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Hi all,
Has anyone used Farxiga for kidney disease? Any experiences or thoughts on that? I went to the pharmacy to pick it up yesterday and the girl said there was an insurance issue so we'll see what happens. Dad was diagnosed with stage 3b CKD. He's also starting to have edema. Doctor said she's going to put him on Farxiga for 3 months. If it helps, great and if not, she is going to refer him to a nephrologist.I'm getting a little ahead of things but I'm terrified the nephrologist would recommend dialysis when dad gets to that point and dad will want to do it. Hopefully not.
The good news is I finally got him to a primary doc instead of only going to the cardiologist-he didn't have a choice as the cardiologist quit taking his insurance. Hopefully this doesn't turn into a "watch what you ask for" thing.
He still hasn't let me call in someone to evaluate his needs and see what he qualifies for financially. One of the nurse practioners at his new doctor was trying to help me by telling him how good the help has been for her mom but he wasn't going for it.So I will be letting him know he will have to do that if he would choose dialysis since he wouldn't be able to care for himself-he barely can now. I'd imagine he's going to need a lot of help at that point whether he would choose dialysis or not though.
Also his mobility has not been good for years now but he's very close to not being able to walk (I've probably said this before and yet he's still walking with the help of walls, walker, and me pushing him in a wheelchair at appts). It's apparently a neurological thing. His muscles are wasting away.His sister got him a wheelchair but there is not room in his house and I don't know if he could even move it around on his own if he did have room.My question is if he gets to the point he can't stand up or walk, would I call an ambulance so I would have access to a social worker? Would they take him for that when he's been losing his mobility for a long time? Or would I have to call APS?
The hospital by his house quit taking his insurance so another problem to deal with.
Also does Medicare (an Advantage PPO with ESA) cover hospice when it's at a hospice facility?
FYI-I do not have POA
Thanks so much!

An Authorized Generic version of Farxiga is approved now. Be certain that the doctor is ordering under generic name to help with coverage possibilities.

Your father is now facing a lot. It is time to have THE CONVERSATION about his conditions. He has a failing heart. There will be no transplant. His kidneys are now also failing. You need to either have a POA or know that you do NOT WISH TO HAVE POA because I can tell you right now that it is a major job, especially for someone with unrealistic expectations.

You don't mention your Dad's age but you do mention insurance. Is he not yet qualfied for Medicare?

I think that your father is gravely ill. I would hesitate to take on POA unless you live there, have the knowledge and time to do this. He sounds not to be realistic or cooperative in management of his illnesses, most of which you are not even aware of as diagnosed.

When your father goes "down" --this will happen--a call to APS may get him hospitalized and diagnosed. From there it may come to placement and you may need to allow the state to take on guardianship.

As I said, it is time for the long conversations, and honest one, with your father. If you can do nothing, then you will know that after this talk and you will call APS when it is needed, or EMS (emergency services) for tranport to a hospital. Be certain not to take on work you cannot do/do not wish to do. By that I mean the ENTIRE POA thing. I was POA/Trustee for my brother. He was organized, cooperative and it was STILL a big job. Think twice. Then think again.

I, too, hope he declines dialysis. For his own sake. I say that as a retired RN.
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slkcma Sep 5, 2024
This is a repeat post. I forgot to hit reply under your post......

Thanks AlvaDeer!
Happy to hear there is a generic now. I need to call the pharmacy and see if it's been figured out.
He has a Medicare Advantage PPO with ESA. It's what he gets as a retiree at the steel mill.
I already have POA on mom but she's cooperative and much easier to work with. I don't plan on getting POA for dad.
He is 86 years old.
I can tell he will soon be needing major help so trying to get my plans in order for different situations so thank for your help!
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Farxiga and its relatives (Jardiance, etc) or generics are very commonly prescribed in CKD now. They originally started as pretty feeble, third or fourth line diabetes drugs, helped diabetes a little bit, but in the subsequent safety studies it turned out they slowed kidney decline, prevented heart issues, and reduce overall mortality much more than expected beyond the minor effect they have a blood sugar. It’s also turned out that they work in people without diabetes.

No idea how old your dad is, and therefore what the chances are that his kidneys may reach the point of considering dialysis. But any good Nephrologist should offer (or even recommend) *not* doing dialysis as one of the options. Especially in someone who’s very frail as you describe above, seems unlikely to help much. Just like you could do chemotherapy or not, or have a surgery or not..
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slkcma Sep 5, 2024
Thank you!
Dad is 86 years old.
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Thanks AlvaDeer!
Happy to hear there is a generic now. I need to call the pharmacy and see if it's been figured out.
He has a Medicare Advantage PPO with ESA. It's what he gets as a retiree at the steel mill.
I already have POA on mom but she's cooperative and much easier to work with. I don't plan on getting POA for dad.
He is 86 years old.
I can tell he will soon be needing major help so trying to get my plans in order for different situations so thank for your help!
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Since Dads insurance is being dropped by his Dr and now hospital, you may want to look into changing his insurance. There is a reason why they are dropping them. Your County Office of Aging can help you in finding a new insurance for him that his Dr and hospital use. Open enrollment is coming up.
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slkcma Sep 5, 2024
Thanks JoAnn29, I will look into it. And I appreciate the reminder about open enrollment.
I don't think he pays for this insurance-one of his retirement benefits-so not sure if he'd go for that or not. Supposedly his union is looking for a fix for this problem because a lot of retirees live in the area where the hospital quit accepting it. They should have looked into it many months ago but this is where we are. Ugh
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