Follow up on epidural for pain after broken sacrum

Mom suffered a broken sacrum just about one year ago but now she's relatively pain free and we're so thankful.  Mom's broken sacrum caused excruciating severe pain for several reasons - it's in a location that is the base of the body's core so key nerves pass through the sacrum.  The break was near the sciatic nerves, those that pass from the spine down into the legs.  The area was bruised which means broken capillaries; the problem is that nerves HATE blood and send pain signals to the brain in response to blood.  So - broken bones, swelling pushing the bones into sciatic nerves and the presence of blood around the nerves was just unbareable. Now mom's relatively pain free but she is much more bent and has no strength in her legs at all.  she can no longer roll over in bed either but that's probably safer since she can't roll out of bed.


Mom's doctor treated her with a combination of drugs and the miracle epidural right in the nerves.  She had immediate relief.  A year later, she still has a pain patch and takes a certain pain medication that works specifically on "nerve pain".  I don't know what that means or what it does but I don't care - Mom's pain free.  If it turned her hair purple, we would not care - anything is better than the torture she suffered last year.

Cause of pain due to broken sacrum,

Fall from a lift and mom's high tolerance to pain leave me worried

Mom's had another incident at the nursing home that will leave me worrying for a couple of weeks.   The aides use something called a "sit to stand lift" to move her from chair to toilet.  Apparently, she lost her grip and she slid out of the lift; the aid saw it coming and caught her and "sat her on the floor".  They said there's no bruising, no broken arms or legs and no pain so she seems fine. My fear now is that something more is wrong but the signs will be so subtle that it will go ignored or unnoticed until she's in excruciating pain; that's what happened last year about this time.
 
I worry that Mom will have pain but won't feel it.  Since her broken sacrum was diagnosed in February 2011, Mom's been on pain medication that works on her nerves (those little things that transmit pain to the brain) and she wears a pain patch.  To make it more complex, I believe that she has an increased tolerance to pain after a stroke during my birth.  I've seen her burn her hand canning and not realize it until her fingers are full of big blisters.  At that time she was un-phased and just kept working; she said "It doesn't hurt, it can't be that bad."

She "seemed fine" after the "assist to the floor" last January yet she ended up dead in the MRI machine.  I told the nurse who called to tell all the aides to look for "crankiness", impatience or asking the aides if it's time yet for another pain pill.  These are all signs that she's having more pain that SHE or the aide's realize.  I noticed it in her over the holidays - before the "assist to the floor", a month before her pain became excruciating.  Mom's normally in good spirits and doesn't complain; but at Christmas she was disgusted and griped constantly about everything - gifts, visitors, her shoes, her clothes, the aides, my hair, the beautician.  I realize now this was her pain talking.  We might have saved her from the MRI fiasco, the delerium of the narcotics and the bedridden period she required to "heal".  ( I don't believe her sacrum will ever "heal" but that's another post..)


I'm frustrated because I've expressed concern about this "sit-to-stand" lift for a few months.  It's a lift that uses straps under her arms to raise her up from a chair onto this small platform where she "stands" - holding on - while the lift is rolled right up to the toilet.  There she's lowered on to the commode to do her business.  The process is reversed to get her back to her chair.  

The straps that go under her arms are too loose and lift her from the shoulders than the behind.  I've told them she could suffer a dislocated shoulder; it falls on deaf ears.  She is also very weak in the hands and unable to grip the handles properly so I worry that she'll let go - which she did yesterday - and just fold up and fall out of the lift.  The aides and nurses don't seem to worry - when it comes to this stuff they are REACTIVE not PROACTIVE.  To do anything differently would require 2 aides not 1 - translation: the lift works for a one time price; another aide = another body at work costs too much.  I suppose they rationalize it by saying that they want the patient to do as much for themselves as possible. 

I know they are operating to make a profit but it often seems to be at the expense of my Mom's well being. 

Here are a couple of photos that illustrate the lift.  The one on the second is the type used with mom - the hand holds are black knobs.

sit-to-stand lifts risks, subtle signs of pain in elderly, use of lifts in nursing homes.

Be thankful there are people who don't like you...

Today, the day after a weekend of time spent with family and loving friends, I am left thankful that there are people who do not like me. In fact, the more they dis-like me the better.   The reason is simple: these people are so lacking in moral fiber and have such little thought for the feelings of others, that, if they did like me, I would wonder just what kind of low-life jerk I had become.

My cousin called this morning upset over mail he received from the attorney for his evil step mother.   Getting it brought back decades of hurtful memories caused in large part by her selfish behavior.  From the time he was 10, any interaction with her and most interaction with his father left him disappointed, feeling abandoned and cast aside.  The evil witch died months ago and her attorney and son, the Executor of her estate, mailed her will just in time for it to arrive on Christmas Eve.  Given the history of this woman, it is a fitting action for someone who was so maliciously and deliberately mean throughout her life. It seems that the evil things she did were lessons well learned by at least one of her children - the other wanted nothing to do with her..  I can understand why.

The "inheritance" she left to my cousin was the small sum of $1.  I am certain she did it so that there could be no way to contest the estate of her husband, father to my cousins, thus leaving everything to her sons.  It's not like there is a lot of cash property to be had and my cousins would not want it anyway because it means hashing up to much pain and disappointment.  But, to leave them with $1 and then send a letter at this time of year is just mean-spirited.   My cousins have had nothing to do with her for nearly 15 years, why is it necessary to send anything now?

Years ago in the 60's, this woman decided that she would marry my uncle - never mind that he was already married with one grown daughter and 2 sons at home.  She pursued him in a town small enough that most people knew everyone else's business and he was happy to have the additional female attention. Neither of them cared that the eldest son was ridiculed by friends on the main street of town because his father was seen out with another woman. Neither of them cared that his youngest sat and sat and sat waiting the driveway of the other woman's house while my uncle visited her and her sons inside.  There were too many times to count that my uncle made a promise to my cousins only to take it back because his girl friend and then wife made other plans.   Most times, she was there to hear the plans and readily agreed yet when the time came, my uncle would cancel at the last minute in deference to her.  She knew my cousins would be hurt and disappointed yet she made other plans anyway.  After seeing her do this over and over, one can only conclude that she knew EXACTLY what she was doing.  We are left to wonder why - there was no threat to her or her relationship with my uncle.  His first wife was to tired and busy working to put up a fight.  My uncle's siblings were too darned polite to cause a rift between them so why go out of her way to hurt his kids?

Through it all my cousins tried to put their hurt aside and treat their father with respect and kindness. When he died, none of them got a call until after he passed even though he was hospitalized for days.  They were denied the gift of simply saying good bye.  None of them wanted anything to memorialize him except for small sentimental things - a fishing pole perhaps - yet she responded with mean cursing, name calling and restraining orders.  She was always good at playing the victim yet she was the ultimate culprit in hurt and meanness.  I've known people who called her, "that poor Pat, the single mother with the sick son."  There was nothing poor about her.  She wanted someone to take care of her and did it at the terrible expense of 4 others.   I can't let my uncle off the hook - he is just as culpable but I do not  believe he was as capable of such malicious planning as she.  His are sins of insecurity and thoughtlessness.  He didn't realize how much he was loved and needed by his family.  His 2nd wife KNEW how much the first family loved and needed him. Taking him away from them made her feel powerful and happy.  God forbid someone like that come into my life - or anyone else's for that matter.

It makes me sad to write something like this at a time of the year when we should be appreciative of family but it also sets me free.  I am thankful that my family and friendships are genuine and sincere! 

More advice on old feet - dealing with "foot funk"

The older we get the more likely we are to develop "foot funk" - it's my generic term for athlete's foot, toe fungus and generally dry scaly appearance.   With my Mom's feet, there are dry patches on her heels and calouses and then there are overly moist hard-to-keep dry areas between her toes.  I also notice that the area between her does almost looked "spongy" at times - the skin was white on top with small holes.  When I spread her toes it would stretch and tear, revealing dark pink skin underneath.  The top layers of skin would very easily peel or rub off and the skin below could split and become painful.  When I first began watching her feet, this happened a lot but over a few weeks time - with diligent attention and a some new practices - we healed up the worst spots and all she suffered was some itching now and then - a huge improvement over the keep cracks and odors.

Poor circulation means that Mom wants socks and shoes on all the time but that means the area between her toes don't get "aired out" and remain moist.   When Mom was home I soaked her feet in a mix of water and white vinegar (4 to 1 dilution), water and listerine (2 to 1 dilution) and tried an occasional massage with tea tree oil after cleaning and drying her feet well. Be warned, I used the tea tree oil ONLY after the cracks on her skin were healed.  DO NOT USE TEA TREE OIL ON OPEN WOUNDS!    The water and white vinegar once a week seemed to work best.   She had a couple of spots between her two most outer toes that were stubborn and it took a long time to see improvement in the skin. For these I used anti-fungal cream for a couple of months.  When I was not there, she was able to put the cream between her toes herself everyday.  This helped it to heal so that a mild vinegar soak was able to keep the fungus at bay.    I didn't want to soak her feet until these areas where improved because I thought the vinegar might burn or sting raw open spots between those toes.

I don't think you can ever get rid of this stuff once it's there;  it's a matter of keeping it under control.   I've read that there are dietary changes that also help - it's basically reducing sugar intake. Sugar is fungus' favorite food so if you eat a lot of it or if you're diabetic and your body can't process sugar, you might have more problems with athlete's foot - and fungus in other spots like jock itch or vagina yeast infections....but - our focus here is FEET so please read on......

Here are some of the things that worked for my mom's feet:  Remember that we had to be diligent about this, it became part of her regular daily routine:
Socks:  always use cotton, wool or some of the new materials that wick moisture AWAY from the skin. change socks daily and wash socks alone in small loads. Use hot water and put at least one cup of white vinegar, 2 cups is probably best,  in the wash water to help kill fungus.  I got the "wicking" socks at REI in the hiking section.  If it was especially cold, I'd put those on first then a 2nd pair of wool socks.
Shoes: if possible, let them go without shoes, this permits air to circulate around the feet.   Often shoes for our elders are made of vinyl or other man-made products that don't permit air circulation.  My mom used to complain of her feet feeling cold and wet when she wore cheap sneakers - they were, she had poor circulation but her feel still sweated and it stayed there in her poly-canvas shoes.  EEE..UUUuuuuu
Powder:  We used a spray athlete's foot powder, medicated foot powder, corn starch and baking soda combined - they all helped if used regularly - meaning EVERYDAY.  The generic store brands of spray powder and anti-fungal cream from Target were just as effective as the more spendy brands.  I recommend avoiding powers with talc; talc seemed to make the deepest problems worse.  Be sure to wipe it off with dry tissues at least once a day and re-apply.

DIABETIC readers:  PLEASE, PLEASE, PLEASE - don't just take my advice here, see a doctor about your feet and how to best take care of your feet.    If cracks in your skin do not seem to heal, you might need more than over-the-counter medication. 

For my original ideas on care of old feet, see this blog post from 2009
2009 article Old feet have special needs

How do i take care of diabetic feet? How do i clean up grandmas feet? how do i trim grandpas toe nails.  Old feet have special needs.