Mom's Health Insurance

I know I have mentioned before that Mom has great health insurance. A couple weeks ago the year-end statement for Mom's treatments at Kaiser and how much she has paid arrived. Over the course of 2016, Mom was responsible for about 2% of the amount approved by her plan. Like I said before, Mom has great health insurance! Like the kind our new President is working on for everyone ... NOT!


Mom went to her 2-month check up with Dr. Pham, her primary care physician. Dr.  Pham had ordered a bunch of blood tests prior to her visit: B-type natriuretic peptide (BNP), creatinine, alanine aminotransferase (ALT), electrolytes (Na, K, Cl, CO2), & Vitamin D 25-hydroxy.

Nurse Linda getting Mom's vitals; Nurse Leo, Dr. Pham's usual assistant, was off today.

The BNP is normally less than 100 pg/ml if your heart is working well. Dr. Pham is checking on whether Mom's congestive heart failure is under control; at 114 pg/ml she is a little high, but not as high as it was in 07/2016 when she was first diagnosed (it was at 275). I need to check daily for water retention & give her furosemide if she is retaining water; the extra fluid puts a strain on her heart. Another symptom I need to watch for is difficulty breathing, especially when she is lying flat.

The creatinine is normally between 0.50 to 1.20 mg/dl; Mom's is 0.75 mg/dl so her kidneys are doing fine. Dr. Pham is checking this to see if any of the medications are affecting her kidneys. Mom's creatinine level has been normal since they started monitoring it in January 2016.

The ALT is normally between 5 to 63 U/L; Mom's is 10 U/L. This test let's Dr. Pham know how her liver is functioning & is done for the same reason as the creatinine. Mom's ALT has also been normal since they started monitoring in May 2013.

All of Mom's electrolytes are normal. Dr. Pham is checking to see that everything is in balance. Mom's electrolytes have been normal since July 2016 when monitoring was started.

Mom's Vitamin D is low, 27 ng/ml; the normal range is 30 to 100 ng/ml. She has been low ever since they started testing her in July 2014; the lowest was 16 ng/ml in March 2015. She has been taking additional Vitamin D which has raised her levels but she will still need to be on it a while longer. I  checked what was in the calcium with Vitamin D3 supplement she is taking & found that she was getting about half of what Dr. Pham would like her to be getting. I added a separate Vitamin D capsule to get her up to 2000 IUs per day.

We talked to Dr. Pham about Mom going to Seattle in late February. She said as long as Dr. Chan has no concerns, she was fine with it. She said the issue would be whether Mom needs a transfusion during the week that she is gone. I have been thinking about that, my plan is to take Mom in at 7 am on the 21st so that the results are available earlier in the day for Dr. Chan. Then if she needs a transfusion it can be done on the 22nd and we leave for Seattle on the 23rd. We would return in about a week. The following day she would get tested and be available for a transfusion before the end of the week. Mom has never needed a transfusion 2 weeks in a row so I think she should do fine with this plan.

The pain in Dad's leg has gotten a little more bearable with the lidocaine patch and acetaminophen. He has been using Mom's walker to get around the house. Tomorrow, while I am at the ATC with Mom for her transfusion, Curtis will be her with Dad to help him out with meals & medication. But Curtis will bring lunch for us as usual.

I am keeping track of who needs what medication at what time on my phone. I have 8 alarms; 4 for Mom, 3 for Dad, & 1 for Xander! Fortunately Dad's medications are only daily until next Tuesday, then the acetaminophen becomes on an as needed basis. And Xander's last regular dose is on Saturday, then it becomes as needed.

Happy Birthday to Allison!