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Mom will be 91 in March and has always been active. Had various issues over years, but just kept going and all have been amazed. It's just her and I in life basically. In July I convinced her to visit cousins out of state and she stumbled in their bathroom and hit her right side very hard. In hind sight I should have noticed that things were very wrong, but almost a month later I brought her to the ER and found out perhaps her rib scratched her stomach causing internal bleeding and a lung to collapse.


She was in the hospital a month and chest tube was removed. I asked for an xray to be sure all was fine, but the doctors and nurses said no. Within a few weeks she was back in ER and I was told she had fluid and was being transferred to the big city nearby.


Two additional chest tubes were added, and a horrendous antibiotic Minocycline and pepcid combination was given. She's allergic to pain meds and just takes Tylenol. About 4 weeks ago she was released and is in horrendous pain. I know that the chest tubes when through the ribs, tore things and there is healing that must take place. The minocycline has side effects even though that stopped about 2 1/2 weeks ago. Intense head ache, dizziness.


The follow-up with the surgeon was that all was successful, she did great for her age, but that was it. I spoke to the PA and she told me that mom will be in great pain for 3 to 4 months. At this point, mom is massively depressed, in excruciating pain, cries every day, wants to sleep, seems to be losing that spark that has always been there.


I know that her age is certainly a factor in the healing process. Also, the three chest tubes were awful and I'm sure did damage inside when they were inserted and removed so that has to heal. That pepcid and Minocycline was just as bad. She's fiercely independent, but it is only me and I work full-time 10 hour days to be off on Fridays for her doctors.


Any thoughts on how I can make her more comfortable related to the internal chest tube healing or the side effects of the antibiotic and pepcid combination? I do not want her to lose that desire to keep plugging along. Tomorrow I have an appointment for her to meet her family doctor that she only saw once a year, if that. She was also only taking vitamins, no meds prior to this stumble. She doesn't want to go, but I shall bring her regardless.


Thanks, Marc

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GA, the OP states that his mother is allergic to pain meds (except for aspirin and tylenol).
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W/o reading all the posts, as I'd prefer to do that leisurely rather than now, I'm wondering if she hasn't been given something stronger for pain b/c of the national opioid crisis, and what I've been told for more than a year or so that doctors are backing off on prescribing powerful drugs.
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Marc; I learned early on (from folks here, actually) to not accept no answers and discharge.

I recall standing in mom's hospital room arguing with a doctor who wanted to discharge my mother; I don't recall what the problem was, but they sure as shooting hadn't fixed it. I said "I'm not signing for discharge; you haven't fixed what she came in with".

(I had NEVER EVER said "no" to a doctor before. My mom burst into tears and said I was going to get her labelled "an uncooperative patient". I told mom that the only acceptable outcome was for them to figure out what was going on and FIX it; I was the one being a b^tch, not her.)

It is unacceptable for your mother to be in this much pain for this long. Don't accept "no" for an answer. It's NOT good enough. Not for your mom.
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Your poor mom. Hope the doctor's visit turns up some new information and mom can get some relief. Good luck. Let us know.
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Durbin, In August 2018, you posted:
"I'm single and sole caregiver for mom who is 91 and lives with me now. She had a stroke in 2016, moved from cane to walker, was recovering well, but was injured during therapy in 2017 causing a torn rotary cuff, ganglion cyst on shoulder that cannot be removed, and additional issues and fears developed. Since the stroke, she's on Plevix and baby aspirin. She is truly allergic to almost everything and cannot take pain meds so only lives on aspirin for pain. Recently, her arthritis pain, muscle pain have taken it's toll and she seems in constant pain. For her age, she's active and we have moved around more than most on drives, shopping, trips, but this past 3 or 4 weeks, arthritis is fierce. Thanks, Marc"

Mom has been in pain for a long time, hasn't she? Have you tried the topicals that were suggested here?

Has any consideration been given to the fact that mom may have developed Vascular Dementia as the result of her stroke? Folks with dementia are notoriously poor at accurately reporting both the severity and the location of pain. Just something else to consider. Also, her anxiety may be ramping up her perception of pain; some folks have had great success with antidepressants for pain.
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https://myhealth.alberta.ca/health/AfterCareInformation/pages/conditions.aspx?HwId=zu2150

Durbin; please read the above link.

I want you to write down, tonight, all the questions you have, including:

Why is my mother in so much pain?
What diagnostic procedures can you do to discover the source of her pain?
What can she take for the pain?
Is there new fluid in her lungs?
Why does this keep happening?
What is her prognosis? Should we consider palliative care or hospice?

As you can see from the above link, her being in this much pain a month after chest tube removal is not normal. Don't let them tell you that it is.

When folks who are in their 90s stay in bed, the develop bed sores and/or pneumonia. Either can be fatal. It is imperative that you get the source of your mom's pain cleared up, even if it means putting her temporarily on Hopsice to get her good pain relief.
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NeedHelpWithMom Nov 2019
Such good points! All of them. Yep, get a handle on everything now because one mishap leads to others.
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I am wondering something: WHO let's a 91 year old woman out of the hospital after a ONE MONTH STAY refusing a chest x-ray to make sure things are okay?

Then I'm wondering, after re-admittance to the hospital for a second time, WHO releases a 91 year old woman knowing she is in 'horrendous pain' and allergic to prescription pain medications?? HOW, exactly, is she (or you) to manage her care now??

Your mother has been treated very badly here, I'm afraid, in every way it's possible for a human being to be treated badly. If it were me, I'd get her BACK to the Emergency Room and DEMAND a full work up be done to see why she's in such excruciating pain and how she can be relieved IMMEDIATELY of said pain. And then I would insist she should go to REHAB to recuperate PROPERLY before she is sent home so she doesn't have to be depressed and lose her spark for life. I mean, who WOULDN'T, under the circumstances?

You've been given the shaft, and for that I am sorry for both of you. Sometimes I hate doctors, especially when they are treating elderly patients who they don't seem to care about at ALL. Use your voice. Loudly, if necessary, and make yourself HEARD.

Best of luck
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NeedHelpWithMom Nov 2019
Exactly!!!
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Marc,

Wow! You have your hands full. This has to be weighing heavily on you. I can’t imagine what you are going through. Very sad situation.

I also cared for an elderly mother in her 90’s. They are frail and have special needs and concerns.

There are some things about your posts that are confusing to me. You say she fell in your relative’s home. Did they call 911 for assistance? Falls can be very serious for the elderly. My mother has fallen several times. Sometimes they injure themselves and require immediate help.

Did they give a reason why the X-ray that you requested would not be done? That’s odd to me because that is always the first thing done when my mom was taken to the hospital. Internal bleeding is always a concern.

She needs something for pain. Tylenol doesn’t help that much. Not sure how reactions to pain meds are handled but she can’t stay in excruciating pain.

I don’t think she should be left alone either while you are at work. I am not trying to lay a guilt trip on you. I’m sure this is terribly disturbing for you. At least hire a sitter for part of the day. How is she able to fix her meals or go to the restroom alone in pain?

Not trying to alarm you but being in pain without anyone to help her is a recipe for another fall and I know that both of you wish to avoid any future falls as best that you can.

Have you contacted a social worker at her doctor’s office or hospital to find out about receiving Palliative care? Ask for referral to hospice organizations. Surely, she should qualify in her condition, especially with regard to her age and being alone. You can’t do this on your own. Speak up for yourself and especially for your mom who is suffering emotionally and physically. You are her only advocate. Social workers are wonderful in helping to guide families to move forward towards the proper care.

I wish you and your mom the very best. Please let us know how you and your mom are after you see the doctor. Will say a prayer for both of you. Hugs!
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Durbin1 Nov 2019
Thanks for the email. Mom uses a walker, but tripped due to the newly installed bidet at my cousins home. To avoid hitting the floor, she aimed for the vanity. It was her right side that hit that. She didn't tell me for 3 weeks and a few days after that this had happened.

She has allergies and Tylenol is what she is used to taking. I will ask the doctor tomorrow for something a bit stronger.

The X-ray was a silly reason since they said it wasn't healthy to give so many X-rays. Of course, when she went to the second place they gave her a multitude of x-rays!

Just up to a week ago mom would not even consider someone coming to the house, but just a few days ago, she seemed open to it. I will ask the doc about that.

Thanks, Marc
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Sometimes when a parent has had an illness or injury, we assume that all further symptoms are related to that.

If your mother stopped the antibiotic 2.5 weeks ago, isnt it possible that her headaches and dizziness are related to something else? Dehydration? A new and unrelated infection?

I'm glad she is seeing her regular doctor tomorrow. Make sure that you get answers.

Isn't there some pain reliever she can take aside from Tylenol?
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Durbin1 Nov 2019
Appreciate your email. I'm assuming it's related, but I am not a doctor so I'm glad that I will get her there tomorrow. Someone suggested that they do a blood test to be sure that there is no other infection going on.

Thanks, Marc
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I'm sorry your mom has had such a rough time, and I add my voice to the chorus asking why her PA thought being in "great pain" for three or four months is acceptable?

When you take her to her regular doctor, you might ask for a palliative care consult -- palliative (mainly comfort) care, which is sort of like hospice except it doesn't require a doctor's certification that she will likely die within six months and one can pursue curative treatment while on it. Hospice care is comfort care only. Both treat the "whole" patient and can take her family's well-being into consideration.

Unfortunately, you sometimes have to rattle cages to get doctors, particularly those in hospitals, to be thorough. That has been my experience anyway. It's a fine line we adult children/advocates walk: push for what your parent needs without making the docs angry. I'm not great at that last part, so my brother often plays the good cop to my bad.

I hope she can get some relief. She is greatly blessed to have you looking out for her.
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Durbin1 Nov 2019
I will rattle all the cages to make her comfortable. The surgeon's PA told me that the pain for mom could last 3 to 6 months. She said it was due to the chest tubes being inserted and removed and the damage that causes normally.

I'll ask about the palliative care since that is something that seems very reasonable. I'm hoping and praying that hospice is not necessary since she's up each day herself to go to the washroom and to get her lunch. I leave things out for her while I'm at work. She's proud that she can do it herself and still maintains her personal needs.

Thanks so much! Marc
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If she's in such pain, why does she not want to see her doctor? Does she believe he can offer her relief? I'd be very adamant that she needs pain relief. Perhaps confirm the healing process is normal. I would take her lead though about slowing down. If she doesn't feel like doing something, I'd listen to her decision, if she's competent. I don't know anything about the injury you describe. I hope you can get some answers that help.
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Durbin1 Nov 2019
She's stubborn and feels in too much pain to go, but I spoke to her over lunch and told her we could even take a wheel chair to go. She uses a walker and refuses a wheel chair. In this case, she may accept it.

I'll ask the doctor to check about the actual healing and the pain.

Thanks, Marc
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Marc, I think it's great that you are taking care of your mom. But you are making some medically unsound assumptions, I think.

What is your mom's underlying diagnosis? Does she have CHF? Why do you think the chest tubes did damage? Who told you she'd be in horrific pain and why is that not being addressed?

I think you need to get a better understanding of her overall physical condition and find a doc who will treat her holistically and compassionately. She might be a candidate for hospice.
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Durbin1 Nov 2019
The doctors were amazed that she took no meds until this accident and the prognosis that I was given was that she would heal fine, but it would take longer because of her age.

I was told from one of the team of doctors that when they put in and remove a chest tube, it causes damage to nerves that have to repair themselves over time. Mom had 2 chest tubes inserted with radiology getting involved, but for the last chest tube, they inserted it in a different way.

I truly do not believe that she's ready for hospice care, but as suggested by some, I will try to get someone to come in for a few hours to help her with the basics.

Thanks, Marc
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