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Saturday, 8 September 2007

Best Laid Plans..........

always go to pot don't they!

All day yesterday I was looking forward to an evening of blogging as I haven't been able to do much of it this week having gone back to work. Then I got a phone call from my brother to say Dad wasn't well and he was really worried about him, though it wasn't life threatening. I said I'll be there are soon as I finish work at three.


Dad had phoned an ambulance at 7 a.m. on Thursday to take him to A&E because he couldn't stand the pain from his arthritic hip and knee. The doctors and nurses had been wonderful with him giving him Tramadol to ease the pain and one 'angel' (as my Dad described her) had even managed to get him down to an orthopaedic clinic to see his consultant before his scheduled appointment on the 10th October! Now that's a true nursing angel! Anyway, after the pain had eased he was quite happy to go home.


He took two Tramadol at bedtime and had the best night's sleep he's had for months waking up yesterday refreshed and ready for anything. The hospital had arranged for the district nurse to visit to keep a check on his blood sugar levels (he's non-insulin dependent) and advise him on pain relief for his arthritis. The nurse duly arrived after Dad had his shower and suggested he take a Tramadol along with the Paracetamol he'd already taken for his pain. Within 15 minutes of the nurse leaving Dad said he felt really ill, luckily my brother arrived to check that he was OK and found him swaying, dizzy and incohorent! Brother phone the doctor who refused to come out - no change there then - don't get me started, and then the nurse who came around straight away. Apparently Dad's blood sugar levels were way too low so brother made Dad some lunch and they got him to eat it all. By the time I got there at 3.20 p.m. Dad said he was feeling better but he didn't look it.


The nurse came by again expecting Dad's blood sugar to be up but it had dropped even more, I made him something to eat but that didn't make any difference either. The nurse decided he needed a visit from the doctor so rang to ask for a home visit. She said if the doctor didn't come we had good cause for complaint. At 5 p.m. the doctor rang to ask how he was - he wasn't getting any better - and said she'd order an ambulance and send him to hospital. I asked why she wasn't coming out to see him, she said there really wasn't anything she could do except send him in hospital. I told her he didn't want to go into hospital and I wanted her to see him before she assessed he should be in hospital or was she refusing to visit him.


"Oh, no, I'm not refusing but I don't think there's anything I would be able to do" she said.


"I want you to come" I said "and in the meantime I'll keep checking his blood sugar level and if he gets any worse I'll phone an ambulance myself".


"Alright, but it will be a couple of hours because we have to finish surgery first" was her reply. It was a miracle she'd agreed to come out to see him so I didn't argue.


At 6pm Dad was feeling very unwell and when I asked if he wanted to wait for the doctor he said he wanted to go into hospital - so that's what we did. Once again the doctors and nurses at A&E were fantastic with him giving him sweet drinks, chocolate and IV glucose to get his blood sugars up, checking his blood, urine and a chest xray to make sure he had no infection. Then they had to send him up to the medical emergency ward for the registrar to decide whether to send him home or admit him. We were still there at 11 p.m. waiting to see the doctor so after a word with the nurse it was decided Dad would be better off spending the night there as he was really tired and nobody knew what time the doctor would get to see him, so brother and I left him there sleeping.


Hopefully he will be home today, they're going to check his blood sugar levels after he's had lunch and if they're OK he can leave. The puzzling thing was why his blood sugar kept dropping even after eating. The only thing different he'd done was take Tramadol - does anyone know if Morphine can make your blood sugar go down?
UPDATE
Dad's home and feeling much better. The doctors have no idea why his blood sugar was up and down like a bride's nightie. Dad takes Gliclazide and Metformin for his diabetes - the doctors have told him not to take the Gliclazide any more, so we don't think it was anything to do with the Tramadol, but to be on the safe side Dad is only going to take Tramadol at night when he's off to bed.

49 comments:

Elween said...

usually elders will have high sugar level problem isn't it? well, hope he is better now...have a nice sunday! :)

Anonymous said...

Along with a variety of other medication I too take Tramadol (8 a day!). I am not diabetic. I have read through the leaflet with my Tramdol today and there is no warning anywhere related to a person with diabetes so I am assuming from that that your Dad should have had no trouble. The pharmacy also said I could take paracetamol with my Tramadol so I know thats not an issue either.

I am always told by doctors/nurses/family etc to eat! Taking any amount of tablets without much in ones stomach is apparently not a good idea!

Morphine is a whole other story and I would suggest asking the doctors/nurses about this. I have had morphine on various occassions and have only ever felt....dreamy! Cant think of a better word to describe it!

I do hope that they get your Dad all sorted out and that he doesn't suffer any more of these little episodes.

{{HUGS}} to you and yours,

T xx

Flowerpot said...

what a worry, Ak but I'm afraid I have no nursing experience so can't help. Tried googling anything? Or ring NHS Direct?

buffalodickdy said...

Blood sugar levels, once out of whack can take awhile to tune back in. Wishing him a speedy recovery!

Queenie said...

thats how I sometimes feel with them as I've told you, more so since taking 2, I will check my BP next time and see if its that.
hope he's feeling better today talk later........

ron said...

Morning Akelamalu~

So sorry to hear about your dad.

Hey listen, I just googled "blood sugar levels and morphin" and apparently...their are studies that show that morphin may effect blood sugar levels.

You may want to take a peek yourself.

Sending you some Reiki in the meantime!

Be well my friend,
Ron

laurie said...

very scary, isn't it? drugs react with each other and you dont' always know what the outcome will be.

i have a lot of experience monitoring this kind of thing, as i helped care for my sister and my father when they were dying of cancer. the morphine, in particular, can do strange things to a person's mind. (my sister was on a 150-mg morhine patch.)

i'm glad he's at the hospital; they will know what to do. i'm so sorry for your worries.

good luck.

Miss Understood said...

I'm a bit clueless I'm afaid. I have experience of taking morphine and paracetamol together (which didn't cause any problems) but other than that, I have no idea.

Good luck, and I hope he's better soon. Hugs. x

CG said...

Oh dear, I do hope he is ok! I can't help with your query but am thinking of you both!! HUGS xx

Akelamalu said...

Thanks Elween he's much better now.

T anonymous thanks for taking the time to read and comment. Eating is a big problem to my Dad as he gets older, I think that is behind his blood sugar problem really.

I will google search when I get a minute flowerpot, good idea thanks.

Ah, let's hope it doesn't take too long then eh Buffalodickdy, thanks.

Yes I remember you telling me that Queenie but he's slept since taking the two. I don't think it was anything to do with the Tramadol really.

I'll take a look at that Ron it sounds intersting. Thanks for the Reiki m'dear and reminding me, I forget to use it sometimes. :)

Thanks for your concern Laurie. Dad is on so many tablet a day I don't know how he keep track really but he does.


Thanks Miss U, hopefully he will be OK now.

The hugs and the kind thoughts are very welcome cg x

Sheila said...

I hope this is straightened out a bit now. He's lucky to have you around. Too much the bride's nightie image! Love that.

Linda said...

Glad your Dad is home and feeling better. I have no knowledge about meds, but it seems like you have received some good advice.

Wishing him a speedy recovery.

Linda said...

I just spoke to one of the paramedics I work with and he said that chances are the combination of the Tramadol (which can affect BGLs) and the Paracetamol is probably what cause your Dad's sugars to drop and not get brought back up again until the medications had a chance to leave his system.

Sometimes one drug on its own is just fine but when you combine them, it can cause unforeseen problems.

Not sure if that's helpful at all but I'm glad to hear your Dad is feeling better now. Hopefully this won't happen again anytime soon!

Tammy said...

I'm glad your father is feeling better. Both of my parents have passed away after illnesses so I know how it is to be worried about a parent. Take care of yourself and your father.~Tammy

Annelisa said...

Glad your dad's feeling better now... always worrying when health things aren't right.

So, how was the first week back? Was it how you thought it would be? Bet you're knackered. I know I certainly am :-)

Catch you again soon!

Bankerchick said...

What a stressful time, Mr B's mom had a lot of trouble getting her drug therapies fixed. It is tricky. Glad he is doing better.

Akelamalu said...

He seems Ok now thanks Sheila

Fingers crossed Linda (T&T).:)

Thanks for checking for me Linda (AWTY). I thought it was strange to be told to take both Paracetamol and Tramadol together. Well he won't be doing that again!

Elderly parents are a much of a worry as children sometimes Tammy!

Thanks Annelisa. First week back wasn't half as bad as I thought it would be. Only 7 weeks to half-term now!!! :)

You're not wrong there Bankerchick. It's a wonder they don't rattle with all the meds they take!

Betty said...

So glad your Dad is home and doing better....

Yes, I collected the badge and thank you for the quiz.....

Thanks for visiting and taking the time to comment on my wooden necklace......Betty

Akelamalu said...

Thaks Betty re my Dad. That necklace is a beauty, glad you enjoyed the quiz.

Cindy said...

I checked the drug interactions site and it said none were found, but I know that some people cannot take morphine- my Dad is one of them. I am non-insulin diabetic too- it's a pain. Hope your Dad continues to do better.

Akelamalu said...

Thanks Cindy, that was really kind of you. We'll be keeping a close eye on Dad.x

ciara said...

that must have been a bit scary for you. i'm glad that they got it sorted and your dad is feeling better. i know what it feels like to feel blood sugar drop when i don't eat, but i can't even imagine the feeling when it just keeps dropping. i prob would've been very freaked.

The Rotten Correspondent said...

I've never heard of morphine affecting blood sugar, but there are a lot of people who have odd reactions to morphine in general. For some people it's like a miracle drug and for others it's a real problem.

And once blood sugar starts getting wacky it can take a while to get it under control. Of course this is problematic too, because the more meds you take the bigger the chance of some kind of interaction that can affect lots of things - including blood sugar.

I'm so glad he's feeling better!

Nea said...

Hi Akela, I once commented that after 50 it seemed to me to be mostly downhill, and got verbally slapped good, but truthfully it seems that for some of us{me}, it is true. I have my own experiences with low blood sugar, and along with mine goes a myriad of other problems, one of which is very low blood pressure, confusion, and lethargy. And it makes you feel faint, sick, dizzy,. I have what they call insulin dumping...basically food reaches my intestines unprocessed and then the insulin comes in abundance, and look out. It really makes you feel sick. I don't know if any of the medication I am taking makes it worse or not, but I get about the same response from my Dr's that your Dad got from his, general apathy.

The problem with drugs, they don't react the same on every person. We each respond differently to the same drugs, wht one can take, someone will not tolerate. The medical profession actually know very little about drug interactions, and what they do know usually has come from someone discomfort...and then they will say, "well we won't try that again on you."

Nea said...

I hope your Dad is doing better, I know what a worry it is especially when you have to "wait and see." And you can't be right there, or evey know what to do.

Jo Beaufoix said...

It must have been such a worry Akelamalu.

Hope he's feeling much better now.

Empress Bee (of the High Sea) said...

oh how awful for all of you! can he get a knee replacement so he won't have to take the drugs? that is no way to have to live! the surgery is so easy now. i hope he can get it.

smiles, bee

Josie Two Shoes said...

Lord, what a scary and frustrating time for you Akelamlu. Sometimes you really would like to strangle medical personnel. For them, it may be an everyday occurance, for you and your family, it is terrifying. I am so glad that things appear to be working out alright for him. My father is 82 and new medical issues continue to arise. I know the worries. My thoughts and prayers are with you.

Alison said...

So glad to read that dad is home and feeling much better! I'm sure that gave you all a scare! Hope you can enjoy your Sunday!

david mcmahon said...

Hope your Dad is home and that he is on the mend. Fingers crossed ...

Been a busy week, but here I am again, enjoying all the posts on your blog.

Keep smiling

David

la bellina mammina said...

When my late husband was under morphine for his chemo, it didn't affect his sugar level, but then again, it could have different effects on different people.

Am sorry to hear about your dad Akela, I really hope he's feeling much better now. My thoughts are with you.

Around My Kitchen Table said...

Parents are such a worry, aren't they! I think they get elderly and then get their own back for all the hours and hours they have spent worrying about us. My partner's mother has terminal cancer and we are just waiting for the awful day to arrive. My mum is 86 and had a bad fall last week - but she's incredible and has bounced back. I do hope your dad stays well. XX

Akelamalu said...

Dad's quite good recognising drops in his bsl ciara and gets something sweet right away but nothing seemed to be working on Friday.

Dad is convinced that it's all the meds he's taking that are causing most of his problems correspondent. Unfortunately he can't do without them!

Yes you're right about the meds Nea it is a case of 'we'll try this' and hope for the best. It's such a worry. I'd have Dad stay with me but he couldn't manage the stairs and is very independent anyway so wouldn't leave his little bungalow.

Thanks Jo, he seems Ok today thankfully.

He's on the waiting list for a hip and knee replacement Bee, but that could take about 4 months.

My Dad is the same age as yours Josie and as you say new medical issues seem to be arising every day.

Thanks Alison hope your Sunday is good too. :)

Thanks for dropping by David and for your kind thoughts re my Dad. :)

I'm not sure the morphine was the problem Bella,though I don't suppose we'll find out for sure.

I'm sorry to hear about your MIL and your Mum's fall Around My Kitchen Table. You're right elderly parents are such a worry. I feel sorry for our son's, I hope we don't become a burden to them!

david mcmahon said...

Had to come back here to check - glad to know your Dad is improving.

That's great news.

By the way, I thought I'd already added you to my blogroll but I'm doing it now. Must lose touch ...

Hope all goes well

Cheers

David

Akelamalu said...

Thanks David, that's so kind of you. You're on my blogroll too. I'll be over shortly for this weeks question. :)

Skittles said...

I only know about high sugar levels.. but I'm so glad to read that he's home safe!

Akelamalu said...

Thanks Skittles - love you picture by the way. :)

Pauline said...

Looks like you've had lots of good advice from concerned readers so the only thing I will add is that my mum is on 14 different drugs, she too is diabetic and has arthritis and asthma, I find the pharmacist is usually very informed about which drugs may have negative interactions, more so than the doctors so I find it useful to check with him.

I'm Glad to see your dad is feeling better now and I hope that whatever caused his problem was just a temporary glitch. I know how worrying it can be to have a parent with health problems. Hope things have settled down for you all now.

crazy working mom said...

I'm glad he's feeling better!

I'm sending good thoughts your way.

Smalltown RN said...

I was reading your post last night but I couldn't keep my eyes open post 14 hour work day. I wanted to let you know I how sorry I am that your father has to go through all of this. I am not familiar with the names of those drugs, Canadian and British drug names differ considerable even when they could be the same drug. Anyhow, the point I am trying to make is....all drugs have side effects...most drugs can cause what we call drug interactions...some drugs can affect blood glucose levels make them high or low....I know with Metoformin that it interacts with many drugs and often we have to take a patient off of their metoformin and substitute it for something else. I hope they got to the bottom of the problem and that your dad is feeling better....just wanted to let you know I am thinking about you....and thanks for the badge for the rhymes....those were hard....

Akelamalu said...

Oh thanks for getting back to this smalltown rn, I really appreciate it. Dad is feeling better but it's such a worry with him being on all these tablets. Although he has all his faculties I worry that he may get mixed up and overdose on some of them. I did buy him one of those containers to set out daily tablets, you know so you don't forget any or double up, but he won't use it - stubborn man that he is!

julia said...

Glad this recent episode has settled down by the time I've got to it. Hope everything stays level.

Akelamalu said...

You must be as worried as I am Pauline with your Mum x

Thankyou for the good thoughts crazy working mom, I appreciate it. x

He seems to be doing OK now thanks Julia x

RUTH said...

So sorry to hear of the problems your Dad's had....glad to read the update and that he's ok. Have been reading the comments you had and sounds like some voices of experience there. I bought my stepmother one of those tablet containers...she says it such a help as she has to take umpteen tablets. Hope your Dad sees the sense in using his.
{{HUGS}}
Rx

Akelamalu said...

Thanks Ruth. He seems a lot better now.

Ali said...

Haven't been around much this last couple of weeks, so I have only just read this. Sorry to hear your Dad was so unwell but it's great to know he is doing much better now. x

just me said...

If your Dad was taking two meds for his diabetes, and not eating enough, his blood sugar could have dropped to the point that only an IV glucose would have brought it up to normal. It takes a while, especially for older people.

I'm glad he's doing better. How often does he check his blood sugar? A glass of juice or milk is one of the quickest ways to get your blood sugar rising. Just what I learned working at the hospital.
Me, I'd get your Dad to test his sugar more often.

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