My Father

[cainek]

My father (he's 75) has been in and out hospital recently. He is in severe pain. Theyve done MRI and CT scans. they are saying they can see trauma to his tailbone and there maybe a compressed nerve. OK, but here is my problem my Father is a very active man but since this accident and introduction of dihydrocodiene he became docile and stopped eating. I asked them to try diclofenac and maybe diazapam for the nerve pain. It was working after two days but then the doctor said his kidney function was acting up and stopped everything and put hom on oramorph and zomorph???? He's a zombie, he hardly ever wakes up and when he does he's not coherant. They want to discharge him like this and offer social care. Is this really the best we can do for our aging generation.

He keeps pigeons, plays golf, but his is killing him

[cainek]

Thank you for your advice.

Last night when I went to see him he was coming out of the morphine haze, only on diclofenac. He got in a wheel chair and we went to the hospital cafe and talked about things for a full hour.  He hardly remembered anything about the last few days and was upset about the idea that he needs full time care, aggitated that his pain is unable to be managed without him being out of his mind on morphine.  We lost my Mum to Pancreatic Cancer 2 years ago and he is still grieving and this is not helping. But we laughed about a few things and agreed on what he wanted and how we should proceed.

Today.....I walked in and he was back in bed sleepy and grey.  He's complained of pain during the night and was back on morphine. He's scared now.  

The social workers turned up and a young doctor.  I made it very clear, answer A or B, would someone be more coherant and reliable to make decisions on or off 25mg of oramorph and a nefopam??? pretty simple.

He has no idea what these drugs are and he is struggling with the affect theyre having on his mind.  I'm so stunned at the disregard for our aims.

Still no answers of why hes in pain or whats wrong with his back.

Tomorrow I'm digging in. I want a new doctor. I've not seen my kids for 20 days, I'm off work and away from my life.  But I havent seen one iota of evidence that I can even leave him for a day.

Gggrrrrr

C

[Tuckamore]

You sound like a wonderful "child" and your father is so fortunate to have your concern and involvement.

I am delighted that you took a stand in his behalf. Your father must be very proud of you. Dementia rarely come on "all of a sudden" although medications, pain and or physical/medical events can make it appear as if it does.  I am more inclined to believe they are seeing the results of medications that his system just cannot tolerate. I think they are labeling it Dementia far" too quickly.

Don't be afraid to get a Gerontologist involved with your Father's care. They are often the best in directing senior care.  I have seen them perform "miracles" when other physicians gave up or wrote off a senior with Dementia or something similar.

If a Gerontologist isn't readily available you may want to just ask for a second opinion.

I will watch for your updates.

My Best,
~Tuck

[cainek]

Thank you for your response. I'm making ripples with his consultant and with occupational health. I put my foot down yesterday when the word Dementia started being banged around. I demanded the morphine be stopped and asked for Diclofenac to be used for a couple of days to get him out of this morphine haze.

He had a second MRI today and is being reassessed Friday.

I've had two spine ops.  I'm intolerant of their ignorance of back pain.

watch this space

again thanks

c

[Tuckamore]

Hello and Welcome to the Pain Management Forum. I am so sorry to hear about your father's pain. Do you live in the UK?

A better question may be, "Is this the best we can do for pain control." .. regardless of a person's age.  It is generally true that seniors  tend to be more sensitive to medications, all medications then the younger population. However believe it or not your father is not "old" a senior yet but today more and more physician don't consider their patients "old" until they are well over 80.  The fact that you father is active and apparently otherwise relatively healthy is to his advantage.

You are right to be non-excepting of the condition the medication imposes upon him. His system is not responding as it should to the meds. In my opinion he is not on the right combination of medications. It is true that your system takes a while to adjust to most meds. The amount of time that adjustment make take varies by individual.

Oramorph is one of the many Brand Names for Morphine Sulfate. It may be that your father just does not tolerate Morphine very well. I don't. Is it the long acting (slow release) form called SR?

Zomorph is also a Brand Name for Morphine Sulfate. I am assuming that one is long acting and the other is short acting. Is that correct? Usually a PMP will prescribe different opiates when ordering short and long acting  opiates for pain management. The fact that this was not done may explain your father's reaction to the medications. He may be receiving too much morphine for his system to tolerate it well. I am not an expert in anything. This is just my personal opinion.

Talk to your father's prescribing physician. Don't be afraid to express your concerns. It doesn't sound like your father is in a position to speak for himself.... he is fortunate to have your love and concern.

I would look into medications that treat nerve pain. There are several good ones on the market. Discuss those with his physician. By all means I think your father requires an opiate in addition to one that treat nerve pain but there are more to select from than two types of Morphine.

In addition to medications I would want to know how they plan to treat his condition. Does he need a second opinion? Will a steroidal injection help with the pain... or PT ... or Acupuncture or other treatments? Your father may seem "old" to you but he very well could have years ahead of him. I know you want those years to be comfortable and for him to remain his active self. Be assertive and don't allow anyone to give up on him and assume he cannot return to his previous active self. Our parents need the same support and guidance they extended to us.... be his voice!  

Best of luck. I'll look forward to your updates with interest.

Peace,
~Tuck