Stubborn

We were finishing up our paperwork at the hospital when my crewmate's mobile phone rang. It was one of our fast car drivers and he was asking if we could hurry up our time at hospital because he had a nasty job that needed to get to hospital quickly. We were the only crew who weren't currently dealing with a patient and so we 'greened up' and, after getting the job from Control headed over to his location.

We arrived on scene to find the patient's elderly husband and her daughter already there – the FRU and patient were nowhere to be seen. We were directed to the top of the stairs where the FRU was trying to persuade the patient to go to hospital.

“She's stubborn”, the daughter said, “we fitted a stairlift for her, but she's too stubborn to use it”.

It would seem that this elderly woman was heading upstairs to bed and had tripped up the stairs – in part because she never used the stairlift.

She was arguing with the FRU, he was telling her that she needed to go to hospital, she was insisting that she just wanted to go to bed. If her injuries weren't too bad we might be able to leave her at home.

What she had done was far from a minor injury.

Both of her shins were essentially 'degloved', the skin on her shins had gone and there was little left except for bone. Surprisingly there was less blood than you would think, but this was a very serious injury, quite possibly one that she wouldn't recover from. To be honest it was one of the nastiest injuries that I'd ever seen.

Given how long leg wounds can take to heal in the elderly, it wouldn't surprise me if, coupled with her other medical problems, that this vast injury would lead to her death.

We managed to persuade her into our carry chair and then essentially browbeat her into going to hospital. We dressed the wounds as best we could and took her to hospital.

What sticks in my mind is that if she hadn't been so stubborn, if she had used the stairlift that her family had fitted for her, then we wouldn't have been needed and our patient wouldn't have suffered a potentially fatal injury.

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The other reason why this job sticks in my head is because my mum is likewise stubborn, and I can see her killing herself falling off a chair while changing a lightbulb, or seriously injuring herself doing something daft rather than ask me or my brother for help.

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For those that care about my suffering, since I started on the Ciprofloxacin I've not had a decent night sleep, mostly due to restless legs or just through waking up during the night. I have this for a month, so, y'know, please send sympathies and Diazepam.

22 thoughts on “Stubborn”

  1. My Dad had a stairlift installed because with Parkinson's he simply couldn't walk upstairs, they really don't get in the way, in fact they can be quite handy for carrying things upstairs 😉 I'd browbeat your boyfriend a bit more! You can park them at the top or bottom of the stairs, and certainly the one my Dad had had a remote you could use to call the lift down if it was at the wrong end.

  2. Sympathy – absolutely!I suffered RLS briefly while pregnant and just had to put up with it. It was a nightmare, especially when added to the usual pregnancy fun of needing the loo every hour on the hour, plus heartburn if I so much as opened the fridge after 8pm. Thank the great pumpkin, its never come back. (Crosses fingers and touches wood)

  3. Tom, you have my sympathies, but alas, diazepam doesn't flow through the 'net. Perhaps a housecall from one of your fellow medics might help?Stubborn is a trait I know well. I am sitting here nursing a knee injury brought on by my stupidity of riding my bike (a mountain bike, with mountain bike tires that work well on dirt, but not on concrete) to work after a rain, before the ground was dry. http://www.portable-essentials.com/2009/05/crash.html if you want to read it… Makes kneeling while holding c-spine real fun.

    Would mentioning your blog entry to your mom make her rethink not accepting your or your brother's help? Just a thought…

  4. Restless legs is one of those things that can drive you absolutely crazy. There's nothing more frustrating than being absolutely exhausted but having limbs that insist on clambering about the bed, apparently of their own accord.I nearly had to stop my antidepressant, mirtazapine, because RLS is a side effect. I need my anti depressant. My GP prescribed ropinirole. It works. Two tablets at night and I'm sleeping like a baby. It does have its own side effect, sleep 'drop outs', which can be embarrassing if you're not in bed, because you just go to sleep. Without warning. Instantly. Better than the RLS, though, and if you take it when you're already in bed then falling asleep isn't a problem.

  5. Trouble is, it's often stubbornness that keeps elderly people going. That was certainly the case for my gran.

  6. A Social Services Occupational Therapist came to my house to assess me, watched me crawl slowly and painfully up the stairs, and immediately prescribed me a stairlift.I'd love to have a stairlift. I fall up/on/down the stairs at least once a week, and although so far I've only ever had minor cuts, grazes and bruises, it's painful and upsetting.My boyfriend refuses to allow one to be installed, though. He argues that it would be in his way, and that if he was to slip on the stairs, he would be more likely to injure himself on it.His stubbornness beats my stubbornness and will probably continue to do so until I'm old enough to sustain 'proper' stair-based injuries.

  7. I think stubbornness in the elderly is a contributing factor to many costs for the NHS. How many elderly people refuse to go into a home where they could be treated and instead stay at home, needing the attention of ambulance crews on a regular basis?However, we focus instead on the problems that young people cause and ignore this – look at the recent Channel 4 'Hospital' series, implying that young people are uniquely reckless.

  8. On a random note, I work in an aquarium and once treated a shark with ciprofloxacin. She came out the other end fit and healthy…

  9. My Gran had restless leg syndrome. They prescribed quinine – she found this most palatable in Gin & Tonic and lived to a ripe old age sleeping well all night 🙂

  10. I suggest that some 'stubborn' elderly people are simply fighting the fear that they will become institutionalised and lose control of their own lives.Remember that, for previous generations, “Going Into A Home” was a truly terrifying prospect!

  11. I know it may be a pain in the arse but l can well understand why the elderly, in the words of Dylan Thomas, Rage, rage against the dying of the light. The fear is, if they give up the fight, then they will go downhill rapidly and l'm not sure they don't have a point.The queston is, how do we balance that right to rage and maintain independence with the requirement to look after those who need help but don't want (Or are too afraid) to admit it. It's a question of balance, rights and resposibilities…never an easy one.

  12. Being with the medical profession. Its just you have taken on your mind.I would say that , you should avoid thinking about that and should indulge yourself in other activities. Best regards

  13. My sympathies re the cipro – it can be a b*stard – I had it prescribed for cystitis once and had to stop after three days, it made me sicker than the bladder infection!

  14. A friend recently lost her very elderly mother when a simple stumble which left a bruise led a GP to insist on an A&E visit for an x-ray … which led to C. diff. twice and pneumonia and inevitably death.It's certainly true that stoic old people do die in hospital even when they go in for trifling matters. They need to go in, certainly, but also to “rage, rage” louder while they're there.

    Tom, I'm sure I've heard you comment before that it's the loud patients who get the most attention, regardless of their need. Just as it's the bolshy passengers who get the train guard's attention.

  15. When my mum had a stair lift installed she raged at it for weeks, we were all mystified by this, all we could see was an aid to her staying in her much loved home and living as independently as she could, all she saw was the future, and its pretty grim.Since reading this blog I've become obsessed with the well being of the senior member of the families shins! and I vow to wear shin pads in my dotage….. As an aside my direct mailing profile has never recovered from sending off for info on stair-lifts for my mum, can I tell you about walk-in baths and raised loo seats, are you interested? It's making me old before my time. Bats-girl… send him packing, you are worthy of more care, consideration and love.

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