Two weekends ago, a week in the life of caregiving, I mentioned intermittent pain in Patti’s left arm.
Examination of the arm by nursing staff and physical therapist found no range of motion problems nor did Patti report any pain.
As an advocate you must do more than monitor a ‘whatdunit’. You must inject yourself IN the mystery.
Whenever I put her jacket on or off, I did so at the nurses’ station so any and all ‘intermittent’ incidents of pain were witnessed and logged.
When Patti’s physician visited she attempted to replicate the problem with no success. Fortunately, there was a file of witnessed episodes, and X-rays were ordered.
No fractures were found, though the x-ray analysis somewhat distractingly reported evidence of osteoporosis.
When a patient is unable to direct their own medical care the ‘advocate’ must help keep the focus.
Patti was next referred to an orthopedic specialist.
To ensure communication I transported and accompanied Patti to her appointment. Her examination revealed nothing nor did Patti complain of any pain.
Before tearing my hair out, I suggested a demonstration … Patti yelped and grabbed her arm as soon as I slid on the left arm of her jacket.
Re-focusing his examination on where she grabbed her arm …
Ortho: “Patti, let me know if this hurts?”… he found a tender “extension mass” in her left elbow.
Patti: (yelp) “If you do that again, I am going to kick your f#@king ass!”
Ortho: “in other words, yes”
Diagnosis = tendonitis.
Extension injuries, we learned, are not uncommon to elbows and wrists for people in wheelchairs.
1) tennis elbow strap
2) intermittent analgesics
3) physical therapy
As for osteoporosis, he did NOT agree with the portable x-ray analysis.
As for Patti all she wanted after that appointment was a ciggie, ‘analgesics’, and a mid-day nap.
Caregivingly Yours, Patrick Leer
web site: http://caregivinglyyours.com/
musings: Patrick Ponders ...