As illustrated by my dependence on decongestants, I am not completely averse to the taking of modern medicines. And yet, by the grace of God, my mother very nearly avoided disaster only by stopping her pill regimen.

Mom's in assisted living by choice, having lost her husband (my father) late last year and declined my eldest sister's invitation to live with her. So she stays about one mile from me and I'm her financial and medical caretaker.

She spent a few weeks in rehab after Dad's death recovering from a back injury. That was the first I realized she was on about 10 medications for high blood pressure and diabetes. (A diet of rich food and sugary snacks had taken its toll over 82 years.) After she moved to assisted living, the paramedics had to be called twice to revive her after blood-sugar spikes rendered her unresponsive. I couldn't get her physician interested in solving that problem, so I hired a nurse practitioner at a local hospital whose geriatric program operates on a "limited medications" philosophy.

Within hours, they had nixed all the blood-sugar depressants and put her on insulin as needed to smooth out the high spots. Now, two weeks into the regimen, she has even gone a few days with zero insulin injected, and a couple of days with just three units.

What had spooked the practioner into such a dramatic change in regimen was, Mom's renal (kidney) function showed about 33 percent of normal. Ten percent means dialysis. What was taxing them was ... metabolizing all those godforsaken pills.

so, if i understand correctly, doctor #1 was propelling Mom toward kidney failure through inattention, while a practitioner spotted the problem instantly in the course of routine lab work.

I wonder how many other dialysis patients would not have been in that state but for the failure of their doctor to realize what he was doing to them.

I am not a lawsuit guy. I do not expect doctors to be perfect in their decisionmaking. What I do expect is, when you are paid by Medicare for virtually anything you do with old people—including pedicures, believe it or not—you ought to at least look at their status once in a while. This guy never saw Mom until she checked into the hospital after the aforementioned blood-sugar episode. And he only saw fit to tweak one dosage of one pill in response.

You could say I'm being hard on him, projecting my own guilt over not being with Mom every day. I can't accept that. I—and you, another taxpayer—lay out enormous sums of money to give our parents and grandparents medical care they could not otherwise afford. Without that subsidy, the doctors would have to lower their rates dramatically to make up for the lost business.

Lots of old people don't know how, or are not willing, to take care of their needs. There's no easy answer to that.

At the very least ... ah, what's the use.

Maybe he's just a bad doctor, and I'm blessed to have caught this before it got much, much worse.

Thank God for that.

Posted by: Michael Rittenhouse at 07:44 PM | No Comments | Add Comment
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