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Gracie61 Asked October 2020

What is the recovery for broken ribs?

My alarm clock this morning was my moms Memory Care calling to say that they came in this morning and found my mom sitting in her recliner and she has a black eye. "Did I want to come get her and take to dr or should they call an ambulance for transport?" Sigh.
Well after a day in ER, I'm sitting with my mom in ICU. No problem with her head, but she has 3 broken ribs.
Because of the dementia and them wanting to monitor for pneumonia which can apparently happen if you don't breathe deep.
I took her to a regular dr at first, but she would just close eye and not let her touch her. Just leave me alone. Or no! So we called ambulance to take her to the ER, because I almost didn't get her out of car at doctor she was being so obstinate.
The paramedics came in, and it was showtime to the max. Talking to them, let them check her joints, take bp. Got to ER and she told the nurses she was so nice.
Then I guess she ran out of gas and it was back to fighting everything they tried. They took her temp under her arm and I have never heard her yell that loud. Just leave me alone and don't touch me. Would not take any meds by mouth. Please, Please. Its been a horrible day.
She's resting now, probably a combination of the hadol they gave her when she wouldnt take sundowning pill, and pain med and exhaustion.
She can have one visitor during the day and it has to be the same person. But they are making me leave at 8pm.
And I had to do the hardest thing I've ever done, sign a DNR order. My sister and I have been discussing it, and we dont feel CPR or intubation is in her best interest at this point, but man it's really hard to sign that paper.
I've never had any experience with broken ribs, whats the recovery like?
I dont know how long they will keep her in the hospital.

AlvaDeer Oct 2020
You are correct in the DNR to get that signed. I have had to do CPR on people of this age; talk about cracked ribs, you can feel and hear them cracking under your hands. They simply shatter. It it horrible.
Now, yes, they are right. Worst case is pneumonia. With cracked ribs, we can have a LOT of pain, and pain with every breath. This causes us to "splint" our breathing (what we call it) and not take a deep breath. The lungs get pneumonia and that can be lethal.
Hospitalization of the elderly often leads to confusion. The tendency to splint the breathing leads to less oxygenation of the brain as well, and that is contributory. I certainly wish you all good luck. Sadly these ribs are going to hurt for a while.My worst fear for her is when she gets out and tends not to take deep breathes.
Just read your update. I am so sorry. I hope the antibiotics go to IV now; she is unlikely to tolerate them any other way. And they will work much better.

Gracie61 Oct 2020
Update.

Mom is not doing well. Ran a fever, so on an antibiotic for pneumonia, probably exhabarated by the nurse crushing up her anxiety meds in some pudding and her choking and possibly aspirating the food. She spent the second day extremely restless, and combative, pulled out ivs, yelled no and leave me alone, and please, please, and help me, all usually with her eyes closed. Although she would occasionally open her eyes and try to speak to me. Had some dips in her blood pressure and they added fluids as she could not take anything by mouth.
Next day, added oxygen, some lidocaine patches on ribs and she is sleeping all day. They can only occasionally get her to react. They backed off on pain meds, took her off the anxiety stuff. Still not normal, vitals stable.
Made the decision to sign DNR, and agree not to ventilate. But had to make the choice to to a nasal gastric feeding tube to see if getting more calories would perk her up. Took them three tries to do it. She kept blowing the ivs so they did a PIC line. Now they are going to do a 24 hr EEG and brain MRI. Cat scan didnt show any issues. Had to move from purewick to catheter, because she was retaining fluid.

When she does rouse when they do something, her grip is strong. They had to put mittens on to protect the tube iv etc.

I felt I had to give her a chance to make it; which is why I agreed to feeding tube temporarily. But now I question whether I should have just opted for palliative care. Because after all this hospitalization and trauma, I'm afraid of I she does pull through, where is her mental state going to be in?

Iit wasn't perfect, but she was doing ok in memory care. Monday she shared cupcakes with the ladies, now shes alone in a hospital bed. The hospital let's me stay from 8a to 8pm, but no one overnight. They moved her out of ICU this morning to a regular room on the neurology floor, since she was stable. Scared me, they woke me up at 630am with a phone call to tell me.

We will see what the doctors say in the morning.
earlybird Oct 2020
I am glad your mother is doing better. Your poor dear mother. Broken ribs are horrible and I had 3 of them. My mother has a Pic line and I cover it with a mesh that slides right up her arm. It keep her from pulling on it. I also put another cloth like material over it, It works great. I would ask the doctor if you can stay with her overnight, I did and they allowed me to spend the hospital stay with my mother. It depends on the doctor, and hospital and if there are Covid cases. Hope your mom recovers real soon.

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NeedHelpWithMom Oct 2020
Oh my gosh, that sounds absolutely exhausting! I’m so sorry that you had to endure this situation.

Sending you a bazillion hugs!

Gracie61 Oct 2020
Thank you everyone. It's hard because she doesnt seem to be able to express herself clearly right now. Except no, and leave me alone and God help me. They try to ask her about pain, and doesnt answer them or say nothing that makes sense

I know shes hurting and confused. They have her in adult diapers, which she doesnt get. And then when she goes in them gets upset and cries, because she thinks she wet the bed. She was trying to get up last night, because she needed to go, and they were going to try to help her do that, but then I worry that too much moving around will make the ribs worse.

And it also makes me sad as I had gotten permission to take her out for a few hours for a 90th bday party at my house on Sunday .
Gracie61 Oct 2020
It also really didnt help that the move from the ER to the room happened during the time when she starts sundowning.
Ggetting ready to head to the hospital in a hour. I didn't sleep much. She has never been in the hospital where I couldn't stay overnight with her
earlybird Oct 2020
I broke 3 ribs last February getting up from the couch in my mothers bedroom. We were having breakfast together. thought I smelled something burning and jumped up and hit my right side so hard I went flying with a hot cup coffee in hand. I was put on tramadol and a lidocaine patch. I used a heating pad which helped. I slept in a recliner for a few nights. It took about 3 months for total healing. It was the most excruciating pain I ever had. I think you are doing the right thing about the DNR status. I did a DNR for my mom about three years ago. Hope your dear mother heals well and she is comfortable.
NeedHelpWithMom Oct 2020
OUCH!
NobodyGetsIt Oct 2020
Dear "Gracie61,"

I'm sorry that you keep going through these difficulties with your mom and that it's been a horrible day for you.

When my mom and I went over those issues at the age of 89 when she was just diagnosed with Alzheimer's, she told me she wanted a DNR, she didn't want to be on a ventilator and she didn't want a feeding tube. When she nearly died in April from severe dehydration and COVID, I was prepared for those things to be in place with the hospital, then rehab facility and finally at her new ALF in their memory care unit with hospice care. She's doing amazingly well and even got involved for the first time with a craft activity today. We thought she was near death at least 3or 4 times since being in the hospital. I will honor her wishes - she left me a note saying "Do for me - not to me." That's what I'm doing.

With your mom, I know the broken ribs is what's making the rest difficult. At this point all you can do is wait and see how the healing process goes.

I will be praying for you both and the situation at hand. May God give you strength as you find yourself doing some of the hardest things you've ever had to do.

lealonnie1 Oct 2020
Next to childbirth, broken ribs are the next most painful thing I've ever experienced, truthfully, and I only had 1. When my DH had 3 broken ribs last summer, he was lying down in bed on his back and could NOT catch his breath.........by the grace of God I had gone into the bedroom in the nick of time to pull him up so he could finally gulp in some air!!

My mother wound up cracking a few ribs a while back when she fell in her apartment at the ALF and didn't tell anyone (this was prior to being in Memory Care). She was complaining bitterly for months about pain on her side, so the doctor wrote a few orders for Icy Hot patches which she was having applied on her ribs a few times a day. Nobody knew at the time what the problem was; she is very good at hiding the truth. When she was hospitalized in May of 19 for pneumonia and had a CT scan, that's when the doctor saw that she'd had broken ribs (and sternum bones) in various stages of healing!!

I guess pneumonia developing WOULD be something to watch out for, because it's very hard to take a deep breath when it hurts so much to do so. Shallow breathing can easily lead to pneumonia, especially with the elderly. Generally, it takes 6-8 weeks for ribs to heal and there is nothing that can be done to speed up the process or to 'cast' the bones, wrap them, nothing like that. Unfortunately.

I think you did the right thing by signing a DNR, hard as it is to do. CPR on an old person is brutal, as the doctor explained to me when I was fighting to NOT have a DNR signed for my dad. I went ahead and did it, after the CPR process was explained to me, and my mother also has one in place for herself.

Wishing you and your dear mom the best of luck with her recovery.

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