Sudden Change in Function
A medical event occurred with a client I had been working with for over a year. Even though she is medically complex and had surgery the month previous, she still walked independently throughout her house and lifted 6# with her leg weights. Suddenly she was experiencing shortness of breath while walking and doing easy exercises–this was a very severe change.
The family made an immediate appointment with a physician. I sent a note along explaining the change, but depended upon the husband/family to emphasis her change in breathing. Unfortunately, the physician did not have my client get up or walk (even with the families urging). The appointment resulted in no explanation other than the physician stated the shortness of breath was due to her “not exercising/moving enough. “
Over the next 2 months her breathing continued to be labored and the family became frustrated with me because I kept voicing my concern. “Nicole, we have mentioned it to several doctors and they don’t think anything is wrong…what should we do?”
One morning, I walked in to exercise with my client and I noticed her left leg was swollen. The husband had noticed it the night before and was waiting for me to arrive. This symptom immediately raised red flags for me. We got her in the car and went straight to the emergency room. Fortunately, the client and husband allowed me to come with them and I knew this was my opportunity to get a full assessment of my client’s situation. The client allowed me to share her history and my concerns with the intake person, nurse and physician. The outcome: my client had multiple blood clots in her leg and lungs. The lung blood clots were likely the reason for the shortness of breath for the previous months.
Suggestions for Families
The family was very appreciative with my advocacy and wanted to know what they could have done differently. They felt they had stated her condition similarly to what I had presented
I will share with you what I shared with my client family: As medical professionals there are “key” words that get our attention faster. We are looking for “acute” or sudden changes in mobility, cognition or function.
“This is new”
“Can’t walk or stand, but could last week”
“This is not normal for her”
“This is symptomatic of when she has an infection”
Key points that will help:
· It is important to have only one person explaining the changes,
· Stress the severity in the change or symptom,
· Trust your gut. If you think something is wrong, ask questions as to why something is not wrong, and
· “Getting old” is not a sign of a dramatic change in function.