A Follow Up to Caregiving Ain’t For Sissies

Thedogmama
Fenway (Photo Credit: Wally G on Flicker: http://www.flickr.com/photos/wallyg/)


Today is Wednesday, I think I’m on the mend and so is Mom. With the help of friends online and otherwise, I managed to quell my daughter guilt and saw the chiropractor on Monday while Mom was taken for the bone scan. My back was pronounced as improving confirmed by the decrease in pain. The orthopedic doctor from rehab called in the afternoon to let me know that the bone scan only showed the previous fractures in Mom’s pelvis and nothing broken in her upper left leg. He suggested trying a Lidocaine/corticosteroid injection to numb the area and see if it will allow her to put weight on that leg.

Tuesday when I visited her I was greeted with a smile but no words. She just lifted her left leg and kicked out her foot once or twice, moved it left and right and put it down again. It was great to see. Today was a little shakier. Now that she has been given the green light to put weight on it, the therapists started to go to work. She wasn’t too happy that they had her up, dressed, fed and down to the therapy room by 9 am. (The time she usually wakes up at home!) By the time I got there she was uncomfortable and I got the feeling she thought the pain was just as bad as before.

So here comes the hard part. Trying to help her understand that she is better than she was and also to try to help the rehab staff understand where she is coming from. Chris wrote a blog this week called On Being An Advocate. So it was time for me to step up to the plate, after all, Mom has been living with me 24 hours a day for the last three years, so I have a pretty good handle on what is going on. First I reminded Mom that two weeks ago she wouldn’t even put ANY weight on her leg, today she took three steps. I also reminded her that when she fractured her pelvis it took two people to move her from her bed to a wheelchair while she was hanging on for dear life and she persevered and was able to be back home motoring around like normal in about 8 weeks. No it wasn’t easy I told her, but she did it.

Next job was to talk to the staff. Sometimes you just get lucky. Today while I was at rehab I was able to talk in person to the physician’s assistant, the rehab doctor, the orthopedic doctor, the physical therapist and the case manager. After the team meeting this morning they felt Mom would do well to stay another week. Yippee! I was able to discuss with the PA how we handle breakthrough pain at home. Unlike the rigid every six hour schedule they adhere to in rehab, our doctor allows us to use her breakthrough meds when she asks for them, even if it is only two hours after the last dose BUT once she reaches the max for the day, that’s it, no more. They are so worried about depressing her breathing they wouldn’t be flexible. Now that they want to get her up and working, she felt if Mom didn’t use the breakthrough meds at night, maybe they could medicate her more often during the day so she could benefit more from therapy. (DUH – score one for the little guys) She also thought that wrapping her thigh with an ace bandage for additional support might help.

Observing Mom for the last couple of weeks I have come to the conclusion that she is not only in pain, she is now terrified of pain and maybe that fear is exacerbating the pain. We talked about trying a very mild anti-anxiety medication to see if it would help alleviate her fear.

Her therapist has been puzzling all week about this soft tissue injury and today observed that Mom has been keeping her left leg slightly bent at the knee which in turn is shortening the muscle and tendon down the outside of her leg and wondered if bracing her knee would force her to stretch out that painful muscle. When I talked to Mom later today she commented that her leg felt better with the brace on her knee. So kudos to the therapist who took the time to observe, consider and then implement a possible solution.

We haven’t fully figured out if she will be able to use her walker when she comes home and we are making plans to have a commode and a wheelchair upstairs for her, but we are taking it one step at a time. As a family we are just going to see how we will cope and what we will need to keep her here with us as long as possible without hurting my back, and hopefully without hurting her.

I will be curious to see how tomorrow goes. As one of the nurses said to me today, when she makes up her mind she needs to move, by God she does it! I suspect she will be that way again, after all Christmas is coming and that is her favorite day of the year.

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