Saturday, May 30, 2009

R/O TBI


My sister called to say that my mother fell out of bed this morning and hit her head. Mom had a cut and a large bruise, and was on the floor for about two hours before my sister found her. "The cut was superficial, and I cleaned it up. The bruise looks awful, but Mom's fine: alert and talking, better than usual, if anything."

I spoke to my mother, who confirmed all this. Being on the floor had been scary, but she was fine now. My sister had cancelled her Saturday plans so she could stay with Mom and watch her, but didn't plan to take her to the hospital, even though there was no reliable way to know if Mom lost consciousness when she fell.

My sister's the mellow, laid-back, watch-and-see kid in the family. I'm the one who panics and starts doing obsessive research, and my default position is always, "when in doubt, go to the hospital."

So I cranked up Google and turned up all kinds of articles, like this one, saying that any head injury in an elderly person should always be evaluated in an ER, because a subdural hematoma (a brain bleed) can go undetected for hours or days before causing sudden death, and there may be only a small window for treating it. If you wait and see, you may be too late. It turns out that Traumatic Brain Injuries from falls are a major cause of death in the elderly.

So I called my sister with this cheery information. She put Mom on the phone, and I explained the issue. "Oh," Mom said, politely.

"Will you go to the hospital?"

"Hell no!" said Mom, less politely. In the background, I could hear my sister laughing.

"Mom, do you understand that not going to the hospital could mean that you'll die, or wind up gorked out from a brain injury, even if you feel fine now?"

"Sure," Mom said, and that was that. I talked to my sister, who was unwilling to go against Mom's wishes. I hung up. I sat and chewed my fingernails until the phone rang just a few minutes later.

It was my sister. "Okay, she's going."

"Thank God," I said, and meant it.

Of course I hope there's nothing wrong, but only a head CT will tell us for sure. I know it's inconvenient and uncomfortable and a lousy way to spend a Saturday, but I'm still glad she's getting checked out.

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