Minor Complications

This morning when I went to change the dressing on Mom's thumb I saw that sometime during the night it started bleeding again and had soaked through. When I took off the soiled dressing it started bleeding once again. I folded a paper towel to make a pressure bandage and had her hold it on her thumb to stop the bleeding. In the meanwhile I had noticed that her right hand (the one with the injured thumb) was much warmer than her left hand, in fact it was hot; it was also swollen and a little red. I took her temperature and she had a low-grade fever of 100.2 F so I called the Kaiser help line. I left a message for Dr. Pham, Mom's primary care physician (PCP).

When the nurse called back about an hour or so later she asked a bunch of questions and I took another temperature - now at 101.3 F and both hands were equally hot. She made an appointment for Mom to see the PCP at 2 pm. I completed the new dressing. (I had left it off in case they wanted me to describe what it looked like.) I bagged up the blood-soaked paper towel so Mom's PCP could see how much leakage was going on.

In between all of this Aunty Judy called. Friday is a free day for her so she was calling to say she would be bringing lunch over for us; which was great since I was so busy taking care of Mom's injury. Aunty Judy brought ribs from Tony Roma, corn niblets from KFC, and 3 kinds of sushi. She was able to stay and visit with us for about 1 1/2 hours before Mom had to get ready to go to the doctor. (I cut a ziploc snack bag in half and taped it over Mom's thumb to create an extra large finger cot to keep the barbecue sauce from soaking in to the bandage. If not, it would have made it difficult to tell where the barbecue sauce ended and the blood leakage began!)

Mom's fingers in lower right, unfortunately you can't see my improvised finger cot!

Dr. Pham checked Mom out and also called the oncology office to confer since Mom had a compromised immune system due to the leukemia; she talked with Dr. Beal since Mom's oncologist Dr. Chan was out of the office. There were 2 options: 1) check Mom in to the hospital to start an intravenous antibiotic drip to knock out any infection, or 2) do some blood work to see if she had a bacterial infection causing the swelling and fever while giving her an intramuscular antibiotic shot now to be followed by oral antibiotics for 10 days, with the knowledge that if that did not knock out the infection she would have to get checked in to the hospital to do the IV drip. Mom chose option 2 because she wanted to go home. Leo, Dr. Pham's nurse, was great! He arranged for the lab tech to come upstairs to do the blood draw and also had the nurse from the shot clinic come over to Mom to give her the shot. He also did a nasal swab to check if she had the flu since it is going around and could be responsible for the fever. He also got a wheel chair for us to use to get Mom around with as little effort on her part as possible. (He could tell she was already losing steam for the day.)

I have changed the dressing for the evening. It had leaked again but was not as saturated as it was earlier in the day. Dr. Pham said I also needed to make sure the red line on Mom's arm did not go any higher (it was at her elbow) and the swelling of her hand also needed to stay the same, so I took out the mini-Sharpie that I carry with me and marked both while in her office. Dr. Pham chuckled, she said that's what they did in med school to keep track of both those things! The antibiotics seem to be working because the red line has now disappeared. The swelling is still there, however. Mom slept most of the afternoon since we got back. She skipped dinner and opted to sleep instead. She usually eats very well so I can tell that the fever is affecting her.

Things I need to be on the lookout for:  high fever, red line going past the line I drew on Mom's arm, swelling of her hand extending beyond the line I drew on her hand, excessive bleeding from the cut especially if I can't get it to stop. If any of these happen I am to take her to the ER immediately. Or if the lab calls and tells me I need to take her to the ER immediately. But for now we watch and wait.

I have been trying to figure out how Mom cut her thumb open so thoroughly. This is what I think happened. When Mom looses her balance and starts to fall she throws out her arms to try and catch something to keep herself from falling over. In the house it is frequently the hallway walls which accounts for the large bruises all over her arms. In the garage it is the cars as she walks between them. In this case I think she hit the edge of the green waste bin as she was flailing. If you look back at yesterday's photo you will see there is an edge at the top of the bin; this could also account for the blood spatter on the bin. I checked to see if I could find blood along the edge but it has been raining on and off today so I did not see anything; even the spatter on the side of the bin is washing away.

Happy Birthday to Sandy and Michael!