Pain killers appear to have put my wife into a catatonic state. Am I wrong to refuse them on her behalf?

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Please pray for us as we are held captive by the medical system and it's pharmakeia (sorceries). Here is our abbreviated story:

My wife, Sharon, has been bravely fighting cancer for a few years now. She miraculously reversed breast cancer with a combination of natural remedies, faith, and allopathic medicine (necessary but contrary to our beliefs). However, it was discovered a year ago that the cancer metastasized to the brain where a tumor causes stroke-like symptoms. The symptoms are controlled with a corticol-steriod (Dexamethasone).

This has been an extremely difficult condition to deal with and has confined my wife to bed and wheelchairs for long periods of time (where she listens to Bill and Clifton's teachings by the way). I was able to put nursing and homecare services in place but the homecare provider and their staff have proved to be beyond incompetent. They repeatedly dropped her and she started suffering severe back pain which made it difficult for her to lie flat in bed. This led to leg swelling and pressure sores on her rear from sitting too much. My wife complained of abuse from one of the PSW's last week and I filed a complaint. A VON nurse stated that Sharon's pressure sores were not going to heal unless she was admitted to hospital, placed in a special hospital air-bed and turned frequently. Together, we decided to take the hospital option to heal the pressure sores. Sharon was relatively fine otherwise.

At the hospital, the nurses and I noticed that her back pain was quite severe every time they turned her. Belately, I started to suspect a spine fracture. After a few days, the doctor advised us to put Sharon on a pain killer (Hydromorphone) three times a day. She took this drug before when she had the breast tumor without any serious problems. However, this time around the hydromorphone has quickly put her in a catatonic state and she is declining rapidly. Yesterday, I wanted the doctor and nurses to at least reduce the dosage. Sharon did not want to take the pain pill and refused to take it orally today. Now they want to proceed with giving her a subcutaneous injection of morphine. This seems like a death sentence to me and they seem determined to proceed with this despite our objections. The doctor says that her catatonic state is from disease progression and the nurses want the convenience of turning her without having to listen to her scream or groan. Short of kidnapping my wife, what should I do? Am I wrong to say no to morphine? By the way, I have power of attorney for personal care.

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As a healthcare provider, if my patient is screaming and groaning in pain you can bet I am going to offer that patient pain medicine and not just offer it but encourage it. The screaming and groaning doesn't inconvenience me, it makes me hurt for the patient. It makes me want to do everything in my power to take away their pain. It makes me want to stroke their brow with my hand and whisper to them that it's all going to be ok, that they're ok, and that they will have relief from the pain in just a few minutes, just as soon as I can draw up their medication. A patient's screaming and groaning from pain isn't an inconvenience, it's a sign that their pain isn't being controlled, and that is unacceptable.

If your wife is in agony every time she's turned she should have pain medication prior to each repositioning. I would also agree with Babalou in suggesting hospice for your wife. Hospice providers are experts in pain control and will listen to your concerns and work with you in providing your wife what she needs going forward.

Your final question to us was are you wrong to say no to morphine. My answer would be yes.
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She took this drug without adverse effects in the past. Why are you concluding that it is this drug that has her in a catatonic state and not the disease process itself?

It is true that Hydromorphone can cause a very long list of side effects. It is also the case that the brain cancer, depending on where the cancer is, can have a huge range of symptoms.

Whatever the cause of your wife's state, drug or disease, she is still in pain, right? I don't suppose you like the idea of your wife screaming and groaning in pain any more than the nurses do, right? It is not a matter of "convenience" -- it is a matter of concern for the patient. Medical professionals typically don't like to inflict pain. So if she is not going to take Hydromorphone, what is your wife going to take to control the pain? The doctor is suggesting morphine. It think that is a very common suggestion for treating pain in cancer patients. (oncolink/experts/article.cfm?id=2347) The cancer itself may be a death sentence, but the morphine wouldn't be. The intention is to keep her comfortable.

I had morphine after surgery many years ago. It certainly was not a death sentence. The surgery was fairly routine and I wasn't in mortal danger. I was just in pain.

I don't know exactly what your beliefs are, and I support you in respecting them for yourself and for you wife (if she shares your beliefs.) But if your beliefs allow you to accept pain management in the form of one drug, I don't understand why you would reject another drug that may do a better job in this situation.

I certainly hope the pressure sores can be healed and that your wife can be reasonably comfortable while that is occurring.
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I'm going out on a limb here but I think this needs to be said. Your first statement was:

"Please pray for us as we are held captive by the medical system and it's pharmakeia (sorceries). Here is our abbreviated story:"

Sorcery? Are you saying the medical professionals are sorcerers?

I do understand that you have strong religious beliefs, but your wife has serious medical issues, and you've sought treatment from the conventional medical professionals for treatment. If you feel you're held captive by these "sorcerers", I'm not sure you really want their treatment or understand what they're trying to do.

First, recognize that morphine is powerful. I had it once and that was the last time I will ever have unless I develop a terminal disease. It knocked me out and had side effects for a week afterward. And that was only for surgery.

Second, your wife is probably in excruciating pain. Isn't it compassionate for the medical professionals to address that and try to alleviate her pain? Would you rather she suffer?

Third, you wrote that a tumor caused stroke-like symptoms. Have you discussed with the doctors whether this tumor can be removed, or would it be best treated with the med as you described? In addition, what parts of her body are being affected by the location of this tumor?

Fourth, you wrote that your wife was "relatively fine otherwise" when she was admitted to a hospital for pressure sore treatment. I don't wish to belabor a point or inflict emotional suffering, but with metastatic cancer and a brain tumor, I think it's not realistic to believe that she was fine.

Fifth, and I caution that I'm speaking only from experience, but when my sister's cancer metastasized to her brain, she also developed spinal as well as mobility problems. She could walk only with difficulty; the brain tumors (13 of them) were affecting her spine.

Depending on the location of your wife's brain tumor, I'm wondering if you discussed with the doctors whether the tumor itself was causing or contributing to the spinal pain?

Sixth, I would suggest you ask yourself that if you kidnapped your wife, how would you care for her during the advanced cancer state? How will you know how to handle any changes or further metastasis?

Seventh, I'm sure that anyone as devout as the two of you are is reluctant to address that cancer can be terminal, and your wife may be reaching that state. Hard as it is to accept, try to do so; get counseling from whoever is head of your particular religion, try to connect with others who are battling metastatic cancer via a support group or through Gilda's Club, and educate yourself as much as you can to the actual physical conditions. This knowledge will help you understand what the situation is and hopefully guide you through the next phases.

As others, I am sorry that this cancer hasn't been contained but hope that you can find some comfort in knowing that your wife is getting better care at a hospital with people who are skilled in treating it than she would be at home in the absence of advanced diagnoses and treatment availabilities.
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Richard, I'm so sorry that your wife's cancer has metastasized and is causing her such pain. Pain from end stage cancer can be excruciating. I'm sure you don't want your wife to be in pain when being cared for.

When one has a life-limiting illness and there are only opportunities for palliation, not cure of a condition, it may be time to consider calling upon hospice services.

Know that you've done everything you can for your wife. Continue to help her complete this journey in peace.
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Havevthey tried pain patches for the area in question? Those have helped my mom who has compression fractures in her spine.
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Richard7, my heart goes out to you. My daughter had brain cancer and was on Hospice. The painkillers are not making her catatonic, the brain tumor is. You know you are close to the end now, please prepare for that. You have been a good and loyal husband.
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Just another thought - you apparently are proxy under her Living Will or Advanced Directive....if you refuse medical treatment that the doctors consider necessary, it's possible they could take legal steps to override your authority and administer the treatment they feel will help, including pain mitigation.

So it might help to learn more about the morphine, the dosage, how it affects her, and specifically whether it's the morphine or the metastasis that's causing the conditions you seek to alleviate.
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Your wife is not going to get better from breast cancer that has metasticized to her brain. It's horrible and awful, but it's true. No matter WHAT the cause of the pain, whether natural disease progression, her caretakers' mistakes, or a combination of both, the pain is real.

Do NOT discourage your wife from medicating away that pain -- whether it makes her catatonic or not. That's not your place.
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Do you need proof of a possible spine injury for evidentiary reasons? Even if that is what it is, how would the treatment be any different from what they are prescribing now? It just seems to me that they would recommend the medication for pain, regardless of what is causing it.
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There are prescription strength ( very strong) varieties that are sometimes used, even with localized cancer pain. Hope this works!
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