Friday, 8 February 2013

07:49 – Another one-dog night. We dodged the proverbial bullet. It rained for hours last evening, and the temperatures were barely above freezing.

I’ve been making up chemicals for the chemistry kits, doing raw-materials inventory as I do so. Yesterday, I put together an order for several hundred dollars worth of chemicals from Elemental Scientific. A gallon of reagent-grade glacial acetic acid, a gallon of reagent-grade n-butanol, two pounds of this, five pounds of that. When I clicked on the button to check out, there was a drop-down list that forced a choice of one of three options for payment: call-in, fax-in, or mail-in. I chose call-in.

I called to give them my credit card number, and spoke to Wade Van Ryzin, the owner. I asked him what was going on, and he said they were in the midst of changing credit-card processors and hadn’t yet gotten the API for the new processor set up on their web site. So I gave him my credit card number and, as usual, we started chatting about this and that. I finally remembered to ask Wade something I’d been meaning for years to ask him. Why does Elemental continue to package chemicals in traditional measures–ounces, pounds, pints, and so on–rather than grams and milliliters? Wade laughed and said they were asked that question all the time. The answer? He said that they’d have to re-do all of their labels, thousands of them, and that doing so would require devoting someone’s attention full-time for a month or more.

Barbara made a flying visit home last night to have dinner before heading over to her parents’ apartment to dad-sit overnight. She’s off-duty tonight, with Frances covering, and then back on-duty Saturday, Monday, Wednesday, and Friday. I asked about getting someone to stay with him nights, and Barbara said she and Frances were talking about it. The problem is that Dutch wants Barbara or Frances to stay with him because he’s afraid that a hired sitter will steal him blind while he’s asleep. I told Barbara that she and Frances need to make her dad understand that the two of them can’t do this indefinitely, and that if he wants someone staying with him it’s going to have to be someone hired from an agency.


11:28 – It all makes sense now. Barbara just told me that the IV antibiotic they have her mother on is levofloxacin, a 3G fluoroquinolone. Here’s some of what Wikipedia has to say about CNS ADRs with levofloxacin:

Fluoroquinolones can induce a wide range of serious adverse psychiatric effects. These reactions may manifest as extreme anxiety, panic attacks, depression, anhedonia, cognitive dysfunction (or brain fog), depersonalization, paranoia, hallucinations, toxic psychosis, seizures, tremors, taste perversions, abnormal dreams, chronic insomnia, vertigo, delirium, suicidal thoughts, and usually involves all five senses. For some people the symptoms resolve relatively soon after discontinuing the fluoroquinolone; for others, in the case of a neurotoxic effect, symptomatology may persist for months or even years after discontinuation. Fluoroquinolones are associated with a significant number of serious psychiatric events.

These side-effects are distressingly common with this drug, and are much more likely to manifest in older people. When you consider that Barbara’s mom is 85 years old and was mentally frail to begin with, it’s not surprising that she’s completely lost it while being treated with this drug. When I told Barbara that I was shocked that they were treating her mom with this drug, particularly in a hospital environment where MRSA is endemic, she said that Sankie is allergic to penicillins and sulfas. I realize that they have to choose a drug that is effective. Still, the one they’re using is hideously dangerous, even within the fluoroquinolone group. I can only assume that cipro or one of the other less risky fluoroquinolones wasn’t effective against her infection. Or at least I hope that’s why they decided to use levofloxacin.