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My mother fell and broke her arm (just above the elbow) in March. Since then she has been in a "cast" which is made of molded (curved) hard plastic and attaches to the upper and lower arm with Velcro straps. There is a hinge at the elbow that the doctor periodically adjusts to allow more movement.

When she first broke her arm, she was told to keep her hand elevated to avoid all the blood draining down to her hand. In short, she didn't do what the doctor told her to do. Her hand swelled and turned all sorts of colors.

I tried to get my mom to move into a nursing home (short term) but she'd have nothing to do with the idea.

Her doctor set up in-home physical and occupational therapy. The aides called me (I'm her POA) because it was obvious to them that my mom couldn't take care of herself while still living in her apartment. With their help, we finally convinced mom that she needed to have 24 hour care and she reluctantly went into a nursing home where she was able to receive the help she needed plus could get physical and occupational therapy on site.

But, because she had to pay for this herself, she left after 3 weeks and went back to her apartment. She's been there for about a month now and has not had any therapy at all and I doubt that she has been doing the exercises that she'd done while in the nursing home (all of the weights and sponges she'd been given to use have been stuffed into a drawer.)

I also noticed that my mom isn't using that hand at all to grasp things (like the handle of her walker or the handle of a grocery cart). When I mentioned this to her, she said that it hurt to do so and was content to just rest her forearm on the handles.

After about two weeks back at home, she started complaining that her hand hurt, her fingers were numb and she couldn't sleep. We called her bone specialist who made an appointment with a hand specialist and, last week, I took my mother for a nerve test, xrays and a meeting with that doctor. We were told mom now has carpal tunnel syndrome.

She has more exercises she's supposed to do and was given rigid wrist splints that she's to wear at night.

Since she didn't do her exercises before and probably isn't going to do any exercises now, what will happen?

She refuses to listen to me. I've told her that if she doesn't use those muscles, she's going to lose use of them.

She also refuses to take Ibuprofen (which the doctor said she should) or will take 1 pill in the morning and believes that it will be enough for an entire day. She believes that if she takes more she'll become addicted.

Any suggestions?

P.S. I did get her set up for in-home physical and occupational therapy again, which will start tomorrow.

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My mother has severe carpal tunnel syndrome with a pinched nerve. I believe it was the same wrist which was broken quite a number of years ago, so that may have been a factor. Mom's symptoms are considerably worse at night, which I have been told by doctors is common. However, she also refuses to wear the splint at night and do exercises. She now has weakness in that hand, chronic numbness and pins and needles, and pain at night. Last year, her g.p. referred her to a specialist for surgery. However, it was a bad day, mom was confused and it was agreed that we should cancel the surgery, that it would be too traumatic for mom. I was also told that a respite relief worker that her brother had the surgery and the carpal tunnel came back. In my mom's case, the condition is progressive and chronic. We even tried acupuncture, to no avail. So maybe, even if mom had been cooperative and did the necessary exercises, I may not have done any good anyway.
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I also had carpal tunnel its very painful and can affect your whole arm and up to your shoulder .permanent nerve damage... Take your Mom in and get the 15 min. Surgery..I'd give anything to have my Mother back. Redappel
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IF all else fails, the new carpal tunnel surgery is done laproscopically with just a tiny incision, releasing the band holding the nerves to the hand/wrist. Yes, in we older persons, decades of using our hands and wrists do take a toll on them. Whatever you do, do not put your hand out when you are about to fall, trying to brace yourself. Your wrists will not take the weight of your body which I learned fracturing both wrists. THE most difficult bones/tendons/ligaments to heal because our hands have so many tiny bones and the ligaments and tendons all need to work in concert to function. Please just do not put yourself in a position to fall. My left wrist fracture was 1997, the right 2003, and in 2015, I still have some trouble when I try to do too much. FYI - each stomach is unique, and each person's ability to tolerate each medication is unique to that person. In my medical practice (nursing), my patient's have just reported more problems with acetominophen and I know how it affects my stomach. I just do not take it. Cheers!
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Naproxin is one of the most irritating to the stomach.
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Some definitions: Naproxin Sodium is taken once every 12 hrs. and Ibuprofen is an anti-inflammatory taken every four hours. Acetaminophen is toxic to a senior's liver and should be used with caution. It also has a higher nausea/stomach upset side effect to it. Exercise is your best pain reliever. Let the body heal itself. Taking a vitamin in pill form NEVER substitutes for the real thing - i.e. vegetables, fruits, milk & eggs. Try those first...
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Just be aware, if she turns down therapy, they won't continue. They have to justify it with Mdicare.
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Wow... sorry I typed such a loooong post... I'd taken my ibuprofen an hour ago and it really does help mask the pain so I can type, obviously...! : )
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I have had carpal tunnel in both hands (and trigger fingers multiple times and two new trigger fingers have begun recently). After YEARS of exercises, sports medicine appointments and exercises, hand splint-wraps of all kinds, especially at night and for a while I had to use them at work (until I couldn't work anymore)... I learned that MOST ALL of those "exercises" I was told to do actually exacerbated the carpal tunnel problems...Have you studied WHY/how carpel tunnel exists in a person's wrist? It's the band of tendon-like material that wraps around the wrist and for some people like me (a former professional pianist and typist), it can occur earlier in life (before I was 40). For older folks, it can just be degenerative... a result of a lifetime of use... The only PARTIAL relief that works (and definitely not a "cure" and all pain never goes away) is surgery - where the surgeon cuts the carpal tunnel band that has become too tight... (causing the numbness and pain) and the resulting scar creates some space - and the partial relief of some pain and most of he numbness. I finally had carpal tunnel surgery on one hand back in 2004 and then surgery for trigger fingers later and two years ago had another carpal tunnel surgery on my other hand. I've been through it all. Some of my hand's muscles have atrophied from years of nerve damage. I watched my father deal with this and my mother who had NO compassion for any of his struggles, berated him for dropping his coffee cup and having trouble holding his tooth brush... So sad. I'm 57 now and even though I had two carpal tunnel surgeries, I can't play the piano well anymore - those days are over. I have difficultly holding a tooth brush, razor to shave my legs, tweezers to pluck eye brows, coffee cups, pots, pans, and forget about twisting the tops on jars tightly, opening or closing doors, buttoning shirts, pinching the edges of anything to pick them up, turning the page of a book... Please consider that her pain is real, and there may not be any "easy solutions" or exercises that will give her any significant relief. She may, like me, be embarrassed about not being able to do such simple tasks and probably has had pain for a long time that she never told anyone about... I know it's not easy caring for ANYONE who is physically and/or mentally compromised... Folks like me really long for someone to just be kind to us and say, "So sorry you're hurting. Here, let me open this jar for you...."
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For neuropathies, hyuralonic acid has been very helpful to me.
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The power of the mind is INCREDIBLE.
Ferris knows.....Hi there....
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LovetoPlay, perhaps you can ask the PT and OT folks if they can use any modalities to decrease your mother's pain? I don't know if TENS or U/S are used for wrist pain, but I did have an unusual modality as I now remember and it was helpful.

I had my wrist therapy at a doctor's office; the therapist had a machine that bombarded my inserted hand and wrist with ground up corn cobs. No, this isn't some new age thing. The corn cobs apparently acted as a massage, loosening up the tension in my hand and wrist. Then the therapist gently massaged the affected areas.

I've seen ads for portable TENS units, so perhaps one of the therapists can bring one if he/she feels it's advisable. If your mother feels better right away, that might be a turning point for lessening her resistance to PT.

Good luck - let us know how the PT and OT visits worked out.
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Interesting comment on B-6. I found that B vitamins can affect what was diagnosed as neuropathy in my lower legs and if this old memory isn't failing me yet, in my arms as well. But it wasn't B in the form of a vitamin, it was an increase in B vitamin foods - lots of good healthy B foods. In fact the increase in B foods was more effective than the B vitamins.

I'm a firm devotee of the Popeye diet!
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There has been research on vitamin B6 in treating carpal tunnel successfully. I have used it with some success for knee pain. It helps the body rid itself of excess fluid as I understand the material that I read on it. For pain due to inflammation, I use neproxin. My doctor told me it is safer on the liver than IBP.
Your mother may be eligible for some home physical therapy if her doctor will recommend it. Every time my mother is hospitalized she gets PT and OT paid in full by medicare and Blue Cross.
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amazing how these oldsters act like bloody 2 year olds and everyone else pays for it except the oldster.
sometimes everything has to be let 'crash' in order to get any help for them. They have to fall and stay fallen, they have to be judged incompetent. That is the only point you can send them somewhere despite all the protestations.
Sometimes I wonder if the easiest is simply to disappear. If we care, that is impossible. but sometimes, we wonder.
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Oh, for those of you who know my writings, I am on a strange computer in Colorado visiting my sister-in-law, with rain coming down, and reeling from the high altitude. I am not responsible for typos on this antiquated computer which she bought from the library and the keys are so dirty and sticky (I'll try to clean them today). Husband is very disoriented, but I had to let him see his sister and relatives for one last time. Cheers! Ferris
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Boy do I have first hand knowledge of this situation (no pun intended)! Although my first wrist fracture resulted in super pain which I then went to five different doctors after my pin surgery to heal the fractures, but still had the pain. Finally a pain specalist recognized I was having "parasympathetic pain dystrophy". Even with ganglion blocks (where a needle is put into the throat area - had two), that did not solve the problem. No anti-inflammatory will solve this problem either. How did I get rid of the pain and swelling? Every night before falling asleep I would tell myself (while stroking my hand-the affected one) my wrist would never be exactly the same, but that it would get better. The mind-brain connection is VERY powerful. It worked! No swelling, no pain, and then I suggest you get her a little ball made out of the soft material to put in her hand and let her just press it over and over during the day. Most doctors want to do surgery for carpal tunnel and if the nerves are actually being compressed (usually from the swelling) rush to operate is not a good idea. Tell your mother she has to talk to herself and tell herself she will get better, but she has to work at it. This problem will exist as long as she thinks she will not get better. Again, I lived this pain. I solved it without surgery, meds, and it took time, but my mind solved the problem. My best to your mother. Please try this as I know you do nott want to see your mother in pain, but she has to do the work too. Then all you can do is remove yourself from the situation. I agree she can manage at her apartment because this lady has a mind of her own, and that is why I know she can resolve her arm issue on her own (mind). Best wishes!
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We live.
We die.
IBP is toxic to the kidneys.
Everyone carries pain differently.
If she chooses not to do the prescribed exercises~that is her choice.

Getting in home PT & OT setup is the best you could do & you have done this.
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This is me and my obvious character flaws talking ... but I have a mum who is also willfully non-compliant in the face of her simple actions that would have beneficial results. Its intensely irritating to me ... where does this come from? I seems like their teenage selves have come back to torture us for how they must have felt when we (dropped out of school/refused to do homework/all the other stuff we did that undermined the potential of future ) that could be put down to sheer laziness or defiance of authority. Or maybe its a lack of the energy that is required for even simple things.
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First of all, you can set your mother's mind at ease about her medication. Ibuprofen is not a medication that has addictive qualities. In fact, none of the NSAID (non-steroidal anti-inflammatory drugs) are addictive. It is the narcotic medications that cause dependence problems & Ibuprofen, Aspirin & Aleve are NOT narcotics, they're NSAID's.

As for the carpal tunnel....whether is goes away on its own is rather dependent upon what, exactly, is causing the carpal tunnel symptoms. The carpal nerve runs down the forearm & through a narrow "tunnel" of bones as it passes through the wrist & branches out to feed the fingers of the hand. As we age, that tunnel can narrow from wrist fracture, arthritis, etc. Any narrowing of that tunnel will compress the nerve & cause the tingling & pain that is so characteristic of Carpal Tunnel Syndrome. The rigid wrist splints she was given are designed to cock her wrists back to open up that tunnel & relieve her symptoms.

From what you've said, I suspect your mother's carpal tunnel is not from a physical defect of the tunnel but from significant & ongoing swelling & inflammation brought on from the fracture well above the wrist (at the elbow) that her lack of cooperation continues to compound. The therapy that you've arranged for will help but, without her cooperation when she's not at therapy, the improvement is likely to be slow & minimal. Unfortunately, like the old adage about leading a horse to water, you can arrange for desperately needed elderly services & therapies, but you can't make them cooperate, participate or follow doctor's orders. I know it's little solace but I know full well what you are going through with a parent that's refusing everything they need, insisting everything is "fine" & convinced they are capable on their own when they're not. Sadly, I have no magic answers for you any more than I do for myself. All we can do is hope that someday when we lead our elders to assistance, they will drink.
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I wore the rigid splints to bed, and took something for pain so I could use that hand comfortably. The carpal tunnel issues did clear up. I have a friend who had to have surgery -- it was a fairly quick procedure.

So the carpal tunnel will probably clear up.
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Yes, it will, with proper treatment and proper exercise. I wore a splint for mine, and believe I did some exercises but don't recall all the details, nor do I recall whether I had therapy for that or for tenosynovitis, which I had in the other hand.

If she's uncomfortable taking pills, try to get her to take as many anti-inflammatory foods as possible. They aren't as powerful, but they will help.

There are some that are much worse than others - refined sugar for one. If you can control her diet and reduce some of the inflammation, she may begin to feel a sense of hope.

Your mother may feel overwhelmed with aging and its side effects and feel that it's "no use". I wish I had some suggestions but right now I don't. I know it's hard to get someone to cooperate once the mind is set and made up. And that's the first step.

Do you think you could get her to go to a therapy facility? She may enjoy that more than home PT. Typically the therapists fuss over older people, so perhaps that attention might break the stalemate. Perhaps just getting out and socializing would be an incentive to continue with PT.

And perhaps you could take her someplace special after the therapy sessions - use them as the basis for a reward. Sometimes we go to the Dairy Queen for our rewards - it really does help to set a good mood of course, all that sugar in the DQs helps as well)!

I don't wish to be blunt or insulting, but has your mother always been resistant to cooperation? Or did it start after the arm fracture? Unfortunately, this seems to be the key to recovery, and I know it's really difficult when someone doesn't want to do what's necessary.

I'm wondering also if she's in denial about the state of her arm?

Wish I could think of something to help but right now I don't have any really good suggestions, but I do hope others will offer good advice such as Maggie has done.
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Carpel tunnel will often go away. If the cast is causing it, it may go away when the cast is removed. insist that mom keep appointments with the rehab people. Insert yourself into the process as quickly as you can so that she doesn't cancel them. Make them your new BFFs. See what they have to say.
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