Tag Archives: Aricept

Another day, another Doctor: Pt. lll

Posted in August by

One of the benefits of having Dr G as Miss Cathy’s Geriatrician is that it’s like ‘one stop shopping’ when we go to see him.

Whenever there is a problem or question (and mom has many) we see Dr G first, and if he doesn’t have the answers he’ll know the appropriate specialist who does.

Case in point, we were back after about a month (it felt like longer) of schlepping around from one new doctor to the next, to discuss their various findings.

The good news was that (other than not remembering what day it is) mom is basically ‘fine’ (a very subjective word these days but considering the alternatives, we’ll go with ‘fine’).

Dr K, her new neurologists, added Namenda to her daily medications, Namenda is a dementia drug that is thought to work well in conjunction with Aricept (which she’s been taking since her diagnosis in 2010) to help sustain memory and issues of confusion.

One of the other specialists she saw was Dr M, a vascular surgeon. I took Miss Cathy to see him regarding the five ‘episodes’ of fainting that’s she’d had over the course of the last three years to get to the root (hopefully) of why they were happening; was it a stroke? Were they seizures? Up till now nobody could say for certain.

He determined that the problem was not the blood flow to her corrated artery (so the ‘why’ and ‘how’ of the episodes is still unresolved but luckily there haven’t been any recently).

After his examination the doctor did recommended Lipitor or it’s generic equivalent to help reduce the possibility of a stroke given her age and all she’s been through.

As we sat with Dr G in one of the (very small, very cramped) examination rooms, he went over all the notes from the other doctors, the things put in place and their recommendations moving forward.

There was a little debate (more between Dr G and himself than with either of us) as to whether or not to put mom on the cholesterol-lowering drug.

Dr G said that while Lipitor is a valid recommendation his concern was Miss Cathy’s various other health conditions; diabetes, Alzheimer’s, high blood pressure and anxiety. So he wanted to be careful that any new drug introduced into her system wouldn’t have either a negative effect or counteract the effectiveness of a current medication.

It seemed at first that he was considering adding the ‘statin’ to mom’s meds and said as much.

Miss Cathy’s response was, “I don’t want to take that. I’m taking too many pills as it is.”

I sat in a corner of the room on what looked like a banquette built for a child or as an afterthought next to a small sink and supply cabinet. There was barely enough room to contain my ever expanding ass and irritation as I eavesdropped on their tête-à-tête.

Dr G smiled and said, “Of course that’s what you say about every one of these pills that we give you to take, so lets just consider this for a minute.”

‘Points’ for Dr G! It may not sound like much but that was one of the rare time that he didn’t just acquiesce to her protestations…..we might just be getting somewhere today.

The Meds discussed in this Blog Post were:

Aricept: is used to treat confusion (dementia) related to Alzheimer’s disease. It does not cure Alzheimer’s disease, but it may improve memory, awareness, and the ability to function. This medication is an enzyme blocker that works by restoring the balance of natural substances (neurotransmitters) in the brain.

Namenda: is used to treat moderate to severe confusion (dementia) related to Alzheimer’s disease. It does not cure Alzheimer’s disease, but it may improve memory, awareness, and the ability to perform daily functions. This medication works by blocking the action of a certain natural substance in the brain (glutamate) that is believed to be linked to symptoms of Alzheimer’s disease.

Lipitor: is used along with a proper diet to help lower “bad” cholesterol and fats (such as LDL, triglycerides) and raise “good” cholesterol (HDL) in the blood. It belongs to a group of drugs known as “statins.” It works by reducing the amount of cholesterol made by the liver. Lowering “bad” cholesterol and triglycerides and raising “good” cholesterol decreases the risk of heart disease and helps prevent strokes and heart attacks.

As time goes by

Posted in March by

I’ve been remiss in writing for the past month. The reasons being unexpected work (which is good) and a monetary self-consciousness (which is bad) about what I’ve been blogging and posting these last eighteen months or so.

I’d been blogging more or less as I’ve kept my journal for decades now; un-self conscious and un-varnished, pretty much the truth of my experience (as I see it, of course), without thought (not much anyway) of tone, ramifications or implications.

Funny how with a little time and distance you can look at something and suddenly see it in a completely different light (kinda like putting on that swim-suit that you got on sale in the off season and now that it’ll soon be summer you put it for the first time and wonder-what was I thinking?).

I made the mistake of re-reading some of my old posts and felt suddenly naked and very exposed (except for that swim-suit of course;) Well, I won’t be doing that again (reading that is-not writing). I’m not going to start editing myself or over thinking what I write-I mean, what would be the point if I did that? No, I’ll just continue to move forward in print and leave the looking back to others.

Since my last post I’ve taken Miss Cathy to her neurologist and to her primary care physician for her regularly scheduled check-ups. They both gave her glowing reports. She did better on the neurologists’ memory and cognitive skill’s tests than she’s ever done before and other than gaining a little weight, her health is better than ever, too.

Dr Aleymayehu, her neurologist explained (once again when she asked about her medication) that the Aricept she’s taking is not a “cure” but it “delays” the Alzheimer’s patient from progressing in the disease. Since she was diagnosed so early moms’ pretty much frozen in time with most of her wits about her so Miss Cathy is one of the lucky ones.

Sure, she still has some confusion, she still has anger issues and some days she gets overwhelmed when there are too many things going on. But, lets face it; those things are all manageable considering what others who are further along in the disease are experiencing

With her doing so much better I can understand why she keeps asking the doctor about the Aricept and what it’s suppose to be doing to help her. We know (well, I know) that Alzheimer’s is a progressive disease and it has no specific timeline of deterioration so it’s possible that Miss Cathy could be the way she is now for years to come. So, it’ all wonderful news but “what’s a caregiver to do?”

Lately I feel I have less purpose here. The first year was all about getting her acclimated to her (and my) new life and for some time she really seemed to struggle with the “day to day” and needed a lot of hands on care. And I was good at helping with that.

Don’t get me wrong, I’m not saying I want (or need her to be sick) it’s just that my days had purpose when she needed me and every day seemed to be a re-affirmation of my decision to leave my life to come join hers.

As time has gone by she’s more independent (compared to where she was after her fall in January of 2010) and has more days where she’s cleared headed and functioning like she had before her diagnosis (albeit slower than before).

She needs me less and I (feel anyway) like I’ve gone from caregiver to reluctant roommate. Or like I’m trapped in some vortex where it’s ten years ago and I’m on a visit home to see my mom but the visit never ends.

I hate to be a “Debbie downer” but I have to ask, “why am I still here?”

Dr NO (show)

Posted in May by

I’m usually loath to speak ill of doctors or Miss Cathy (lately) but recently the two-separately and together have made for a prescription too toxic not to tell.

I’ve gone on and on about Miss Cathy’s visit to the neurologist where (in her mind) he set her free, like Lincoln with the slaves. No, this isn’t about “that” but it did (start) during that infamous visit.

One of the things she had scribbled down on her neatly folded piece paper of “things she wanted to discuss” with the doctor was having help getting her Aricept through mail order. She said that Blue Cross/Blue Shield had quoted her a price of $30.00 for a 90-day supply in lieu of the $86.00 she just started paying (for the same quantity) of the generic because until recently Aricept was not available in a cheaper generic form because of it’s exclusivity on the marketplace (making it was more than $280.00 for a 90 day supply).

Ah yes, the real “pill” here is the Pharmaceutical companies in my book. HIV/Aids and the elderly are there cash cows these days. I have friends with HIV /Aids and their medications can start at $6,000.00 a year (even if one has insurance) and most people have to take more than one pill so you can imagine the astronomical yearly costs!

The same is true with the elderly, patients with Alzheimer’s or Parkinson’s can spend hundreds of dollars a years for their degenerative disease medications alone, not to mention the other medications that accompany old age; high blood pressure, diabetes, high cholesterol, insomnia, depression…..the list goes on.

Anyway, her neurologist happily agreed to “take care” of changing the prescription to come through the cheaper mail order form-that was on March 27th. By early April she hadn’t received anything through the mail so I started calling the doctor’s office to see what was going on. I was told it would be “taken care of” (and at that time I had no reason to doubt the veracity of that statement) so we waited patiently.

We waited and waited until her daily supply of Donepezil HCL (generic Aricept) was dangerously low so I called the office (again) to check on the status of the medication and I also asked to be given some samples of Aricept to “tide” Miss Cathy over until the meds arrived in the mail.

Later that day while I was at the office picking up the samples the doctor was “in” so I got a chance to talk to him and remind him of how long this has been going on. I made a point of telling him that the delay was making Miss Cathy very agitated (and he’s the one who said that wasn’t good for her).

He listened patiently and told me that he would take care of “mom” (which I guess may be a custom from his country as a way of addressing the elderly or it’s just a “catch all” way of talking to and about elderly black ladies who’s names he can’t be bothered to remember). I didn’t like his dismissive approach-I didn’t see him write anything down or ask me for any pertinent information but, I left with a fist full of samples and his assurance not to worry.

Which I didn’t, I didn’t worry a week later when I’d check the mail and “no pills”, or the week after that. I didn’t worry-I got pissed off, I was pissed off that I had to start calling his office “again”. On May 13th I called to see what the hold up was and left message after message with Lydia, the receptionist (and gatekeeper) who said she would ask the doctor what was going on and call me back-she never did.

So, I called “her back” on the May 17th and was told that the doctor “phoned in” the prescription to CVS Pharmacy on April 15th and it’s been sitting there waiting for me to pick it up. I told her that was not what the doctor had agreed to do and that I wanted to speak to him, she said, “he’s busy now with patients and will have to call you back when he has some time.”

Again, I left a message for him to call me back that day-he never did.

A couple days later after I got home from a cater/waiter job I did see two missed calls from the doctor’s office so I called the next day. Lydia proudly and accusingly told me that, “the doctor tried to call you” to which I replied, “Yes, I see that, but when he called “I” wasn’t available, he’s not the only one who’s busy.”

I asked Lydia to call CVS to verify that a prescription exists for Miss Cathy because I told her that I never got a call to pick up the meds (which is there standard method of operation). “Why do I have to do that? I’m not going to do that”, she said.

“Well”, I said as calmly as I could, “because it’s your job, and not mine, and quite frankly I have spent more than enough time with you on the telephone trying to get what my mother should have had months ago.” (What I wanted to say was “B*tch, I’m not here to do your job!”).

She put me on hold, after a moment I was talking to Danielle (not the doctor) another receptionist. At least Danielle was co-operative (even if she did talk to me like I was a mental patient-apparently “Danielle” must be the re-enforcements they bring in when Lydia’s had enough)-whatever!

At least Danielle called CVS then me to say that the prescription was $86.00 for the generic and it was not at our local pharmacy but at a CVS that was 10 miles away which was probably the reason I was never called but who knows).

I asked her to have the prescription moved to our local pharmacy and left another message for the doctor to call me. So, almost two months after the initial request to have the medication sent through mail order, it hadn’t happened and I had no explanation from the doctor as to why.

I picked up the meds from CVS and explained all of this to Miss Cathy a few days ago. At first she was a little aggravated (a lot actually) so we talked about it and we agreed that the doctor had messed up and never did what she asked. She even offered to call Blue Cross/Blue Shield again to verify that the medication is available through mail order (and I thought this was a great idea, she was more than capable of handling this matter and it would give her a “project” to do).

I know that I should have been the one to follow up with the insurance company and doctor (after all, that is what I’m here for) but frankly I was burned out and couldn’t handle another conversation about Aricept-generic, mail order, or pharmacy pick up. Later that night Miss Cathy and I talked about it again (by this time she was pretty worked up about the confusion and the cost).

I couldn’t blame her really, but I didn’t want her to be as upset as she was about the situation (especially at bedtime) so my focus was to calm her down (which then gets me worked up). I told her it was okay to be upset and to wait until the morning when she could make phone calls, that way she could channel her energy where it would some good.

By the time I “put her down” she’d calmed her down enough for sleep. The next morning she called me in to talk and I thought she was going to tell me her paln of ‘action” ask me for the doctor’s phone number again so she could call his office (the night before she said she wanted to call to give them “a piece of her mind”) instead she told me that she’d been thinking and although she appreciated all that I’d done for her she’d come to the conclusion that the doctor did “what she asked him to do” and she would wait until her current supply of Donepezil HCL was gone to call the insurance company herself to get the meds through mail order-“WTF”!

I started to say that the doctor didn’t do what she asked him to do as evidenced by the fact that she didn’t have the $30.00-90 day supply but the $86.00 bottle of generic pills that she already had in place “before” she ever talked to the doctor.

I almost said that but I didn’t, what I did say was, “I just can’t talk about this anymore, if you’re happy with the way things turned out then that’s all that matters to me.”

The doctor is still a “no-show” by phone but at this point it doesn’t matter, Miss Cathy “seems” to be at peace and I just have to make my “peace” with the fact that I’ll never get back all that time that I spent on the telephone.