Sunday, May 4, 2014

Supra live stupidity

My wife's disease has given me plenty of opportunity to annoy MD's with my stupidity.  She was taking a medicine that control's the volume of pee she makes and was taking it according to her main endocrinologist's recommendation. Since she had partial pituitary function, it was dangerous to take too much of the medicine as she would retain water driving the volume of sodium down in her blood. If she did not take the medicine she would pee out her water leaving too much sodium relative to her water volume in her blood causing hypernatremia. It is still safer in her condition to undertake the medicine as her thirst drive will cause her to drink water. She will be running to the bathroom every thirty minutes but will maintain the proper level of sodium as long as she drinks to replace the water lost. The endo wrote her prescription for many years at the greater dose in case she needed it but with the verbal instructions not to take it if she was not thirsty. It worked well when she had her normal level of mental functioning and did not have memory loss. I did not understand any of this and when I took her to one of her many visits to the ER I could not explain to the doctors why my wife was not taking the prescribed dose. She was adamant about not taking the morning dose when I offered it.  I don't know for sure but in the ER they replaced quite of lot of normal saline fluid and when she started peeing that night her sodium levels probably went through the roof. I wonder if  Doc's sometimes do not take the particular lab needed if they suspect what is happening as a way to cover themselves.. The amount of water she was peeing would have given them the clue they needed and in their haste to correct the problem the 2nd year resident gave her the hemophiliac dose of the medicine. The dose was about 30 times her normal. The next day when I arrived in the ICU the resident laid in to me real hard and basically accused me of altering her meds.  I already had been accused of possible abuse by a MD seen a psychiatrist who seemed to be setting me up for drug habit and had a wife who was really sick with an undiagnosed condition. There was not much I could say at the time. My own stupidity about her original disease was responsible for my inability to tell the resident why she had not taken the prescribed dose..

The idea that I was altering my wife's meds followed me around the hospital for many years on top of the possible drug use and the possible physical abuse. Several years later the point was brought up by both her primary MD and her rheumatologist. Her rheumatologist laid in to me again about giving her the pee medicine the wrong way.  (The funny in a bad way thing is I had just taken her out of the hospital with an early discharge the week before because the hospital was screwing up her sodium for the umpteenth time. Often it felt Keystone Coppish with one doctor saying one thing and another care provider doing something else). The rheumatologist brought up the point that her 'Lupus' was very rare and hard to diagnose. I was trying to agree with her and mentioned that her endo always said that she benefited from supra-physiological dosing of steroids.  Growing up in Long Island, NY we have a habit of taking the 'er' and make the 'a' sound and taking the 'a' and making a 'er' sound. So Mr Parker becomes Mr Parka and the parka you wear becomes parker. So what the rheumatologist heard was 'super'-physiological and put it in the chart to further alert future docs that we got a live stupid one here. Super physiological just sounds dumb and in my opinion reinforced the original belief that I was probably altering her meds. It puts an additional layer of complexity on a very complex problem. The tragic thing is her primary endo used the term supra-physiological in a letter to them many years prior and just before her major admit to the hospital. In my interpretation it would indicate to them that it was always an autoimmune condition. Even with the positive antibodies for Lupus her condition was not diagnosed for over a year later by outside doctors.

So it was with great trepidation that I am going to use the word supra again. There is a term supra legal suggesting the legal issue is above/outside the law.  I think the work I am doing with my left tongue is 'supra' normal. I don't think it is needed for my 'normal' functioning. I am beginning to think that the development of my being right or left handed could have gone either way but it was based on my relationship to what I perceived in my environment. My working on the left tongue therefore would be outside my normal development. So the rheumatologist was also right. I am definitely a supra live stupid one.

No comments:

Post a Comment