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- Mar 17, '05 by chadashQuote from suzanne4Thanks for the encouragement!In answer to your first question, at the top of the section, there is a little box that says "New Thread" --- you just need to go there to begin a new topic.
Now to your question: Is she using ant type of corrective shoes when walking? Length of her toenails? Is she being followed by a podiatrist especially since she is a diabetic and is having foot issues? Is she able to ambulate any distance at all? or even just to the bathroom? Have you spoken to the RN who visits? Perhaps leave her a note suggesting that she follow up with PMD for podiatrist consult if there isn't already one........
With a diabetic patient, who is having foot issues, this is most important....
Hope that this helps you.................and thank you for taking so much interest in your patient, we need more like you............ :wink2:
She is not using corrective shoes ( she does not walk much), she has seen a podiatrist (about two months ago), but the toes have changed since then (the skin is smooth and a little taut from edema, just the toes: no edema in the feet). Her toenails have not grown much, but I told her today her podiatrist would be a good idea. She can ambulate from her chair to the bathroom and sits for a shower, and then back to her room, probably about 12 feet one way. More is difficult because of her breathing. What concerned me was the blotchy spotty appearance, and the difference between her toes and her feet. I pressed her nails, and there was some refill towards the tips, but the base is white and stays white. I have not personally spoken to her RN, who is with a home health agency. I presently freelance, private duty (soon to be LPN student!) The Pt does communicate well and has spoken to the RN. I bet the nurse is watching them, probably just not saying much.
Thanks for taking an interest! If there is anything alarming I should look for, let me know...
- Mar 17, '05 by HoozdoQuote from janfrnHmmmm, being a liver transplant recipient and a type II diabetic I would have to say that being immune suppressed for life is much more onerous than accuchecks and multiple insulin injections daily. In fact, the reason I am diabetic is that my main immune suppressant - Prograf,( FK506, tacroliminus), has a side effect of hyperglycemia. Actually immunosuppresion has many bad side effects besides the obvious of being immune suppressed. Depending on what drug/drugs determines side effects. Most new transplantees are on triple drug immune suppression with a combo of Prednisone, Cyclosporin, and Cellcept OR Prednisone, Prograf, and Cellcept. Personally, I also get tremors from Prograf which makes IV insertion very interesting.Just weighing in from Edmonton, the birthplace of islet cell transplants. Our hospital pioneered this procedure under the guidance of Dr. James Shapiro (a delightful man who actually respects nurses) and has done about 100 of them since March of 1999. I had the privilege of caring for our first (only) pediatric recipient about a year ago. Within 72 hours of her transplant she was producing enough insulin that she was maintaining a normal blood glucose without any help. The immunosuppressive regime is considerably less onerous than multiple blood glucose checks and insulin injections each day, and I expect has far fewer serious side effects than Type I diabetes when dosages and levels have reached steady state.
I don't mean to be lecturing by this post, just informing.
Organ transplantation works - just look at me.
Lu Ann (LPN in AZ currently attended school full time to get RN, inspired through the nurses I have encountered during transplantation)