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Sorry to keep asking questions about my dad's diabetic foot sore. The "biopsy/culture" or whatever they want to call it , seems like it would be more than one little swipe across the world with a cotton swab ?? Am I overreacting ? and I am very good at that!! I've been reading where they take samples of the skin and people say that it hurts, cotton swab did not phase my dad. Now I'm worried about his diastolic blood pressure number being in the 40s several times during the month of March at his foot doctor according to his records. 149/43 and 129/47 on his last 2 visits at foot doc, The previous four visits the blood pressure cuff was not working so they just didn't take it . At the last two visits the nurse said we finally got a new blood pressure cuff ? really, I should've asked at the first visit, seriously, you don't have another one anywhere here in this office. Yes, I know, no shoulda, coulda, woulda.......from my experience being in different ERs in dealing with different doctors in different towns back-and-forth things always get mixed up,diagnosed wrong,bad communication, whatever. Yes, we have had some very good doctors but more very excellent nurses ! I know they are overloaded.... I just want correct treatment for my dad right now and maybe I just need to quit reading on the net, yes, I make sure they are reputable sites. Plus, does this low number possibly mean that's why he has had two falls in the last two weeks ? Does this loan number mean he has congestive heart failure since he had five bypasses 14 yrs ago... I do know how diabetes affects the vessels in the body. Yesterday had the girls at assisted-living check his blood pressure and it was 130/78, I do you know how the blood pressure can fluctuate at different times of movements and being still. yes, waiting to hear back from his blankityblank doctor again. going to new doctor starting in late April, Endo appointment soon, and waiting to hear back from result of culture today hopefully

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Bella; WHO on earth is criticizing you?!

If I could give you one piece of wisdom from our family's journey with mom, who has vascular dementia, it's that at some point, you stop trying to fix things. There is no fixing a worn out, old body. There is only making things a bit more comfortable. No cure for old age.

If this were one of your kids with an illness, yes, you'd research the heck out of the topic and get all the latest information. But this is your old, possibly demented father, who is noncompliant with what he's told to do. Give yourself a pass.

Take care of yourself and be honest with dad's new doctor about what the likelihood is of your dad's being compliant with treatment. Ask about what level of care s/he recommends for dad; is a nursing home the place for him, since he clearly can't care for himself? Make is clear that YOU can't get him to comply and have no intention of killing yourself in the effort.
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Tired of hoping and wishing that my dad would help himself get better
Tired of reading all the doctors reports and questioning things, Reading and trying to educate myself on the Internet to figure out why certain things are happening in his body
Exhausted with trying to find answers, prevention of further disease,
Tired of putting Band-Aid on top of Band-Aid
Tired of grinding on my teeth making my jaws ache, tired of the blades twisting thrashing around in my stomach with worry and anxiety
Tired of him not eating right for diabetes

disgusted with myself because people think I'm crazy for wanting to figure all of this out especially regarding his health
Tired of the rolling of the eyes from others when I ask certain questions

I very well know I am the one with the problem, stop reading on the Internet, stop trying to change my dad, quit wishing for a different relationship that I never had.
So I just sit with my dad and enjoy the time with him, disregard any problems he has, take him to a new doctor and leave it in his hands...everything will be hunky-dory

It's like a d*mn dog that wants to go out and fight with coyotes and comes back home all beaten up and I say oh well throw him some food and give the dog a bone. Yep,  he chose to go out in those woods! I see now that this is how it must be, I feel like I'm going insane with it all.

Tired of searching, helping, suggesting, on what I feel is right for my dad because I love him. Even through all his wrong choices in his life I feel deep compassion for him and I know he loves me the only best way that he can.

So I will take your advice and back off
The last 25 years of doing this has been a real struggle mentally and physically but the last year and a half has been the worst.
My daughter got married last June, my husband's mother died the week of the wedding, the funeral was to days before the wedding, July, my dad had the stroke,  mom had a stroke in December...had to move my divorced parents to the same assisted living ...during the whole time trying to fight bedbugs in his home and ours

Tired of being criticized for trying to make things better for him and people rolling their eyes at me

Feeling mentally exhausted and beat down
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That's very touching Bella. We all want the best for our parents. I know that I do and that I cringe a little when mine do things that I think is unwise. I realize it's different if the person is incompetent. In that case, you have to exert more control, but, it's a slippery slope, unless it's clear and his doctors are on board. Even then, it's tough to get someone to comply with strict medical protocol, unless, they are able and willing to do it.

Have you considered Palliative Care? Considering your dad's multiple medical issues and resistance to treatment, I might explore it. Of course, as long as he's competent, (I know this is cloudy), it's really his decision.
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Yes

Frankly I'm tired of asking questions regarding my dad's health

Tired of wishing he'd comply with doctors orders

Tired of the million phone calls...
doc appointments, tests/labs, 5 bypasses, eye exams/lasers/vitrectomy, setting upMedicaid, opening months of mail, when he'd finally ask me, to open (bills over due...and he'd say "pitch it-let them come get it", driving while legally blind, watching him support low life's, watching him live with mice turds, bedbugs, spiders and snakes in his dumpy trailer...then the stroke and seeing bedbugs crawling on the hospital sheet, the trauma of discovering in his bagged up clothes of bedbugs in his shoes, shirt, jeans, a nest in his hat, the casings in his billfold that I put in my purse!! tired of the fear of bedbugs in our home, which did happen! I still look for them. The expense was unreal, for my family and him...his dumb choices with finances became my problem? Why? Because I'm a dumb*** child of 54 that still wants that make-believe relationship with a dad that I never had.  A dumba** child that was thrilled last week when my dad kiss my hand for the first time ever...
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What sort of heart attack? Was this before the bypass?
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"Where did the idea congestive heart failure "spring" from"?
He had a heart attack.


No worries...no more questions from me
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Bella it isn't cynical to observe that by far the commonest reason for weird blood pressure readings is incompetence on the part of the person taking the reading. New cuff, hm? Good at fitting it yet, are they?

But then you mention two falls. Well, that could be hypotension (exaggeratedly low blood pressure). Or it could be hypo/hyperglycaemia, because his insulin/blood sugar management is all over the place. Or it could be almost anything...

Then you mention that back at the facility his blood pressure is read at 130/78. Sigh. Was he lying down?

I think you will drive yourself nuts trying to guess at all this (it's certainly making me go cross-eyed!).

Where did the congestive heart failure idea spring from? What was the root cause of his needing bypass operations previously? It's more usually arterial disease, which would also fit better with the diabetes. Low blood pressure is not diagnostic of CHF, no (the opposite, in fact, as far as I remember - the body tries to compensate for the poor heart function by raising blood pressure). Classic presenting signs are really severe breathlessness, especially on exertion, and fluid retention - which you can't miss: your feet and legs look like they've been inflated, and when you press on them with your thumb the dent stays put.

Augmentin is a new(ish) generation of amoxycillin, plus a clever chemical that breaks down the cell walls of bacteria so that they're more sensitive to the antibiotic. It's effective, but not fun to take (I know this one from my days in hospital as Cat-Bite Woman).

Also, was this pseudomonas bacterium swab cultured in the same office where you'd previously observed those abysmal standards of infection control? So it could be that your father's diabetic ulcer has been infected with this bacterium. Or it could be that it is now, because the person who took the swab was carrying it. Or it could be that they did God knows what with the swab between its touching your father's foot and being sealed ready for culture. More importantly, how is the foot looking? Better, worse or much the same?

You are right. You need to stop looking stuff up on the internet!

I hope your father copes well with the new px. But as always, what really matters is how he seems to be feeling. Worry less about what might be happening, and just concentrate on him.

And hurry along that new PCP!
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Still waiting to hear back from his primary regarding the low diastolic readings
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Culture results:
Pseudomonas aeruginosa
New antibiotic change:Augmentin
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Nope I lost all my editing

Darn... was just wanting to know how far to go with all this crap
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OK I understand about the culture etc.
Do they normally do a culture first and then a biopsy if needed?

Was editing my first post and U2 answered me and I added a bunch other stuff sorry to be so confusing
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........I have led this old horse to many basins of water but he doesn't want to drink
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One good thorough contact done correctly is usually adequate  for a culture. The qtip is then inserted in a growing medium at the bottom of a culture tube. It usually takes 48-72 hrs to get a culture result but can take longer if the bacteria is a slow grower.
Yes please ask the doctor about the blood pressure questions. You have received good information with prior responses about the wide pulse pressure.
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A biopsy and a culture are two very different things.

Think about this. When you have a suspected UTI, they do a culture. They take some urine and place it in a little dish with some culture medium (usally seaweed jelly) and they see if any bacteria grows. Same thing with a swab from a child's sore throat, testing for Strep. A swab of the throat, the result goes into a dish to see what grows.

It sounds like what they did was a culture of dad's wound to see what will grow.

In a biopsy, a piece of tissue is excised and examined under a microscope. And yes, it hurts.

No idea about the BP stuff. Make a list of those questions to ask the doctor at dad's next visit.
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