Chapter 531 - A Month of Exelon
After four weeks on the Exelon patches her neurologist had asked me to phone the clinic nurse at West Beer Hospital to be given further instructions, I suppose if problems have occurred. Documentation suggests the Exelon 5 patch may only be the introductory dosage. Because I find giving technical details by phone somewhat error prone, I sent an email with comments, quickly receiving an automated response to say the nurse was on leave until month's end and to ring the given number on the email. I must do this on Monday. Below is the list of redacted comments from my email.
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1. The first Exelon patch was applied on Friday 16 Aug when her Duodopa flow rates were at 7.0/2.0 . No changes have been made.
2. During the first few days [She] was stressed with wild dyskinesias and had bursts of sleep of up to an hour although these had occurred prior to Exelon. On 22 August I took her to our GP Dr J who was able to observe [Her] fall asleep and declared that the event was just that, Pam had fallen asleep and her BP, pulse and breathing were normal as expected. [Her] bouts of sleep still occur, perhaps less frequently.
3. Probably because [She] tends to be hot and has sweaty skin, the Exelon patches tended to partially lift, once one actually fell off, so I have been placing two pieces of tape across a patch. The patches are moved from left and right upper arms, chest and shoulders each morning about 0830 after showering and dressing.
4. [She] says she feels "better" since beginning the patches. I think she is less stressed this past month. My FitBit traces from her right leg show that on some days dyskinesias are minimal, on other days quite vigorous, so probably minimal improvement.
5. Dr F warned us of Nausea/Tummy Upset, Drowsiness, Confusion, Dizzy Spells/Blackouts, Severe Tummy Pain. None of these have occurred unless some of the sleep incidents are included that are of short duration, maybe 5 minutes or so, since these may not always be noticed since she is in a wheel chair all day.
6. [She] continues being compulsive about sorting items, cleaning spots unnecessarily and sewing projects by hand without completing any.
7. After going to bed at about 1915 each night [She] will usually read novels on an eBook reader for at least 3 hours,
8. [She] is scheduled to undergo cataract and glaucoma procedures at B on Wednesday 18th September.
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She has commented that the dyskinesias "feel" different and her toes are painful. Last night when the Wild Dog Carer and I were preparing her for bed she complained of pain in the toes of her right foot. Thinking that her foot was not properly fitted into the show, I removed the shoe and then replaced it. On removing the shoe again, I saw blood on one of the toes and then noticed a small sewing needle embedded in the side of the toe, which was quickly removed and a band aid applied. The needle would have fallen into the shoe while she had been pinning and sewing the same quilt she has been working on for at least two weeks. Much of her time is spent collecting pins and needles from the floor, dropped or spilled there. I often find pins and needles on the seat of her wheel chair after I have transferred her onto the toilet, and expected to extract same from her bottom, not her foot.
After some lunch at the soldier's club on Thursday she wished to go to her favourite cheap shop where she saw wooden clothes hangers, realising she needed two packs of six, then spools of crochet cotton and rolls of ribbon with which to pad and decorate to hangers. We left after buying $35 worth, All these items are now forgotten in her sewing room as she concentrates on the never ending quilt project which for ever remains at the pin-together stage.
I attempt to encourage her to complete the paper cup finger holding exercises advised by the physio. She thinks she is able to do the exercise, but in my opinion very poorly, and only when I hand her the cup and then not for any length of time. She does not attempt any exercise of her own volition.
She has been asleep with feet up. I see on the Echo Spot that she has woken, so I will see whether she wishes to spend some time down the street, perhaps lunch.
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1. The first Exelon patch was applied on Friday 16 Aug when her Duodopa flow rates were at 7.0/2.0 . No changes have been made.
2. During the first few days [She] was stressed with wild dyskinesias and had bursts of sleep of up to an hour although these had occurred prior to Exelon. On 22 August I took her to our GP Dr J who was able to observe [Her] fall asleep and declared that the event was just that, Pam had fallen asleep and her BP, pulse and breathing were normal as expected. [Her] bouts of sleep still occur, perhaps less frequently.
3. Probably because [She] tends to be hot and has sweaty skin, the Exelon patches tended to partially lift, once one actually fell off, so I have been placing two pieces of tape across a patch. The patches are moved from left and right upper arms, chest and shoulders each morning about 0830 after showering and dressing.
4. [She] says she feels "better" since beginning the patches. I think she is less stressed this past month. My FitBit traces from her right leg show that on some days dyskinesias are minimal, on other days quite vigorous, so probably minimal improvement.
5. Dr F warned us of Nausea/Tummy Upset, Drowsiness, Confusion, Dizzy Spells/Blackouts, Severe Tummy Pain. None of these have occurred unless some of the sleep incidents are included that are of short duration, maybe 5 minutes or so, since these may not always be noticed since she is in a wheel chair all day.
6. [She] continues being compulsive about sorting items, cleaning spots unnecessarily and sewing projects by hand without completing any.
7. After going to bed at about 1915 each night [She] will usually read novels on an eBook reader for at least 3 hours,
8. [She] is scheduled to undergo cataract and glaucoma procedures at B on Wednesday 18th September.
############
She has commented that the dyskinesias "feel" different and her toes are painful. Last night when the Wild Dog Carer and I were preparing her for bed she complained of pain in the toes of her right foot. Thinking that her foot was not properly fitted into the show, I removed the shoe and then replaced it. On removing the shoe again, I saw blood on one of the toes and then noticed a small sewing needle embedded in the side of the toe, which was quickly removed and a band aid applied. The needle would have fallen into the shoe while she had been pinning and sewing the same quilt she has been working on for at least two weeks. Much of her time is spent collecting pins and needles from the floor, dropped or spilled there. I often find pins and needles on the seat of her wheel chair after I have transferred her onto the toilet, and expected to extract same from her bottom, not her foot.
After some lunch at the soldier's club on Thursday she wished to go to her favourite cheap shop where she saw wooden clothes hangers, realising she needed two packs of six, then spools of crochet cotton and rolls of ribbon with which to pad and decorate to hangers. We left after buying $35 worth, All these items are now forgotten in her sewing room as she concentrates on the never ending quilt project which for ever remains at the pin-together stage.
I attempt to encourage her to complete the paper cup finger holding exercises advised by the physio. She thinks she is able to do the exercise, but in my opinion very poorly, and only when I hand her the cup and then not for any length of time. She does not attempt any exercise of her own volition.
She has been asleep with feet up. I see on the Echo Spot that she has woken, so I will see whether she wishes to spend some time down the street, perhaps lunch.
posted by Kilpike | 10:26 am
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