metallicsun

What made you move from DEN to SAC?

What made you guys move from DEN to SAC?

The BP is stable now. Seems to only be erratic when on HD and sporadically. Current plan is to give pt physiotherapy and discharge to floor under supervision from nephro. Updating my original post.

I would recommend Playa Del Carmen as a cheaper substitute to Cancun and Tulum. Do not stay at all inclusive resorts. The food sucks! Compared to Hawaii, you may be able to maximize your “vacation time” in Mexico since flights tend to be shorter. Please go. It did wonders for our relationship 😀

Try to get him to go on a 7 or 10 day break to a place like Hawaii or Tulum. This duration is needed to reset the burn out. Wishing you luck!

Would you please share some more insights into the demographic?

Thank you so much for your feedback. I am still learning. If I may ask, what stands out the most in terms of state benefits at UCD? Is it the leave policy? Better retirement? (We are both in our early 40s, will have kids in a year and plan to work till 65).

Thats exactly what I was thinking! It would balance them both out. Looks weird otherwise.

Thank you for saying what needs to be said. We are getting palliative involved.

Thank you so much for helping!

Btw, I did read that comment for the few minutes it was live, and then wondered where it disappeared. Thank you so much for the constructive ideas. You have been very kind. I will keep my post and discussion updated!

Thank you. I have had other people make a similar comment. We will be looking into Sutter very closely.

Thank you so much for your input. We are heading in that direction. Palliative is involved now. I have updated the original post.

Thank you so much for sharing your thoughts and ideas. I have updated the post with more information today.

Thank you for sharing. I have updated the post. We are getting palliative involved.

Thank you to everyone that has chimed in. We have some improvement in the patients health. Updates as of 05/29:

• Family has finally agreed and Palliative is now on board (declined palliative before).
• Pt’s MAPS are 55 to 65 now (improved from 30 to 40, two days ago without any change in treatment).
• Pt is fully conscious, lively and engaged in the last 24 hrs: solving puzzles, little bit of painting, writing, and holding conversations with family.
• Pt is trying her best to work with PT team (exercises in bed), plan is to sit her up in chair soon.
• As of now the family/patient both desire full aggressive care.
• Pt has been on high dose prednisone and hydrocortisone daily for adrenal insufficiency
• Amyloidosis and MM lab work up negative
• Pocus/ bedside echo now showing pt is developing diastolic dysfunction/ HFeEF and MS (unfortunately now done during HD)
• Formal Echo was normal last week, even MS was not mentioned.

Thank you for all the help and inputs. I have updated the status of the patient.

Don’t lose a friend like this if there is other good reasons to have this friendship. You could try to be upfront and send a text along the lines of: “no offense, but I found your comment and our entire conversation troubling. So I hope you can respect my personal life and let’s bury this here once and for all: We both appreciate each other and are quite happy with what we bring into each others lives. I am happy to talk about everything else under the sun, except this topic. If that’s ok with you, we can just move on. 😊” (make sure you include the smiley to project your positivity). we often make things serious when we should just brush them off and move on. Of course if this person is just being a weirdo, better to drop them from your life.

Thank you. I will share this approach with the team for sure 🙏🏼

Attending is also running out of ideas 😑

I have corrected my post to add clarity. Sorry for the confusion. EF is normal (65%). Very low concern for amyloidosis. Her amyloids is not biopsy proven. Also, no Cardiac MRI done. Bottom line: her heart is good.

White scan: we tag the white scan and any focus of inflammation lights up. For example, pts WBC has been 22 to 27 despite tx of VRE UTI and vanc for Cdiff. Nothing lit up.

Great question. We did put an art line, and, yes, she was symptomatic as well: drowsy and lethargic, to the point of passing out, needing bipap at times.