How do I know if my mom needs rehab for her ankle/foot pain?

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Mom currently lives in assisted living. Mom went to the ER yesterday because she couldn't get out of her recliner. She said she "couldn't make her leg work." So, after a battery of tests including blood work, X-ray of foot and ultrasound of leg (to rule out blood clot), the hospital determined there's nothing wrong with her foot and all other vitals and blood work looks good so she can be released to rehab care. Also, she sat in a wet depends for so long that she had a scorching diaper rash and the hospital was alarmed at this. They kept her overnight for observation, mainly because she couldn't get placed into a rehab facility. She wants to go home. She has done the rehab thing before and hates it. Not the therapy itself but the skilled nursing environment. I also want her to go home but right now she can't put weight on the foot. She can't walk to the bathroom or any distance without pain. If her foot is not broken, what could be wrong with it? I asked them about gout and they say it does't look like that and are not even interested in testing for it. It came on overnight. So, one day she was fine, the next day she has ankle/foot pain that is so bad she cannot walk. Do I ask for another doctor consult? My plan today is to ask for a physical therapy consult and see if they can get her on her feet. If she can manage, I'm going to insist she go home. If she cannot manage walking with her walker I guess she will have to go to rehab. She is able to change her Depends by herself but if she is in pain I can see how she would prefer not to get up and will just sit in a wet Depends. At her assisted living place, they will wheel her to meals but they won't take her to the restroom and change her Depends. What should I do?

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Personal experience here:
My foot was x-rayed, negative. A year later my ANKLE was x-rayed after a fall, and there was the "old fracture" on the other side of my ANKLE. Having been sent home with pain killers, (not good for me),  I have always wondered how many x-rays, how many body parts x-rayed would it take to get a proper diagnosis....and treatment.

Recalling Dmanbro's mother was sent to rehab and screamed in pain when physical therapy was tried...this went on for quite awhile....as many thought she was faking.  Turns out she had a broken pelvis.

Advising an orthopedist consult to discover the fracture; and determine if she has ostopenia causing bones to break and get that treated. Request consult while she is still in the hospital,
if it is not too late. imo. imo.
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She is not that mobile. Uses a walker. Its leaning more towards gout. She hasn't been released to rehab yet. She also might have a low grade Uti. Running another test for gout. This might buy her another night at the hospital and maybe she can get on her feet. She could put weight on it today. I swear the most important thing for elderly folks is having a patient advocate. She has dementia and cannot explain how she feels. If I hadn't been here yesterday, the ER would have just discharged her to rehab. I'm an only child so I'm the only person that can sit at the hospital, ask questions, advocate for her care. It's exhausting.
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That is so true about them not being able to describe or point out the pain. But a good orthopedist should be able to examine your mom in such a way that she will react when the dr manipulates the problem spot. They should be able to tell where the pain is coming from: muscle, nerves, bones, or something else. Once they can determine the source of the pain, then they will recommend what kind of rehab would be useful. I do not understand why the doctor sent your mom to rehab without a diagnosis - it could do more harm than good.

If she has a stress fracture, it might not show up on the x-ray (unless it gets worse). Those are painful and are usually treated by babying the foot -- plenty of rest, keeping weight off that foot. So if that's what's causing her pain, rehab will not help her foot. (Though doing PT exercises for her strength might be beneficial, especially if she's not getting around much.)

Your poor mom! Was she pretty mobile before this happened?
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Just a thought. That sudden onset and inability to tolerate weight on the foot is exactly what happened to me and I went online and figured out it was plantar fasciitis. (Doctor confirmed that when I went to her.) VERY painful, especially when one first gets up in the morning or from a long sitting spell. Like needles and pins shooting into every inch of your foot with the slightest pressure, yet there's nothing visibly wrong. What worked for me is a combination of (1) frozen bottles of water rolled back and forth under my feet (Wow! The relief!); (2) stretching my foot both ways -- pulling the toes up toward my leg then down away from my body 5-10 times; (3) Stretching exercises on the stairs, especially standing with toes on stairs and letting body weight stretch the heels down toward the floor. (Remember to hang onto something as you're doing this.). Your Mom may not be able to do all of this, but if some of this does help, it might indicate that it was, in fact, plantar fasciitis. Good luck! There's nothing worse than knowing you hurt and having someone in authority start hinting that you're faking! NOT their job!
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Good point. One of my daughters walked on a broken ankle for a month after a negative xray.
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If the x-ray showed nothing, they should have done an MRI. That would show a torn tendon or ligament (very painful). Also, an orthopedist should evaluate her for plantar fasciitis, a symptom of which is a stabbing pain in the bottom of the foot. Emergency rooms will only do enough testing to rule out an emergency, or something that needs acute attention right then and there, such as setting a broken bone. They should have advised your mom to follow up with an orthopedist. He can check for tendonitis and plantar fasciitis and he should also order an MRI to see if any of her tendons or ligaments are torn. I would insist on all of those things. You can't move forward with treatment if you don't know what the problem is, and pt isn't always the answer. Good luck.
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Did they stay anything beside her foot? Her knee, her hip? Dementia patients are notoriously bad at localizing pain.
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Also, by observation, experienced in the E.R., that original x-rays did not show a fracture, but they showed up 3 days later on several patients, as told to me by the E.R. physician that I worked for when these patients came to the office. Just F.Y.I.
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Did the E.R. wrap the foot, ankle?
Immobilize it?
Guessing not.....
Insist on, advocate for a second opinion.

You or others may ask why this is important if she has alzheimers...it is important.
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ALG1447 yes being in the hospital for days and having to be her advocate IS exhausting. I've been there too and know exactly how you feel. On top of that hospital staff, just aren't like they used to be and an advocate is necessary. I hope they find the source of pain soon...and you can get a bit of respite afterwards. If you have to pay extra for her incontinence needs or hire a caregiver to be with her during the day, it's essential you take care of you. I nearly had a mental breakdown after my dad's hospital stay. He had his appendix out at age 95!!! "Calgon take me away!"
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