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My questions are:
(a) what should I expect will happen ?
(b) what should I do ?


My situation:
Mum is 96yo. On 8/12, she went to the bathroom: I helped her. When she finished, she walked to the sofa (6 feet away) and sat down. I was washing my hands. I think she had a seizure from low Blood pressure, fainted and fell off the sofa. Her head crashed onto floor and right shoulder took the blow but her left side of collarbone maybe broke (not sure - no xray) yet.


The doctor came the next day 9/12 and prescribed PANAMAX. He said she will never get well without it. But it did not agree at all with her. Since then, dry-retching every few hours. I stopped PANAMAX today 12/12 but she has not eaten one bite nor drunk one sip since morning and now is 8pm. All she did was go to bathroom twice and sleep sleep sleep.


I am so worried. Is she going to DIE ? All because I was careless one time ? I never imagined she would fall off the sofa when she was sitting down !! How long can she go without eating and drinking ? Her doctor has gone on holidays and will return in 10 days. He told me to tell the other doctor but that doctor refuses to do house visits.


I put her in a sling of 35inches (she is size small) and tied a cloth around her to stop her from moving her arm and hand. But she forgets and keeps on moving and the sling and cloth both loosened so I had to tighten them again which really hurt her.


Hospital /nursing home is NOT an option. We live in Australia where there is too much elder abuse in hospital/ nursing home.


Today I bought a sofa-chair-cum-bed because getting a hospital bed is a big drama. So she does not have to get in/out of bed for meals. Due to xmas rush, I will have to wait 10 days to get it in the post.

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PreferNotToSay, the "come to the clinic" advice completely sucks! Haven't they heard of Covid??? Never mind keeping a sore 96 year old lady sitting in a hot/cold/draughty/noisy waiting room on a hard chair for 2 hours.

I expect you already know about:

https://www.healthdirect.gov.au/hospital-emergency-departments

This page also has numbers to call for advice. I think probably the things to concentrate on are a) pain relief that won't upset her and b) the best way to immobilise the arm/shoulder, and whether it's practical for you to do that yourself. Do you have district nurses or the equivalent, to show you how to do it?

Looking at your profile, that's quite a list of "complex co-morbidities"! I can't believe her GP goes swanning off on holiday without leaving proper cover for his patients. Or I wish I couldn't believe it, anyway. What sort of Australia are you in, a rural bit or an urban bit?
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Thanks for the update. What we call tylenol. Sorry she had a reaction to it. I think the doc is trying to limit the pain without giving opiates that could cause further falls. With pain I worry she won't breathe deep. As I said a read danger for her now. I wouldn't try self application of bandaging without being shown how to do it. This can be very painful. Honestly not a move she fan make but that it won't tweak that area. So sorry this happened. Keep in touch with her Docs one way or another. Don't delay if a cough or fever develops.
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Thank you for all your helpful tips. I really needed the info. I bookmarked this page.

Sorry about the dates: my mind is so scrambled. Yes, it is in dd/mm format.

Panamax is paracetamol. https://www.nps.org.au/medicine-finder/panamax-tablets

The other doctor refuses to take phone calls or emails or anything except 'you come to the clinic' but that is too hard and there is a wait of between 1 hour to 2 hours which is too much. No specialist can see us without referral from doctor. I asked a geriatric nurse (acquaintance) to phone but he has not yet. Probably too busy with corona.

Where do I get reliable info on 'figure of eight' bandage for broken clavicle ?
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She has 8/12, 9/12 and 12/12. So CM says 4 days so does this mean 8 days out of 12, 9 days out of 12, and 12 days out of 12? In the US have never seen written like this before. I thought it was dates.

I think she needs an xray. When my sister had a broken collarbone (and it been 67 years ago when she was born) they did a figure 8 on her back with bandaging to keep the bone immobile.

I don't think Mom had a seizure I just think she passed out. If Mom had a good #2, the blood pressure can lower. Happened to my Mom and she had to sit in her chair for a while before it came back up. This is not unusual.
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Countrymouse Dec 2020
Ah yes of course, the date problem!

We (UK/Australia) do: day-month-year. DD/MM/YY = today is 12/12/20 (oh. Bad example!) You would say it, 12th December, 2020.

I know it's the other way about in the US: month-day-year, MM/DD/YY, so you'd read the OP's dates as the 12th August, 12th September, and 12th December.

But "next day" - so I'm reasonably confident it's the 8th, 9th and now the 12th December that the OP means.
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96? Trust me, no matter what you do, accidents will happen. As to what to expect, that is something you should discuss with medical. I am not familiar with Panamax. What does this drug do. Have you used your search engine to research it? Off hand and with just a cursory exploration, the only thing I get in the USA with this search is a silly surge protector!
In general clavicles heal themselves, but only an xray interpretation can guess at what this will take in terms of time, and with the complication of aging. It will be PAINFUL as there is almost no move she can make that won't hurt. If the Panamax is a pain medication she cannot take it may need replacing.
You are right to keep the weight of arm on that side off the injury.
The worst danger you have right now in my opinion as a retired RN is PNEUMONIA. Because of pain your Mom is going to be taking teeny tiny short little breathes in, and not inflating her lungs. This can give her pneumonia. Also the tendency not to move at all is a danger.
Keep in contact with your own medical personnel and remember that they are the ones to guide you. They will understand if she cannot tolerate a medication and may try one similar.
Remember, Accidents DO happen. It is an age old adage in our country.
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cwillie Dec 2020
I think it is just acetaminophen Alma, although I'm also seeing formulations that include codeine.
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I'm so sorry this happened :(

Broken collarbones are very miserable. You are doing the right thing immobilising the arm as far as possible; but the reality is that your mother will need to move her arm (or have it moved) sometimes, and when she does it will hurt, and the rest of the time it will ache, and it is rotten for her.

There are soft fabric slings and braces available: you could have a look online - Googling "slings and braces for broken collarbone" gets plenty of results.

You and she will also need patience. It will gradually improve.

Pain relief: call the doctor, because even a doctor who won't come to the house can still advise you about alternatives to the Panamax. It could be that some kind of topical anti-inflammatory gel might be helpful for her but DO NOT try this without her doctor's agreement.

You also need medical advice because the next thing is to think about what caused her to fall. It was NOT your neglect! I expect the doctor who visited considered a number of possibilities, but I also expect that he did not think it right to subject a lady of 96, in pain after a nasty shock from her fall, to a load of stressful questions and tests. The other doctor, a few days later when she's settled down a bit, might agree that it's worth a review.

How is your mother overall? Bear in mind that it's only four days since this happened and she will have had a shock to her system. Keep encouraging her to eat and drink but don't force it - she won't drop dead from missing square meals for a day or two. Offer her small amounts of whatever you know she likes best.

Don't prevent her from getting up and moving around as much as she is able to. Mobility is really, really important, so unless the doctor - again - advises against it, you should encourage her to stand and walk a little and often, with her arm well supported.

I've just been looking up YouTube videos to show you how to help your mother stand and walk, but it would really be better if a trained aide, nurse or therapist could *show* you. Do you have any of those professionals in your area?
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PreferNotToSay Dec 2020
Hello Thank you for your info. I will deeply appreciate if you could please answer 4 questions:

Question 1: Please can you send me link to a YouTube video how to help her get up from lying-down-in-bed to sitting-on-sofa safely ? Transfers really hurts.

Question 2: Should I do a figure-of-eight AND a sling ? Would that help her recover ? Or should I leave her sling alone ? Because it hurts whenever the sling is disturbed even slightly ?

Question 3: Please can you send me link to a YouTube video how to do a figure-of-eight safely ?

Question 4: Please can you send me link to a YouTube video how to pick her up safely from the floor ?

She again fell off the sofa trying to get up unaided. Luckily she did not hurt herself. My husband picked her up like a baby but could have injured his back. We tried to hoist her up from the floor onto the sofa using a sheet underneath her but she was too frightened to cooperate.

She had 2 pain-free days off PANAMAX. On day 1 she slept whole day. On day 2, she ate, prayed, lightly exercized for 1 hour (not on her left side) and played computer solitaire. Normal day.

Today day 3 she is in great pain so I changed PANAMAX dose to 2mL 4 times daily instead of 7mL 4 times daily.

There is no doctor and no nurse (district nurse or any other type).

Last time (years ago) I took her to ED for severe chest pain, the nurse HIT her whilst taking her BP because she complained he was hurting her. Lucky no broken bone. We left after waiting 6 hours. The doctor wanted to do a rectal examination (for chest pain ???) and she refused.

I am in Sydney city suburb not the rural area. Australia only has 'leading-edge medical research'. Ordinary problems that ordinary people face are too boring for super-smart Oz medicos.

It is NOT her doctor's fault that no doctor wants to help her even for a few days. They only worry about legal rubbish.

May God Bless you and all other people who answered and helped me with info. We rely on God, Internet and good-hearted folks !
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