Tuesday, August 24, 2010

A Traumatic Day

Yesterday, Monday,  was a traumatic day.  Helen and i went shopping before dropping in to see Margaret at 9.15 am.  As we walked in we were met by the RN who had been trying to contact me by phone.  Margaret had had a serious fall.  She had hit her head quite hard and had a gash on her forehead which would require stitches.  An ambulance had been called and she was going to hospital.

The ambulance arrived promptly and she was in the Noosa Emergency Department by just after 10.00 am.  The senior nurse on charge was D who had fixed up a serious skin-tear for Margaret back in April.  He was superb and soon had Margaret calmed down and on a drip and blood taken for testing.  She was in total shock and very confused.  X-rays were taken of her head and arm.  This took some time so Helen and I had a coffee to keep us going.

The Trauma Doctor came and showed us the X-ray results.  Her head is fine and would be stitched up but her arm was seriously damaged.  The original break had re-broken and the humerus shaft was displaced from the ball joint at the shoulder by about 30 mm.   This would normally result in a complete shoulder replacement as the socket was also damaged but in Margaret's case this wont be done as she wont survive the surgery.

Worse still her kidneys had shut down and the Doctor wanted to put her on Dialysis ASAP.  I asked her to consult her specialist who was on call.   When he arrived he said the arm was irreparable and in time the ball would become necrotic as it had no blood supply.  She will never gain the use of this arm.  Her kidneys were in the End Stage Failure state and she would not be suitable for Dialysis.  I had two options to consider:

  1. Return her to the Nursing Home and start Palliative Care immediately and she would die within a couple of weeks.
  2. Leave her in hospital where he would try and get her kidneys working again as they had done at Nambour in June .   She has seven days before the Kidney Failure became irreversible.
Initially I felt that she should go back to the Nursing Home and I was left to make my decision.   I talked with Helen for a while and finally we had her admitted to hospital where, with luck and good care, she may be able to go back to the Nursing Home after 5 weeks or so.

She was admitted to the ward about 3.30 pm.

We went back to the Nursing Home to get some things and she will keep her room providing she is back in nine weeks. Home to feed and exercise Louis who had been on his own since 8.00 am and then back to the hospital just before 6.00 pm.

Her specialist called in to see her and had a quiet chat with me.  He is stopping most of her medications in order to give the Kidneys some chance to recover but she is critically ill at present.

Helen and I went home for dinner and are off to visit her this morning at about 9.30 am.  Visiting is not until 11.00am but they make exceptions when the patient is so ill.  Actually, as she has no usable arms (one broken and the other immobilised by a drip), we are useful to give her drinks and feed her.   We will leave after her lunch to have our own, feed Louis and walk him then rest up before we go back for her evening meal at 5.00 pm.  We will come home about 6.30 pm for our dinner.

Helen is staying until things resolve themselves.

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