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biblio

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About biblio

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  1. LWT, Thanks so much for posting the article, which helped with various points of hygiene that no one had mentioned in the ER. I think we are doing a better job of protecting the system from infection now. I will be using the video for reference when changing to the leg bag for the first time tomorrow. We finally have a leg bag to use and can tape up everything for exercise as TH described. Trying hard, Thanks again for your help this week. It's been rough with dad's condition progressing and our having to face yet another paradigm shift in caring for him. On Monday we were fortunate to get in early to the urologist, who addressed the bleeding by taking Dad off his daily dose of aspirin. As Dad's ability to exercise increases, his mental status is improving, too. We have done a lot of problem solving---some of it with your kindly help!-- and we have a strategy going forward. This past week has been so stressful that it seems to have lasted about three eons! Thankfully, we're starting to catch our breath now. Hope all is well with both of you.
  2. Trying hard, Thank you SO much for the detailed reply and the reassurances. We were given very little background information or instruction in the ER. Your note, which we read carefully, confirmed what Mom had suspected, that the tubing is just too tight between the stoma and the stabilizer. We're working on a solution to this. The stabilizer itself may have to be replaced higher on the leg. He was first catheterized Feb 2 after we brought him to the ER with a grossly distended bladder. We didn't know at the time that the catheterization would be permanent. It's been a bit of a roller coaster since then. We're going to get a prescription for a leg bag on Monday. We will try your double-taping method as soon as we get one. I will have more questions for you then. In the meantime, thank you again, very much. Your help reduced the stress level around here. Hope all is well on your end. Biblio
  3. Thanks, Trying hard I'm sorry to bug you with yet another question, but Mom and I are at our wits' end. Dad has some blood in his catheter tubing every day. We took him to the ER, where they flushed the catheter, did some blood work and ran a urine culture, which was negative. The ER staff thought there might have been some trauma when he pulled himself out of bed rather awkwardly at home the other day--otherwise they couldn't account for it. They said not to worry too much unless the urine was port wine colored. They said it was okay for him to continue exercising.They said to give him extra fluids, monitor his temperature, and wait for the blood to pass--but we're seeing it every day. We thought that maybe he was causing trauma when using his stationary bicycle, but his neurologist, the PA and the nurse at the hospital had all okayed his using the bicycle. We do have the impression, though, that when he exercises--even just walking around the house--that the motion is causing the bleeding. Do you think that the catheter could have been placed badly or that there isn't enough slack in the catheter tubing and that when he moves the catheter is irritating the bladder? Perhaps he needs a different type of catheter? I don't like to let bleeding go, but he desperately needs exercise in order to maintain his blood pressure. He doesn't see the urologist for nine days and his primary physician will not treat catheter issues. We don't have a home health nurse to contact yet, and a nurse couldn't replace a catheter without a doctor's order, anyway. I know this is a lot to unload on you, but could you give me your thoughts?
  4. Every time Dad has been catheterized in the past several years, he has developed a UTI. Recently a permanent catheter was placed, and since it has to be changed monthly, Mom and I are worried about chronic UTI's. We are looking for ways to prevent these infections, although the staff in the hospital ER seem pretty fatalistic about the likelihood of recurrences. After doing some research on the Web, I've come up with some possibilities: Supplements: D-mannose capsules: D-mannose is a naturally occurring sugar found in berries and other fruits. When taken preventatively, it is supposed to provide preferred binding sites for E. coli, the usual bacterial culprits in bladder infections, thus preventing the bacteria from binding to the bladder wall. The bacteria can then be flushed out with the urine. cranberry capsules: The vitamin C in cranberries again attracts E. coli, and prevents it from binding to the bladder wall. probiotic capsules: Beneficial microorganisms that may or may not prevent against UTIs. Supposed also to alleviate bowel problems caused by frequent antibiotic usage. Hygiene: Cleaning the catheter site daily, along with the catheter tubing. Preventing the port for the catheter bag from touching the floor. Ensuring that the catheter tubing is always well below the level of the bladder so that urine cannot reflux into the bladder. Has anyone tried any of the supplements I listed or found any others that are effective? I am particularly curious about d-mannose, which sounds promising. Could someone explain what measures he or she has found helpful in preventing UTIs in a catheterized patient?
  5. Dad uses the condom catheter system for urination at night so that both he and Mom can get an uninterrupted night's sleep. It's a two-piece system including the night bag and the condom itself. The night bags are supposed to last for about two weeks before needing replacement. However, Mom is finding that the bags can fail after three, four, or five nights, and she's wondering why. Is anyone here familiar with this system? Mom cleans the bags with white vinegar, as instructed by the medical-supply person who sold her the systems. Perhaps she's using too much vinegar, which is eating through the anti-reflux valve? Is she getting bags from a defective lot or are these things just notoriously short-lived? Does the bag have to be emptied _immediately_ upon being removed? Is there a special way to store the bag prior to cleaning? Are there guidelines anywhere? Any information would be helpful.
  6. biblio

    Stationary pole a good idea?

    Thanks so much for the info, Dianne and Trying hard. Mom and I are uncertain about the particular product for sale near us, the "Stander Security Pole and Curve Grab Bar", as there do seem to be stability and cleanliness issues. Miracleseeker, wrt a cane, we are now looking at something called the "Couch Cane" for use in rising from a chair. Golden01, thanks for the links. With the commode legs raised, his problem is not so much rising as losing balance after he has risen owing to poor posture. We're still thinking of something heavy opposite the toilet, possibly with a grab bar above it. A shopping trip last night failed to turn anything up but we'll be looking again today.
  7. biblio

    Stationary pole a good idea?

    We've just come to the same conclusion. With the commode legs adjusted to increase the height of the toilet seat, a chair opposite the toilet might just work. We tried using his sturdy shower chair, but that is a little too big for the available space and not quite high enough. We're going shopping for an alternative, which might not be a chair.
  8. biblio

    Stationary pole a good idea?

    Miracleseeker-- Thank you. His arms are weak (although he is trying to recondition) and he has difficulty with balance as well as dizziness due to low-blood-pressure problems. Dad is now telling us that he definitely wants something to lean on because he lacks the strength to hoist himself out of a chair using the grab bar. He prefers to have an ottoman or a bench in front of the chair. I'm unsure about the safety of that solution. As for the toilet, it's positioned between the bathroom counter and the bathtub, so there's nowhere to put a grab bar. That's why we were thinking of putting a pole in front of the toilet. Again, that probably won't work, so maybe a sturdy bench or heavy vanity that he could lean on? He tends to lean over while he's standing up, lose balance, and fall. He says that leaning on something will help him regain balance and stand fully upright.
  9. They sell a stationary pole that runs from floor to ceiling with a "grab bar" in the middle of it. Would that be helpful in assisting a PWP to get up from a toilet or a chair? Has anyone tried one of these? My father is skeptical about its usefulness because he prefers to lean on something rather than grab something when he is rising from a sitting position.
  10. biblio

    Constipation

    Dear Kathrynne, My father is 77, diagnosed with PD about six years ago. He is a heart patient, about 13 years post-bypass now. He takes a small dose of amlodipine for high blood pressure (one pill at night) but has to guard carefully against low blood pressure during the day. He has early-stage chronic kidney disease with numbers that are still usually in the normal range. He eats a low-protein vegan diet. He has done well until recently on a regimen of carbidopa/levodopa with annual physical therapy and daily exercise. In mid January he injured his knee while using the rowing machine and was forced to quit exercising. It took weeks and weeks for the sprain to heal. Without his accustomed exercise he grew weak and had a couple falls. He is currently in physical therapy to help him recondition, regain strength and flexibility. Although we reintroduced limited exercise as soon as possible, the enforced inactivity caused severe constipation. We spoke to his MDS, who prescribed Miralax, and we have used a packet of this nightly for the past two weeks. His bowels move daily but his stools, though soft, are of small diameter and produced only with severe straining. His MDS has warned that straining could cause a hernia or a dangerous drop in blood pressure. We are contacting the doctor for further recommendations but were hoping that you could recommend some dietary changes or supplements that might help. Currently, on the pharmacist's recommendation, we are giving him a diet that heavily emphasizes soluble fiber: sweet potato, potato, zucchini, carrots, onions, brown rice. We have eliminated salads. He has slow-cooked oatmeal with pared apple slices and prunes for breakfast. He is taking Benefiber in a cup of water two or three times daily. We cannot increase his liquid much, except perhaps in the mornings, as it keeps him up at night urinating. Since my mother has to help him with toileting each time, it exhausts them both for him to take too much liquid late in the day. Thank you very much for your help. Bev
  11. biblio

    Diarrhea after spicy foods

    Dear Kathrynne, I was grateful for the caveats regarding the possibility of impacted bowel or C. difficile infection. I will know in future to rule those out before assuming a simple case of diarrhea. He has not had recent antibiotic treatment and has no abdominal distention or pain. After reading your reply, I started him on the sweet potato, which seems to have had a very positive effect. He has now gone for 24 hours without diarrhea. I also purchased the probiotic water kefir that you mentioned, and he is starting that too (in teaspoon doses at mealtimes, per the instructions on the bottle). I hadn't known that kefir was such a potent probiotic or that it was available in a vegan form. This might become a regular or periodic supplement for him, as it is supposed to be helpful for constipation as well as diarrhea. Banatrol looks as if it could be very effective for stubborn cases--I will keep that in my mental file. I think Dad is on the mend, for now. Thank you so much for the detailed, thoughtful, and comprehensive reply. --Bev
  12. Dear Kathrynne, About a week ago my father, who has always loved spicy food, decided to douse his green salad with LARGE quantities of mild salsa, mustard, and hot sauce. He has had loose stool/diarrhea ever since. His tendency prior to that had always been to constipation, so this is quite new and obviously a reaction to the peppery sauces. He is not dehydrated as far as we can observe, although I have started giving him Pedialyte twice daily just to be sure. He has a strong tendency to low blood pressure, which is monitored four times daily, and corrected with the addition of salt (in the form of a few olives) and about 10 ounces of water with each dose of carbidopa. He also takes one low-dose long-acting high blood pressure pill each day (Monitoring his BP is a delicate dance.) He is 76 years old and was diagnosed with PD in 2008. He has very little tremor, and his worst symptoms to date are fatigue and the bouts of low blood pressure triggered by meals, exercise, or carbidopa dosing. Right now he is doing 15 minutes of cardiovascular exercise daily. He generally follows a low-fat, low-salt, vegan diet owing to a history of heart disease and a heart bypass in 2001. My question for you regards tips for resolving the diarrhea. I have read about the BRAT diet. Right now we are emphasizing boiled potatoes, rice cereal, crackers, and applesauce. I am thinking of emphasizing sweet potato, rather than white potato, because I think sweet potato might be more soothing to the gut. I am also thinking of adding small quantities of acacia powder, which is pure soluble fiber, because soluble fiber helps retain water in the stool. Do you know of any foods that are particularly soothing to a gut inflamed by contact with hot peppers? Do you think soy yogurt (with active cultures) or probiotics might be worth a try? Is there any other strategy I have overlooked for banishing diarrhea? Thank you. I very much appreciate any tips you can give me. --Bev
  13. gmk, Adding a couple pills to his regimen seems a very small price to pay for the benefits of the drug. As I understand it, the purpose of the drug in his case is not to control current symptoms but to enhance the effectiveness of the levodopa over the long term. In terms of complexity, adding a couple pills is nothing compared to trying to follow a diet that is both vegetarian and low in tyramine. Thank goodness that won't be necessary.
  14. Dr. Okun, Thank you so much for your timely response. It has been most helpful.
  15. My 74-year-old father, a heart patient, was diagnosed with PD about 3 years ago. He has done quite well on a regimen of carbidopa/levodopa plus vigorous daily exercise and physical therapy as needed. At the most recent check-up, his movement disorders specialist recommended that he add a small dose of selegeline to his daily regimen. She wants him to start with 5 mg and work up to 10 mg daily if he tolerates the smaller dose. She said that over the long term selegeline would help reduce his need for levodopa allowing him to avoid, as long as possible, the unpleasant side effects of the drug. Currently he takes 5 carbidopa/levo 25/100 tablets daily. Selegeline is, of course, an MAO inhibitor. If he takes the drug, the pharmacist says he will have to follow a low-tyramine diet, which is very restrictive, especially for someone who is already a strict vegetarian. His vegetarian diet has allowed him to stay in very good shape cardiovascularly. I understand that the FDA lifted the dietary restrictions on resagiline, another MAO inhibitor used to treat PD. Here are my questions: 1) At a dosage level of 5-10 mg selegeline /day, are the dietary restrictions as severe as the pharmacist suggests? Total exclusion of high-tyramine foods? 2) Is there another drug---MAO inhibitor or not--that offers the same benefits as selegeline without the dietary restrictions? One I could ask his MDS about? My concern is about drug options--please do not refer me to the dietitian. Thank you very much for your help.
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