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She can't have surgery because she has pulmonary fibrosis. I don't know what to add other than we have contacted the orthopedic department at Mayo...She is going to PT twice a month....I caregive part time and an agency does the rest. She lives in her own home and uses a walker...

I feel powerless and ignorant to what other options we have. She was crying this morning...she said she can't take it anymore..and she's not a complainer....I feel helpless watching this happen. Thanks for listening

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Thanks Veronica. I was thinking that with technology these days there has to be some sort of solution. My sister had a resurfacing done on her knee. One bad knee has been hereditary for myself and all of my sisters.
I will ask the ortho doc. Thanks
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Smitty, Resurfacing is the replacement of just the ball of a ball and socket joint as in knee, hip or shoulder. I am not personally familiar with it but from what I have read the surface of the damaged ball is shaved off and a cap placed over it which goes back into the socket of the joint. The new cover has a prong on the back which is driven into the remaining part of the ball and is either cemented or new bone is allowed to grow in and stabilize it as with total joint replacements. full use can begin at once and there is minimal physical therapy involved so co-operation from a demented patient is not required she would either use it or not.. It can be done under sedation and regional anesthetic but usually everyone is happier under a general. I doubt that with your mother they would consider any intervention at this stage but it never hurts to ask. I have seen long bones pinned for patients with metastatic cancer to stabilize them and allow them to continue to walk as long as possible but they did not have lung disease.
I was thinking of resurfacing for Pink's mother because of less need for PT.
I believe it is more common in Europe than here so anyone would need to find a center that had experience in the procedure but any orthopedist should know about it even if they don't do or recommend it. The key question is "How many of these have you done?" as of course with any procedure that is relatively new.
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Veronica, what is resurfacing? Does it require anesthesia? Thanks for the natural tips...I will try the turmeric and Deep blue and arnica..
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Pink, I agree that you're right to get your mom to an orthopedist. And we've all learned from our mistakes, since none of us are perfect. One thing I've learned the hard way (with my own health) is that doctors often won't tell you that other options exist if they're not the ones who can provide that kind of care. So you have to demand it (like your demand for a referral) or find it yourself. It's a sad but true fact.
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Pink
You are right to insist on seeing an orthopedist. once he has seen the X-rays he may be able to recommend a lesser procedure such as resurfacing which may need less PT. You don't know till you ask.
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pipruby, there is also a great product by DoTerra called Deep Blue rub. I like arnica and the creams.
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Veronica, that was what he doctor thought would be the problem, that she wouldn't cooperate with the PT after a replacement. He didn't think that she would benefit from an ortho doctor either but I pushed for the referral so that I could get a specialist to check it out. I wish we had it checked out sooner but hindsight is 20/20.
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Try Turmeric capsules, an anti-inflammatory spice. Also talk with her doctor about lavender oil and/or Arnica massage to relieve pain. Consider a gel foam top pad on her mattress, or if she is heavy, a Temurpedic mattress or something like that.
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Nightingale
You did not mention in your first post that Mom has cancer in her bones. This makes it a whole different ball game and increases the reasons she can't have surgery. Does she have the cancer in her shoulders. if so they can do palliative RT to the tumors which will may ease some of the pain. and won't be too difficult for her to tolerate. Have you considered having hospice come in?
I do not agree with placing her in a nursing home. As long as you can provide 24 hour care the best place is in her home. That is unless she wants to go. Her care will be far better at home. Hospice may be able to use better medication to control her pain. Again hospice is very very good about pain management and pain clinics often abide by the "we do not want to get her addicted" My answer to that is "Why does it matter she needs whatever it takes to keep her comfortable" With cancer in her bones her life in this world is coming to an end. Has anybody considered giving her Prednisone.

Pink LA
Get thee to an orthopod ASAP.
I can not predict whether surgery would worsen your mothers dementia, that is obviously a risk to be considered but living with such pain does not improve her quality of life either. These days a knee replacement can be done in less than 1
1/2 hours. The anesthesiologist can use a spinal anesthetic and heavy sedation so she will be asleep while it is done. There is little blood loss with a knee but of course it will be painful and she will have to co-operate with the PT and probably spend a little while in rehab. If you think she can cope with all that at her current stage of dementia I would certainly ask about it. Don't be brushed off till you know the facts. Many people tolerate it just fine. Depends on any other health issues she has besides the O/A and dementia.
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My mom has bone on bone in her knee. It is very painful for her and she takes acetaminophen four times a day. the doctor said that she could take up to 2000mg per day to help with the pain. He said no "unnecessary" surgery for her because it could worsen her dementia, so a knee replacement isn't in her future.
She walks with that one leg straight and drags it. That is why she fell a couple weeks ago, it caught on a small lip in the road. She has to be watched most of the time because she can easily lose her balance because she doesn't want to use that leg. She uses a walker when we go out but refuses to use a cane inside the house. Stubborn lady.
Her MD thought that PT wouldn't be helpful and I pushed for her to see an orthopedist. We will can get her in to see him in a couple of weeks. I'm hoping that he has a solution. I will be sure to ask about the synovial fluid possibility.
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My friend used the electrical impulse device and it did nothing for her.
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Lovingmom have you talked to the orthopods about doing minimally invasive surgery with less anesthesia? They can do so much now with very small incisions. But you have to find surgeons with lots of experience. If your current docs can't do that, but others can, they won't necessarily tell you that. I don't know if that kind of surgery can be done with less anesthesia, I guess I'm just advocating that you check around with any teaching hospitals in your area to see if it's a possibility.

The other idea would be a TENS unit, where an electrical impulse is sent to an area to confuse the brain about sending pain signals. Here's what I found online about TENS for the shoulder: TENS is a type of physiotherapy where small electrical pads (electrodes) are stuck to the skin over your shoulder. The TENS machine delivers small pulses of electricity through the electrodes, which numb the nerve endings and control your pain. So definitely check those two options out. Good luck to you and your mom.
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I agree with the person who mentioned the artificial synovial fluid. I would find out if they can do this for her shoulder. Seems like that would cushion between the bones.
My mother has a torn rotator cuff and they don't want to do surgery because she might not make it. I have mixed feelings because she is in a lot of pain sometimes.
Any comments on that?
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My mother has bone on bone arthritis in both shoulders. The orthopedic surgeon said injections wouldn't help her, at this point. I rub a bit of (RX) Voltaren on each shoulder and, then, put a microwaveable heated pad around her. PT helped for awhile but its so painful and the rubbing sound is very noticeable. She, also, sees a pain management doctor for RX pain pills (there are a multitude of issues due to cancer in her bones.) She is never left alone, at this point, to avoid falls.
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PSteigman....thank you...i agree that she needs an OT eval...and agree that her walker is her undoing...I think the time for her to remain in her home could be coming to an end...
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Some very interesting and helpful answers. Thank you. Mom can't tolerate ibuprofen because it hurts her tummy....i'm sure it could have been the answer we're looking for...thanks Blannie about the synovial fluid injection info....I will ask her doc about that...she has had numerous cortisone injections which bring temporary relief. IF ONLY she could have surgery. A friend and I have been praying for answers. Thank you all for your feedback.
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Just another thought, the walker could be really hurting her shoulders too. I have to use crutches every now and then if I really over do my ankle, the crutches kill my shoulders and underarms, would think her shoulders would hurt from a walk, perhaps, some padding on hands of walker, or adjustments to her height could ease it too.
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Going to PT twice a month will not compensate for using a walker all day every day. I would suggest an OT evaluation in the home. At some point she will need nursing home care and this should be discussed with her MD.
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my lumbar verts are all worn out. im going to install stainless steel water pump bearings to replace them. yea im gonna have 4 grease fittings in my spine. the AMA is still stuck in the dark ages .. losers!!
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Thank you Blannie, I did not hear about synovial fluid injections, I just researched it, found an article dated 2009 and it was being first introduced at that time for joints other than the knee. I will do more research on this, perhaps, it will be of use to me, I will not get an ankle fusion. Thanks again, I will do some homework, they were referring to it as hyaluronic acid tx.
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Another idea is the artificial synovial fluid they can inject to cushion the joints. You hear about it most in the knees, but it looks like they can also inject it into shoulders.
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You might consider talking to a acupuncturist (personally I prefer someone who trained in China) to see if acupuncture might help alleviate some of the pain. Some arthritic conditions respond well to acupuncture but not all conditions do. Acupuncture treatments are not covered by Medicare.
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What about cortisone injections???
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looks like the moderator kicked me plum off of this thread. well, ya win some and lose some i s'pose. i have cheese filled brotchen rolls in the oven and the moderator doesnt. sour grapes, im thinkin..
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You can take something like Prilosec or plain ol tums with the ibuprofen. My mother had xrays, diagnosed with osteoarthritis in shoulders, had the steroid shots, what worked, a new mattress, and ibuprofen, go figure.
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This a very painful and difficult problem for your Mom. Have they tried steroid injections? Moist heat may give her some relief. Wring out a cloth in water as hot as you can bear and gently drape on her shoulders. You can cover with another towel to keep the heat longer. Soaking in a hot bath may help too under supervision. She probably would benefit from more PT too. Can you go with her and have them show you how to help with her exercises. She should do a little something every day. Does she have a walker with wheels on the front? That will be easier on the shoulders than lifting it.
The other things she needs is to be really comfortable in bed and when she is sitting. A Craftmatic bed is ideal with a really soft mattress . Have the head elevated to what is comfortable for her. Get three really soft pillows and put two upright making an inverted V. Put the other one across the top so there is a kind of nest for her to snuggle in. Raising the foot of the bed may help to balance her. This works well with a hospital bed too with a foam mattress.
Does she have a comfortable well padded recliner preferably an electric one so it helps her get up easily and saves her arms. Again a very soft pillow or cushion for her head. If she is most comfortable in the recliner encourage her to sleep there too. Cover her with something light and warm such as a soft down comforter. It will make her feel cosseted and really comfortable which will go a long way to easing the pain. Ibuprophin is very good for the pain unless it is contra indicated along with something in the narcotic line and or a muscle relaxant. I prefer the Advil brand of ibuprofen because any generic gives me heartburn. I personally can no longer take it because I am on blood thinners.
Keep the shoulders warm again with something warm but soft and light. it may take some experimentation till you get everything right for her but I think it will help. if someone is coming in frequently have a commode by the bed or chair so she does not have to walk far
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Is medical marijuana legal in your state? Do some research on that. I haven't used it, but I know people that do and they are pain free.
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I have ankle osteoarthritis, which is bone on bone, no cartilage. I feel for your mother. I found for myself the greatest relief was ibuprofen, plain ibuprofen, and Maxilief, it is panadol and a small amount of codein, if I have been on my feet for too long, or walked a bit more than I should, I take one at bed and I am good to go the next morning.

Another thing to look into is her mattress. I found my mother having a lot of shoulder pain getting up, we got a new mattress and she has no issues to speak of.
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