STEAM ROOM FOR ANGER
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@bcincolorado Thanks, thanks, hugs back. So sorry about the second hit with the dementia thing. Sucks. I had a couple of old messages from you when I logged in this time. What led you to suspect something was going on? Should I go back and read old comments? I get that when you may have explained at length and now tired of re-explaining. Hells bells might be in your last post. Kinda why I'm asking, somethings going on here, even trying to figure out which doc to go to, bummer.
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@chicagoan Thank you, yeah, bummer, we talked several times a week. We were both adverse to traveling. We only were together twice in 20 years. Very weird. But we were very comfortable with the phone. I was with her in the last couple of weeks.
The mask thing. the Denmark study was ignored basically. Public not being notified of OSHA fit requirements -awful. You are so right about the tight fit. Even with the tester trying multiple times to get my fit right, I still smelled the scent.
Why did people buy into the cloth masks and masks. Fear. The early reports were not good. The west coast reports from the initial nursing home. Ever something facility. Media. It's like the guy that shows up at all hurricanes, Italian name Can something. The joke here in Florida, it's bad when he shows up. Now with supposed "worst temps thingy" The back screens are all in red to change perception. When by history we are the same in Florida as we have been since it started to be measured. The screen is an oh so subtle thing. My machine had "88 degress Near record". Duh, by adding the near record, it causes a question, a concern. It's a normal temp for Florida in August. Change the language, change the presentation, it plays well in poukipsee.
What I object to is that by the false narrative that masks work, people can be harmed by thinking themselves safe and others are harming them by not masking. Creates division, anger, hatred.
Now for my self when I got covid, it was a fools tread. Someone came to a party of five, she was sick, didn't declare it. We all shared a joint. We all got covid. No testing on my part, but two were. It's kind of a duh thing.0 -
Hahaha, I reread my note from the 18th friday, Damn ring cover popped off again on late Friday, only partially, then off on Saturday. Totally no coincidence. No nada. Nothing. Just a snap lock thing. Kinda reminds me of GHOST the movie.
Maybe we need a ghost and phenomenan thread?1 -
Okay did it: "Ghosts and other Phenomena" thread
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As a new nurse in the late '60's, the only masks available at that time were made of cloth. I worked in a pediatric communicable disease ward and can honestly say I never became sick then. So while you may think they are worthless, I was exposed to many communicable diseases transmitted through the respiratory tract and for some there were no vaccines available yet. They served as a reminder of my need to be mindful of disease transmission including handwashing, avoiding touching my face, etc.
Initially I used the cloth masks with a filter in them and for all the negative reports you are citing think they kept many from contracting Covid from non-maskers. I think they reminded people to be careful of close contact with others, to be socially distant and to be mindful of others. In those 3 years, I never even had a common cold and only had access to surgical masks and N-95's in the last of those 3 years.
No mask guarantees 100% efficacy in disease prevention and quite frankly even 50% efficacy is better than none. I continue to mask in situations where there are large crowds, on airplanes, etc. even though I am up to date on my Covid vaccines and boosters. I did contract a mild case of Covid in January on a cruise which could be categorized as a super spreader event. I was one of the lucky ones who survived and how many of those who were unvaccinated, and anti-mask, on their death beds changed their minds?
I respect your right to express your opinion but to cite articles which support your stance and then mention they are not available for others to read doesn't provide them with the opportunity to see how you formed your opinion. As my mother would say "your opinion and x amount of dollars would buy a cup of coffee." You may say the same about my opinion.
I believe in science both as a nurse and as someone who spent years working in infectious diseases detection and prevention. I did not just survive BC, to die of a communicable disease.
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@ctmbsikia No question masks are a controversy. BUT it is known aerosolized particles aren't filtered. Hopefully fit tested N95 does it. BUT I read the Factcheck.org post that you linked. There is lot's of gobblygook in it.
Their conclusion paragraph "“Ultimately even a very careful person will be infected eventually, but masks could delay that or reduce the rate of infection from once per year to once every few years, perhaps,” he said. “Community masking is not aimed to prevent everyone from ever getting infected, the aim is to reduce transmission and ‘flatten the curve’, reducing peak healthcare demand, or to work in combination with other measures like social distancing to contain transmission in the short-term.”
WOW says a whole lot of nice words but doesn't say they work. It's why I wrote the thread about how to read studies(and articles about studies which is apparently in the BCO computer netherland. Think about what this is saying "but masks could delay that or reduce the rate of infection from once per year to once every few years". Interpretation? Where masks endlessly? I get that the cancer community is at risk, I've had 3, BC Thyroid and nose twice. and surveillance for a bunch more b/c of taking RAI-31 for thyroid. I'm not oblivious of you concern. This fact check writes a good—-con line. They are trying to lay low, discount, smear Cochrane et al. You'd be better off reading the whole of Cochrane and paying attention to what they say. They are the star in the industry of watching studies and evaluating them.
Thinking about comparisons. The drug go to is dailymed which is the government repository for all drugs. Could have given a full URL if I knew beforehand I would cite them. Another site that is very valuable is Medscape., another Healthline. Medscape is primarily directed at professionals, but don't be dissuaded trying to register. It's free. Once registered you get access to studies and the companion articles explaining the studies.
That is truly a key, the companion article. I'm sure in the industry there is a bonafide name. It's one step out from the study. The reporter/author takes the study info and translates it for us mere mortals.
IF there has been no mischief in the study, and IF the next level reporting states correctly what the study is saying, we may get useful info. The problem is mischief. Next post0 -
With BC it has been commonly cited that obesity was a risk. I searched it back until 1992. The first discussion of obesity. Seared in memory. It was in the discussion section of the study. The discussion section of any study is a summation of what the authors have learned. They describe what they feel (edit) is significant and conclusive, what are areas that are inconclusive but have importance and need further research ( by definition speculative). It's a discussion. Then each study has a conclusion. The problem with the BC research as near as I could trace, WAS the next level reporting included it as a risk factor. Once something is reported at that level, it's a given. It's in the risk list. Now oddly when I did that search, I was studying the microbiome -2015 here- What the microbiome search showed was that there was a connection. BUT THAT IS DIFFERENT THAN WHAT HAD BEEN IN THE MEDICAL VERNAULAR SINCE 1992.
For approximately 20 some years, obesity was in the risk factor list on all(most) sites. Nothing conclusive was shown. My look at it was in 2015, nothing conclusive then, but they thought a connection was found. AGAIN, not conclusive. Perhaps, something since 2015 has been categorically with data finalized. (NOT going to look)
Hence the point being is studies can be flawed and gain wide acceptance, or the reporting can report the findings incorrectly, or once in the public sector is consider gospel. My opinion, the study interpreter is where the mischief can do serious harm if there is no miscchief in the study Their job is to truly report. If they have a bias of any nature, that can cause all kinds of problems. On Mesdscape they can be trusted. My bias is I trust Medscape and the interpreter at that level. Outside Medscape, no I don't trust.
Corporate type sites b/c of legalities have a responsibility on reporting. What happens is you get each subspecialty writing guidelines for their thing on a calander expexted timeline. For example, American Heart Association has their main congress every 5 years, but produces new guidelines at the 2.5 years. And then if there is an something unusual, they publish new guidelines. I ran a paramedic program. The joke in our statewide group was "What are we teaching this year?" Hey, lives depended on it, and we were joking about it. B/C we knew you can't jump that fast.
Think about it: the American Heart Association recommended margarine v butter in the 70's. Then the whole trans fatty acid thing blew up when? DUH. My choice at the time was to do a library search on margarine. 1930 thereabouts, chemically made, at that point only 40 years old. All off history for thousands of years cows /goats origin for butter. I went with history. Oddly, enough my twin went margarine. Different outcome.
I'll say question now, but it the science question. It's an abstract for future research. May be being researched now.
Question: What has been the impact of the chemical basis of margarine on health and longevity? A study like that should have been done when margarine was introduced in the 30's. Then when American Heart Association(AHA) recommended it in the 1970's . what did they base their recommendation?
It's what I describe as a breadcrumb trail (Hansel and Gretel). You have 1.something you need to know, 2, you figure out how to find the info, 3, you follow each lead exhaustively 4. reexamine subject every x-y years based on need or interest. Works with anything.
For all here, you need to read and research everything about your disease. You need to be your own advocate based on what you have learned. Those that say you shouldn't go to the internet are wrong. Let me talk about what I learned about how to search medical stuff ———next post1 -
My job in the late 70's was running a Paramedic program. It was in the Department of Emergency Medicine. All doc residencies have what's called Grand Rounds (presentations). The nitty griity, the resident was expected to review at least several dozen articles/studies (weight on studies) for x number of years (weight on most recent years), include a historical perspective, then develop a presentation with Audio/visual, then a question/ answer period. AND present what their opinion was the future based on all this info. It was quite fun. Seriously fun.
Outcome from my point of view, for example, was the resident that did the required residency bug/ spider/snake research became my go to guy to do the bug spider snake lecture for the paramedics. The further outcome was they became the resource for other docs.
What it taught me is how to research and evaluate what I was reading.
I did do a thread on this, it's in the abyss
1.Determine search term(s), modify as needed to pull studies, 2 Expect to superficially read many studies to see if they apply to the question/topic. 3. Refine search by deleting studies or refining search term.
4 How to read a study as an ordinary medical/ nursing/ nonmedical person. This is my approach probably millions of other approaches. The construct of a study is absolute. It was so to speak codified in the late 40's. and is referred to as the Scientific Method. The intent was that world wide research could be expected to follow a common method. That way anyone can research the same question to validate the previous study
The construct: Abstract, Introduction, method, data, discussion, conclusionMy approach, remember I said that, would love to have others to state their approach,
I read the Abstract which is a synopsis (The short story with a conclusion Kind of like Cliff Notes) The body of the study states intent (Question and hypothesis), method, data, discussion, conclusion.
I read the abstract and the conclusion first. Reason is long ago, not sure which year or study. The abstract was not stating what the conclusion was stating. It was a random catch. It was quite a WTF moment. Why would that be done? Anywhooses that's been my approach ever since. Have I found discrepancies since? Not that I can quote now. But that one occurrence caused the wariness.
Then I read the discussion, Maybe the introduction to find out what their initial thoughts were. The discussion is very informing but can be misused. They identify the strengths and weakness of the study and identify areas of future research.
It can be a problem where the next level decipher of the study translates it to us normals. I did a posting on the science thread, on an AP associated press release that said that Champaign could reduce Alzheimer's. It was in our press and on the tv news last a few days. I traced it to UK Sun News, to an interview that the person being interviewed was going to start (Otry)a study and talked about all that they "predicted" would be the outcome. But they hadn't been approved for the study, no enrollee's in the study0 -
My job in the late 70's was running a Paramedic program. It was in the Department of Emergency Medicine. All doc residencies have what's called Grand Rounds (presentations). The nitty griity, the resident was expected to review at least several dozen articles/studies (weight on studies) for x number of years (weight on most recent years), include a historical perspective, then develop a presentation with Audio/visual, then a question/ answer period. AND present what their opinion was the future based on all this info. It was quite fun. Seriously fun.
Outcome from my point of view, for example, was the resident that did the required residency bug/ spider/snake research became my go to guy to do the bug spider snake lecture for the paramedics. The further outcome was they became the resource for other docs.
What it taught me is how to research and evaluate what I was reading.
I did do a thread on this, it's in the abyss
1.Determine search term(s), modify as needed to pull studies, 2 Expect to superficially read many studies to see if they apply to the question/topic. 3. Refine search by deleting studies or refining search term.
4 How to read a study as an ordinary medical/ nursing/ nonmedical person. This is my approach probably millions of other approaches. The construct of a study is absolute. It was so to speak codified in the late 40's. and is referred to as the Scientific Method. The intent was that world wide research could be expected to follow a common method. That way anyone can research the same question to validate the previous study
The construct: Abstract, Introduction, method, data, discussion, conclusionMy approach, remember I said that, would love to have others to state their approach,
I read the Abstract which is a synopsis (The short story with a conclusion Kind of like Cliff Notes) The body of the study states intent (Question and hypothesis), method, data, discussion, conclusion.
I read the abstract and the conclusion first. Reason is long ago, not sure which year or study. The abstract was not stating what the conclusion was stating. It was a random catch. It was quite a WTF moment. Why would that be done? Anywhooses that's been my approach ever since. Have I found discrepancies since? Not that I can quote now. But that one occurrence caused the wariness.
Then I read the discussion, Maybe the introduction to find out what their initial thoughts were. The discussion is very informing but can be misused. They identify the strengths and weakness of the study and identify areas of future research.
It can be a problem where the next level decipher of the study translates it to us normals. I did a posting on the science thread, on an AP associated press release that said that Champaign could reduce Alzheimer's. It was in our press and on the tv news last a few days. I traced it to UK Sun News, to an interview that the person being interviewed was going to start a study and talked about all that they "predicted" would be the outcome. But they hadn't been approved for the study, no enrollee's in the study. At that point I guesstimated 2020. That was about guessing 10 years ago. At the time I thought the Champagne afrea of France was quite happy. All the free advertising re: Champagne No study done, but reported throughout the US as a way to ameliorate Alzheimer's
The serious point of that: AP reported it, assumed there UK arm was correct. Reported on all networks and news outlets. It was completely a messed up false story. No one checked anything.
Again be your own advocate check everything related to you own care0 -
sas-schatzi thanks for sharing that link and glad you feel your sister's presence still.
ctmbiska good to see you and glad to know you are still around. Know you have some hard things going on in your life. Hope you have been able to enjoy your summer months.
Already got reminder on MO appointment this week. Keeping fingers crossed.
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Just found this thread! I have a younger sister who has been somewhat jealous of how my life has turned out compared to hers. I got married, had three boys, and have been pretty successful as a realtor. She divorced from an abusive husband, and never got remarried or had children.
She thinks I lead a charmed life, like everything just falls in my lap. When I told her i would be getting reconstruction surgery and my other breast would get a free lift, she said "See, even when something bad happens to you, something good happens to you!". Grrrrr.
She has her health own issues and I've never said anything to her to make light of it (COPD and a thoracic tear). She just has this love hate thing for me that makes me feel such toxicity, and I'm all she has!
On another note, a woman I met who's daughter dated my youngest son, was diagnosed about a year after me. Her daugther tragically was killed by a drunk driver while she was on skateboard. At her memorial she told me about her diagnosis. It was node positive, but she didn't have chemo or a mastectomy. I was automatically set up for chemo once my nodes were found to be positive. I didn't understand the treatment, but some here said that was normal. Now I find out that early this year she was diagnosed with stage 4. She was undergoing chemo treatment and her husband is begging for prayers. I tried to reach out to her, but I've had no luck. I sent her a PM on facebook to let her know about this site, but she didn't read it. :( I'm hoping that she responds well to treatment and I'm constantly checking his page for an update.
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Hi @ sas schatzi, as the OP of the steam room, just want to say thank you for starting this thread. I've spent some trying times in here. Nice to see you came back. I always appreciate reading other points of view, without bias since everything these days is so polarized and politicized. It's hard to have sensible conversations with people these days.
@bcincolorado-sorry to hear of your recent fall and hope you are recovering well. Wishing you well on your appt. and with the issue they are watching.
@homemom I just couldn't imagine having a sister like that. My sister and I are not exceptionally close at all, but we do have a loving relationship. That goes for my brothers as well. I try not to go on more than a couple weeks or a month without touching base. Otherwise, she would just go on living her life which she once told me that's what she wants to do. She is metastatic (practically de novo) since age 50. Bone mets. Very different from me @ stage II. She's anemic now and on another hiatus of Ibrance so her MO can try and figure out if it's the drug, or the cancer. Luckily, she hasn't needed any more red blood for awhile now. I hope you stick it out with your sister-best wishes with that.
I am actually doing OK-well I think I broke my big toe Friday night. Going for an X-ray on Wednesday morning. Pretty steamed about that~!!!!!!!
My daughter just got engaged, and this weekend I'm throwing my son a 30th birthday party at a restaurant on the water. I'm anxious about spending all this money, but surely this is why my husband left me with some. It's still a scary thought. It's not going to last forever, and I have 5 1/2 years to go before I can get full SS benefits and be back to having 2 incomes. Job is going fine. The bay cottage is still not finished. Currently waiting on the owner to bring over a fridge and stove, and then we are left with all the finish trim and things. The weather has been good on weekends lately, so I try and go down and do what I can, plus enjoy the water and family and friends I've made down there. I'll leave you with a picture of the back bedroom that I painted after the walls went up, and over the winter I worked on making these boards from pallets and they just recently were added.
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homemom I hope they do respond to some treatment for holding it off for a bit. I know everyone has to make their own choices on what is best for them for treatments and reconstruction or not but know some are so scared to do much and it hurts them a lot in their options. Keeping good thoughts for them and you.
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@ctmbsikia Thank you, I'm sorry your sister is going through all of that. I wish I had a better relationship with her, but she thinks we have a great one. I'm just an enabler because she says she suffers from depression and I don't want to do anything to push her over the edge. So in her eyes, I guess her words and actions towards me personally aren't very destructive. I could write a book on what I've done for her and how she has pretty much verbally abused me in return. She has been renting around the corner from me for the past 2.5 years and she just bought a property, so she will be moving about 20 min away in the next week. That will help a lot, but it's not that simple. Anywho, it is what it is, nothing a good psychiatrist couldn't fix.🙄 LOVE the woodwork you're doing in that room. Is that a weekend property you own?
@bcincolorado I got the impression that the doctors said she didn't need it. She was a bit of a problem drinker and it got worse after her daughter's death, which I couldn't blame her for trying to mask the pain. I feel so bad for her and hope the treatments buy her many many years like I see for some women here.
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I really and truly think the US health care system is getting worse every year. My insurer is married to CVS and I never go to CVS, always used the pharmacy at the grocery store. Insurer started making me jump through hoops opting out of this or that. The pharmacy calling every month saying insurer wasn't covering a certain script. So, yeah, I logged in and signed up for mail order with CVS. It actually is saving me $$ and it's a 90 day supply instead of 30. BUT the anastrozole I have to pick up. I don't know why. The other 3 meds have been delivered the last THREE TIMES to my sister in laws home. Of course, that's the mailman's fault, but seriously?
I just logged on again to try and change to just pick up ALL my scripts. Do you think this is allowed? NO. You can switch from pick up to mail order, but not the other way around. I thought about changing the ship to address to CVS, but I chickened out and sent a message instead to ask if I could switch to pickup. Well, here is the response:
We are unable to remove the prescription from your list at this time. However, we can request the prescription to be discontinued so it will no longer appear on your refill page. If you would like the prescription(s) discontinued, please respond to this e-mail with the name and strength of your medicine(s) so we can submit your request to our
pharmacy or call Rx Member Services at the toll free number on your member ID card.Now, I did not reply to this email. They called my primary doc and said I discontinued!!! That triggered another phone call from them to me to check to see. Jesus. I logged back in and just re-ordered the 3 scripts, and I picked up the 1. Get another phone call regarding payment. These people don't know what ringing phones do to me!! I didn't check which card I had used to check out so that was my fault. My "Health spending account" is bone dry for the year! Had to make another phone call to speak to a human, and I gave them the payment——nowhere on their site was I allowed to change the card number myself.
Unreal! I feel better now. Hope everyone is hanging in there.
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You can try talking to the pharmacist at CVS about changing scripts to pharmacy, My DH was getting his scripts from CVS via mail and I was concerned about the effects if extreme temps on the meds in the delivery process plus sitting in a mailbox. He was able to get them changed. Our prescription insurance is aligned with CVS much to my annoyance.
Personally I find CVS to be a royal pain when it comes to customer service. Our pharmacy is overly busy and I feel short staffed for the volume of business they do. Last year they posted walk-in flu shots were available. Did not post anywhere that they were restricted to certain days only. I was told that I needed an appointment on the day I tried a walk-in and directed to come back the next day. Told them, nope and went to another CVS that truly had walk-in shots offered.
Cannot remember if they own Aetna or Aetna owns them but they are going to be doing massive layoffs soon and not sure if this will impact pharmacies. Turnover of pharmacists and staff is continuous. Overheard them complaining about the antiquated computer system they use for prescriptions and that is scary. It was one of the pharmacists who was complaining.
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Thanks for your input. Hmm, no wonder. I also saw where they denied the Prolia claim from July saying there wasn't a pre-certification. Well, the pre cert was done in January and should be good for the year which would have included this last injection. Saw the cost went up another $2K! Not really worried about this, but annoying is a very good word to describe Aetna and CVS.
Will see what happens with my employer's decision for coverage next year. If they stay with this company, I will be certain to bring up my complaints at the election meeting.
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If a person enjoys making an appointment for a vaccine, standing in very long lines, and being told at the counter "we no longer have the staff for that," then come to my CVS! The pharmacy closes for an hour midday and at 6:00 PM weekdays, 5:00 PM weekends. CVS continues to send relentless messages to make an appointment for this-or-that vaccine. We're transferring all scripts and vaccinations to another pharmacy.
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I am going to vent right now because I am so saddened by the loss of the mother in a family that has had more grief to handle than any one family should have. She was diagnosed about a year after me (2014). She had cancer in her lymph nodes but they didn't do chemo. I was a little surprised at that. She was still grieving the sudden loss of her 19 year old daughter at the hands of a drunk driver. After her daughter died, she drank a LOT, and I can't stand in judgement of that, but it may have exacerbated the situation, I don't know. I also think that she may have stopped being monitored because she was complacent or her doctors were. She also moved about an hour south of where she was living at the time. She was diagnosed with stage 4 just over a year ago, had meds and radiation and then chemo this past Feb.
I'm overwhelmed because my son dated her daughter for over a year, and while they weren't together when she died, they were talking again. He went through years of working through it to be able to function again. He came over to let me know that her mother passed away last night. I'm just so saddened by this!
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My condolences to you and to that poor family that has such losses. The death of a child has got to be the worse experience for a parent. Your poor son may be triggered by this loss given his relationship with them. I hope both of you can find strength in supporting one another. (((Hugs)))
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Condolences. Losing a child is so hard to deal with. I remember when my uncle passed and my grandma said to me no one should out live children and have to deal with that pain. You expect to lose grandparents and parents but losing a child is the so hard. Does not matter how old they are they are our babies.
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@homemom so sorry for your loss—sucks. just so sad. Please extend that to your son.
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Having to deal with my mom who is close to 85 had to put her dog down this week. We used to care for him when she went out somewhere since she could not leave him alone and he would bother her neighbors in her old folks building. It is hard since he spent so much time here as well. We love our pets and hate to see them suffer as well. Hate dealing with something else right now since have to try to take care of my mom and it also means can't take care of myself like I need to right now.
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bcincolorado, Sorry for your loss and your mother's as well. Losing a beloved pet is difficult.
Can another family member assist with your mother? I do think there are times where we have to make ourselves the priority even though it seems selfish. It is not, because it is called self-preservation, and if you do not take care of yourself, you won't be able to care for your mother. Hope someone will step up for you.
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No I have one sibling who lives in another State and my dad is living with him who is even older and has health issues of his own. My mom moved here to be near us after she retired and my grandma had passed away from another State. She lives 2 miles from us so it is close by us and considers herself "healthy" for someone who is 85 but has had issues with not eating right and drinking enough and has fallen and hit her head a couple of times even in falls and about passed out. Too dehydrated. I have stressed food on schedule and water on schedule to keep her ok and not happening again. Now she has to go get some testing done because of issues with dizziness and they think it from those falls. Have a feeling she is going to end up with more skilled nursing care than I can give her.
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bc, I'm sorry for all the stuff you're dealing with regarding your mom. It's hard to watch our parents age.
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bcincolorado, it seems the priority for your mother is a safe environment and agree she most likely needs more supervised care than you can provide. You mentioned she is in an old folks building, does this mean it is a private apartment or an assisted living facility? My MIL was in assisted living but frequent falls meant she had to go into a more skilled facility for her safety. This may be the route you need to explore. Good luck and (hugs).
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My mom lives in an apartment in a secure bulding and it is all seniors. They used to be able to do a thing where they turned on a light in their apartment in the morning and it would light up in the office at night and turn it off in the morning. If no one responded they would check on them. Then someone said they needed other licensing for that and made them stop doing it. Now I check on my mom every day by phone and or email a few times a day and make sure she is eating and drinking ok. She still drives and is off going to the store and to church or over here. Nothing is too far.
We did take her out to go watch the grandkids play in some games over the weekend. Very tiring. They live about 30 minute drive from here. It is her great grands. They gave her some big hugs about her doggie since they knew him as well. That helped her be a little cheered seeing them.
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@bcincolarado (not hyperlinking?). sorry, for your trouble. Been there. The worry. The feelings of no control even though your trying your hardest to help. It sucks. I'll cut to chase of my thoughts from a nursing perspective.
Some doc is directing her care.
1. Ask if the following labs have been done. TSH(thyroid stimulating Hormone), B12, Folate, Mg, Vita D, Vita A (you will get very serious pushback on this request—-you push back), plus standard Metabolic profile, CBC. In researching each of these tests, some element in the symtom lists apply to many. That's why most of these tests are include in the yearly exam, and in change of condition evaluation.
2.Referrals for the following:
—-Physical Therapy Evaluation and treatment for falls. Best person for that evaluation TaDa, It's covered by insurance b/c falls are close to the top of insurance payouts. Prevention is a priority.—-Next referral, Memory Care Specialist Evaluation and Recommendation. The professionals go by many names or alphabet, but the key is specialization or extra training in the evaluation of memory. Just like every other doc specialty, they are even more specialized within their own specialty. Don't be afraid of this type of evaluation. You expressed multiple times in your post. YouR concerns of her wellbeing. The professional doing the eval can make recommendations and orders for neurolgist eval, tests like brain MRI/ Ct Scan.
The sequence of docs/ other professional evaluations may be required by different insurance systems. The key is always to rule out a physical cause first. ABSOLUTE KEY. So keep working the problem.
Next referral. Home Health Agency to Evaluate and treat. This causes a Nurse to go in an admit with the patients consent to be admitted to home care. The nurse can make all kinds of referrals based on that one sentence. Mechanism of the how isn't a need to know in the sense that the system is designed to bring all the services together to provide the highest level of in home evaluation & care. The nurse can order in an Aide that can help with baths, linen change, light housekeeping, grocery shopping; Physical Therapy E&T. Social Worker E&R. Occupational Therapy E&T.
The CENA (the Aide). May be covered by the facility. If not covered by the facility, the key here is she safe taking a shower by herself. By medicare rules a patient can be approved to six hours a week of assistance. That can be broken up many ways based on need. The time however is very defined, it must be used for direct care given. Traveling time between patients isn't approved.
An Admission to Home Care is for an eight week period. Insurance companies follow Medicare guidelines. In that time period all the specialties that would evaluate your mom would have evaluated her and how her surroundings impact her. They will work on bringing her to her highest level of function for her situation.
Ophthalmologist referral: Before this decade I'm in now, I would have never said that AND rarely if never will you find this in the algorhtim for problem solving about Falls. BUT I have Wet Macular Degeneration. Guess what you won't find in in the symptom list—Falls. Of course, it started with dry mac . The key to macular changes is that your depth perception is affected. Try walking in a world where what you see isn't exactly right. Every step is suspect. But the average person may not connect an eye problem to a balance/falls problem. Key request to ophthalmologist "Can any condition with in these eye(s), contribute to Falls".
Your job is to make the request of her doc with her permission for refferrals. Trusting that you have Health Care Surrogate papers. Once the ball starts rolling the ideal is for you to be at every in home evaluation b/c by watching the professional's put mom through the paces you will see the problems. The evaluations are designed to make them manifest as a problem.
It will seem alot. But it's this many NURSE, PT, OT, Soc WORK. FOUR thats doable. You do two things by being present at these evaluations. YOU REDUCE YOUR ANXIETY about something being done to help her. And you are helping her by getting this all going. Plus the doc referrals which I count max three—neurology, memory care, and ophthalmology
It's very busy over a couple of weeks and then your time involvement will fall into a pattern. At the pattern point, you will request updates by phone. Home Health Agencies are very used to this.
After the evaluation session you do not need to be present for any visit. Unless someone thinks it should happen. Then you do & they do. That's a very important point. The key is to reduce everyone's' stress. A plan is worked out. Reduce all visits that you have to be present at. Quality not quantity.
I'm happy that I wrote this, unhappy about sequence of referrals. It can be confusing as written. But I have had a gummy and on a roll. Perhaps, I could write out the way the request would be salient0 -
@bcincolorado
Lab request CMET(CMP), CBC, TSH.B12, Folate, HBA1c, Vita D, Vita A, Mg
Referral. Home Health Agency to eval and Treat to include PT, Social Work, Occupational therapy.
Request that Insurance agency assign nurse to follow and expedite problem care.
Referral for Neurology and or Memory Care Evaluation.
Referral to ophthalmology for evaluation of Night blindness, dry eyes, retinal changes, Cataracts, Glaucoma, Visual perception changes
All that rambling up top reduces to a few sentences0
