I have a story to tell and questions to ask.
I have a very stubborn caregiver who does not like going to the doctor. It takes too much of his time (the waiting time along with not seeing his regular doctor) is very annoying to my caregiver but his insurance plan is a poor one.
My caregiver has only a few medical issues that need to be addressed but they are getting worse over time. His doctor has increase some of his medication and decreased others. This increase and decrease has created MORE problems with his health and he constantly has to call the nurse advocate.
Recently I found my caregiver up at nights rubbing his arm in pain and annoyed because the pain medication he does not like to take at nights (he says it keeps him up). I tried talking to my caregiver but I get snapped at.
I somehow found a way to get through to him when I reminded him that...
Who is going to take care of me, if something happens to you?
That seemed to make a reality check on his, so we started talking. We researched his pain medication and symptoms. He might have either torn his rotator cuff or has a pinched nerve in his shoulder.
Naproxen turned out to be the answer. We did a test to see if this medication works for him and low and behold, his pain levels are down and the medication is working for him! He will see the doctor tomorrow if I have to nag him to death!!!
It was really hard to talk to my caregiver since he is so busy take care of me, when he has a pain issue, he just blows it off and snaps at me. It took a LOT to try and find the words to help or to get him focused on treatment. At least now we are talking about his issues.
How do you break through to a stubborn person? I just happened to be lucky this time. I could use some advise from stubborn people or anyone who has the same issues. Awaiting the wisdom of the ages. Thanks for listening.
I got an amazing answer from someone who I want to quote below:
Do you want to end up like me, depending on someone for your needs? Ask him how he would feel if it got to that point. I'm sure that his independence means a great deal to him.
Now that is an answer no one can argue with, I think?
Pain and injury cause anyone to become verbally abusive, have a short-temper, and become irritable. It is "built-in" to the human nervous system. A patient in an auto accident and with blood loss will ounch the first responder in the mouth and curse the triage nurse, but after his hematocrit is up to snuff he/she become apologetic.
Problems with arm pain are not solved by pain killers.
My gut feeling is not a nerve in the shoulder, but a pinched nerve in the cervical area. This may make life unbearable. his may be determined by having him/her lie flat while experiencing the pain (not masked by pain killer) and applying axial traction pulling the head upward along the axis of the spine.If the pain diminishes you have your answer. Treatment is an axial traction device eight to ten minutes six to ten times a day, a transdermal lidocaine patch over the cervical area no more than 12 hours a day, and rotation of the head through the limits of pain.
I appreciate the response.
I read your answer and understand some of what you are saying. I am not worried about him snapping back at me, understand what it is like being in pain.
The Naproxen seem to be helping the pain at the moment. Yes, I could be a pinched nerve but his last visit to the doctor showed nothing in the xray. All his doctor will do is prescribe another pain pill. Refill his Tramadol. He doesn't like the Tramadol and the Naproxen really seems to help. He is only taking the Naproxen twice a day (every six hours). He is discouraged by his doctor.
The other information you offered sounds a little complicated. Could you simplify the medical terms. I have been out of the medical profession for years and don't want to go back to the books to look up the technical terms just yet. It sounds like you are writing that something needs to be stretched or pulled from what I gather.
Thanks for your information.
Let's imagine this is the television series House and we are connecting the dots, which most physicians cannot do. It is most likely your caregiver suffers from what is called a subluxion injury, caused by forceful flexure of his head a long, long time ago. The problem starts many months or years after the flexure. The kind of pain that develops after such an injury can be so bad the patient wants to "eat the gun". There is a "co-factor" in a narrowing of the passageways in the cervical area through which the nerves pass. The pain in the arms and the shoulder is imagined because these points are on what is called a "pain dermatome". An MRI is helpful, but not definitive. Muscle relaxants are contraindicated, as is a cervical collar. This kind of pain does not respond well to opiates because the pain is due to glial cell inflammation. Often sleeping in a certain position eases the pain.
It gets worse and worse until the patient is in a walker and often unable to move his arm. This is called a "frozen shoulder".
An x-ray will show "ungotz". I worked as an x-ray tech and took thousands of them.
Treatment is non-intuitive. Common sense tells a person that you will make the situation worse by movement through the limits of pain. In this case, the patient "self-splints" because movement causes pain (BAD pain - blackout-level pain) until the arm is immobile and every step a nightmare.
Curiously the drug Metformin sometimes helps, as does fasting and lowing glucose levels, which affect osmolality. Keeping well-hydrated is helpful
Separating the cervical vertebra enables the fluid pressing on the nerve to disperse, and the nerve to "settle down". Usually this is done with an initial does of oral prednisone, although DSMO is also helpful.
Sometimes there is calcification or deposits that built that have to be "broken" by forceful manipulation of the head. Chiropracters are good at this.
Without axial traction the problem will get progressively worse. A home axial traction device costs about $35. Throw away the water bags and use gentle suspension (not FULL suspension) for three to ten minutes a dozen times a day with an hour between traction for starters.
A good pain specialist should have been able to pick this up, and I urge consultion with a physician with expertise before following any of my advice.
In general axial traction will not cause any harm. It will either work or it won't. The normal x-ray cleared the patient of degenerative spinal disease. The juxtaposition of the two complaints "in the arm" and "in the shoulder" are part of the "pain dermatome" for cervical nerve compression. An MRI will show some narrowing of the passageways through which the nerve passes (spinal stenosis), however this is not necessary for diagnosis. If pulling the head upwards along the axis of the spine relieves the pain/discomfort the diagnosis is definitive. If caught early enough there will be improvement. These patients present with excruciating pain, at times, and would be unable to push a wheelchair. The high pain level is another clue. And the pain is usually positionally relieved. This syndrome is often misdiagnosed as a shoulder injury.
Normal xrays will not show up pinched or trapped nerves.
I had a similar problem with pain and pins and needles radiating down my right arm. The physiotherapist was able to identify that the nerve was trapped and helped to release it by pressing on one of my vertebrae.
Just tell you caregiver that if he does not pester the doctor to refer him to physio and the problem is not sorted, it will get much worse. He is the one that is feeling the pain and you do not like to see him in pain and lose him as a caregiver.
Pain relief is just that, it relieves pain. It does not treat the cause of the problem. Tramadol and Ibuprofen does not suit everyone.
My caregiver has done some research on some of his pain issues. One of the medications he stopped is the statins. That does seem to be helping. Along with a strong vitamin regime and exercise, he is feeling better and only takes the Naproxen as needed.
Positive results finally.
By the way, he has a very POOR doctor. Not much he can do about that except complain. He doesn't have the time or energy to do that. He is finding his own cure and for what ever it is worth, it is working for him. Thanks....
I'm glad to hear that he has stopped taking the statins.
They do not suite everyone and there was a TV programme about them last year about men who have had their lives damaged as result of the statins.
My next door neighbour had to come off them because they made him ill. My husband won't take them which I am glad about.
Can he not change his doctor?
Glad to hear that your caregiver is now taking control of his own health to make him well again.
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