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MaggieMarshall Asked September 2014

Mom can't stand.

Mom's on one diuretic every other day now (from two a day being her normal). They were discontinued seven days completely, then started up at one every other day. She can no longer stand up...can't push herself to help me stand her up with her gait belt. Takes time to raise her up an hold her in place. She's pretty much dead weight.

The doctor doesn't understand why her need for diuretics has dropped significantly. Little fluid retention.

She's eating well; alert; not sleeping all the time. But apparently much muscle weakness in her legs.

Anyone have any ideas?

I can't keep her at home if I can't get her to "stand and turn" -- and for the last two days, I've been unable to do that. Tom has to help.

kathyt1 Sep 2014
Dad does this sometimes. Can't stand or get out of bed, legs just fold.. I up his Parkinson's medicine, till the crisis is passed, usually three or four days. I also rehab him in bed. I move the leg muscles for him to keep them supple and firm. Maybe it is time to call hospice and see what they say.

brentefs Sep 2014
I am about to go in for my 6th CT scan...This time with a contrasting dye... Yesterday they took biopsies of two swollen growths in my throat..I looked at them along with the DR, You can't have TWO growths that look alot like reappearing tonsils...He agreed, but puzzled, hence contrasting dye... Sure am worn out.. BL

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gladimhere Sep 2014
Another thought. Two years ago my MIL all of the sudden could not stand or walk. Upon checking her blood the cause was too much, way too much calcium in the blood. I cannot remember what it was called but the levels of calcium had reached a level of toxicity. It was able to be brought down and she returned to independent living what initially all thought she would have to go to a nursing home. She passed in July from a stroke and heart attack.

vstefans Sep 2014
Ask for her to get a BMP (basic metabolic panel) at home -can be done on a fingerstick if needed, though a regular blood draw might be better. Some diuretics deplete potassium. I have a feeling though it is possible this is not reversible and it is just time to prepare and be comfortable as possible, if it is something simple you may want to try to fix it.

JessieBelle Sep 2014
The inner ear. There are semicircular canals to orient us in space and a central area with "hair cells" that are critical for feeling balanced. Little calcium rocks float on the hair cells, letting us know how we are standing (or laying). If those rocks get stuck, we get mighty dizzy.

brentefs Sep 2014
what part of the ear keeps a persons balance??

gladimhere Sep 2014
Maggie, have you checked her for a urinary tract infection? About a year ago my Mom was hospitalized with stroke symptoms, couldn't walk and speech very garbled. It was not a stroke, rather a UTI! These older folks just do not experience the sort of pain most often associated with UTI's.

JessieBelle Sep 2014
I agree with Pam and Jeanne about calling in hospice to evaluate her as a client. The O2 sat is mighty low, and the diastolic is also fairly low. Is her heart rate also low? Chances are that she is not getting good perfusion of her muscles with blood and O2. They don't have any fuel to work. How is her body temperature?

jeannegibbs Sep 2014
I suggest calling hospice. If they evaluate and think it is not time, no harm done. If they seem intrusive you can request fewer visits until you need them more. I don't see what you have to lose.

pamstegma Sep 2014
She is failing Maggie. Heart rate will pick up in an attempt to move O2. Morphine would help open airways. Haldol would relieve delirium and that is coming soon. Steady as you go.

MaggieMarshall Sep 2014
Thanks, Pam. I'm glad you kind of changed your recommendation. Her oxygen level is 77. She's not short of breath at rest or talking. ?? (I took it three times after taking mine and Tom's twice...in the 90's.) Her BP is 162/61. The high number is usually 115 or so. She's not dehydrated by your great test.

I don't get it. She's not acting like there's anything ailing her. Alert. Talks/eats very well.

I don't want to take her to the hospital. Every time they admit her, she comes home a complete mess with her diuretic meds, and me picking up the pieces. I'm hesitant to call hospice, because, since she's not in pain, I'm thinking they will just be an intrusive presence. Or that they will say it's not time yet. (Doc supported it. I canceled the appointment.)

pamstegma Sep 2014
Oh, Maggie if you are going palliative, I understand completely. Then you put her to bed and make her comfortable. Get Hospice on your team, it does keep your feet on the floor.

BarbBrooklyn Sep 2014
Maggie; I would follow Pam's advice, but this feels like an emergency to me in any event, ie. a big change in her physical status. That being said, I know that your mind set is palliative. So I would call the doctor tonight and talk to her/him about the ups and downs of transporting her to ER. Three weeks ago, my mom was mobile with her walker. After 5 days in the hospital, for chest tap, infection, sepsis, she is no longer able to raise herself out of the wheelchair. Now, of course, she's already in a NH, but there is a "cost" to every hospitalization. I'm rambling a bit, I realize, but I would call the doctor and discuss the "cost benefit anaylysis" of acting (ER) and waiting until she can be seen in the doc's office. So sorry this is going on.

pamstegma Sep 2014
Maggie, pull up the skin on the back of her hand. It should go right back down. If it does not, she is dehydrated. Check her BP, heart rate and O2 if you can. If you can't measure BP, at least feel for it. If the pulse is faint and heart rate is over 100, get to the ER.

blannie Sep 2014
Does she shuffle? Are you familiar with normal pressure hydrocephalus (NPH)? I wonder if she could have something like that going on? It mimics Parkinsons and/or dementia. 60 Minutes did a great segment on it, you can find it on Youtube if you aren't familiar with it.

So this inability to stand is of a very sudden onset then. Hmmmm...I'm stumped. I'm sure others will gave good suggestions.

MaggieMarshall Sep 2014
Thanks, Blannie. She was walking up until two days ago . . . her legs never seemed to be the problem. She walked like a SNAIL, though; which I equated to Parkinson's. A snail, believe me. But always firmly planted on her feet.

blannie Sep 2014
The only idea I would have would be to get her to rehab where they can work on the strength in her legs. If she's dead weight at this point and she can't stand once you get her up, I don't see there's much you can do on your own. I'd say she needs professional care to regain her strength, if the professionals think that's possible.

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