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Mother’s neck surgery recovery continues to go well. She probably has one more visit with the neck surgeon and then will be cleared. She just had x-rays done and we are waiting on that visit but so far so good. But her thoracic spine is hurting and she needs to go to pain management. The neurosurgeon referred her to a highly regarded pain management doctor, who works in his building in the big city Medical Center. We just went through that paperwork, and find that anyone on a continuous narcotic or muscle relaxer prescription requires an in person visit to obtain refill for a 28 day supply. Every single time. It is getting harder to get mother different places. She has insomnia, and tends to stay up all night and sleep late into the morning. She’s also had IBS, my entire life, and lately it tends to act up right as we are trying to go somewhere. I’m not about to load her in the car for an hour long ride when her bowels are about to act up. We actually had appointments scheduled today with this pain management and the neurosurgeon, but they have predicted all kinds of nasty stormy weather and mother decided we should not go. I also hesitate to drive in the weather they are predicting. So after reading the pain management policies. I decided it was going to be too hard to get involved in something that requires, a trip to the big city med center every few weeks. I’m just not signing up for that nightmare. So I found a pain management doctor close to where we live. He may not be the best of the best or recommended by the hotshot in Neurosurgeon, but it will be much more manageable.


We are waiting to see if there is some procedure or injection. He can do to her thoracic spine. I know the goal is to get her off of narcotics, but I’m not convinced that will happen. She has osteoporosis in some things that look like compression fractures.

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This may be no use at all because your mother certainly doesn’t have my scoliosis problem, but it is so unusual to see someone with a THORACIC back pain problem that I want to pass this on. I have done amazingly well in the last four months with Mobic, alias Meloxicam, which I should have been on years ago but made mistakes with Ibuprofen, which I can’t tolerate. You need to take Mobic with food (I now have it between mouthfuls of half a cold cooked sausage with my breakfast), but it’s one a day and where I am you I get repeat prescriptions. It doesn’t stop all my pain, but my codeine intake has dropped right down, sometimes none in a day. I wouldn’t worry about ‘getting her off narcotics’. I’ve been on unlimited codeine for years, it’s the least addictive ‘narcotic’ and I’m certainly not addicted. (I can assure you that I'm not addicted to the cold sausage either). Mobic is doing me better than the hospital-based pain clinic that put me on a mini dose of psycho drugs years ago (in retrospect I think they were experimenting). Pain is not a lot of fun, coping gets to be a pain in itself, so go for the easiest way to cope!
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I am so pleased to hear how you are looking after yourself in the decision making too.

This year I have a few family members that have needed to collect all sorts of specialists. We are blessed to have options & everyone is willing to keep things local where possible. This allows the more independant ones to drive or take a short solo taxi ride. Those needing a driver to wrangle walkers or wheelchairs make it easier on family by choosing sensible locations.

Only varient is an ER listed as preferred location for one LO. It is accross town, busy & hard to park, but, is connected to a good rehab, which is easy to travel to & park. It has better links to permanant care in an area I'd be happier with longterm too.

People fall, get ill, have accidents. The future is unknown. But if I do get to choose an ER so that the follow-on pathway suits - good.

I'm looking after my mental health too.
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Lea,

What do they do with cases such as yours? Is PT helpful? Would strengthening muscles help in this situation?

PT helped my husband after rotator cuff surgery on each shoulder. He had awful pain for a while.

PT helped me tremendously after my surgery for an open compound fracture that I had in a bicycle accident.

I was paralyzed for a while. The physical therapist forced movement and I went through an aggressive physical therapy program for several months.

PT was worth it though. I have some permanent damage but I got back about 80 percent of my range of motion.

It’s funny, I can tell when the weather is going to change due to the steel rods on my bones! I can’t get through X-rays at the airport. I get thoroughly searched when I travel.
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Wow! You’re dealing with a lot.

Hopefully, they will be able to manage her pain and find the right balance of meds so she can feel better.

Living with chronic pain is miserable! Addiction does complicate matters.

Everyone responds differently to meds. Wishing you and your mother well.
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And this is also complicated, because due to her 50 years of chronic pain and psych issues, she does have a pill addiction. But so far, since she’s been back on the meds after her surgery, she has not abused them. And she does have some legitimate pain problems that needs some sort of help or attention. Her medication list includes hydrocodone 10 mg, zaleplon, 10 mg, venlafaxine, methocarbamol, and gabapentin. She was just taking off of the Seroquel for insomnia because it was making her dizzy. She’s on a ton of powerful medication.

i’m trying to put some things together from the time we were absent. When she kept being found outside disoriented, and one time naked, the only difference in her medication list was she was on Soma and Elavil for the antidepressant. And it sounds like she was really out of it at times then.
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You’re doing the right thing by scheduling visits in your area, rather than traveling further away and dealing with traffic, especially since she has IBS. I don’t blame you for not putting her or yourself through this.

My mother went into the hospital for seizures. While she was there, I was told that they saw symptoms of Parkinson’s disease.

We were instructed to make an appointment at a large medical center because they had a doctor on staff that specialized in Parkinson’s disease.

Since this was a teaching hospital, mom initially saw the doctor they recommended, then she had rotating doctors who treated her throughout her time under their care.

My mother wasn’t comfortable with this situation and said that she often felt like a guinea pig.

My mother was more comfortable seeing one doctor on a regular basis. I found another neurologist who treated mom very well. It was closer to home, easier parking and a lot less traffic.

You’ll be fine with a place other than the place that was suggested for your mom.
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Heating pad, pain patches, and Tylenol work as well as anything else to manage pain and arthritis in the spine. I also take 1 Tramadol a day but my entire spine is a terrible mess. A Velcro binder/brace helps too, from Amazon or Walgreens, for the lower back.

https://www.amazon.com/s?k=back+brace+for+women&crid=D257F3N1B438&sprefix=Back+brace%2Caps%2C191&ref=nb_sb_ss_ts-doa-p_5_10

The thoracic spine is a particularly painful area for me now after I had kyphoplasty surgery to repair broken vertebrae. Hard core pain meds aren't the answer for me because they cause more issues than they cure, plus we build a tolerance for them after awhile and need more.

I think it's a good idea to look out for YOURSELF these days bc it'll be one thing after another with mom.
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Sometimes the fancy-pants doctors are just the ones who have received the most drug-company money and published the largest number of articles. And of course their "prestige" is shared with the center in which they work. All of these relationships are very symbiotic.

I doubt your mother will receive inferior care at the closer place. You can always read articles by Dr. Fancy and discuss them with Dr. Local.
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I actually read an article in the New York Times about a woman who used VSED to have a final exit due to continual spinal issues. It is dreadful when this is the issue because it is basically only helped with heavy duty drugs and they will cause further falls, sleep problems, over sedation. It's a crucible and terrible to live with chronic and severe pain that has a REAL cause and that will NOT be going away. The woman in the NYT article had a peaceful exit with her daugher arranging things; her friends were all gone; she was more than ready and could not deal with the pain.

I so hope that there is good pain management that works here, and so worried you won't be able to find the right mix and combo to handle this. Compression of the spine adding to whatever issues are already there is excruciating. I deal with chronic back pain as a former nurse; motrin used to be my best friend before I understood the damage it did to my IBS and my Diverticulitis. I am medication free now, and just "deal with it" but can well imagine at 81 there will come a time when it won't be that simple.

I sure wish you luck. I congratulate yourself for arranging this so well. Massive pat on the back to you, but not enough to knock you over, O.
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The city where this is has a huge world-renowned medical center. It is also known for horrific traffic, and the direction we come from has notoriously horrible rush-hour traffic. Just too many obstacles to get involved in doing that on a regular basis. The care we’ve already had to seek There has been a real pain in the behind. But of course, complicated neurosurgery is not available here, so we had no choice but to go there. But I’m ready to be done going there. she will still require treatment from the rehabilitation doctor she sees for osteoporosis, but those visits are not very frequent.
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My philosophy when helping others, its at my convenience. Driving an hour into a city I would never do. I have told my nephew to make sure the doctor knows I won't go further than 30 miles north from where we live. No cities.

He may recommend Mom coming in every 28 days but that is not the law. With DEA controlled meds, a 30/31 day refill is only allowed. None of that 90 day refill stuff. In my State, u must see a doctor for a new prescription every 6 months.

You did OK.
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