June 9, 2012
Vitals: BP: 100/60, Temp: 37.5, O2: 97, HR: 88, RR: 26
Homecare Essential No. 1
A Good Family Doctor Who Can Visit
When we were small, our father was suffering from a chronic asthma. He was homebound but we did not have a problem about his medications because the good doctor Abundio Echavez whom the town fondly called Doctor Abun came to visit. He didn’t mind walking from his clinic to our small hut along Campos Street to give injection to Melit’s father.
Today, there are no town doctors willing to do that, not in the city. Luckily, we have Dr. Joanna Sabal, a kind and bubbly Family Med specialist who also trained in Palliative Care. Because we enrolled Melit with the AKBAY Homecare Health Services, we can always call Dr. Sabal to consult or when necessary, we ask her to come for a visit together with trusty nurse Ching.
Dr. Sabal takes care of the patient and the caregivers. Her advices are practical. Yes, obviously she is not a specialist in critical care, as some family members have noticed, but she specialized in chronic care, which at a certain point a comatose patient requires.
(Comatose patients do require healthy caregivers.)
Caregivers should be able to assess whether the comatose loved one requires critical care or chronic care. As we have learned, they flip constantly like two sides of the same coin.
THIS WE HAVE LEARNED ALONG THE WAY:
There are essential parts of the caring that are CONSTANTS: such as feeding, perineal, morning care, oral care, bed turning, rehab exercises and so on. It doesn’t matter whether Melit is in “good health” or in critical stage, we have to do those things.
There are elements necessary for CHRONIC care, or when Melit does not have any health emergencies and simply requires maintenance medicines such for her brain (Citicholine – 1 g Q12)), her antisiezure (Levetiracetam 500 mg tabs BID); blood pressure (Telmisartan 40mg tabs OD and Atenolol 20 mg tabs OD), her stomach (Omeprazole 20 mg cap OD), her supplements (Moriamin and Stresstabs both OD); her lungs (Salbutamol – Q6 or PRN) and oxygen; and her skin (Calmoseptine). These are her medications for the first phase of her homecare.
And then, there are times, when we have to treat Melit as under CRITICAL care, when there are sustained extremes in her vitals (according to Dr. Sabal), and when she looks restless and suffering. This is when we need the opinion of critical care doctors and provide Melit with antibiotics or such stuff.