With co-morbid conditions including morbid obesity, severe rheumatoid arthritis, asthma, long-term emotional abuse by ex and live-in sons. My sister is facing an immense surgery and is frozen to accept available help. Does anyone have experience with 1. Scoliosis surgery in elderly with co-morbid conditions, and 2. Family dysfunction with live-in adult sons who are abusive (who she believes are her moral authority because of her heritage)?

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I feel so sorry that the people your sister should be able to depend on the most are instead using and abusing her. I don't think you said exactly what kind of home she shares with her sons, but given her physical limitations perhaps it would be easier for her to move to a smaller supportive housing unit than to try to evict her boys from their current home? If she is free from their negative manipulations she may grow strong enough to make better decisions about them and also about her own needs.
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I have no experience with this but your post has had me searching the web. I think that the success of any kind of back surgery depends on the underlying conditions, if her spine has degenerated due to arthritis then there is unlikely to be any long term benefits, especially if she can't lose some weight and follow the post operative exercise programs.
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I have no experience either, but do have some thoughts about the underlying and surrounding situation of family abuse, apparently culturally influenced.

One of the important aspects of successful surgery is the recovery, with a supporting family, which apparently is lacking. And assuming that a culturally driven attitude isn't going to change overnight, if at all, I'd be thinking about what support you can provide for your sister.

Are you authorized under HIPAA to speak directly with anyone on her medical team? The doctor(s) performing the surgery might be able to refer you to a social worker who also might be able to identify sources that could help with the abuse and cultural issue.

And I'm very concerned that the abuse could predispose her to post-surgical depression if not some level of despair, as she won't be getting support at home.

So I'd also ask the medical team if there's a possibility of long term rehab, such as at a Select Specialty hospital. where she could at least be away from some of the male dysfunction and in a more supportive environment.

Reach out to cultural organizations of this woman's heritage, and try to find those who might be American born, more supportive, and perhaps dealing with family abuse. Someone who understands it might be able to help this woman recognize that abuse isn't normal, regardless of the culture. I'm not sure any embassy would have suggestions or resources, but it's worth a try. I suspect your sister isn't the only one suffering at the hands of male family members.

Nor is assumption that moral (especially moral!) authority is automatically superior because of gender. Is she living in a community of others of their culture? It's harder to go against the norm in that situation.

You might also contact support groups for emotionally abused women; perhaps she could at least participate and share common concerns with women in similar environments.

Even if you can find a psychologist or social worker familiar with her culture, that could be helpful.

Your sister is fortunate to have you and your concern, and I hope you can find a way to build in that support and help her escape a remaining life of lack of support from the men in her family.
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Heritage shmeritage.

I'm sorry to be impatient. But name the culture, tradition, religion that endorses the abuse of parents by their adult offspring, please? - 'cos I'm buggered if I can think of one.

Your sister, browbeaten over decades, may well no longer have the spirit to deal with her ghastly sons or to let anybody else help her. But that is nothing to do with heritage. That is probably to do with a pattern of abusive behaviour repeated over generations by *people.* And goodness knows you get them in every culture, heaven help us.

Your sister's surgeon will have weighed up the risks and benefits of the surgery being proposed. It crosses my mind to wonder if the surgeon might also think that her being confined to rehab away from her home might do her no harm at all. Are you happy that your sister has thought the decision through and is giving the surgery her informed consent?
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I have little knowledge of a cultural systemic abuse, I’ve read a little about it. About the back problems, I know a lot.

~Congenital lumbar scoliosis (severe)
I was born with scoliosis, I received treatment for it while I was so young I don’t remember much...this was in 1954.

~Extensive Spinal stenosis (lumbar) This is a painful condition but according to the doctors, it’s not unusual to have after 60 years of age. This is seldom operated on but palliative measures are standard treatment.

~Degenerative lumbar-sacral arthritis...bone density has gone so vertebrae fractures aren’t unusual. Also Pinched nerves in facet joints & I have 2 crushed lumbar vertebrae amidst this painful mess.

Two doctors want to operate, after the first doc explained the surgery would be done in THREE phases, with screws, bone graft and all together I would be under anesthesia for 12 hours. I also have COPD, generalized arthritis (hands, knees, hips & neck).

POST-OP RECOVERY TIME would be 6-8 months. AFTER seeing both doctors and talking to numerous back surgery patients my decision was NO. I believe they’d kill me, that’s a sincere and carefully thought out decision.

So I live with the unknown and make sure I don’t fall.

It seems to me that to recover from this extremely arduous surgery would call for peace, quiet and no strife.

So I live with chronic pain and will until I die. My husband has been my nurse and I try very hard to figure out shortcuts and easier ways so I don’t over demand from him. He works full time and he is my everything.

One last consensus from my survey on whether or not to have the scoliosis surgery was NO. “You’ll exchange one kind of pain for another!” I understand that. And I’ll keep my familiar pain.

I hope this is helpful, I know a lot about the ailment but nothing about the culture.
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Thank you all for responding and giving me more to consider. Polarbear: Thanks for bumping me up, and cwillie for researching. I confused people because I made it sound like my sister ‘s abuse stemmed from a cultural identification, when actually Countrymouse nailed it as multi-generational abuse, emotional abuse that leaves a person a walking zombie, always doubting one’s worth. My sister’s ex-husband was cruel, and though she raised her sons without his help, her sons more identify with their father who demeans my sister. You were right about the surgeon, too. Sis had reflexively answered “Yes” when the surgeon asked if she had someone at home (I had repeatedly coached her not to say yes, but she did, trying to put best foot forward). While waiting for imaging, she phoned me and we discussed the “yes” answer. When back with the surgeon she said that he should know that her live-in son believes that she was responsible for all her physical afflictions and she was lazy and despicable that she should just “get over it.” Surgeon gave her a kind smile, and said, “We’ll do a consult …” (assuming that means social worker or psychologist) and Rehab is in the recovery plan for sure.

The past few months, I have called APS for my sister. Sons refused to speak with them so APS was ready to help her with eviction. But at the last minute, she froze and backed down and APS closed her case. She was so ashamed of herself, but I try to reassure her it is very normal when trying to get out of an abusive relationship. During the past few days, apparently neighbors have heard the two boy-mean yelling at each other outside of sister’s house, and some walk to the street and stare at them. I don’t know if they report anything. I’ve asked sister if she could phone WomenSafe herself. She always says she will, but doesn’t. She isn’t free to talk in her own home, and also is exhausted after teaching all day. I may call again tomorrow just to report the recent yelling bout, the phone people urged me to do so, as all information helps them to corroborate stories.

I try hard to support my sister, but I live over 400 miles away from her and can’t take her in because my own husband, 85 and disabled, simply needs peace and I am the caregiver here. I make sure Sis has contact phone numbers and daily reassurances that she deserves respect and a peaceful life.

HolidayEnd, Sis was born in 1957, so you are close in age. She was born with extensive congenital scoliosis, but over the decades the whole lumbar and some thoracic spine have degenerated. The surgeon said one of her discs is “gone,” and her case “…One of the worst I’ve seen.” Sis doesn’t care about the chance pain could be worse. As she puts it, “I can’t live with the pain I have now.” My DIL (a Family Practice physician) says in all her years of practice, she’s never known back surgery to ever mitigate pain, but it usually helps with functionality. Sis says she’ll take a chance for a hopefully more functional old age, and is willing to deal with pain getting worse after surgery.

Holiday, you’ve got to be a very thoughtful and rational person to have worked out your “No” decision. Your husband sounds like a good partner, too. I am grateful you could share your thinking, decisions and accommodations. I suspect my Sis will waiver in her resolve as she has follow up appointments and learns more.

Thanks everyone. Any additional thoughts will be very welcome. Surgery is projected for May, but she has a lot of pre-op preparation to do. Like losing 50 pounds and physical therapy.
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50sChild I don't think you're overbearing. You have the same rescuer and "fixer" syndrome that I have. Because I'm a strong, decisive person, people naturally gravitate to me for answers. And because I'm a control freak and I love fixing things (and people), I am happy to step in and do the research and find out the best options. But then I get frustrated when people make "bad" decisions. After a lot of self-work, I now step back and try to realize that other people have to own their decisions and lives and their own reasons for doing things that may differ from my choices for them. It actually hurts me to get too emotionally involved when my concern flips to resentment when others don't take my "correct" advice or I feel used and abused by putting in too much time or effort when they don't listen to me or make bad decisions and want to cry on my shoulder.

You can offer your sister options, but then let her make her choices and live with her decisions. You don't have to fix everything for her. She needs to do that in her own life. You sound like you've taken on far more burden with your sister than is rightfully yours to carry. You didn't make her sick or make your mom a terrible mother. Those aren't your crosses to bear. Just be a loving presence, but let sis carry the weight of her own life decisions.
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I'm moving your question up, so hopefully someone who knows the answer will see it.
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I’m in a hurry so this will be longer than it should be. You all have raised great thoughts and mullings in me. Cwillie: Sis lives in her two-story home with basement, not standard steps (old do-it-yourself farmhouse type home). She is considering moving, but obviously that won’t happen before May. You fleshed out what MACinCT brought up and it’s exactly that rhythm – Sis in crisis (after long non-response), I mobilize to be greeted with another cycle of Sis silences. I have long suspected she uses me and her sons.
MACinCT: She did ask for my help. Bingo on my not inserting myself, or at least being careful. It’s a huge problem for me (my husband says I leap into the breach). I am starting to recognize this panic on my part, when it need not be. I appreciate your observation.
Blannie: Thank you for stroking me for the good sister ideal I want to be. I see there is wisdom in stepping back. I would never forgive myself if she relied upon my advice. I try to say, “There are pros and cons, it’s for you to decide.” I even suspect if her surgery goes well, the hellish recovery is going to be unbearable for her, as she has never stuck with any physical goals whatsoever. I caregave during my husband’s triple laminectomies, which were a piece of cake next to what Sis is facing.
HolidayEnd: She’s been getting facet joint injections for fiver years but they no longer help more than a day or two. I love that you shared your successes with pain management. Sis has been in pain management for five years, and it’s “not helping.” All of you responders suggest maybe there are things I don’t know. I agree.
Joann29: Yes to rods, I can’t believe you actually went through it with a young nephew. Sister’s older age seems quite an obstacle to her simply taking the summer off and resuming teaching in September. It’s her inability to grab hold and consider the worst outcomes that concern me. Surgeon has and will continue to explain, but she won’t come up with her own questions. It’s as though she is about 10 years old in emotional maturity, passive, and needing help I can’t provide. She certainly was hugely traumatized as a kid, and I played her mommy, being five years older. So I unwittingly set her up to play the baby. She was never good at self awareness or introspection, or playing her own devil’s advocate. She is also realizing that each she ages, surgery becomes less and less an option. I believe her panic about aging is driving her “decision.” But I think I will leave that to her therapist.
I have long felt guilty for her congenital challenges. As a four year old, I remember responding in panic to her gut-wrenching, unabated colic. My mother was always venomously angry, so I tried to protect her and sooth her (never worked). So I have always leaped into the breach, and my four-year-old maternal instinct is huge with Sis.
Sis probably does use her sons as she uses me, I thank you for bringing a little light to that. She doesn’t seem honest about her needs and motives. Her sons, nasty as they are, are going to spend the rest of their lives sorting through their own history.
The big gift you gave back to me: I can’t walk her paths and it is dawning on me that the very fact I post here about her suggests she isn’t using the resources I have forwarded to her. So now I am open to the notion I am overstepping, and maybe overbearing.
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Blannie, I totally agree, and it's nice to know you've been through it. I especially appreciate "Just be a loving presence, but let sis carry the weight of her own life decisions." That's a lot of wisdom in a single sentence.
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