My mom is 97. She fell recently and has a compression fracture of the first lumbar. Tramadol and Tylenol 3 have very bad side effects on her which led to two more falls resulting in three broken ribs and a nasty bump and a staple on her head. The pain has made her crazy but the pain meds have made her crazy and mean to the point of violence. She is currently in the hospital with restraints and occasional haldol so she can rest. What else can be done?? Everyone including doctors seem at a loss. Prior to this she had minor age related dementia with no diagnosis of dementia. Now she is full blown dementia with paranoia, hallucinations and violence.
Well I am disabled with a spinal cord injury. My lower spine was crushed when I was 6 months pregnant. So severe my unborn baby suffered a traumatic brain injury. Although we only learned that after he was born.
My lower 5 vertebrae were crushed beyond repair. I had to wait months for surgery. 12 years later and I am still on pain management. I have gone through dozens of medications and too many horrid side effects and reactions.
There are a few less common drugs worth exploring and some nerve pain meds that might prove better for her.
1st with her age, some medications may be to risky. But a combination of muscle relaxers might help. Dilaudid, is a less common pain medication that works on different receptors. A very low dose of fentanyl patch is an option. My mother who died of breast cancer broke a vertebrae towards the end and used a 12.5 mg patch every 72 hours. ,methadone is a good one, but typically an ekg is needed first. Lyrica can be a stand in for some. Also ask about lidocaine patches over the hurting spot. Some OTC ibuprofen patches might offer some aid. Even a Tens Unit has benefits.
What would be great is if your mother could get into a pain clinic rather a regular Dr or orthopedics. They are run by highly trained anesthesiologist who can find the best solution. Even nerve blocks in the back can be discussed.
Miralax is great for keeping stools soft and not harsh to the aged body. 17 grams in 4-6 ounces of juice is all it takes. Also, diet sodas are he'll on bad backs. They increase constipation, which itself is he'll on broken vertebrae.
Another option is the resting back brand brace. They help too.
Is she getting any physical therapy? What type of bed is she sleeping in and is she avoiding sitting in hard chairs?
Life for me is harsh, pain wise. So I pray she finds comfort soon. If things don't improve get her to a neurosurgeon and spine place. Neurosurgeons are more highly trained than a regular orthopedics spine Dr.
17 years in the medical field have shown me over and over the best outcomes are through them.
There is one last thing I finally did for myself and my boys. We had the Dr do a DNA Profile on us to test which class of medication would be best for us. It proved life altering. Now we skip the guessing game and have those results to guide choices. Medicare and Medicaid both pay for this testing. Genetic Concept is the preferred one here, but your providers should have this available. Some places use the term Genocept for short.
I hope she can avoid prolonged suffering so close to her earned rest.
Let us know how she comes along. Thanks for taking such good care of her.
WITH the pain meds.If you can get
THC/CBD oil tincture,get a 1:1 and
use 3drops under tongue.Increase
dose 1drop at a time for 4-5days at a time until desired effect...the 3
drops should be fine.Get 3rd party
lab tested CBD so u know exactly
what you're getting.
They have vape pens that are an excellent delivery system for both.
They are not addicting and should not cause any mood changes. The patches are OTC (over the counter) I buy the Lidocaine Patches several boxes at a time over the internet to get the price below $1.50 per patch, the Menthol Patches are more reasonable -- I would say get a box of each and see which helps the most.
I know the elderly tend to have a negative psychological reaction to a lot of different medications and it’s has to be worse for them when they are in pain and physically restricted. I hope the right combination of treatment is found soon. Hang tough!!...??? (I know it feels impossible sometimes!!)
I see you are already thinking and investigating UTI, good because it is very likely more than one thing going on here now, so often any hospital stay at an advanced age now means several rabbit holes to follow...the cognitive decline/signs and symptoms being common which is why it is so helpful to have someone that knows them well around to advocate for them a lot. This is not always because the hospital is a bad one or the wrong place for them even it's just a fact of life for the aging I think and yes some hospitals and facilities are not great places to have to be many of them are very good too but still new surroundings and any imbalance in their bodies are things our minds just don't deal well with as we advance in age.
Tramadol was a Godsend for my mom, obtw.
Maybe ask for hydrocodone or oxymorphone which are synthetic forms of codeine which may not have the same adverse effects as codeine in her case.
Also a lidocaine patch to the area or a low dose fentanyl patch may work.
There are many other meds to manage pain other than Tylenol3 which is first level & often doesn’t work with conditions such as a fractured vertebrae.
Try repositioning too. The less she sits or puts pressure on the area the better.
Her bones are quite fragile at her age. I would try to avoid any extended movement to prevent further injury to her lower back. ALWAYS arrange for someone be with her if she gets up to walk to the bathroom.
Ask for a lumbar brace she can use when she is ambulatory and have it available to use at your fingertips.
This is so sad to me as I really get bothered when someone is in pain & medical providers don’t take it seriously. A body in pain won’t heal quickly. This whole opioid “crisis” withholds pain medication for people that really need it.
But bottom line she can just as well be allergic or sensitive to any new pain medication synthetic or not, so proceed with caution. Low dose first.
Good luck to you both.
I would not let them tell you she needs to be placed in a memory care facility. She needs her medical issues addressed. This is a tough time to be in hospital. I would request a spinal specialist and a pain specialist. I would also request that they rule out any type of infection.
I had to be a raging b!÷@h when my dad was in hospital to get his medical needs addressed, I don't know why they think people are there, holiday I suppose. You are dealing with the bottom of the barrel when you are dealing with hospitalists, these are the doctors that can't have their own practice because patients meet them once and run the other direction. Stick to your guns and get specialists called in.
Best of luck and may God give your mom pain relief. That can make a person crazy beyond belief.
She needs her pain dealt with, maybe something topical to get it calmed down.
Does mom have an infection? Infection of the menings can cause this" although rare, can still happen. Also has she be tested for a UTI? I know you are probably thinking what one has to do with the other but the body is one system made up of many systems. UTI can also cause this type of behavior in older people. I am just throwing more ideas out there.
Ask about surgical options - vertebroplasty or kyphoplasty.
People have mentioned pain patches rather than using oral analgesics
Medical marijuana?
Nerve Block Injections?