…it’s easy to fall into the trap of doing it too often. Thank you for your opinion, it’s very much appreciated.

Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s


%d bloggers like this: