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Real or imaginary pain?
dashwood60
Posted: Thursday, July 11, 2019 10:02 AM
Joined: 4/9/2018
Posts: 66


I moved my mom moved from her home to memory care 2 weeks ago. She was walking just fine. During the assessment for memory care she threw her legs over the arm of her chair to show the "doctors" what great shape she was in. (She never sat like that, ever.) In fact she would get agitated and not sit still during meals and I'd have to remind her to sit down and eat. 

A few days after moving to memory care she began complaining of hip pain. I told them she's complained about that before, x-rays were done, all was fine, and she hadn't complained about it in over a year. The facility did an x-ray anyway and all was fine. They gave her a wheelchair and pain reliever.

Today I got another call. Now mom is refusing to try to walk at all and says the pain is unbelievable. She didn't cry out or moan - just said it's too painful. They gave me the choice of  sending her to the hospital (for what?) or having the Dr. check her. I said to have the Dr. check her. 

I feel like my mom was always a bit of a hypochondriac and liked the attention of doctors. She went to memory care not knowing where she was going or why. She didn't fall, didn't exert herself but suddenly can't walk. I think she thinks she's in a hospital therefore there must be something wrong with her. In fact the first time she complained of the pain to an aide, a nurse was sent in and asked her about the pain and my mom said "What pain? I'm not in pain." 

My mom thinks her parents are alive. She'd forget to eat and refuse to shower or change and claimed she did all the housework in her house. She has her own reality.  Isn't it likely that she could misrepresent pain? She's in an unfamiliar place and she doesn't know why so she feels "pain"? 

Has anyone experience something like this? 


Army_Vet60
Posted: Thursday, July 11, 2019 10:26 AM
Joined: 6/21/2019
Posts: 461


What stage is she in?

She could be in pain from a combination of things: e.g. poor diet and lack of exercise both take a physical toll on ALZ sufferers.

When she did that stunt throwing her legs over the chair, she may have suffered some severe muscle pulls or tears.


zauberflote
Posted: Thursday, July 11, 2019 11:17 AM
Joined: 10/24/2018
Posts: 508


I agree with Army Vet. In any case, could the doctor have PT evaluate her? Just for another set of educated eyes and maybe hands on the possible issue. There are all kinds of hip pains that don't show up on xrays. My mom has intermittent low and middle back pain. The low back is probably from a previously fractured vertebra, and the mid-back is (according to me) simply soft tissue/muscle pain from a weak back and sitting in a chair that really doesn't have customized support.

We actually had to go to the ER last winter because of an unspecified but horrendous back pain. Mom had sat in a hideously uncomfortable wooden church pew for about 2.5 hours, then walked briefly to bathroom and church dining room, where she sat for the beginning of the meal in another hideously non-supportive wooden chair. Her back (according to me) went into spasm and she couldn't walk, sit, stand. We had to call the ambulance to get her a stretcher. The EMT's first question was, does she have a history of...I forget, aortic aneurysm maybe. I told them it was Her Back, and could she please go to ER for pain relief.

At ER, they'd gotten her in 30 seconds before I got there, and I was not allowed in back with her until after her assessment, which made me pretty disposed to be ticked off. They gave her IV pain med and she relaxed at once. By the grace of God I was able to catch the physician just seconds before he sent an order for blood work. The results would have caused her to be admitted for observation, and she likely would have wound up declining so rapidly that she might never have walked again. Of course it was her back, I even knew exactly what it felt like, and to have to prevent the medical profession from doing harm by merely following their best practises (tests out the wazoo!) is not encouraging.

Upshot-- she was let out, she walked to my car, and the rest of the evening was normal-- definitely bed time! She didn't even remember it by the time we got pj's on, possibly by the time we got to my car! Sometimes common sense trumps the doctor, you know?

All that to say, I don't think a PT evaluation would harm your mom at all, and it may be quite easy to obtain.In my state, one can self-refer to PT for 12 visits. I don't know what other states this is true of.

ETA I think I remember my MIL doing that "throw legs over chair arm"  show-off thing! She could barely walk....


dashwood60
Posted: Thursday, July 11, 2019 1:32 PM
Joined: 4/9/2018
Posts: 66


Thanks for the input. 

She's was fine for 2 weeks after throwing her legs over the chair and was fine for several days after getting to memory care. Anyway they're sending her to the ER because the Dr. wants to be sure they aren't missing anything and they can't get her in to see an orthopedist for 3 weeks.

So much for thinking memory care would help alleviate all my worries.


Army_Vet60
Posted: Thursday, July 11, 2019 1:53 PM
Joined: 6/21/2019
Posts: 461


Dashwood60,

 

How old is your mother, BTW?


Deanna_M
Posted: Thursday, July 11, 2019 1:59 PM
Joined: 12/24/2016
Posts: 202


Hi, it is funny that you posted this today. We are dealing with hip pain for my mom. She has a history of some arthritis pain in her hip, so she gets tylenol regularly for that. But, she now is constantly complaining about hip pain. She also is shuffling more now and struggles to get in- and out- of her chair. She has always been very vigorous, so this is new, but seems to be coincident with a pretty significant drop in her cognition.

She had a couple of weeks of physical therapy. The physical therapist found no evidence of pain and was impressed with how strong she was. She was discharged from physical therapy because of that. She has had hip xrays, which have shown nothing remarkable.

So, my sister and I suspect that she is stuck in a loop: she needs to complain about something, so she complains about her hip. She cannot carry on a conversation, so mentioning her hip is her "go to." It is usually just the phrase "arthritis does not like me" and it seems like she uses it as an excuse for her slower, unsteady gait.

She used to complain about her scratchy throat (which never sounded scratchy) and constantly request cough drops. The doctors found no problems with her throat. And, eventually, she quit complaining about that...we assume because she has forgotten about that and is now focusing on her hip.

We don't know what else to do since no one has found any evidence of real pain.

Such a tough disease!!

 


SelEtPoivre
Posted: Thursday, July 11, 2019 1:59 PM
Joined: 3/8/2018
Posts: 797


My mom fell last June at home and had a bad muscle pull. Despite weeks of PT, she still complained to me of “excruciating” pain. Had her checked at the ER, no issues. Saw her doctor, no complaints. But every day, despite Tylenol and Advil, she complained of pain to me.

One morning, I saw her wiping crumbs from under her chair in the kitchen. She was able to get down and get up on her own, I didn’t hear any ouching. She did the same thing at lunch. Up, down, unassisted, and no ouching.

A few times when she would say she had pain, I gave her a vitamin D tablet, saying “my doctor gave me these for pain, they’re very strong”...and no pain after.

But she always complained to me. Her doctor, my therapist and I began to wonder if it was discomfort + attention seeking + brain pain processing issues.

After she went to MC she never mentioned pain in her leg. Go figure.


eaglemom
Posted: Thursday, July 11, 2019 2:09 PM
Joined: 3/7/2012
Posts: 2380


I want to just add something here. It will seem like its coming from left field........

Sometimes our LO say they have pain - and they might. However, it might mean they are too cold, or too hot, shoes are tied too tightly, are hungry, need to use the restroom, etc etc. They know the word pain therefore use it in all circumstances. I'm certainly not saying they aren't in pain - but sometimes its simply the wrong word.

I too would error on the side of caution if you think or the facility thinks a trip to the ER is medically necessary. That's a change of environment and can cause confusion - just be prepared.

eagle


harshedbuzz
Posted: Thursday, July 11, 2019 3:40 PM
Joined: 3/6/2017
Posts: 1850


I think my dad sometimes reported pain as a bid for attention; nothing like saying my fill in the blank hurts to get my mom's undivided attention. Other times he used it as a conversation starter like the time he pointed to an imaginary scar on his arm and told me all about his knee replacement surgery. FTR, it was my mom who had both knees replaced.

But then there were his ongoing reports of broken ribs. He had taken a spill stepping off a curb and nearly landed on my mother. She has osteoporosis and several fractured vertebrae in her lumbar region, so she jumped out of the way to avoid breaking his fall. This angered him and the incident stayed with him for some reason and over time it became her fault. When his new pulmonologist ordered a CT scan to check his COPD I looked the result up on the patient portal and discovered he had some inflammation around his gall bladder and stones. Evidently the surgeon who removed his gall bladder in 1982 left enough behind to get him in trouble. We were able to adjust his diet which helped a lot.
Peter5
Posted: Thursday, July 11, 2019 3:59 PM
Joined: 5/30/2013
Posts: 1131


I personally think that sometimes when our loved ones describe pain or another physical issue, its because they are confused or trying to make sense of what is happening around them, and the only way they can express that confusion and ask for help is to say they are in pain, or have a headache, etc.  Its the only way they can come up with at the time to say "help, what's happening to me".
mikeswife
Posted: Thursday, July 11, 2019 8:53 PM
Joined: 12/15/2012
Posts: 112


My MIL has been getting the shakes and back pain.  We give her Tylenol for the back pain per our doctors orders but there is nothing they can give her for the shakes (she gets bouts two or three times a day that last 45 minutes to and hour and a half).  Instead of telling her there is nothing we can give her for the shakes then having her scared the whole time we started giving her a Tums as a placebo.  It calms her right away because her pill will help, and if she forgets she took one it hasn't hurt her to give her another.  It doesn't work like a true placebo and make the shakes go away but it helps her get through it without all the panic.  

 


dashwood60
Posted: Friday, July 12, 2019 8:40 AM
Joined: 4/9/2018
Posts: 66


Thanks for all the feedback. It's always good to know I'm not as alone as I feel.

Seems like I'm the world's worst daughter. Do I get a trophy?

The Dr. examined my mom and couldn't be sure so we ended up sending her to the ER. They did a CT scan and she has a pelvic fracture. There doesn't appear to be any displacement (which I'm told is good but who knows.) 

We don't know how it happened. The facility doesn't think she fell because how would she have gotten up? She was on osteoporosis meds for many years and she's very tiny so I'm guessing it's related to bone insufficiency. Judging by the way she used to plop down in her chair - I suppose even that amount of force might have cause the fracture.

I moved my mom to a very nice memory care facility. She was walking. Within a week, she was in a wheelchair. I thought her pain was probably her being unhappy with her unfamiliar surroundings but asked for an xray. The xray looked fine. Now she's in the hospital with a fracture. 

By the way, the night after I moved her, I fell in my bathroom. I missed a week of work and I'm still using a walker. 

I sure hope things start to look up soon. I'm exhausted mentally and physically.

 


zauberflote
Posted: Friday, July 12, 2019 12:50 PM
Joined: 10/24/2018
Posts: 508


Dashwood, you are NOT, repeat Not, the world's worst daughter!!!! Please don't take this guilt onto yourself. 

I'd say "no displacement" could maybe mean that the pelvic bone is still in the form it was before the fracture-- no separation of halves in any plane? So that would be a good thing, bc it would maybe tend to heal in its correct shape, and not cause yet more pain down the road. 


Army_Vet60
Posted: Friday, July 12, 2019 12:56 PM
Joined: 6/21/2019
Posts: 461


Dashwood60,

 Why don't you think of yourself as a good daughter?

You brought your concern about whether or not your mother's pain was real to this forum.

You got advice that your mother's pain could be real for several reasons and to get a follow up examination.

You took that advice and found out she fractured her hip.

So, what did you do that was so wrong again?