My wife and I are trying to care for her 93 year old mother Alma who lives in her home about 1 mile from here. She has a pacemaker which is about 8-10 years old. She has been on Coumadin but she is getting stubborn about taking her medications. Says she feels better without them. However she has complained twice within the last 7 days that she has woke up in the middle of the night with breathing problems. Her doctor retired 1 year ago. Should we take her to the emergency room?
At her age this will come to a head in one way or another.
Awakening a bit breathless is not a problem if it passes quickly, doesn't happen in the day, and causes no appreciable change in O2 saturation. Next time she has this symptom have her call you, and go with the 20.00 O2 oximeter you put on the finger, measure her O2 levels. If she is above 90% by the time you get there she is likely fine.
Your question now, today, should be asked of her MD. I would say that they are unlikely to advise a trip to ER in Covid-19 times with only this short-lived and momentary symptom. However, you need also to tell the doctor that the coumadin is/may be being taken irradically. So what you are looking at now is a visit to an MD to discuss all of this.
Almost certainly your Mother is one of those who wishes to stay in her home to the end. So decisions will have to be made weighing safety versus risk quite soon.
Wishing you good luck.
My FIL had a pacemaker. One of the symptoms of having a pacemaker that needs their batteries replaced is difficulty breathing.
Please take her to the emergency room or Urgent Care as "Grandma1954" suggested as soon as possible especially since her doctor has retired a year ago!
Best wishes to you all. -
It's a $20.00 oxygen saturation measuring device that I think most pharmacies carry. 20.00 being the price and 02 meaning oxygen.
I'm going to get one for DH to wear and watch his O-sats (oxygen saturation) during the night. He refuses to wear his CPAP breathing device at night and I don't think gets 'good sleep'.
If you think your mom needs to be seen by a doctor Urgent Care location might be better and possibly safe than the ER. If they think there is a problem that they can not handle they will tell you to take her to the ER. If it is severe enough they may even call for transport.
Good luck!
Because of that really productive experience, I think that in your situation I’d be looking for something similar.
An emergency room where I am might not even allow her to register for care, and a walk-in might be even less likely. Someone her age needs a practice that is prepared to consider the whole spectrum embracing the issues of aging.
She also needs someone who will be familiar with all of her needs whenever she’s seen.
Does she have home testing equipment or does she go to a lab?
If she isnt taking this med consistently, she is at risk for blood clots, stroke and other disasters.
I agree that down the road she needs a geriatrician but right now I would start with an ER to test her INR (this is based on the fact that Urgent Care centers here in NYC lack the capacity to do that testing (DH is on Coumadin).
The cardiologist could interpret the data and make determinations on his cardiac condition from that data, w/o Dad having to go in for an appointment, which he also did, but not as often given the remote transmitter.
This would allow the cardio's office to determine if the interruption in anticoagulation therapy is affecting your MIL's cardiac condition.
Is she refusing to take all meds? Or just Coumadin? Can you narrow it down to which meds are affecting her disposition? Perhaps they could be changed. D'c' ing or interrupting a Coumadin regimen is very frightening for someone who really needs it.
Did anyone take over practice of the cardiologist who retired?
An oximeter is a device that measures oxygen saturation and heartrate. It's put on a finger and is very easy to use. You can purchase one at most drug stores or Wal Mart, and they are relatively inexpensive. It might be a good tool to have on hand.