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We sold our own home and moved into the lower suite of my 85 year old mother-in-law's home 2 years ago to help her stay in the home as long as possible. Until this spring she was golfing, bowling and square dancing weekly, a social butterfly and a gorgeous lady. In May she went for a massage for an old back fracture and ended up with nerve damage. Since that time she has had back pain and has gone from the busy vibrant lady she was to housebound and not dressing or moving from the couch. She has had a difficult time getting any pain relief because she is on warfarin so she has on had Tylenol for pain. Physiotherapy has not helped. She is now waiting to get into a pain clinic but that is 4/to 6/weeks away. I finally demanded the doctor give her pain meds and he gave her a butrans patch 2 days ago so we are waiting for some relief from that. Our main concern is that she was told that she should be walking and perhaps swimming and.or using an exercise bike (which we have and we have gotten out for her) but this very previously active lady is now not moving AT ALL. If I don't go up to make her a piece of toast for breakfast and phones her 89 year old boyfriend and has him come and do it for her. So she is pretty much moving from her bed to the couch and back. She must be going to the washroom so I told my husband that if she can do that she should be able to get to the kitchen for toast, particularly if the doctor is saying she should be on an exercise bike and swimming! Am I being cruel? I make her supper and my husband takes it to her. She used to eat out with her boyfriend at least 4 times a week and lunch out with friends almost daily. That was only 3 months ago. The other day when I mentioned it to her she said she had been on one of the medications for her nerve pain (which just happened in May) "way longer than 4 months".). She just got it from the doctor in July. So now I'm beginning to wonder if she doesn't realize what state she is in in that living room day in and day out. She has a TV tray in front of her that is covered with stuff that I am continually trying to clean off but can't keep it clean. It is like trying to clean up after a toddler but this one doesn't move around. Tuesday shewas to go to physo and I went to get her 3 times and she was still sitting watching TV. Finally I had to say are you getting ready? And then she finally realized what time it was even though she has a huge clock right above the TV and I had been up 3 times and mentioned it. She is very strong willed. She complains all day about the pain but shoots down every idea and plan anyone has to help. We have a home TENS which she has been told would give her some relief but she won't use it. She won't let me open the curtains of air out the room which smells like urine. I feel like the few friends and family that do come to visit are probably judging my husband and I but she is very strong willed and set in her says and stubborn and doesn't realize that what she is doing is bad for her health and I believe will put her in a wheelchair in no time at all or worse. I think this thing is quickly going beyond us if I don't get some help. Who do we turn to? Her doctors? Elder care in the area? We live in Canada. My husband is going to talk to her boyfriend this evening and tell him to quit helping so much. She needs to get up, I think. Do you agree?

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I posted my comment before I read your updated information.
So glad you took action and bless you for not just listening to one Drs opinion.
I hope things go better now for your MIL.
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At the very beginning of your question you said she went for a massage due to an old back injury, and the massage caused this new damage. I wonder if the masseuse was ignorant to your MILs age and used too much pressure for an elderly, already injured previously, woman to endure. Was this a qualified/medically certified massage therapist? Maybe you should report this incident to whoever employs this person.
As for your poor MIL, I think you should get a second Dr's opinion. Maybe her pain is a lot worse than the Dr. thought, and she's depressed because she can't walk around or ride the stationary bike, and she's disappointed in herself for not being able to do all that the Dr. said she can do.
If she was so active before, she's probably a fighter so I believe the Dr probably didn't get the severity of her pain level correct.
In any case, I'd definitely get a second opinion and then you'd be sure she was diagnosed correctly.
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I am so happy and relieved for both of you. What is said above is so true...99% of people, if exhibiting signs of pain, have a medical reason for it to exist. Why is that so hard for drs to understand? Good for you for taking the bull by the horns and geting her help. I imagine that when she gets better, your relationship will have changed for the better.
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Just thinking the same thing, CW. My mother had an undiagnosed hip fracture two years back. Where there is pain, there needs to be an xray.
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I'm so glad she's no longer in pain and that you, good lady, took action. Best of luck to you and to her. Let us know how this works out.
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I'm so glad you finally found someone to listen to your concerns and take action. I found the similarities between your mom and dmanbro's mom striking, and danged if there wasn't an undiagnosed fracture and heart failure too, shame on the first doctor for dismissing all your concerns. Hopefully the hospital can get things stabilized and your mom resting more comfortably. Bravo!
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Its been a long, emotional, exhausting week so far. This will be long-winded. I dont think i ever told you that my MIL, Marion, was 5 years with smoldering multiple myeloma. Her last blood test, in June, was clear. All she has ever had in way of bone issues is the one fracture at L1 two years ago, which healed. On Monday morning I got up and drove to her clinic, stood at the front desk and asked for an appointment with her primary doctor, Carter, who she hasnt been able to see since June for one reason or another, vacation, booked up, teaching, etc. When they said she was once again booked up I began to cry and the nurse took pity on me and got me a conference with her. When I told Dr. Carter what was happening and that Marion refused to go to hospital she told me to bring her in immediately. I went and got Marion and Dr. Carter talked to her and examined her and was quite alarmed about her condition. She sent us to the hospital (remember we are in a small centre, hospital is pretty much next door) for chest and back x-rays and blood work. Dr. Carter told us if anything got worse we should get straight to the hospital. As we were leaving after the chest x-ray Marion told me she had had a coughing fit while getting re-dressed. She asked me why they asked for a chest x-ray and I said it was because she was complaining that her chest hurts and is heavy and she is short of breath and that they are likely worried about pneumonia. We drove home and when I got her settled on the couch she started coughing and coughing up phlegm uncontrollably. I said thats it Mom, we're going to Emergency. Once at Emerg (after the wait) they had all her results. She was in congenital heart failure, kidney failure, she has two new fractures on her spine at T12 just above the healed L1 fracture. They admitted her to a private room, she has been vomiting all week, she cant eat but she cant be on saline IV because of the salt content and the kidney failure. She hasnt had a BM since Sunday, she is looking better, her pain if finally under control. Ironically, shes under the care of the doctor I was texting that wouldnt give her anything but Tylenol, the one that thought it was nerve pain, because her primary doctor doesnt have hoslital privileges and he does and she asked for him. Grrr. He told her the first day when I wasnt there he was putting her down for rehab physo. I just about lost it when I showed up and she told me!!! Then the next day she told me he came back that evening and told me hed read her chart and there would be no physio. Yea!! I think not!!! Today my husband and I talked to him and I asked if the kidney failure and vomiting was indicative of the multiple myeloma. He said absolutely. However, they did a CT scan yesterday and no lesions showed up and her blood tests do not show the usual levels indicative of MM. So now they have to send her by ambulance to our cancer institute to her doctor for a bone biopsy to be certain. So thats where we are at. Shes echsusted but out of pain and where she needs to be and the whole family and all her friends are so relieved that we got her off the couch and out of this house. I sat here Tuesday evening and crird with relief as it was the first evening in 3 months that I didnt feel helples with my loved one sitting under the same roof as me in excrutiating pain. I still feel a bit helpless and I still want to hang around at the hospital and hover and fuss but its only 7 minutes from home and at least now I can come home knowing shes out of pain and comfortable, I can take a hot bath, look after myself without guilt and look to another day.
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You should call an ambulance and get her to the hospital. Specialists will see her in the hodpital who can't /won't see her as an outpatient. If you take an elderly person to the ER with chest pain you get action. If she dies of untreated pneumonia, how are YOU going to feel.?
Look, mol os not playing with a full deck due to the pain. You have been appointed the grownup. Now call the ambulance.
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Why would an ortho not see her? There are other treatments besides surgery (cortisone shots, etc).
So, she will never forgive you..for what? Trying to do the best for her? She will, and if not, you can rest easy that you did what is best for her health.
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Well we started out this morning not being able to get through on the phone to the clinic again so I drove there and got a conference with my MILs principal doctor. She has made a time to see her at noon today. No more of this crap. I told her the pain she is in, the chest heaviness and loss of breath, the not eating, the depression, her inability to walk more than just from the bedroom to the living room to the bathroom to the kitchen and back, the crying, the inability to leave the house because of the pain, the fear of going to the hospital. She agreed with me that she should probably be in the hospital and I should just call an ambulance. I said she would never forgive me. I think she is scared that if she goes to the hospital first, she will sit there for hours in severe pain and second that she may never come home. The doctor did tell me that no ortho specialist would see her if she is not a candidate for surgery and she is not. Also that you cannot get a priority appointment for a pain clinic. So it is simply up to these doctors to make her comfortable OR she has to go to the hospital. Thats it.
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Heaviness in the chest and shallow breathing could be pneumonia and/or pleural effusion. If this were my mom, I would be taking her to the ER pronto.

I'm sure if the do proper imaging they will find a fracture. There is a thread in Discussions on this site titled "My mother's stubbornness is so confounding". Stubborn mom had a fracture that the hospital missed. But right mow, I'm more worried about her chest.
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Take your mom to the hospital get her a CT scan and find out if she has compression fractures or herniated disks , find out what can help her , sounds like to me they are just snowing her with medication and not helping the problem ... She can get off all that narcs and have a quality of life ,,,ask if a kyphoplasty or vertabralplasty ( another name for it) will help,the poor woman . She doesn't need all that if they fix the problem sounds like to much drugs , elderly people's kidneys don't metabolize meds well , the meds hang around in their system and they end up drowsy and high fall risk. I hope they can help her , please keep me posted .. Hugs to you
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it's awesome mom has no back pain anymore she is mobile and it's easy peasy .. Low risk , fast and I'm grateful they did it
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No they don't it's a local its done in radiology dept they give a little anesthesia but it's just twilight and the interventional radiologist injects the cement it takes 1 hour then you lay flat for 3 hours until the cement sets ... Then you are up,and about as normal
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Ohmeowzer, this kyphoplasty, do they have to have a general anaethestic, because her doctors have told her with her leaky heart valve she would not be a candidate for surgery. I question the validity of this and have asked her if we could please see someone more qualified to give us this decision, but again, she believes every word these walk-in clinic family doctors tell her to be gospel.
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Thank you so much EVERYONE. This site is a Godsend for me. I cannot possibly answer everyone's questions separately, I'm so exhausted. But believe that I have taken each piece of advice spoken into consideration and every other comment as well. Every one of you has such a wealth of experience, information and knowledge, I feel blessed to have stumbled in here. Sunnygirl, this resulted, apparently, as a result of a healed fracture. She went for a massage to a woman a friend referred her to and a day later this started. The rmt was obviouly not qualified to work on geriatric patients with spinal compromise but MIL will never admit it. She still says she wonders how this started. Cwillie at this point she refuses to change doctors. She also defends them and resists us when we suggest taking her to hospital in Edmonton to get her seen by a specialist more quickly. HOWEVER, this weekend her 5 mcg butrans patch, after 6 days of wearing it, finally may have started to relieve her pain a bit as today she said it wa somewhat better. We spent most of the weekend with her watching golf and her boyfriend's brother is in final stages of terminal cancer so she was busy on the phone all weekend, she is finally weaned off all ghe neuontin she was taking that wasnt working so she has her appetite back a bit (plus perhaps not in as much pain) and so her only complaints were that she was very tired, the pain was wearing her out, it was better, she could actually tolerate the pain but the heaviness in her chest and shortness of breath is really getting to her these days. Now I KNOW that is her atherosclerosis but the damn doctors wont TELL her that's what it IS. They just let her go on WORRYING about what it is!!! I have gently told her her and she tells me I am wrong and continually comes up with things that might be causing this. Its usually related to some medication she is taken, something she has eaten or the weather!! What is wrong with these doctors?? They have also never told her exactly what is going on in her back. It makes me wonder if they even KNOW. My husband and I told her today that we feel that if we dont get satisfactory reslonses from our appointment tomorrow we feel we should take her to the University hospital so that she can immediately be seen by orthopedic and pain specialists rather than waiting any longer. She continued to fight us. I'm beginning to think she is frightened that if she goes she wont come home.
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The kyphoplasty is a easy procedure , you go home that day or the next . Easy peasy and I had her placed in the hospital where I work . It's just her and I now and I can go to work and check on her .
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My mom had back pain the CT scan showed a compression fracture Thoracic 12 and Lumbar 1 . I'm a RN and had her placed in the hospital they did a kyphoplasty , which is where the dr injects cement into the fractures to give it strength . There's no reason for your mom to live in pain. She needs a CT scan and treatment . My mom is doing great now hardly any pain and up walking ! She was in agony believe me but we got her fixed and now we can work on other things ....
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Jeannegibbs you are absolutely right. Thank you. Thank you. Thank you. Thank you. Why couldnt I reason that out for myself??? Best knock on the head I have had in awhile.
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I'm thinking back to what your eventually told about your mom's condition. They say she does NOT have a spine fracture, right? Have her doctors actually treated seniors with spinal fractures before?

Even if it is a spine fracture, the options are limited. When my cousin fell and fractured her spine, they told her that it would take time for it to heal and prescribed her pain medication. They also prescribed a back brace, which is supposed to help with pain during the healing,( including Tylenol), but due to her dementia, she refused to keep it on. Because of her dementia, she couldn't understand she needed to wear it and it could not be forced on her. The dementia also made her resist therapy.

Over the course of about 6 months the fracture healed and she doesn't have any pain from it now, however, she never regained her mobility and she is wheelchair bound. She can propel with her feet and get around though. The doctors believe it was the dementia that put her in the wheelchair and not the spinal fracture. No way to know for sure.

If your mom is not a candidate for surgery, then what benefit will the MRI have? I would see if the doctors could answer that.

Have they checked her out for pain somewhere else in her body? She may have pain from something else that is not being properly conveyed to you or the doctors.
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Do you have any option to find a new GP, or are there doctor shortages where you live too? I'm in Ontario and every province is different, but I have discovered you need to find a doctor that can work with you. If your doc's main practice is running a walk-in clinic they are NOT focused on long term caregiving. Yes, it's difficult to get an MRI, but if the right doctor pushes for one it CAN happen. You need to INSIST on seeing a specialist, and you need to INSIST that the appointment takes place in a timely way, not in months from now. You may have to travel to find one with an earlier opening but it might make all the difference. As for you having to do all the research about treatment options, I think has becoming all too common. It is a rare doctor that takes the time to look at healthcare holistically and treats the whole person rather than the most immediate symptom.
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Jilly2015,

Today, it appears that the insurance companies control the doctors and basically tell them how to practice medicine.

The so called affordable care act has skyrocketed the amount of paperwork done, My doctor tells me that his perception is that all of these changes are really about control and not about care.

Fewer people seem to be going into general medicine because of how difficult it is to sustain a practice with mainly government supported health care which does not pay like private health insurance companies do.

Our whole medical world view is far more into being reactive with care, than being proactive with prevention. Many doctors carry a stigma about the health care needs of the elderly which leads them to be more passive than active. Thus, we end up having to advocate for ourselves and our elderly relatives.

In looking out for myself and my own care, I am now changing to my 4th doctor in 13 years.

It's a sad messed up world in which it looks like doctor's are no longer free to practice medicine without the insurance company henpecking them; teachers in public education have to basically teach the test and so what's next? Are clergy going to be told what they can or cannot preach or teach about because of some government control regulation? We seen to be getting closer and closer to that strange new world that the science fiction writers have been warning society about.
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Jilly, you sound like a very caring, very compassionate caregiver. You say, "her doctor has said that she should be walking and riding an exercise bike and wading through the water at the pool so we feel that she should at least be walking to the kitchen. Do we ignore the doctor?" Yes.

You also explain how little respect you have for her medical providers and why. Why are you torturing yourself trying to implement what these (in your words) "quacks" are telling you?

It is precisely because this lady "was golfing 18 holes twice a week, bowling in 2 leagues a week and square dancing every Thursday night," that for her to suddenly not be able to do anything is suggesting to me that something is drastically wrong. And besides that you describe her as fiercely independent. Such people do not suddenly decide they'd like some attention and fuss and moan about pain they don't have. They do not ask for someone to make them toast. They drag themselves to the kitchen just to prove they are still tough and independent.

Either she is having very legitimate pain problems or something has gone haywire in her brain, or both.

If you were going to insist she do something she doesn't want to do, I'd vote for getting her to a big-city medical center, to specialists who will actually examine her.
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And Babalou her doctors are QUACKS. We live in a bedroom industrial city that has two walk in medical clinics with doctlrs that see patients at 10 minhte intervals all day long. Or for howevero g their shift is. They are so overworked, uncaring and so fearful of litigation that they just pass you off, if they remember who you are at all. They move people through this system like cattle. Its terrible. Her actual doctor is probably in her 50s and she keeps passing her off tl her nurse practitioner and was taking so little interest that she finally went to see this other one whom she says is so thorough. Hes 65. He did notice that the x-ray the last one was referring to wasnt even low enough to show ghe proper location and that was after 6 weeks of pain and now its been another 6 weeks and HE hasnt done much more other than another x-ray and a bone scan and pushed extra strength friggin Tylenol until I freaked at him last week for a pain patch. WHY arent these doctors PROACTIVE?? WHY do I have to PRESENT my OWN treatment options to my doctor nowadays??? Isnt HE the expert anymore?? I find this even when I go to see the doctor! But for my MIL I had to ask him to try her on neurontin, I had to ask for acupuncture, I had to ask for pain clinic appointment, I had to ask for diclofenac, I had to ask him to suggest to her she use our home TENS, I had to ask for pain patch when she couldnt tolerate pills. Dont these doctors give out treatment advise any longer?? And if not, what do they do????
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Thanks everyone. She takes the warfarin for atherosclerosis and heart valve issues. I believe her family doctor has told her they wont consider surgery because of hef heart condition but thats just from her. Apparently, the pharmacologist at the pain clinic says she can have a form of steroid injection without going off he warfarin bht again that is second hand info from hef and a conversation they had on the phone Friday. No MRI. To get a senior in for an MRI in Canada they either have to fork out the $600 to $700 for it or the doctor has to suspect cancer and he didnt see a tumor on the x-rays she has had. No fractures on the CT scan and nothing from the bone scan so she didnt want to pay for an MRI and we cant get her to let us pay for one. Its not for lack of funds on either part, shes just stubborn, she didnt even want the patch when she heard Blue Cross wasnt covering it in spite of the pain she is in! Shes a tough case! This morning was difficult. We sat and cried together on the couch. She looked like she had aged 5 years when we were first sitting there. She was judt spent. I was so mad I texted her family doctor because we werent able to even get through to the clinic switchboard on Friday to make an appointment after talking to the pharmacologist at the pain clinic so now we wait in pain another whole weekend! He never even responded. Im going to go postal I'm so riled at the lack of help we are getting. I want to take her into the city to a decent hospital but she wont go. My husband (her son), her 89 year old boyfriend and I all agree thats the route we shluld take but she wants to wait and see what happens with the pain clinic! We dont even have an appointment to the pain clinic yet! It could be 6 weeks yet! She is failing before our eyes! On Monday she is seeing this doctor again. My husband and I are both going. I am going to get my husband to tell this doctor, who is the same age as him, how she sits at home in agony crying and ask him if he would like to watch his 85 year old mother like that day after day.
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From someone who has also had 2 back surgeries, chronic pain will keep you on the couch. Unless your pain MEDS are strong enough to let you move around there is no way you can exercise. As stated above you need to get the pain under control. I don't know how the medical system works in Canada but has MIL had an MRI? This is truly the only way to get an accurate diagnosis of the problem. My dad who was around 82, under the care of an orthopedic doc, went majorly downhill in about a week. Doctor was out of town and we were told to go to ER on Monday, they gave him pain MEDS till dictir returned on Friday. On Wednesday he was having problems urinating, back to ER and catheter was inserted. Went to doc on Friday and he sent us right to the hospital in town. Y dad had emergency back surgery on Saturday of labor dad weekend. He was told he would probably lose the use of his bowels and bladder if he chose not to do the surgery. Prior to my first back I went thru pain management for injections/epidurals and requested physical therapy because I felt like I was losing strength in my leg and was told I needed clearance from a surgeon Waited 3 weeks for sppt. When I finally saw the surgeon i was told my foot was almost fully dropped and needed immediate surgery. My advice, see a surgeon first to make sure your MIL is doing more good then damage by going the physical therapy route. Back pain and nerve damage suck, I live with it everyday. Good luck.
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The stronger Butrans patch will make her even sleepier, so dont expect her to jump up and want to go dancing or anything else. I'm in my 50's and can't stay awake with it!
If she has a steroid injection, she will have to discontinue warfarin a week before.
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Back to the beginning. Who has looked at her back with what imaging? Are they CERTAIN that this is nerve damage and not a new fracture or a tumor?

She's on War far in for "just" artherosclerosis? Not a heart valve or some more serious cardiac issue? My impression (I am not a doctor, my husband has an artificial valve and has been on Coumadin for 10 years) is that there many other blood thinners that can be used for other applications. Is this doctor of hers very old, or very old school? It might be worthwhile getting some other opinions.
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Sunnygirl, good point about the mental decline and I hear what everyone is saying about the tough love idea. Question then: why do you suppose her doctors have said she should be outside walking, on an exercise bike and swimming? And bear in mind, 3 months ago this lady was golfing 18 holes twice a week, bowling in 2 leagues a week and square dancing every Thursday night until 11 p.m., not to mention driving all over hell's half acre to the city 30 miles away to do these things, partying every night of the week, casinos and dinners out and never to bed before midnight. So she is a very young, vibrant 85.
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jeannegibbs I fuss over her as much as she will possibly let me. Up until this happened she was a VERY independendent lady and we continued to allow her to keep the charade that we moved in with her not to help her but because we needed help financially that's how proud this lady is! So its a very difgicult tadk indeed. I take her her coffee in the morning in a pretty cup. I get her her pills and her water. I clean her TV tray off for her, I do her laundry, I clean her house, I chat with her, we discuss her options, I keep her optimistic, I drive her to appointments, I make her snacks, I buy her treats, I pick up her prescriptions, I make her bed, I worry myself sick over her pain, in fact, I'm too soft and that's the only reason the tough love comment came up because her doctor has said that she should be walking and riding an exercise bike and wading through the water at the pool so we feel that she should at least be walking to the kitchen. Do we ignore the doctor and let her languish until she is in a nursing home flat on her back? When we sit with her for awhile and she can talk and talk the pain seems to miraculously go away so we believe she is in pain but we also think that that jt is amplified by the complete change in her lifestyle and tbe fact that she is so bored and housebound and lonely. Yet she doesnt want me there much either. Sbe tells me to go home. She wa ts her boyfriend there and whdn he isn't she cries about the pain, wont eat and is cranky. When hes here she is happier, eats well and isnt in as much pain. She is also using her pain to get all of us to do things for her, I'm afraid. She is very little in to nice clothes or having someone bring her flowers or things. She is actually quite difficult. My husband is amazed I am so persistent with how special I have always treated her when I have always been so spurned over the years. There is always some complaint. Too much honey on the toast, the coffee is too strong, the mug too heavy, she doesn't care for the chips I bought her, theyre too thick, dont buy that brand again. I tell my husband it doesnt bother me because I know she loves me and I had a mother of my own who didnt so I just go with the flow anf think of the day I wont even have that anymore and it makes me very sad. I dont know if I'm doing the right thing or the wrong thing jeannegibbs and I sure dont want to get into a semantics argument about it. Love, tough love. Its just love to me. My husband is kind of tough on her but last night night he sat down with her and told her it sas only because he is so concerned. She has a call from a pharacologist at the pain clinic today. Shes on the cancellation list. The head doctor is in Europe until end of Sept. This pharma was wonderful. Talked to her for a long time. Gave her his direct line and told her to call any time. Said he was going to send his recommendations to her family doc. Said he thinks her pain patch is likely not sgrong enohgh if she hasnt had relief after 4 days. Will recommend a 10 mcg butrans patch. Jeannegibbs I tend to agree with your suggestion about the warfarin but I dont think her doctors would agree. She has advanced atherosclerosis. One thing the pharmacologist did say is that she could indeed bave a sterlid injection which her doctlr has been zaying for 3 months is contraindicated to the warfarin a d therefore he wouldnt refer her for one. Both her darn family doctors have been useless as far as helling her. I finally had to go with her, suggest a pain patch, suggest acuphncture, suggest diclofenac, suggest pain clinic, wth?? For the 2 and a half months and 4 visits before that the had her on Tylenol and physio! But she wouldnt let me go with her before then. She finally broke down and asked me to go after 3 months and the 5 visit. I was almost frantic. I thought I would go on a rampage. Then they still didnt do much. Now we are waiting for the pain clinic appointment. We dont even have one yet. This is Canada's medical service for you. Horrendous.
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