I get a call from Cathy who tells me she has called 911 and Bruce is on the floor in the bathroom. Off I go from work and met Jen in the parking lot, who figures out immediately what is going on and actually beats me there. This has not happened in a long time, as a matter of fact, we all have been working on letting Bruce do more for himself.
As we are waiting for 911, Cathy and Jen remind me that we just upped Bruce's Baclofen dosing. In all fairness, we girls could have gotten him up, but 911 arrived just after me and we let them do it. Bruce was transferring to the toilet, when he listed to his weak side and Cathy just eased him down. Medics got him to the shower bench in the shower and then Jen and Cathy got him to the toilet, while I did the paperwork. His right arm is bruised and his butt, but having professional and well-trained help made it much easier. Cathy could have said, he weighs 200 lbs and I weigh 100 lbs, so just let him go. This is, afterall, a part time job and I can't jeopardize my full-time, real job. But as a pro, she knew just how to take him down to avoid injury to both of them.
Lessons learned: the new Baclofen dosing is kicking. He is more incontinent, a side effect of the Baclofen and his muscles in his leg and arm "feel" different. This, I am hoping, is the medication kicking in. Bruce is used to the leg being a "log". Now it has tone, is looser and just "feels" different. He does not know what to do with it. Does he trust it to weight bear like he is used to? We, as caregivers, still need hands on until the new dosing kicks in. I will spend the weekend working with Bruce to allow him to feel and become comfortable with the new tone.
I know, as Bruce works towards more independence, that falls will happen. This reinforces that he still needs help here and just maybe he will consider some new PT-OT help now that the Baclofen is helping. One thing I am sure of is that we are starting from square one and all need to be on deck as to the new situation we are in. Back to the spotting and hands on movement. This will be tough for Bruce, he is so used to us all just backing offand letting him do it.
The incontinence-only 2-6% experience this as a side effect of Baclofen, but Bruce's immune system is so sensitive and I am sure he is in this category. I have packed extra Depends and maybe we will have to double pad him for a bit. The Texas Catheter is always an option, but it will take him back and perhaps even never allow him to consider working on the incontinence, since well I have the catheter, who cares? He has a Urology consult next month, so probably will just insist he toilet every 2 hours until then. I can do that, as he won't refuse me, but with the caregivers, that is another story.
I blog this as a Nurse: what do you see, what is the response. Objective vs Subjective. I go to bed at night, crying. Again he has no sensitivity as to what I am trying to do, what it costs me emotionally. All I want is one gesture of knowing how hard this is. Being responsible for another life. Trying to make decisions objectively when one only feels that she is alone and spitting in the wind. While I am driving home tonight-one mile mind you-I am out of my mind that he is hurt-is he really OK, should I have stayed home, let him go to the ER? And when I get home at 7:30pm, he says no, I was OK, not scared and you made a big deal out of nothing.