It is very minor really, more just a "compass reading" so to speak. Just some readings from her latest labs are a bit off compared to the ones 4 months ago.

I had kinda anticipated a UTI, she was less alert, sleeping more, a tad confused, her urine was a bit darker and smelled stronger (maybe she was getting dehydrated? she had lost a little weight, but didn't look dehydrated, skin passed the "pinch" test).

Her RBC is 3.72 and norm is 3.8-5.10

Glucose, serum is 59,,, norm..65-99 (this was an hour after a breakfast of fruit, oatmeal, and juice.)

Glom Filt Rate..56,,, should be 60-128

Creatinine ratio was high.. 30 as compared to 8-27.

None of this stuff is so far out of whack, that I am panicking, not reading too much into it. She is 93, and all I find says by 80, 30% have decline of kidney function to a similar level, and this is the first that the numbers have been off for me to see. The report explains all the symptoms I have noticed. No infection, WBC count is fine and urinalysis is totally normal.

Her Doc feels, that Mom's diet is good and should not be altered. Maybe more carbs, less protein, but her diet is pretty high carb now to keep her fiber up. So, not much to change. No treatment or meds are being suggested as useful now, and I pretty much agree that the risks and trouble of action, won't be worth it. There is no time frame on this at all.

I don't have plans of mentioning any of this to Mom, but sooner or later, I will have to update Bro and since he is a absentee "fixer", it better be sooner so he can get his questions out of his system.

I need to get ready for an overnight with her. Catch up with everyone tomorrow afternoon.

Melissa, thanks, it's worth alot.

Hi Bobcat. For what this is worth, I asked my partner - who is a retired nurse - about your Mom's lab results. She says that, given your Mom's age, the results are pretty good.

Given that we are both daughters, we also understand your concern. I do hope that your doctor can ease your mind and give you helpful suggestions. You're obviously very much on top of things - your Mom's a lucky lady.

Well, I don't really know much more today. I had to take Mom to her gynocologist to have her pessary removed, cleaned and reinserted. It is always hard on her. Painful and some of the delicate tissues always tear and result in spotting. At least they let her use "the chair" ( the one for the late pregos that can't get on the table). She really can't stretch that poor old broken hip so that her feet can be in the stirrups. I have to hold one. It is an intimacy few people share with their mother, but many here understand.

When the gyno asked about any changes in Mom's condition I told about the lab results. Of course she made notes, but was reluctant to comment, except to say that few at Mom's age had kidneys that good, she hoped I would get more advice from primary to put my mind at ease but she saw no reason to panic.

ME? are you talking to Me?

Anyway, as you would expect, I didn't tell Mom about this dreaded appointment until this morning when it was time to get ready. Saw no reason for her to stew about it for weeks. It was almost funny, she couldn't stand up because her sock was wrong. She was sure she had wet her pants again and needed to go back in the bathroom, she wanted a different blouse and skirt. We made it on time. Got it done. Next time, I just won't tell her where we are going until we get there. (Like she would really let me pull that off.) She knows she has to go.

Once it was over, she was fine, wanted to ride around, eat french fries,

BC your absolutely right in what you did.
Sometimes we question ourselves, put things off, but there are always good reasons behind it.
You reaching for more answers is NEVER a bad thing....
Bro should thank you for the update and know that you are doing your level best at finding more answers never doubt that, if he doesnt, take comfort in knowing that we know what your reasons are

T.O.R.P. thanks for the thought. This was an interesting search. Someone else might also like to read about it. Here is one site
http://www.wrongdiagnosis.com/a/adrenal_insufficiency/symptoms.htm
And I will ask.

DOCHKA, Although it makes me crazy at times and weary to my bones, this time I have had with her may be the most valuable 6 years of my life, especially the last 4 while she has needed so much help. It now is more clear to me than ever how a tiny effort can bring on a smile, a moment of impatience brings on a crash. Just a little self discipline can make a good day, or at least prevent disaster. (Sometimes nothing will, but that is OK, too.)

I got a little cowardly and e-mailed bro. I embedded this lab report in a general update and said I was digging in a little more to be sure I understood and then would fill him in completely. Somewhere between who has had vacation and how the plumbing problems are going. He doesn't read his messages on the weekends so he can't say I didn't tell him, I really saw no reason to actually call him, though, not yet.

This is not doom and gloom, I just want to make sure that I have read all this right and react or change the program in a way that does no harm. The hints I have gotten from you all mean a lot. I would never have thought about kidneys not filtering out insulin and therefore trying to increase her carbs could boomerang on her. I don't think I could reduce her protein by much and still keep her body from breaking down. Still a lot to find out. I'll be doing an over night and take her to an appointment tomorrow, so I'll know a little more by the end of Monday I hope.

quote:

It has been such a surprise over the last 6 years to find that my Mom has so influenced me. Only by caring for her, am I finding how much we have in common.

Lovely!

I find that to be so true. I guess they carry on in us as their legacy.

Whoa, I am amazed at how all of you are so knowledgable! I'm glad YOU all can help with the medical terminology which is Greek to me!

But I can prescribe TLC STAT for mom and yourself BC. It seems stress levels are at a zillion and pressure is rising-- take special care of yourself too, friend.

Listen to your instincts about how to deal with bro and you can't go wrong.

I wouldn't hurt to ask him about the adrenal insufficiency too. I don't remember all the symptoms, but do remember that it involved his blood sugars and also affected his kidneys, that he was really tired and foggy-brained.

It was actually mom (a retired RN) that figured it out, and talked the doctor into ordering a test. It was just a blood test, I think. It's been long enough ago that I don't remember specifics.

I love you all,
T.O.R.P., The point you brought up, Excess insulin not being filtered out? This is an excellent hint. I must discuss that possibilty with the PCP.

I should have another conference with her Doc early next week. Adrenal insufficiency is an unknown, but I doubt sleep apnea applies to her. 3xs/wk I sleep on the sofa in her room, get her up 2xs during the night for the bed side, move her circulation, make sure she's clean and dry. (4 other nights are covered by others) She sleeps well, dreams, Last night I interrupted home made fruit cake when it was time to get her to move. She laughed and told me I had bad timing. She doesn't snore, snort, or have other symptoms, But H has apnea, and I will keep that in mind.

I want to put my anxiety off on Bro, but it is "how is he going to take it when I put a name on the problem?" None of you know, I don't know. I need to get every detail I can before talking to him.

I don't want Mom to go through a lot of CR*P that goes nowhere. Dad loved it. He wanted every test and proceedure because he was fascinated by them. He was an industrial engineer and loved every gizmo ever made... did not care if they were worth a hoot or not, it was his big chance to see industrial progress ( his view of CATs, MRIs. He thought it was fun. I had trouble relating to Dad).

Mom just goes from season to season, this is the time for "mums", now we have pansies, then camelias... early spring azaleas, red buds, dogwoods, wisteria, lilacs, roses, then crape myrtles, geraniums, Vinca. Zinneas for the vase.

Start Over. It has been such a surprise over the last 6 years to find that my Mom has so influenced me. Only by caring for her, am I finding how much we have in common.

I was thinking she had Diabetes so if mom was not a diabetic then this is something more sorry BC...

The low blood sugars can be caused by a lot of things. I'm thinking that it's probably related to her reduced kidney function, though. The problem is that since her body isn't filtering out excess insulin, I wonder (don't know ... you'd have to ask her doctor) if giving her stuff like OJ or the sugar gels between meals to raise it might just trigger her body to make MORE insulin and just make her worse. This may be why the doctor doesn't really want any dietary changes. But boy, when those sugars get low, they do get sleepy and draggy.

Other things that I *know* of that cause blood sugars to be low are adrenal insufficiency (dad had this) and sleep apnea. (Weird, huh?)

Thanks MB, Tums and zantac are usually close at hand.
BG, Mom has escaped diabetes, and has no dietary restrictions. Well, for a long time her sodium was always low and her Doc felt we were pushing too much water on her and put her on a limit. (I should say, Put US on a limit .

This limit was far from extreme, still 2 quarts/day, it was mostly making us aware of everything that counted as a "fluid". She has never been thirsty and can always haver water beside her chair. It's been barely in the normal range for 8 months.

Her BS level was usually about 120 but it never bothered us or the Doc because it would be about an hour after her breakfast if I had to take her to the lab. Only when Home Health used to come, was it ever "fasting", and then it was fine, but that was fall of 2004.

Well, it's Friday, and another "hair day". And as long as she still wants to go, all is A-OK.

BC could you please refresh my memory is mom a diabetic?
Sorry I rushed out an didnt ask and I just perused your first postings I didnt see anything about it but Im curious if she is and if shes still taking meds for it...

quote:

So what is the problem?? It's my problem, I guess

I feel ya on that one, BC. Mom's most recent bloodwork shows a slight decline in kidney (singular) function, but her pre-albumin is up to almost normal, soooo... nothing terribly abnormal, considering... We simply do what's most comfortable for Mom and let the chips fall where they may. Sometimes, my Mom rallies for a while, then she slowly declines... then she gets another UTI, is treated, rallies for a while, repeat...
Panicked? No...
Reading too much into it? no...
Reading the handwriting on the wall, ummmm.... well, yeah, which explains the need for Rolaids...

Give your Mom a hug for me...
and save one for yourself!

Your absolutely right BC about added tests I feel ya there.
In the matter of her BS levels if they plummet like that either get glucose gel or let her suck on a lollipop something with a sugar rush, OJ is another this can make her sleepy if her BL's are plummeting like this.
Try the OJ first check her BS throughout the day to see if the sleepiness coincides with the drop.

Thanks everyone,

What can I say?? She seems tired, drops off to sleep in a heartbeat. No edema, blood work shows all electrolytes in the proper range, so hydration seems reasonably correct.. I really understand why her PCP, who has fought for Mom before, and never steered me wrong, believes it would be counter-productive to have her under go tests and major changes.
Especially since the tests don't show extreme distress yet.

It would be a travesty to deny her the favorite foods, or frighten her into super stress zones with tests she doesn't want or understand. There were the symptoms I mentioned, but she is basically a happy, good humored, and attentive elder. I don't see any decline in those catagories.

I have to come clean with bro soon, although there is no reason to believe we will face anything major in the very near future.. He may want to step up his visits, and he certainly has a say in the decision about tests and treatments. I simply agree with her PCP this time. Maybe he will have a different opinion.

This is just a very early sign that her ticket out of here might be this way. Might not. An asteroid might fall on her house before this comes into play.

Last night she ate well, drank well, slept well. So what is the problem?? It's my problem, I guess, I had heartburn and didn't sleep much at all.

Interesting BC...moms BS level after an hour is unusually low...
Unless smaller portions now?
I know your giving her a healthy diet....
Check...wait what kind of sweetener are you using?
Fruit if its fresh, an hour after should give off a reading in the 100's as with juice should give off readings between 130 and higher depending on the type of juice, fresh or processed.
Oatmeal heck you should be in the mid to upper 100's if not 200+

Creatine are you giving her alot of meat?
And is she hydrating properly still?
Replacing electrolytes? Gatorade?
If she doesnt like the taste get the freezer pops (kiddie section) and mix that into a fruit shake you wont be able to taste it

Sending some positive energy your way!

Bobcat, when we are informed of the slightest difference in tests results we know they have meaning.
You will deal with this in your way.Too many times we do not need tests results to know a loved one is declining

I should probably add, that out of 40 items in the CBC with Differential/Platelets and the Complete metabolic panel, these were the only items not in the normal range. Pretty good, I guess.