MIL fell and I think her wrist is broken - ER tonight or wait until morning? Update in first post

[Kassia]

My MIL fell and I'm pretty sure from her description that her wrist is broken.  She has to be at the hospital tomorrow for cancer infusion and was wondering if she should just wait or go to ER tonight?  DH is taking her to her treatment in the morning and he'd have to take her to ER tonight.  She said it's swollen and hurts.  We have a winter weather advisory until 4am and roads aren't great.

And those of you who know me know he's also taking care of me while I recover from foot surgery and a concussion.  I feel so bad for him.  😞  

 

Update:  She had x-rays this morning and I just saw the results in her portal.  She doesn't know yet.  
"Comminuted fracture of the distal radius. Fracture of the ulnar
styloid.:  

And...dd 19 (1100 miles away at school) just told me she was exposed to Covid and has symptoms.  I am going to have a nervous breakdown.  😞  

Edited January 21, 2022 by Kassia

[kbutton]

Can she get adequate pain relief?

If she can get comfortable, I would wait due to the bad roads. 

If her pain is controlled, I would plan on hitting the ER after her infusion or asking her doctor to send her directly to a good hand/wrist orthopod to bypass the ER entirely.

Someone else might think of extenuating problems with my proposed plan, and I would add a caveat that so many little odd things can destabilize the elderly. If she's easily destabilized by small things, she probably needs to be seen in the ER. (My 89 y.o. grandma would probably not even tell anyone until morning, lol, but that's not great either!)

[catz]

If there was any way to avoid ER use right now I would do it.  We're in the upper midwest so covid would slow me down more than roads, but that isn't great either.  I would encourage icing and pain relief and call ahead in the morning to the clinic if possible.  

[Kassia]

2 minutes ago, FuzzyCatz said:

If there was any way to avoid ER use right now I would do it.  We're in the upper midwest so covid would slow me down more than roads, but that isn't great either.  I would encourage icing and pain relief and call ahead in the morning to the clinic if possible.  

I'm worried about covid, too.  Our hospital is at 100% ICU patients w/Covid and almost 40% of regular beds.  I told her to ice and elevate for now and to call her PCP and/or oncologist.  

[Kassia]

7 minutes ago, kbutton said:

 

If her pain is controlled, I would plan on hitting the ER after her infusion or asking her doctor to send her directly to a good hand/wrist orthopod to bypass the ER entirely.

Someone else might think of extenuating problems with my proposed plan, and I would add a caveat that so many little odd things can destabilize the elderly. If she's easily destabilized by small things, she probably needs to be seen in the ER. (My 89 y.o. grandma would probably not even tell anyone until morning, lol, but that's not great either!)

I would love if she could go directly to orthopedics but don't know when she could get in.  That would be best. 

I also thought of any additional risks because of her age.  I have waited a whole weekend with a broken bone so I could see the orthopedist and skip the ER.  

[Dmmetler]

Are there any urgent care Ortho clinics? Here there are weeknight hours, and they would be the ideal place for this-it woule be safer and faster than an ER, and they can do the Xrays and casting right there. 

[Kassia]

2 minutes ago, Dmmetler said:

Are there any urgent care Ortho clinics? Here there are weeknight hours, and they would be the ideal place for this-it woule be safer and faster than an ER, and they can do the Xrays and casting right there. 

No there aren't.  I wasn't even aware they existed before WTM.  That would be ideal.  

[regentrude]

I would not go to the ER because that would likely mean many hours of waiting with a non-life threatening injury and being pushed to the bottom of the list every time a truly emergent case comes in, while sitting in a crowded room with people who will definitely have Covid. 

[Kassia]

1 minute ago, regentrude said:

I would not go to the ER because that would likely mean many hours of waiting with a non-life threatening injury and being pushed to the bottom of the list every time a truly emergent case comes in, while sitting in a crowded room with people who will definitely have Covid. 

Thanks.  I agree.  I was actually going to call first to ask how long of a wait it would be.  She'd be better off comfortable at home than sitting in ER for hours and hours.

 

And it's way too cold to wait in the car.  It's 14 degrees and dropping.

Edited January 20, 2022 by Kassia

[ktgrok]

Does she have pain medication at home to keep her comfortable? If she has feeling in her fingers and can't move them and has pain meds she can wait until tomorrow I would think. The only reason I went to the ER was I was in a lot of pain and did not have pain meds and with the swelling it almost looked as if the bone was very displaced. Turned out that was a hematoma.

[Katy]

I’ll be the dissenting voice and say she needs to go in. One of the things they’re watching for in the ER is if circulation is impaired. She may need surgery tonight, or it may be just a quick yank & set. 

[Kassia]

2 minutes ago, ktgrok said:

Does she have pain medication at home to keep her comfortable? If she has feeling in her fingers and can't move them and has pain meds she can wait until tomorrow I would think. 

I'm not sure about either.  We're waiting to hear back from her.  The snowplow guy was coming over and I'm wondering if he took her in because we haven't heard from her in a while.  We didn't want to call in case she was waiting for a call from the doctor's office (we told her to call her PCP and/or oncologist to ask their opinion).  

1 minute ago, Katy said:

I’ll be the dissenting voice and say she needs to go in. One of the things they’re watching for in the ER is if circulation is impaired. She may need surgery tonight, or it may be just a quick yank & set. 

Thank you.  

[mlktwins]

I know your DH is caring for you too, but is there any way he could go stay with her tonight?  My dad was a mess when he fell and badly injured his dominant hand in July.  He couldn't get into and out of bed, get up from his chair easily, go to the bathroom, etc.  

I would avoid the ER if at all possible!!!

I'm so sorry!  You have had so much going on and so much stress.

[prairiewindmomma]

57 minutes ago, Kassia said:

My MIL fell and I'm pretty sure from her description that her wrist is broken.  She has to be at the hospital tomorrow for cancer infusion and was wondering if she should just wait or go to ER tonight?  DH is taking her to her treatment in the morning and he'd have to take her to ER tonight.  She said it's swollen and hurts.  We have a winter weather advisory until 4am and roads aren't great.

And those of you who know me know he's also taking care of me while I recover from foot surgery and a concussion.  I feel so bad for him.  😞  

 

 

A few thoughts:

1. If there is an after hours oncology support number, she may need to call and see if they want to put off the transfusion. It may be a balancing act depending on what chemo drug she is on and what it does. A lot of chemo drugs delay healing of bones and tissues because of how they affect blood counts. OTOH, the chemo may need to go on depending on how all of it is playing out, depending on how much spread there has been.  (We learned this when dd broke her tibia during chemo. Fun times.)

2. If oncology wants her to be seen, they can possibly pull strings to get her admitted directly into a separate area of the ER.  We also did this when dd was going through chemo. We didn't ever have to wait in a waiting room, we just waited in the parking lot until she was called in. They did imaging or whatever had to be done in the hospital and then she went straight up to the floor. A broken wrist may not be that level of crisis, but it may depend on what her last blood count was. (dd was almost always neutropenic)

3. If I were you, I'd be calling and willing to drive to a 24 hour ortho imaging clinic. I honestly don't trust ERs with hand/wrist stuff, but do trust orthopeds who specialize in hand/wrist.  FWIW, the swelling may be so bad soon that imaging won't be reliable anyway. I've generally been advised to wait 72 hours if circulation isn't impaired and then do imaging, and then have whatever surgery needs to be done within 10-14 days of the break.

Basically, I wouldn't just show up in a ER.

 

[Katy]

Do google “orthopedic emergency” to see if you have urgent care orthopedic clinics first. I last googled it maybe a year ago and there were none in our area, but I did it again and there is one less than an hour away and 8 in a 2-hour radius. 

[Kassia]

15 minutes ago, mlktwins said:

I know your DH is caring for you too, but is there any way he could go stay with her tonight?  

I would avoid the ER if at all possible!!!

I'm so sorry!  You have had so much going on and so much stress.

I'd probably be okay but I don't know if he'd be willing to.  We have a complex past with her - she was awful to us until FIL died in 2020 and she suddenly needed us.  We were suddenly her only caretakers (mostly DH) after years of vowing to ourselves that would never happen.  It's been really hard.  

You've had a lot of stress too.  So many of us have!  😞  

 

13 minutes ago, prairiewindmomma said:

A few thoughts:

1. If there is an after hours oncology support number, she may need to call and see if they want to put off the transfusion. It may be a balancing act depending on what chemo drug she is on and what it does. A lot of chemo drugs delay healing of bones and tissues because of how they affect blood counts. OTOH, the chemo may need to go on depending on how all of it is playing out, depending on how much spread there has been.  (We learned this when dd broke her tibia during chemo. Fun times.)

2. If oncology wants her to be seen, they can possibly pull strings to get her admitted directly into a separate area of the ER.  We also did this when dd was going through chemo. We didn't ever have to wait in a waiting room, we just waited in the parking lot until she was called in. They did imaging or whatever had to be done in the hospital and then she went straight up to the floor. A broken wrist may not be that level of crisis, but it may depend on what her last blood count was. (dd was almost always neutropenic)

3. If I were you, I'd be calling and willing to drive to a 24 hour ortho imaging clinic. I honestly don't trust ERs with hand/wrist stuff, but do trust orthopeds who specialize in hand/wrist.  FWIW, the swelling may be so bad soon that imaging won't be reliable anyway. I've generally been advised to wait 72 hours if circulation isn't impaired and then do imaging, and then have whatever surgery needs to be done within 10-14 days of the break.

Basically, I wouldn't just show up in a ER.

 

1.  I thought the same thing - that her oncologist needs to know ASAP so they can decide if they will go on with treatment tomorrow morning.  

2.  That's a great idea except for the parking lot wait - it's bitter cold here.  

3.  I have no idea where an ortho imaging clinic would be.  And the roads are bad now - not a good time to be driving in the dark to an unknown place.  I'm also hesitant to do imaging too soon but don't know about circulation.  

Definitely don't want to just show up in ER.  Thank you. 

 

[Kassia]

4 minutes ago, Katy said:

Do google “orthopedic emergency” to see if you have urgent care orthopedic clinics first. I last googled it maybe a year ago and there were none in our area, but I did it again and there is one less than an hour away and 8 in a 2-hour radius. 

I just did this and found one an hour away but they wouldn't make it anyway before the place closes.  But thanks for the suggestion. 

[Harriet Vane]

37 minutes ago, Kassia said:

I just did this and found one an hour away but they wouldn't make it anyway before the place closes.  But thanks for the suggestion. 

This would be the place to go tomorrow or try to get an appointment with a local orthopedic doctor. They often do fit in emergent breaks right away.

[prairiewindmomma]

Do you have 24/7 telemedicine options through her Medicare insurance provider? Here the hospital systems have that set up. I sign in to my patient portal and there is a button I can click. There are appointment times or there is a wait in queue option. Just another thought… But, I also know that’s not an option for my rural out of state family….

[Kassia]

3 minutes ago, prairiewindmomma said:

Do you have 24/7 telemedicine options through her Medicare insurance provider? Here the hospital systems have that set up. I sign in to my patient portal and there is a button I can click. There are appointment times or there is a wait in queue option. Just another thought… But, I also know that’s not an option for my rural out of state family….

I don't know.  I don't know what to do with her.  I told her to call the PCP and the oncologist but she didn't want to do either because it's after hours.  She rarely listens to me even though she wants advice.  It's so frustrating.  DH is on the phone with her now.  I think she's going to hold off until the morning and go for her cancer treatment and show them her wrist then.  She's elevating and icing and taking extra strength tylenol.  At least this is what I'm getting from listening to DH's side of the conversation.  

 

 

[kbutton]

29 minutes ago, Kassia said:

I don't know.  I don't know what to do with her.  I told her to call the PCP and the oncologist but she didn't want to do either because it's after hours.  She rarely listens to me even though she wants advice.  It's so frustrating.  DH is on the phone with her now.  I think she's going to hold off until the morning and go for her cancer treatment and show them her wrist then.  She's elevating and icing and taking extra strength tylenol.  At least this is what I'm getting from listening to DH's side of the conversation.  

Given your history (I had forgotten), I say to not beat yourself up about whatever course she chooses. I have a MIL that everyone swears listens to me and wants my opinion...ha! Not really. She wants it so that she can do something else, usually making whatever important points I raised completely moot. If something happens to DH, I will not have a relationship were her past trying to make sure my kids see her when they want to. I live far enough away that we shouldn't be ensnared as daily caregivers, but I do want to be sure the one sibling that lives in town with her has resources. The sibling that enables her is free to move cross country and continue that enabling, lol! I used to live in fear that she'd move near us (when we were seriously considering and trying to plan a big move, she said, very seriously, that she'd move near us), but I think she'll stay put where she is at this point. 

[Kassia]

@kbuttonwe wanted to move farther away to avoid this happening but needed to wait until dd finished high school (2020) and then there was Covid and FIL died and it was just one thing after another so here we are.  Glad you are not too close.  🙂

[Granny_Weatherwax]

When I broke my wrist in March, the ER missed the break. They told me it was fine and sent me home. When I saw the ortho a few days later, the xrays clearly showed a break. I was told then that oftentimes a wrist fracture doesn't show up until a bit of time has passed because of the lack of vascularization in the wrist bones. I think that if the color is good and her fingers look okay (other than swelling) a wait of 12-24 hours should be okay.

If she has any tingling, discoloration, or obvious malformation, go right away.

Maybe you could call the nursing hotline and ask them what they would recommend. They may inform you that a short wait isn't detrimental.

I'm sorry you're going through so much. I think your DH deserves his favorite coffee tomorrow.

Edited January 21, 2022 by Granny_Weatherwax

[Kassia]

1 minute ago, Granny_Weatherwax said:

When I broke my wrist in March, the ER missed the break. They told me it was fine and sent me home. When I saw the ortho a few days later, the xrays clearly showed a break. I was told then that oftentimes a wrist fracture doesn't show up until a bit of time has passed because of the lack of vascularization in the wrist bones. I think that if the color is good and her fingers look okay (other than swelling) a wait of 12-24 hours should be okay.

If she has any tingling, discoloration, or obvious malformation, go right away.

Maybe you could call the nursing hotline and ask them what they would recommend. They may inform you that a short wait isn't detrimental.

I'm sorry your going through so much. I think your DH deserves his favorite coffee tomorrow.

First, I had to laugh about the comment about DH - he hates coffee!  But, yes, he deserves so much special treatment with everything he has going on.  

I've also had a wrist fracture missed at ER when I went soon after I was injured.  

She'll be at the hospital first thing in the morning for her cancer treatment and will have her wrist looked at then.  Not my choice but that's all I could do - I really wanted her to make some calls to confirm that was the safe thing to do and that they will even proceed with the cancer treatment if she has a fresh fracture.  

[Mom_to3]

Your family just can't catch a break at the moment!! And that stress probably doesn't help with the concussion...Hopefully the cancer center will help her avoid the ER. 

[prairiewindmomma]

1 hour ago, Kassia said:

I don't know.  I don't know what to do with her.  I told her to call the PCP and the oncologist but she didn't want to do either because it's after hours.  She rarely listens to me even though she wants advice.  It's so frustrating.  DH is on the phone with her now.  I think she's going to hold off until the morning and go for her cancer treatment and show them her wrist then.  She's elevating and icing and taking extra strength tylenol.  At least this is what I'm getting from listening to DH's side of the conversation.  

 

 

Let her make her choices. She has info and options. 🙂

[Kassia]

9 minutes ago, Mom_to3 said:

Your family just can't catch a break at the moment!! And that stress probably doesn't help with the concussion...Hopefully the cancer center will help her avoid the ER. 

yes, it's connected to the hospital so I'm hoping they can somehow just get her to imaging without having to sit in the ER waiting room or exam rooms.  We'll see tomorrow.  

7 minutes ago, prairiewindmomma said:

Let her make her choices. She has info and options. 🙂

That's all I can do!  I feel bad for her - she's been through a lot in a short period of time but I wish she'd listen to us when she asks for advice.  

[Kassia]

Update in first post.

 

Thank you to everyone who replied.  

[prairiewindmomma]

So, surgery likely. Sorry. I would push for her to go to a facility for post op care rather than Dh take it on.

[Storygirl]

So sorry that she is hurt and that this adds a big complication to your life. I agree that if she has surgery, she should go to a rehab facility instead of your husband taking on her post-op care.

I hope your daughter doesn't get too sick. Can she get a test?

[Kassia]

1 minute ago, prairiewindmomma said:

So, surgery likely. Sorry. I would push for her to go to a facility for post op care rather than Dh take it on.

I agree.  For some unknown reason, her oncologist just sent her to ER.  She was x-rayed after her cancer treatment and they sent her home without knowing the results yet.  So I don't know what is happening now...will they just wrap it?  I doubt they will do surgery immediately.  What a mess.  I wish she weren't going to ER of all places.  

I don't know if medicare will pay for a facility after wrist surgery though.  More likely she'd need in-home care?  I don't know.  I am worried sick about dd now and, of course, poor DH.  😞  

[Kassia]

Just now, Storygirl said:

So sorry that she is hurt and that this adds a big complication to your life. I agree that if she has surgery, she should go to a rehab facility instead of your husband taking on her post-op care.

I hope your daughter doesn't get too sick. Can she get a test?

She tested and was negative but we both agree it was too soon.  She's been quarantining since she found out she was exposed (Wed).  

[Catwoman]

Ugh! When it rains, it pours!!!  I'm so sorry you have all of these constant worries, Kassia!  😞 

[Katy]

Oh Kassia, I’m so sorry. 

[Kassia]

1 minute ago, Catwoman said:

Ugh! When it rains, it pours!!!  I'm so sorry you have all of these constant worries, Kassia!  😞 

 

Just now, Katy said:

Oh Kassia, I’m so sorry. 

Thank you.  I swear I am not making this up for attention!!!  

[Katy]

Just now, Kassia said:

 

Thank you.  I swear I am not making this up for attention!!!  

I believe you. I’ve been in those seasons of life. And you’re not a drama queen in all the other years I’ve known your posts. 

[fraidycat]

12 minutes ago, Kassia said:

 

Thank you.  I swear I am not making this up for attention!!!  

When it rains, it pours.  I'm sure no one here suspects that you are attention-seeking. I think most of us have had those stretches where "everything that can go wrong, does go wrong... all at once." 
 

Hopefully this is the last of yours and things start going better soon so you can just concentrate on resting and healing.

Hugs!

[Spryte]

Oh my goodness. I’m so sorry!

Some times in our lives are just like this. Hang in there, hold on for the ride (for dear life!), and this season will eventually pass.

If you MIL is hospitalized, she will likely have the option of rehab at a facility. 
 

How’s your DD?

[Annie G]

I’m so sorry! Sending good vibes to keep you calm while dealing with your mom’s injury as well as dd’s potential Covid.  

[Catwoman]

41 minutes ago, Kassia said:

 

Thank you.  I swear I am not making this up for attention!!!  

Of course not! If you were, your MIL would have been kidnapped by aliens and your dd would have been bitten by a vampire. 😉 

[Kassia]

19 minutes ago, Spryte said:

 

If you MIL is hospitalized, she will likely have the option of rehab at a facility. 
 

How’s your DD?

Dd just has a scratchy throat so far.  

I don't know if MIL would be hospitalized.  When I had ankle surgery years ago I went home same day.  And the hospital is full of Covid patients and she's immunocompromised due to cancer treatment.  

5 minutes ago, Catwoman said:

Of course not! If you were, your MIL would have been kidnapped by aliens and your dd would have been bitten by a vampire. 😉 

thanks for the laugh - I desperately needed that.  

[scholastica]

I am so sorry!! So much at once! Praying for you.

[ktgrok]

Yikes! That is quite the fracture. Or rather fractures plural. I think I'm gonna go take some more calcium now. Y'all, take your calcium and your vitamin D and do weight-bearing exercises!

Feeling very grateful for the outcome of my arm injury now! The ER doctor actually said I was the luckiest woman alive to not have more damage given the extent of the injury. I'm crediting that to strong bones,

[mommyoffive]

Oh no, that is way to much on your plate.  I am sorry.  And with your recovery too.  I am so sorry.  I wish I could do something to help.  

I hope your dd has a mild illness. 

[Kassia]

50 minutes ago, mommyoffive said:

Oh no, that is way to much on your plate.  I am sorry.  And with your recovery too.  I am so sorry.  I wish I could do something to help.  

I hope your dd has a mild illness. 

Thank you!  You are always so kind and supportive. 

Dd is experiencing body aches now in addition to her sore throat.  I hope she doesn't get much worse.  I'm more worried about her than anyone else at this point.  

[mommyoffive]

2 hours ago, Kassia said:

Thank you!  You are always so kind and supportive. 

Dd is experiencing body aches now in addition to her sore throat.  I hope she doesn't get much worse.  I'm more worried about her than anyone else at this point.  

I feel so bad for her.  It is the worst to be sick when you are away from home for your first time.   Does she have meds and extra vitamins?  Is she in school housing?  I hope someone is there checking on her and taking care of her.  

[BusyMom5]

I'm so sorry- sounds like a lot hitting at one time.  My college age DD was really sick and I was able to InstaCart her groceries and OTC meds.  I think it helped just knowing I cared.  Its so hard to be sick and alone. 

[Kassia]

31 minutes ago, mommyoffive said:

I feel so bad for her.  It is the worst to be sick when you are away from home for your first time.   Does she have meds and extra vitamins?  Is she in school housing?  I hope someone is there checking on her and taking care of her.  

 

8 minutes ago, BusyMom5 said:

I'm so sorry- sounds like a lot hitting at one time.  My college age DD was really sick and I was able to InstaCart her groceries and OTC meds.  I think it helped just knowing I cared.  Its so hard to be sick and alone. 

So far she just has a scratchy throat and mild body aches.  She has plenty of meds and vitamins and is an on campus apartment.  Fortunately, classes are virtual for the next two weeks so she doesn't have to worry about missing class.  

I did tell her we could have groceries or anything else she needs shipped.  I want her to know that even though we're far away we'll do whatever we can to help.  I keep checking in with her and telling her I love her.  She does have support from close friends and her boyfriend but I think her boyfriend is quarantining so he can't really do much.  He doesn't have symptoms (yet).  Fortunately, with technology, they can still spend lots and lots of time together - young love...  ❤️

Edited January 22, 2022 by Kassia

[Melissa in Australia]

Hugs

 hope your dd feels better rapidly