Nurses, Folks with Medical Experience, Good Guessers even...

[Camelot Farms]

Wondering if this rings any bells for anyone.

Grandpa (age 89) was taken from the Nursing Facility to ER for intense pain in his hip and leg. Thought his hip was out again (for the 30th some time) but xrays say no.
He has a bruise on that hip and a large growing mass on his buttock. The mass is under his skin, sort of like a fatty tumor but fluid filled.

Docs planned to drain the fluid but needed to reduce his coumadin to do so. So his coumadin levels are low for him but the draining has not been done.

The ER has run blood tests and scans and can find no source for this pain. They ended up putting him out with morphine as the pain was sending his BP high...189/110 and normal for him is 100/60. So, they are bandaiding the symptom since they cant find the problem.

This is a small county hospital with NO pain management expertise. I'm not being facetious or snide. They really dont.

Do any of you have any thoughts as to what could be causing this pain/these symptoms? I imagine that they have looked at clotting since the coumadin levels are low.

This is a man who flicks pain away with the twist of a wrist. Nothing gets him down so if he is saying he is hurtin and he is cryin then its bad.

Thanks for anyone who can chime in here with some thoughts.

 

[maple]

It's unusual but it can happen and I'm no medical person but people can get fatty tumors and I wonder if that could be what it is and if it is pushing on a nerve. Hip/leg pain can also point to sciatic nerve problem.

I think he needs to get transfered somewhere more capable.

Hugs and prayers for him and you,
gretch

 

[WingingIt]

The mass pushing on nerves was my first thought, too.

 

[Boyd]

Blod clot?

 

[seminolewind]

Quote:
I agree. Maybe on the sciatica. Let's see, there's a fatty tumor, a bruise, and pain. Hmmm, what would you think?

I have carpal tunnel. Whatever nerves are being pinched, I can't tell you how bad it hurts. At night, I have to get up to make the pain go away.

He could also have inflammation of his hip joint, that would hurt real bad too.

 

[Beekissed]

Regardless of what this is, I doubt they recommend much testing or even surgery, due to his age and general health. The question is this....do you want to go on a fact finding mission and maybe...just maybe find the problem and pursue treatment? Or do you just want to relieve his pain and let him not spend his latter days submitting to tests, treatments, surgeries?

Was there a mass/edematous area prior to the bruising and pain? Did they reduce his coumadin just to drain this mass or did the mass and pain start simultaneously? Not sure from your post.

The morphine is a good start and seemed necessary to get him out of a pain crisis. Very soon his doctor may be asking you the questions I asked in the first paragraph and you might want to think about this. His hip has "been out about 30 times" in the past, which is very painful, he is on coumadin therapy which seems to indicate he has an issue with clotting ~cardiovascular problems?~and he is 89 years old.

Things wear out, things start to go wrong, age prevents most of these things being fixed....sometimes the best you can hope for is palliative care, like pain management. Do you want to try to "fix" this aging man or do you want to provide relief from pain, because rarely do you get both at this age.

 

[arabianequine]

abscess? (sp) although they are very painful I am sure would be red and hot to touch and blood cells elavated

 

[PineappleMama]

I agree. Maybe on the sciatica.

That was my first thought... when DD planted her head on mine I hit the floor.

Could be the tumor thing doing the pushing... hope they figure it out very quickly.​

 

[twentynine]

Can't spell worth a nothing. So don't laugh.

Sebateous cyst?

Maybe, 89 years old, arthritis?

 

[Sjisty]

Maybe draining the abscess will relieve the pain. Sometimes small country hospitals are better than the bigger ones - you get more one-on-one care. Don't count them out yet.