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Windyridge Asked July 2015

Mom (85) with multiple health issues, has been having bad cramping, feet, legs, hands, and upper thigh. Any advice?

I Thought she was going to ER today.She's diabetic, hip replacement in Dec, on too many meds to list. Mind is pretty good, mobile with walker and capable of light cooking and house keeping. She drinks a large glass of water with meals And meds, maybe 48 oz per day or more. Diet could be better but not too bad for her age. I am long distance caregiver. Any ideas would be appreciated.

Windyridge Jul 2015
She is mentally competent, I cannot force her to the ER or anywhere else. I've been phoning her and checking on things once or twice a day. Dad picked her up some calcium D supplements and she's esting well and drinking water. She does not drink diet soda. Yes, Dad is still driving every almost everyday but has cut way down on trips the last few weeks. (I monitor his every move in the car with a GPS device I planted). And this will most assuredly not be a wake up call to check in the nursing home. This is very small potatoes for us compared to some things she's been through. Thank you all so much. It's great to be able to post a question and get so many well thought out responses.

anonymous281963 Jul 2015
E.R., DON't wait.

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anonymous281963 Jul 2015
WINDYRIDGE, (Not shouting), capitalization is so you won't miss this:
After hip replacement in Dec. A deep vein thrombosis is an emergency.
Myself, I take the nuclear option first in certain cases, certain symptoms, because I am not a doctor. After more research, considering you are a long distance care-giver, I would consider calling 911 (in her area), and sending paramedics to her.
IS SHE ALONE?

freqflyer Jul 2015
Windy, how will your Mom get to the doctor's office... will your Dad attempt the drive?

Do you think this will be a wake-up call for them to think about downsizing to a nice continuing care complex? No? Didn't think so. The numerous ER visits with my Dad still haven't convinced either of my parents it is time to move :(

anonymous281963 Jul 2015
Bananas high in potassium.
What are her pain meds, ck them for side effects.
With diabetes, peripheral neuropathy is more dangerous.
Finally, is she drinking diet colas, and so much she would not admit it to anyone?
Get the blood tests.

JessieBelle Jul 2015
Pedialyte is a good source of electrolytes. The unflavored type tastes salty, so not so pleasant. The flavored would be better if it is sugar free. I don't know if it is or not, so be sure to check.

I am concerned that is could be impeded blood flow from vascular disease. This is something that urgent care wouldn't check. I would go to the regular doctor, instead. The doctor can have electrolyte panels run and check for blood flow in her limbs.

GardenArtist Jul 2015
For me, the issue of (a) whether or not the urgent care facilities could run an immediate blood panel and get results while you're waiting, and (b) if she's still having widespread camping would be the determining factors.

If no and yes, I'd go to the ER. Some of the urgent care facilities I this area are just regular doctor's offices that are open beyond the regular hours. They might be able to draw blood but would have to send it out for analysis.

If she's cramping and seizing and in a lot of pain, ER would be the choice.

I think a walk-in clinic tomorrow am would be a good choice, again assuming they can interpret a blood draw. That will give her a chance to get a hopefully restful sleep, rather than going to an ER this late and being up so late waiting for analyses. She's probably already tired.

Windyridge Jul 2015
Thanks again to everyone. Talked to mom after reading above advice. She's got some multi vitamins and some calcium in the house and she's going to try and drink a little more water. She's diabetic so I didn't think the gator aid type stuff would be good. I told her just a little calcium for now until she gets some blood work. She will call the walkin clinic in am to see if they can do the testing.

Thanks again, you guys ROCK!

FeelingLost Jul 2015
Windy, ER vs Urgent Care really depends on the respective facilities. If the urgent care you'd use is set up to run a blood chem panel & CBC on site, they're worth a try. If not, better to go direct to the ER.

Electrolyte imbalance came to mind as soon as I saw the headline. I've had bad cramps like that myself from drinking water only during heavy exercise in hot weather, which depleted my electrolytes. Has there been a recent change in amount of water consumed versus amount & type of food?

blannie Jul 2015
I would call her doctor on Monday, explain what is going on and see what they recommend. They might say she's OK to wait for a regular appointment they might get her in that day, or suggest she go to the ER. They have her history and would be the most prepared to give her the best follow-up care (in my opinion).

freqflyer Jul 2015
I have found the walk-in places pretty good especially if the doctors are trained Urgent Care physicans.... if they feel your Mom needs to go to the ER, they will call an ambulance [I hear it frequently on my EMT scanner].

Windyridge Jul 2015
Great advice all! Logistics questions: if she calls her doc Monday, assuming she doesn't have a flare up tomorrow, who knows when he can see her. She has gone to the local walk in clinic in the past and they have been pretty good.

Should we try to avoid the ER and use the walkin place, get the tests done there, or ordered by the doc there?

GardenArtist Jul 2015
Windy, some questions as well as thoughts...

1. Onset: suddenly and rapid or slowly, and whether or not this has occurred before?

2. Duration of cramping: consistent and debilitating, or short and on and off? Can she still move around or are the cramps too intense?

3. I also would have thought about magnesium, calcium and potassium.

4. I agree with the others - going to the ER; blood work would likely be ordered and the complete metabolic panel would offer insight into a lot of the critical values.

5. Meds: someone can take a range of meds for a while and then gradually reach a critical mass level at which a side effect or interaction can occur. This happened to my mother with her BP medicine. Her reaction was different but It wouldn't hurt to google the meds and determine whether cramping is a possible side effect either with other meds or of longer term use.

6. There's a list of other issues that can cause cramping here:
http://www.webmd.com/sleep-disorders/tc/nighttime-leg-cramps-topic-overview. I've found WEBMD to offer some basic, not in depth advice, but rather a general overview that can suggest other issues to investigate.

One that strikes me as something that might affect seniors is sitting for long periods of time.

Is there someone in her area who can take her to the ER? If not, I think I would be calling an ambulance. With diabetes, age, lots of meds, who knows what could be happening? Best to get it checked out ASAP.

Please keep us posted.

vstefans Jul 2015
IF you already know her kidneys are OK, you can try OTC magnesium supplements first. She might need a little more potassium too, and maybe even salt but be careful with that. Getting a BMP or CMP (basic or complete metabolic panel) would give you and her doc enough info to know if it is OK to do that much, and would make sure she isn't low on calcium which would be the one really dangerous cause of this symptom. Also think about vitamin D and get that measured. Many people run low, some shockingly so, and correcting that helps a lot of things feel better.

CarlaCB Jul 2015
I think the first thing is to have her electrolytes checked. Regardless of the cause, she needs a medical evaluation.

JessieBelle Jul 2015
I can only think of two things -- imbalance of ions in her blood and peripheral vascular disease. One is easily corrected. The other requires a bit of surgery.

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