We had a good reason to be worried. The swelling in our elder’s leg was not following any pattern that meant injury. In fact, even though I’m not a doctor, I could think of only one reason for it; a blood clot.
There were many reasons for this opinion; our elder is 88, spends most of her time in bed and had an ankle injury five months ago. These are all risk factors for a blood clot. Thankfully, the caregivers were all very observant and noticed the symptoms. Some people never know they have a clot until the situation is very serious.
It didn’t take much discussion to make the decision to head for the emergency room. In fact, our elder requested it. That’s a first…she hates going and complains about how mean we are when we drag her there. I think even she knew there was something seriously wrong.
Going to the emergency room is hard on everyone, but when the patient has moderate to severe dementia it becomes very difficult. Our elder couldn’t remember why she was there, why she couldn’t “just make an appointment” and come back when “they weren’t so busy.” She couldn’t remember she had an IV line or why she had it. The litany goes on quite a ways, but this is part of the problem.
Saturday nights in the ER contributed its bit in the equation. It was fairly quiet (a word that the staff didn’t like hearing…) but there were three babies. One had a high fever but was mostly quiet. One was too far away to be heard by our elder. The other had colic, and it cried a *lot.* In fact, I could tell when it got a shot, because it had the newborn angry cry with its little hiccup. I knew it was a shot because the crying abruptly stopped and silence reigned.
Very soon after the ultrasound was done on her leg, the nurse came in to get a second round of blood. Blood draws go over like a lead balloon with our elder, but at least it didn’t result in another needle. The blood was taken from the IV line (no IV was hooked up, it was a “just in case” installation.) The second draw caused all of us some concern. It’s not the usual way things happened in previous visits.
When the diagnosis came that a blood clot had been found, she was quite ready to go home. Problem found, give me some pills, it’s past my bedtime. Blood clots don’t exactly work that way.
We watched a video about the medication she would be on. We had a demonstration of how to give the injections she’ll need over the next few days. We were given twenty or more pages of reading material about the condition, her diet, signs of problems and so on.
In all, we were at the emergency room for six and a half hours. The only thing that kept us all from going insane was her evening caregiver. He brought along stuff to keep her entertained, and knew when to do what to stave off a verbal avalanche of displeasure.
It was a difficult night. It could have been worse than that. Observant caregivers found the problem early and helped keep her calm. The advance information helped the doctors to zero in on the problem and find it fairly quickly. By the grace of God, it was a quiet night in the ER. I think we have a lot to be thankful for, despite the difficulties.