Cloud of Pain

I don't remember the last time I had any sort of major pain.  I have been fortunate in that regard.  It probably was 2003, when I had my bike accident and dislocated my shoulder. But the thing I remember about that time is that when you are in that much pain, it's like you are living inside a cloud of pain, oblivious to everything around you. 

Looking at my mother today, that's all I could think of.  She was in this big cloud of pain and nothing outside the cloud registered with her.

Of course she was not wearing her splint.  They've taken to calling her "Houdini" for how quickly she can get out of it.

The wrist was much more swollen and discolored and every little thing that touched it, or came near it, caused her to cry out in pain.  I think if she could have taken a pill to end her life then and there she would have.

And of course she doesn't know why it hurts.  And she can't understand that the splint is to protect it so that she can't accidentally brush it against anything (she told me she didn't know anything about a splint and guessed she didn't have one).

I told one of the aids today that I have noticed a significant decline in her cognitive functioning recently and she agreed and said "sometimes it comes on suddenly."  At 98, that's not surprising.  I suspect that even after the wrist has healed, she will have taken another step down from which she probably won't recover.

Today was her appointment with the orthopedist and we had to check in an hour early so she could get an x-ray.  Of course I couldn't stay in the room with all the rays flying around, so I don't know how much the manipulation of her wrist to get four shots hurt her, but I suspect a lot.

Then back to ortho to wait for her to be called.  Her official appointment time was not until 2:50, so we had about 45 minutes to wait and after about 40 minutes, she had to go to the bathroom.  This was my first time with bathroom duty for her and getting the wheelchair into the ladies room was almost impossible and with her unable to understand such commands as "hold the bar while I move the wheelchair" made it even more difficult.  I finally got her to understand she should hold onto the metal bar while I moved the wheelchair out of the way, but then she couldn't understand that she had to lower her body to the toilet.  Trying to manipulate her I couldn't help at brush her wrist several times and each time she let out a mournful groan.

I suspect this is something I will get better at doing.

They finally called her back to a room and the certified physician's assistant came in. I have to admit I'd never met a medical person named "Sundance" before!  She was very sweet and very patient and said that it was a bad break, that they had aligned it well in the ER and that it had shifted a bit, with all the splint on/splint off-ing. 

Said that she couldn't put a cast on her herself, so she called the wonderful Arthur, who got her all decked out in a bright green cast.

She was already picking at it before he'd left the room, but he assures me that it is solid and she won't be able to remove it.

I'm not convinced and I'll be curious to see what I find when I check on her tomorrow.

We dropped her back at Atria and I decided to let the aid take her to her room.  She was totally lost and confused and didn't know why I was there and I told her I'd see her tomorrow. 

I came home to take my now-normal post-Atria nap.  Unless she tears the cast off between now and next week, she won't have to return to Ortho until next Friday.

I was back at Atria today and found her in the community room, no splint on. I got her back into her apartment and, with great pain, put her splint back on. The swelling in her wrist is worse, and it's more painful to try to slip the splint over her arm. I tried to impress upon her that it would not hurt if she would not keep taking the damn splint off! She said she understood and then, as I sat down, she started to remove it again. I know she can't remember and I just don't know what to do to help her.

I was back at Atria today and found her in the community room, no splint on.  I got her back into her apartment and, with great pain, put her splint back on.  The swelling in her wrist is worse, and it's more painful to try to slip the splint over her arm.  I tried to impress upon her that it would not hurt if she would not keep taking the damn splint off!  She said she understood and then, as I sat down, she started to remove it again.  I know she can't remember and I just don't know what to do to help her.

I don't know if the orthopedist is going to put her in a plaster cast (and don't know if she can remove that or not) but nobody can do anything until the swelling goes down...and it is more swollen and bruised now than it was 2 days ago.

I came home and, as usual, took a long post-Atria nap.  I seem to need that to come down after the frustration of visiting her these days.

This is how I ended yesterday's entry:

We finally got back to Atria and helped the aids get her settled in bed, though I will be interested to see how they found her this morning.

This is how I found her room.

And this is how I found her in the community room.

She was in pain and didn't understand why her arm hurt.  I've discovered that she not only has no short term memory, she also has selective hearing.  She doesn't want a broken wrist, so when you try to explain that her wrist is broken, she doesn't even hear you.

Since tomorrow is a holiday and it will be two days before Orthopedics will be open, I called the ER to find out what to do.  The Advice Nurse consulted with a doctor and said to bring her back to the ER.  And so instead of writing the article I was supposed to be writing, we were back at Atria and packing up a very reluctant mother to take her back to Kaiser.

We didn't have to wait TOO long in the cast room, but my mother was very irritated that people didn't come right away.  But we were there long enough for me to learn that my mother is really Adrian Monk (of the show Monk), who suffers from OCD.  It bothered her that the sheet on the gurney was untucked and she mentioned how much junk there was in the cast room.  (They think she may have fallen trying to pick something off the floor.  She is forever finding microscopic bits of something on the floor and leaning over the pick it up.  They keep warning her not to do that.  But of course she won't listen.)

The doctor and I talked about what we could do, since she can't have a plaster cast until the swelling goes down.  The doctor finally decided to try one of those splints that you have for carpal tunnel because even if she rips it off, it can easily be put back on again.

When we got that done, we drove back to Atria.  They had saved a plate of dinner for her and I sat with her for a bit (they brought her steak, a baked potato, and a roll, none of which she could eat with only one hand!).  I cut everything up for her and  then said I would be going home.  "Can't I go with you?" she asked.  When I told her that she lived at Atria, she was very frightened that I leave her alone in the place where she eats 3 meals a day because she didn't know anybody and didn't know what to do.  Walt and I ended up staying longer, but finally left and one of the aids promised to make sure she got back to her room all right.

Will she keep the splint on all night?  I don't have a clue.  But at least if/when she takes it off, it will be easy to put back on again.

Update:  They called me (and woke me up) at 6 a.m. to tell me she had removed the splint.  "Put it back on," I told them.

I was awakened by Walt poking me and holding out the telephone saying it was Kaiser calling.  It was about 11 p.m.

The doctor said that my mother had a fall and that she had broken -- I thought he said her rib, but it was actually her wrist.  The doctor said they would call when she was ready to go, but I knew she would be frightened, so we left right away and drove the 30 miles to the hospital.

My heart went out to her.  She was lying in the bed calling out, softly, "help me.  please help me."  She was happy to see me and the first thing she wanted me to do was to help her to sit up so she could help me.  But we wouldn't let her sit up because I thought she had a broken rib.  We had to fight to keep her down and explain to her over and over again where she was and why she was there.

The doctor finally came in with the supplies to put her in a cast while he sent Walt and me out to the waiting room, where we sat with barfing lady, a poor woman who had a barf bag and made horrible vomiting sounds every couple of minutes, as her bag slowly filled up.  It was lovely.  I was very happy when they finally took her into the back to examine her.

I was surprised to go back into the room and see my mother with a huge cast on her arm.  That's when I realized that she had broken her wrist.   

As I told Jeri this morning, my mother is a lovely woman who is very gracious and will do anything for anyone.  When she first saw me, she was scared in pain but the first thing she said was that she wanted to sit up so she could help me.  But when there is something wrong with her, she can be a real bitch.  She hates the look of the cast and the doctor said she had already torn it off once, so they had to strengthen it.  I had to keep her from trying to tear it off.  She still didn't know why she had to wear it or what had happened to her.

We finally got her into the car but first she complained of the cold, then of the discomfort of the car, and then the wait for Walt to pick up her meds at the pharmacy (many, many times), and all the while picking at the cast.  I got into the back sat with her to keep her from ripping at her cast.

We finally got back to Atria and helped the aids get her settled in bed, though I will be interested to see how they found her this morning.  It will probably take about six weeks for her to be in the cast.

I suspect it will be a long six weeks.