She is living with family and live-in carer in Jamaica. Mum suffers from spinal stenosis, a result of osteoarthritis. She was on Fosomax for some 10 years and was told to stop taking it by the orthopedic surgeon. She's not a candidate for surgery based on her age and bone density. Efforts to control pain and maintain mobility are with Lyrica (75 mg) and now Celebrex. Her pain seems to be debilitating and was exacerbated with the Chikungunya Virus in early October 2015 which was rampant in Jamaica where she lives with my siblings and a live in Carer. She recovered well but it's hard to determine how much of the pain is age-related deterioration and how much is related to Chik-V. My sister, who lives with Mum thinks that it's more weakness than increased pain levels. The Celebrex seems to have helped with the pain since she started taking it late last year, but generally speaking the pain level seems to be difficult to manage - the feeling is that it's more about her general quality of life - nothing else to focus on but what's wrong and where hurts. She believes that the dose of Lexapro doesn't even begin to address Mum's depression. Recently, she has been having lots of sleepless nights because of her back pain/leg pain. She's asking again about seeing someone who can recommend something (x-ray, meds, whatever), but we're not sure what to do next. Friends keep telling her she's to use the walker rather than walk with the aid of her Carer (though that makes her feel more confident) - so it's a bit frustrating. My sister feels that mum really cannot physically manage the walker, nor does she have the confidence to use it. The physiotherapist, on the other hand, who comes to work with her, believes that she has good strength in her legs and would prefer her to be encouraged to use the walker, but it requires consistent patience and effort every day. Her b.p. is fine and she's eating well -- her main issue is intermittent pain. My brother had another doctor visit her recently and he suggested that she go to see someone for pain management; He was willing to continue doing home visits, but mum doesn't want to change her regular GP; She's been with him for over 20 years and he is happy for her to take Panadol for the pain, which she is already doing. My sister thinks she would benefit from sleep medication: says she hardly sleeps at night nowadays - and believes that tension is as much a part of her pain cycle as the osteoarthritis.
She's also complaining about things biting her in her bed. They've changed the mattress pad and removed the egg crate topper, but to no avail. It may be mosquitoes but my sister will need to investigate further. In any event they will replace the egg crate because it is felt that she needs it.
I would very much appreciate some expert advice.
The pains killers stopped working years ago.
The injections of hydrocortisone stopped working a few years ago
Last year the orthopedic cauterize a couple of nerves in her back. This is the treatment of last resort! It has left her pain free, but somewhat unsteady on her feet. After all, those nerves are there for a purpose, not to cause pain....so dead nerves, no pain, BUT, some loss of function.
In Moms case, she has had so many surgeries on her back through the decades...she is just not going to allow them to do it again. So...when the time comes when the pain from another part of her back becomes too much...they will consider doing this again. Sadly, either the procedure or the pain(or both) will deprive her of the ability to walk....if she lives long enough.