Mom's stubbornness is confounding to me...

GA: This actually IS the second opinion, they brought in a specialist who's worked with this sort of thing with the elderly before. And they're actually using the procedure you described above too, they're also doing the biopsy at the same time. How they'll treat the second fracture remains to be seen. I can say that as Mom's pain has been somewhat relieved she's clearly much more comfortable and lucid. I can see her "real" personality coming through again, she's still confused and a little disoriented but the relief on her face is palpable. She seems to understand her injury and in a weird way finally knowing what's going on has given her a little peace of mind. Me too.

Babalou: Working on that right now. I'm supposed to meet with the Medicaid person late this week (apparently she only sees applicants on Thurs. and Fridays). They're already pushing re: discharge, however I'm "tuning it out" until I see how her procedure goes first. She might return to the rehab center (under a different protocol, obviously), however the copay is an issue right now so I have to work out some sort of payment plan there (again). As hesitant as I was to bring her home before, I'm definitely not going to mess around with a spinal injury, as I already feel terrible enough about how her prior rehab stint played out.

Dman, you're way ahead of me but I'm glad to learn that the specialists are right on top of the issues and plan to use what I understand are cutting edge technologies.

It also must be very gratifying to see a smile on your mother's face and know that she's feeling better.

I suppose you talk to her, tellin her, we are raising your head now, ok? On the count of three, we will push the button together. Count 1, 2, 3, ok mom PUSH THAT BUTTON!!.. Make it fun.Keep asking her if it's high enough? How is that mom? Do you want it higher? Ok, lets go again. Put heer finger on the trigger, and say Mom you COUNT THIS TIME. Make it a game. So simple math to get to the next number... Or say, when get to her favorite color purple, we raise the legs a bit... ect etc...make it fun. Bring carosoul music in...Good Luck.

GA: Hopefully it all goes well, it's supposed to be relatively non-invasive and she'll be under for it. Obviously at her age there's always some risk but right now it's her best shot at real pain management. I know she wants to feel better, she's still fighting and hopefully this helps.

Sometimes our little ones act out for us, but once we leave, they go about and play, no one around to put on a show. Maybe bring a treat. When you finish your workout mom, I have a treat waiting for you in your room? No, I can't tell you now mom, when you finish, you can find out.

Kyphoplasty, i think is the name of the procedure.

With regard to payment, just remember that you are using mom's money for these expenses. I seem to recall you are not POA? So you are not signing anything with your own name.

Update: the procedure went very well, the doctor was able to treat both fractures today and they took the biopsy too. Her cardiologist recommended that she be placed in ICU for post-op recovery so she's there now, sound asleep and way out of it. Pleased she got through it so well.

Babalou: Yup, that's it. Also, we have a shared account so accessing it isn't a problem. She was "bilked" out of some money a few years back so at that point I began helping her out with that stuff. I also have a little money put aside that I can use if need be, not a lot but it's a start.

Social workers...(sigh). Today I heard from #6 (I number them now, it's easier that way) and she asked me if I've contacted "ABC" regarding a Medicaid appt. I said, uh, no, you gave me "XYZ's" number and told me to line up an appt. with her and all I get is a "this VM box is full" message. "No, I said ABC"..."no, you said XYZ, I wrote it all down" and etc. All I could do was laugh, it's so absurd sometimes.

As long as you can still chuckle.....

Glad the procedure went well and that she's in CCU where they monitor your every breath. Hold steady, this looks like it's starting to go well.

I think having the cardiologist involved may slow down the discharge drums....

I'm happy to hear the procedure went well and they were able to treat both fractures. I hope you can get a bit of rest now that she's in ICU. Make sure to take care of yourself. As you've learned, this is a marathon and not a sprint and you need to make sure you have enough downtime to recharge your own batteries.

Dmanbro,
I would double and triple check on any civil action to recover damages for your mom's medical treatment. I would confirm if recovering any money would disqualify her for Medicaid Or if she would have to spend it, before she would qualify. I don't know the answer, but I would confirm that recovering damages wouldn't hurt her in the Medicaid process. There is no guarantee of what amount she might get, but unless it's an awful lot, it might not be enough to pay for her care for that long, but just enough to mess up her qualification.

Great news! This has been quite a journey for you and your mother but it's so encouraging that you're in the recovery and improvement phase now.

You have a lot to be proud of; were it not for your persistence, those fractures may never have been discovered.

Babalou: I hope that's the case, as IMO she really needs at least a day or two of steady observation without being lugged and shuffled around a lot. I know how she is regarding anesthesia and pain meds and IMO she'll still be sort of foggy and groggy for a lot of the day tomorrow. This is the first surgery she's ever had and I'm sure it's been a lot for her to handle, although by all accounts she did very well before during and so far, after. So maybe another day of rest without being bounced around an ambulance and being admitted to rehab again would be a wise idea.

But then again, nothing would really surprise me at this point. I could very well get a call tomorrow morning (sixty seconds into my wake-up shower, no doubt) informing me that she's waiting at the curb in the rain for me to pick her up and I'd better make the Medicaid appointment immediately but the office is closed until Thursday. This hospital SW (#6) keeps telling me she'll call and set me up with an appointment, then the next day she acts like the day before never happened. So I'm assuming I'll just end up doing it myself and really it's just easier and less frustrating that way anyhow. IF she gave me the correct number this time, that is.

Congratulations! If you think about it, your mom could have just received the best medical care available to anyone on any insurance plan, after what was most likely mistakes in her diagnosis that you could have sued for. Bless you and youf mom.

Nothing really going on today, Mom's all sleepy and groggy as I figured she'd be. I mean I'm exhausted too and I'm younger and didn't just have back surgery. Plus I know that strong drugs always send her on her way for a while, exactly why she's always been wary of them.

Today I was informed that she's been accepted back into rehab (the same one) which means I'll be discussing money again with these people. It has to go differently this time around, though, that's for sure. I also heard from another Medicaid "pre-screener" today for some reason and wow, what a grim robot she was. Apparently it's all done by mail here. You apply and a few months later you either get a card or a rejection letter. First she told me that Mom probably "gets too much" to be eligible and then she asked me if her house was "listed yet". I mean they don't even try to pretend they're not coming for everything. When I asked re: exceptions she pretty much sneered at me before explaining my options there. Not pleasant.

Well, today Mom was discharged back to rehab, apparently it picks back up where she left off. The good news is that she clearly feels better since the surgery. No pain (some discomfort but not the crippling pain like before), her posture and movements are way better and mentally I see real progress as she's emerging from that awful fog she was in. She still has a long way to go but the difference is obvious. Today she was complaining but this time it was about "typical" things..."this soup is still too hot, the cable service here sucks" and etc. It really is terrific to see her sitting up and reaching for things, I even detected a bit of an attitude from her today which, given her prior state, is actually good to see!

This time around they'll be able to focus on treating her actual maladies instead of guessing and I think there's at least a fighting chance that eventually she'll be able to return home. I'm not sweating the money end so much this time around, they're just going to have to accept a payment plan as she simply doesn't have a huge lump sum to plop down right now. She has around 25-30 days of those $157 copays to cover which isn't insurmountable or anything. She probably needs a few days of post-op recovery before she can do any real PT and again, this time around it's not going to be a rush job. Still waiting for her biopsy results although her specialist was guardedly optimistic re: that.

That's such good news after all you've both been through! I'm so happy for both of you.

Wow, what terrific news!

I'm wondering if there is anyway that the Hospital/rehab could be convinced to reset the clock given the errors. Couldn't hurt to ask.

Good news. It's comforting to see a positive report after the trauma you and your mother endured.

And it's good she's complaining! If the soup is too hot, she must have an appetite and is hungry. If she doesn't like the cable line up (and who does?) she must be interested in watching tv.

I'm so glad this journey is back on track and headed in the right direction.

And thanks for keeping us updated.

The cable service sucks… I'm delighted to hear it, she must be feeling sooooo much better to have noticed! :) Very good news, hope her recovery continues more smoothly from here.

Thanks all, she's crabby, frustrated and bored but definitely not in the sort of pain she was before, it's obvious. Now we have to get her on the mend but at least this time we know what the problem really is. Hoping the rehab folks will work with us here and not play hardball with payments, as we really need to set up a practical payment plan to cover the remaining copay days here.

Weird day today. I visited around lunchtime, I walk into her room and I almost have a heart attack as she's in that leftward-leaning position, moaning and groaning, like the last week never happened. A few minutes later I found a half-masticated pill on her bed. Turns out she spit out her pain pill and was all achy and etc. I had to let the weekend staff know that she CANNOT be trusted to swallow every pill, best to crush them up and give her them in some applesauce or whatever. Came back a few hours later and she was back to what's "normal" now, a little pain but otherwise not bad.

The mental aspect is going to be tough IMO. See the "stubbornness" mentioned in the title of this thread. Trying to get a "straight" answer out of her is impossible sometimes and it can be extremely frustrating. I'm hoping they can put together a practical PT program for her that might give her a sense of accomplishment that she can build on, as "too much too soon" is just going to cause her to withdraw and make excuses to dodge it. Right now she's maybe 25-35% "there" which is definitely a step up from the 1-10% before, but still a lot of work to do.

If the pain pill is codeine do not underestimate the agonies of constipation. Which is especially no joke if you were in pain to start with. If that is what they're giving her she should be being given lactulose or similar, too; but believe me I've just been through this and I expect my moaning and groaning frightened the neighbours. Too much information..? :/

Is she still in the hospital? Any plans for a psych workup? It would be good to have a professional opinion about her cognitive skills and her state of anxiety/depression.

Countrymouse: That's a good point, thanks! Entirely possible and treatable...if only she'd just SAY "I feel backed-up". With my mother it's always guesswork as she never just flat-out says "my ABC is XYZ". Or "there's a pill I didn't swallow on the bed".

I have an appointment with the rehab people on Tuesday to discuss "her treatment and therapy" (and probably "her assets and money" too). My goals here are realistic, I'm not expecting any miracles or anything. I want to see her regain some modest physical functionality and confidence which could lead to more mental stimulation too, which I think she really needs. I hope they're on the same (or similar) page here and that they don't try to push some "wham bam discharge day" idea on me. Yeah I'm cynical, I know.

I think this time around it's crucial that we can get her comfortably in a wheelchair, as she not only needs the mobility but she needs mental stimulation. She's been in and out of reality in hospital beds for a while now and it's definitely making her weird and squirrelly. But this time she has to ENJOY things like talking to people and being outside which won't happen if she's in pain, so right now getting her to a point where she can sit upright for a few hours without being miserable is the first goal IMO.

Babalou: She is in the rehab now. I definitely want the psych issues to be re-addressed, as the first time around they were based on an assessment done before she was accurately diagnosed. Thus IMO the issues have to be seen differently now, how much of it was due to the severe pain she was trying to hide? IMO she was dismissed too many times early on as being more out-of-it than maybe she was due to her reaction to the pain and diminished movement. In fact I can remember my concerns being brushed away with sympathetic looks, like "oh poor deluded son, can't see the truth" even when I insisted that her sharp mental decline matched the timing of her physical symptoms exactly.

Dman, does the facility have pet or music therapy?

What was she like, mentally (sharp, forgetful?), emotionally (depressed, anxious, perky, optimistic, self sufficient, happy) before this recent downturn. What was she like in her day to day interactions with you and others? What was she managing on her own (checking account, bill paying, setting up and taking meds, driving, shopping for and preparing food)?.

I think you need to get clear what her baseline was before. Was she declining cognitively ? Having trouble managing bills and such?

She may have had a TIA or small stroke somewhere along the line. She may not be able to clearly express "I have pain here, or I can't swallow that pill". Loss of cognitive function often leads to much anxiety and depression. Getting a clear picture about those issues is key in getting her the right meds and the right help.

If you don't feel that the psych people at the rehab are seeing her clearly, you might think, down the line, about taking her to an outside neurologist who specializes in dementia.

The big question is ALWAYS or NEW? Is mom's stubbornness a new development or has she always been this way? Usually cooperative or usually impulsive and pigheaded? Compliant with doctors or dismissive?

Babalou: It all kind of happened all at once. As soon as her physical symptoms appeared, she went straight downhill mentally too. It was like one day she was a somewhat creaky but generally happy little lady and the next she was all curled up, unable to move and unable (or unwilling) to elaborate on exactly what was wrong. Her stubbornness is a complex web of unwavering ideas, a distrust of medicine and a weird desire to "not trouble or worry anyone" by complaining.

Knowing what I do now, I think it all played out something like this. According to what her doctor just recently told me, she was treated in 2004 for a back injury, which became the lower back fracture she was suffering from. I never knew about this, which is totally understandable as my sister was probably involved and her view of modern medicine was completely bizarre, as was her desire (and Mom's) to "not worry me" by telling me about things like that. This injury became a degenerative thing which Mom chalked up to "arthritis" in her "hip" which was always her go-to complaint.

The second upper back fracture occurred far more recently, my guess is sometime in mid-June of this year. I have no idea how or when and if she knows she isn't saying. This injury was so painful it forced her to adopt a posture which in turn put even more stress on the lower back which led to a snowball effect of sorts. At the exact same time she became very withdrawn and disinterested in everything as the pain and the fear of having that pain diagnosed and treated kicked in. From there it was almost like she was in shock, as she became non-communicative and even more withdrawn.

Right now the best way I can describe it is that it's almost like she's emerging from a coma state. She's all achy and sore from the lengthy period of inactivity, she's shocked that so much time has gone by, she's surprised to have survived it and she's still exhausted from the whole ordeal. I can see her personality peeking out here and there but it's tough to say how far it's been buried as of yet. Hopefully I can get her assessed based on what actually happened to her as opposed to what the first impressions doctors have of her are, as IMO it's all symptoms from the same thing.

And BTW her stubbornness is not new, although her distrust of the medical profession sort of is. She was always good about her health, never missed her regular doctor appointments, never missed a pill, always followed doctor's orders. This was in very sharp contrast to my father and sister, who were complete opposites. (I ranged more toward her side of the spectrum there although on the whole she's probably been better about it than me). Now though, she withholds information, gives evasive answers and generally makes things difficult. My hope it that it was the pain and suffering that sparked this and that perhaps time and care will alleviate that somewhat.

Like I said, stubborn is a broad word and to properly describe it would take all night, but yeah, she's always been like that. Example: My mom is from that generation that thinks every new piece of helpful technology features a self-destruct button that must not be pressed so it's just safer to unplug the device entirely (wouldn't want to start a fire!) and go back to the old way of doing things. Phones, TVs, VCRs, DVDs, car radios, you name it, she's afraid she'll somehow "break" it by using it. I've forced her to adapt, she loved the new TV I got her a few years back, yet she still has her old rotary phone, I kid you not. She can be incredibly resistant to the simplest things sometimes and if it involves money in any way she's SURE it's a scam. She'd call the water department to ensure that the bills were real then she'd pay them in person just to be safe.

A few days ago my niece was visiting and she sends me a panicky text saying that Grandma is moaning and carrying on complaining about being in pain and etc. and that she seemed pretty bad. So I visited later that day and she was OK, nothing unusual going on. So today I asked her what the deal was with that. First she said she didn't remember but I didn't really believe her as my niece hadn't visited in a few days before that and I knew Mom noticed and wasn't pleased about it. So I asked her, "were you just putting on a show to make her feel guilty there?" and wouldn't you know it, she cracked a grin then tried to hide it. I keep telling these medical people, you gotta watch this one, she's got cards up her sleeve.

My mom also thinks that she can break thinks by pushing the wrong button; I've got more sympathy for this idea now that my daughter has a very complex tv set up that my 3 year old grandson can work but which defeats me at every turn.

I want to posit an alternative interpretation to your mom's saga. Mom injures her back and at the same time, has a TIA iron other vascular event which also goes undetected. Now , using the reasoning skills of a 5 year old (it hurts, if I don't tell anyone, it will get better), she resists and evades intervention. What I'm saying is that it may not be the pain that has caused this; it may have been a vascular event that caused both the loss of cognitive skills AND the injury. Just something to ponder. The important thing is that she's getting better physically. Cognitively, you'll have to see where she is.