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Hello, everyone. My mother is as stable as she gets. It’s been a year since her multi level, hardware in the front and back 6 hours long neck fusion. She continues her Tymlos shots for osteoporosis, and has been released months ago by the neurosurgeon. However, right before she had the neck done, her thoracic spine began hurting. She’s had two spinal injections plus a nerve ablation. It’s not worked. She continues on Hydrocodone 10 mg three times per day (and I think she takes a 4th here and there when she’s got insomnia). GABA pentin, methocarbamol, zaleplon and doxepin for sleep. None of it seems to work well. She can’t tolerate being upright for very long.
Tomorrow is another pain Dr visit, and I predict he will want to do another ablation. My question is… are there other , stronger meds she could get if she were on palliative care? I actually don’t think it would be safe for her to live alone on more or stronger meds. But what exactly would palliative care offer that she’s not already on? I hesitate to mention this in front of her because I know she’ll confuse it with hospice.

I do not think the choice of medications would change with Palliative Care.

What you might want to do is make a phone call to a few Hospice/ Palliative Care in your area and ask this very question.
Ask how often a Nurse would come by to check on mom.
Ask how the medications would be prescribed and how they would be delivered.
Ask if she would be take off any medications and what they would use instead.
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Reply to Grandma1954
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Good question to put to the doctor when you visit.
It is my understanding you get better and more of the "good drugs" on palliative care, as addiction is no longer a concern.
I would discuss with the doc.
If you are hesitant and wish to avoid it all, just aoid it all. No sense asking for more trouble.
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Reply to AlvaDeer
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Saw the pain Dr today. He wants to do an implanted pain pump. Too many levels of spinal degeneration to treat with just an ablation. Annoying that he probably already knew it would not work. But I’m sure insurance requires him to try the lesser things first. Getting her off the narcotics would be better for her. Today she’d not eaten or drank AT ALL , but had taken all her meds. I made the 20 min drive to the dr. She was too weak and dizzy to get out of the car. Took a couple of tries. As we sat in the office waiting, I realized her speech was slower and her eyes sort of droopy. I told her she looked loopy, and she said she felt loopy. Her bp was 92/60. Had to get help getting her to my car. Got her a cookie on the way home with a drink and she perked up some. Still not great but better. I told her she must eat and drink non caffeine, and to not take meds on empty. Sheesh.
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Reply to Oedgar23
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O. I thank you for this update. There often, at the end of life is no good answer.
Not everything can be fixed. Our spines were not made to hold us upright, and not made to last so long as they have to. Now the answer I think is pain relief. Even if that relief means a quicker final exit. People have made their own final exit with VSED over less than this.
I am so very sorry. Just so very sorry. You know there is addiction at this point, but at this point, with this amount of degenerations, that's hardly the point.
So very sorry for you both. This will be pain until there is peace; that's the sad truth. I hope when it comes you will allow yourself to feel the gift that it can be to have our loved one as rest, without fear of further torment and torture when that is all that's left, really, of their lives.

My heart goes out to you BOTH.
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Reply to AlvaDeer
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Oedgar23 Jun 5, 2024
Thank you. Oh yes there is a long long history of addiction. But now, there is legit need for these drugs, and she “mostly” takes them as ordered. It’s so hard to get narcotics due to the opioid misuse epidemic and a shortage of availability. I have to call several pharmacies each month because nobody has it. I don’t even care anymore of she’s addicted, except for safety reasons. Can’t have her being more of a fall risk. And it’s all a nightmare since her almost-hoarded house gives me anxiety. I won’t sleep there. She can’t stay at mine either. Her weirdness makes my autistic son anxious, plus my house is large and rambling, full of tile floors. She’d fall here too. I refer the the current state of affairs as “ trapped in hell.” I wait for the other shoe to drop.
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Well, as she’s already on Vicodin, there’s probably not much more she’d get on palliative care.
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Reply to PeggySue2020
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There are stronger medications available on palliative care, however your concern about safety is certainly valid. Another advantage of palliative care is that your mom would no longer have to go to a pain clinic and other medical care would come to her. I had talked to my husband about palliative care for quite awhile and he agreed when we were going to have to drive across town to a different pain clinic. It was a blessing.

I just saw that a pain pump is being considered, hope that is helpful for her. If she has that procedure, be sure everyone is aware how much pain medication she’s taking so that it can be decreased gradually. I was surprised how little attention was paid to this at various points in my husband’s care.
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