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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 16 of 16. This is the beginning of the thread.
Posted by spriggy on September 28, 2005, at 13:15:14
My mom called me crying because my dad is wigging out. He is hallucinating, doing weird/strange things; putting forks in the toaster, bread in the washing machine, etc..
They just added new meds but my mom couldn't remember what was new. He's on sooo many.
I asked her for a list of his meds (his diangosis is BiPolar, Hepatitis C, heart disease, diabetes, degenerative disc disease, COPD).
They are headed to his doctor right now (but he has so dr's that aren't working together and each one gives him different meds).
He also has a morphine pump installed in his back.
Here is a list (does anyone know if these could be counteracting and freaking him out?):
****************************************
1) Zofran 4 mg's for nausea
2) Klonopin (2 mg's twice per day) My mom did say he ran out early and just got his refill in a few days ago.
3) Seroquel (100 mg's)
4) Neurontin 600 mg's ( 4 times per day)
5) Darvocet 100 twice as needed
6) Toporal Xl 50 mgs (1 tablet daily)
7) Lamictal 100 mg's
8) Plavix 75 mg's
9) Lexapro 20 mg's
10) Lasix 20 mg's daily
11) Lonoxin tab .125 mg
12) Mavik 2 mg
13) Shots of Lantis 100 units (twice per day)
14) Novolog 10 mlPersonally, just looking over this list, I'm surprised he's not dead by now. There are so many things here he's given by all his different specialists without ever checking what else he's on.
He's also been known to abuse his meds too so who knows if he took too much of something or added a little MJ on the side of this cocktail.
I could hear him in the background over the phone and he is totally out of touch with reality. He thought I was calling about the fish he caught (he hasn't left his house in a week and doesn't fish).
Any help would be appreciated.
I'm really worried about him. If anyone has any insight, please let me know.
Posted by Racer on September 28, 2005, at 18:33:05
In reply to I need help... SLS? Ed? Linkadge? larry??, posted by spriggy on September 28, 2005, at 13:15:14
That's my first question, if all he's using is Lantus. No fast acting insulin at all?
I'm afraid that I don't know enough about the other issues to have much to say about any of them, although with so much going on, it's got to be scary for all of you.
When he's not this wigged out, how lucid is your father? What's his mental state like on average? Is he coherent enough to work with a good treatment team? If so, I strongly suggest that you help your mother arrange to get all those doctors talking so that there's less chance of a bad interaction. After that, I'd also suggest -- very, very strongly -- that you provide a small safe to keep the medications in (except those that need refrigeration, of course) and have your mother play Nurse for him. Only give him what he's supposed to take, when he's supposed to take it, so that he doesn't abuse the drugs. Especially with the diabetes, that's a very dangerous thing for him to be doing.
If he isn't able to be helpful in his own treatment, it might be worth talking to an attorney about having a guardian appointed for him. It would probably be your mother, of course, but it would allow her a lot more freedom to get those doctors working together.
I'm sorry that I can't be more helpful. I do hope things turn out well.
Posted by Phillipa on September 28, 2005, at 18:45:20
In reply to What are his blood sugar readings like? » spriggy, posted by Racer on September 28, 2005, at 18:33:05
Spriggy, does he get his meds from the same pharmacy? If he does then the pharmacist would question any new drug or combo of meds. All that pain medication could be doing it too. And I'm really really sorry. Love Phillipa
Posted by tecknohed on September 28, 2005, at 19:26:27
In reply to What are his blood sugar readings like? » spriggy, posted by Racer on September 28, 2005, at 18:33:05
Just thought I'd add that I have diabetes and I doubt its his blood sugers. He's taking Novolog which is a rapid acting insulin. A low blood sugar may make him giddy but he'd collapse before long.
I hope your father gets better soon Spriggy.
Posted by spriggy on September 29, 2005, at 11:53:09
In reply to Re: What are his blood sugar readings like?, posted by tecknohed on September 28, 2005, at 19:26:27
When he got to the dr. his blood sugar was over 500! So it was likely a blood sugar issue.
I don't know what they are gonig to do about it. My dad's health is back and forth.
Thanks for the help.
Posted by tecknohed on September 29, 2005, at 16:38:13
In reply to Thanks everyone...., posted by spriggy on September 29, 2005, at 11:53:09
> When he got to the dr. his blood sugar was over 500! So it was likely a blood sugar issue.
>
> I don't know what they are gonig to do about it. My dad's health is back and forth.
>
> Thanks for the help.So it was his blood sugar! Sorry I advised that it wasn't! I was thinking more of low blood sugar. But then with all your fathers meds its not surprising because high blood sugar alone can distort a persons thinking (I get irritable and short tempered).
500 mg/dL is very high (thats about 28 mmol/L in UK). Does he have type 1 or type 2 diabetes? I have type 1 and occasionally go over 20 mmol/L (375 mg/dL) but because I do regular blood test readings (at least 4 x day) I manage to catch it pretty quickly, plus I can 'feel' it anyway.
Maybe you could get you father to do regular blood tests even if its just once a day. Its very important that he does, as his doctor has probably told him already.All the best,
Kev.
Posted by Racer on September 29, 2005, at 19:44:53
In reply to Re: Thanks everyone.... » spriggy, posted by tecknohed on September 29, 2005, at 16:38:13
> > I have type 1 and occasionally go over 20 mmol/L (375 mg/dL) but because I do regular blood test readings (at least 4 x day)> All the best,
> Kev.
>
>Too funny -- my overinsulinating spouse tests betweeen 12 and 20 times per day. I only wish we could make "regular" and "at least 4 x daily" synonymous around here.
Sorry to break in, I just found myself brought up short over that one.
Posted by ed_uk on September 30, 2005, at 15:05:27
In reply to Re: Thanks everyone.... » spriggy, posted by tecknohed on September 29, 2005, at 16:38:13
Hi Kev,
What sort of insulin do you use?
NovoRapid, Humalog and Lantus are all really popular at the moment. Most people use the cartriges or the pre-filled pens. Some people still use the 10ml vials though.
>I do regular blood test readings
What sort of test strips do you use? Sorry, I'm soooooooo nosy. Active, Advantage II, Compact, Glucomen, FreeStyle, One Touch Ultra and MediSense are all widely used.
A new insulin just got approved in the UK. Here is some more information.......
Rapid acting insulin analogue effective in a range of body types launched
New rapid acting insulin analogue insulin glulisine has been launched by Aventis Pharma this week.
Aventis Pharma says that insulin glulisine (Apidra) has a faster onset of action in people with body mass indices ranging from lean to obese, compared with rapid acting insulin analogue, insulin lispro.
The company adds that insulin glulisine provides equivalent reductions to insulin lispro in HbA1c in people with type 1 or type 2 diabetes.
Insulin glulisine is aimed at people with type 1 and type 2 diabetes who require a basal-bolus insulin regimen. It should be given no more than 15 minutes before or soon after meals. It should be used with an intermediate- or long-acting insulin or basal insulin analogue and can be used with oral hypoglycaemics.
Kind regards
~Ed
Posted by tecknohed on September 30, 2005, at 16:45:51
In reply to Re: Thanks everyone.... » tecknohed, posted by ed_uk on September 30, 2005, at 15:05:27
> Hi Kev,
>
> What sort of insulin do you use?
>
> NovoRapid, Humalog and Lantus are all really popular at the moment. Most people use the cartriges or the pre-filled pens. Some people still use the 10ml vials though.
>
> >I do regular blood test readings
>
> What sort of test strips do you use? Sorry, I'm soooooooo nosy. Active, Advantage II, Compact, Glucomen, FreeStyle, One Touch Ultra and MediSense are all widely used.
>Ask all you want mate! Its nice that you're interested!
I use NovoRapid 3ml cartridges, @10 units 3-4 times daily. But it varies. I'm forever topping up because of my somewhat unstable control (there's no pattern - I've asked for funding for a pump but apparently I'm not 'unstable' enough, despite my constant irratic readings! If your HbA1c reading (average over 1 month) is ok then as far as they're concerned you're fine!).
My long acting is Glargine (Lantus), 24 Units at night from a prefilled pen (the pens for self inserting Lantus cartridges are cr#p).
My Pentip needles are Penfine 8mm.My test strips are Active & the lancets are Softclix (both Accu-Check).
I have several meters but the one I use most is Accu-Check Active - small with convenient carry case.I have'nt tried the new glulisine but I did try a newish long acting recently which made things worse. I'm best off with what I've got, it aint perfect but its the best I've found. Until I can get on a pump that is!
Enough answers? lol
Take care
Kev.
Posted by ed_uk on October 1, 2005, at 14:48:45
In reply to I'm soooooooo nosy » ed_uk, posted by tecknohed on September 30, 2005, at 16:45:51
Hi Kev,
>the pens for self inserting Lantus cartridges are cr#p).....
So the Lantus Optiset is better?
>I did try a newish long acting recently which made things worse.......
Insulin detemir (Levemir)?
~ed
Posted by tecknohed on October 2, 2005, at 7:21:55
In reply to Re: I'm soooooooo nosy » tecknohed, posted by ed_uk on October 1, 2005, at 14:48:45
> Hi Kev,
>
> >the pens for self inserting Lantus cartridges are cr#p).....
>
> So the Lantus Optiset is better?
>
> >I did try a newish long acting recently which made things worse.......
>
> Insulin detemir (Levemir)?
>
> ~edYes you're right on both.
The mechinics in the pens for the cartridges stops working after a short while (they have a digital reader), and I've tried 3 pens. Thats dangerous if you ask me! The Optisets are much easier to use, even if they are a bit stiff - old people or people with arthritis might find them a bit difficult to use.
And yes it was Levemir. I remember my doctor telling me he thought it would do the trick - hardly! I think that once you've settled on one type of insulin for a while, you can become somewhat resistant to a change. At least in my case (my fathers too).
My biggest problem is absorbtion. Too often its like my insulin isn't even getting in and my glucose goes sky high for no apparent reason. And it is'nt just delayed as I need more insulin to bring it down again. Either that or my liver's had it and just keeps pumping out glycogen whenever it wants!
It would be nice to see a patch or inhaler in my lifetime. Or even a cure (yeah right!). Sorry if I sound bitter about it. But it is s#!t.
Regards,
Kev.
Posted by ed_uk on October 2, 2005, at 8:41:57
In reply to Re: I'm soooooooo nosy, posted by tecknohed on October 2, 2005, at 7:21:55
Hi Kev,
>Levemir
It's not that popular to be honest, not compared with Lantus.
>It would be nice to see a patch or inhaler in my lifetime.
http://news.bbc.co.uk/1/hi/health/4228412.stm
Do you take any other medication apart from insulin eg. aspirin 75mg, ramipril, enalapril, lisinopril, simvastatin or atorvastatin (Lipitor)?
Kind regards
~Ed
Posted by tecknohed on October 3, 2005, at 7:44:32
In reply to Re: I'm soooooooo nosy » tecknohed, posted by ed_uk on October 2, 2005, at 8:41:57
Thank for the link. It annoys me why they keep putting it off! Why should I wait till 2019 - I dont smoke.
I dont take asprin or any others you mention. I dont think many type 1s do. Though I'm still young(ish!) at 25.
Posted by ed_uk on October 3, 2005, at 14:06:48
In reply to Re: I'm soooooooo nosy » ed_uk, posted by tecknohed on October 3, 2005, at 7:44:32
Hi Kev,
>Though I'm still young(ish!) at 25.
I like to know people's ages :-) I'm 21.
~Ed
Posted by tecknohed on October 4, 2005, at 19:50:45
In reply to Re: I'm soooooooo nosy » tecknohed, posted by ed_uk on October 3, 2005, at 14:06:48
> I like to know people's ages :-) I'm 21.
>
> ~EdCool! You're very knowledgable for a 21 y/old!
Do you study or work in Psychiatry, or is it just a hoby?
I wonder how old everyone else is?
Posted by Dr. Bob on October 5, 2005, at 0:06:47
In reply to How old? » ed_uk, posted by tecknohed on October 4, 2005, at 19:50:45
> I wonder how old everyone else is?
Sorry to interrupt, but I'd like to redirect follow-ups regarding how old everyone else is to Psycho-Babble Social. Here's a link:
http://www.dr-bob.org/babble/social/20050929/msgs/563056.html
Thanks,
Bob
This is the end of the thread.
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