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We need help here. My 84 year old already handicapped mom fell in the kitchen a week ago, Monday November 7, 2022 around 3 PM. In 4 hours it will be exactly 7 days since the fall. We went to the ER by ambulance right away. They released her in severe pain with no medication, no plan of action, no consultation with me or any family member on helping her. On Thursday we finally went to the orthopedic surgeon who has been seeing my mom for almost 14 years. He prescribed 50 mg Tramadol HCL 5 days supply. Gave ZERO pain relief. And again , no consultation with me and no plan of action for proper care. No suggestions on getting up and down, no suggestions on what to do. Her back and bad leg were severely injured. When I say BAD LEG, believe me, it was so bad, it took the worlds most foremost leg surgeon at Shock Trauma 3 months to figure out how to rebuild it.
On Friday we called the primary care doctor and mom tried to explain the situation and he said he will contact visiting nurses on Monday. That would be today. Meanwhile my mom called the orthopedic surgeon this morning to say the Tramadol, taking two 50 mg tablets every 6 hours as prescribed did NOTHING to relieve any pain. A PA is supposed to call sometime today and hopefully prescibe something stronger that will work.



My mom been in pain everyday for 14 years. But this fall is so bad. She has been the perfect person her entire life. Very kind to everyone. Never causing trouble, never getting in trouble, for the entirety of 84 years.



She prays for everyone and asks for help in prayers, her whole life.



As her son I think she deserves to be pain free for at least a couple days now. If there is a medical reason this cannot be done we need to know what it is.



She is in great health other than the pain. The only meds she has ever taken is Tylenol everyday for 14 years, and Xanax which started maybe 10 years ago.



She had the heart recently checked out with a 48 hour monitor and a stress test. LOW RISK, everything fine.



She has mammograms every year like clock work, no cancer ever found. She had her lungs checks, skin checked, gastro checked, gynecologists checked, everything. NOTHING IS WRONG WITH HER



EXCEPT THE PAIN!!!!!!!!!!!!!!!!!!!!



Before the fall she would walk a little. Push a cart slowly though the supermarket twice a week. Walk to the bathroom, even at night, but always putting her sneakers on to do it. She could cook and make great meals. I would just need to help get things down, and in and out of oven, and stuff like that. She could hang up laundry in the closet.



Now she can't do anything and is getting DEPRESSED.



She and me are both willing and begging to be allowed for her to try again to get better.



WE NEED HELP! We don't know what is right or wrong. Everything we are doing is a guess.



I hope the visiting nurses call and can come here. They can assess the situation, and get us set up. I think we need aside from nursing services for 2 hours or so a day, physical therapy services.



I think a kind caring visiting nurse can help with the depression as well. Just be coming with a smile and helping hand.



Please , we need relief.

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Call 911 and have her transported by ambulance to the hospital. It would be good if she moans and cries a lot. I am serious. If she acts like she's coping, the ER won't pay enough attention. While she is being examined, you make a fuss. Rage if you must. This worked for a friend whose husband was in the ER with multiple comorbidities and Covid. Friend saw him fading away and HAD A FIT. Literally kept yelling, "Can't you see he's dying?" It got attention, husband survived and is well enough to be out and about again. It's too bad it has to come to this.
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James, what xrays have been done? If none, call ambulance and tell them you will call one over and over until the diagnosistic tests are done and a pain relief consult arranged. With age we can get compression of the spine. I am so sorry this is ongoing but you are going to have to COST THEM it seems, to get attention. Returns to the ER dings the records for hospitals when the reoccur in a certain time. They may find a way to get you help so that they don't see you every day.
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JamesG4Justice Nov 2022
The xrays and CT scans were done in the ER. Nothing broken. All muscular , bruises, and sprains, Severe muscle sprains in the back and side, and the bad knee is swollen on the bad leg, that the thigh muscle was ripped out of, and has rods instead of a real femur. Both legs have that.
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The PA is supposed to call back today and perhaps write a script for stronger meds, right? And a visiting nurse to come to your home? Sounds like a great start to me.

Other than waiting it out for those actions to take place:

Did you make an appointment with a pain management clinic who can get her on on a schedule of opioids or narcotics to help with pain?

Get her back to the ER and let them know she cannot manage her pain successfully, that xray and scans need to take place. You may get a referral to a pain management clinic at that point. Or ask the PA for such a referral if a script is written for 5 or 10 pills only. Mom needs a longer regimen and that may be the only way to get it.

Good luck to you, I'm sorry for all the pain and suffering that's happening.
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JamesG4Justice Nov 2022
The PA just called. I could hear her through the phone, she said "they are done with prescribing narcotics". She suggested 1000 mg Tylenol every 8 hours. Advil every 6 hours with food. And finish the Tramadol, which will be tomorrow night 8 PM with the last tablet. That is it. If me mom is still in such severe pain after a few more days, I hope the Visiting Nurses can talk to the primary care doctor and get us the REAL DEAL. The real deal is you take a pill and in 15 minute you are feeling no pain. We only need it for a few days while we get situated.
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Constant pain keeps us in a state of mind that often leads to depression.

Your poor mom.

Tramadol is widely prescribed now, but is not very effective for most people I know. Tylenol alone is useless. Ibuprofen is probably not a good choice for an elderly person. Aspirin is not tolerated by anyone I know.

I am known as being a real PITA about allowing people to live pain free, or at least pain-tolerable lives.

Be mom's advocate. I know I had to practically beg my mom's pain clinic dr to give her 10 Tylenol #2's. (325 mg of Tylenol and 5 mgs of codeine). She had to make those last for 2 weeks. It was horrid.

I have chronic arthritis and I am in pain 24/7 to some level. I find that when I take my pain meds regularly and don't let the pain get 'out of control' I do much, much better. If I let a couple doses go, it will take me a few days to get it back in check.

I've stated this before and I will state it again: The opioid crisis is a scare tactic for 'regular' people. It's keeping people living in pain and not being able to live lie to the fullest.

Addicts will still get their stuff. NOTHING stops them. An 84 yo woman deserves to have the best quality of life possible. If a Tylenol 3 can keep her pain at bay--what's the harm?

Be mom's advocate. My mom didn't want to be a 'bad' patient, but I sure didn't mind being her mouthpiece.

Your mom might qualify for pain patches, which slowly release the pain med into the system and seem to be very effective and you can control how much she gets.

If you have to get 'nasty'--by all means, do so. Nasty in a nice way. Sounds like you mom is too sweet to get aggressive with the PA.
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Sometimes, one can have a hairline fracture, which is extremely painful and just as painful as a real fracture.

A hairline (tiny) fracture won’t show up on the X-ray, MRI…It might show up weeks later when the bone is healed.

I hope you can find some anti-pain medicine.
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Take her back to the ER. Or to a different ER.

Request a pain management doctor.

Has she tried the medication regimine that was prescribed?
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JamesG4Justice Nov 2022
Yes, we been doing it all along. I need help, backup. The visiting nurses. They took very good care of the situation in March 2009, and again in 2013. But mom is now 84 and everything is that much ore harder including her stubbornness and depression. She doesn't want a hospital bed in the family room. She fought me on the visiting nurses for 4 days, was gonna rip my throat out if i even suggested it one more time. Now she has agreed to it. I can change the bed every day, wash the sheets, help her to the bathroom. Help her from the bed to a wheelchair everyday. Answer her every need as she believes them to be. But we have no idea what her REAL NEEDS are. WE NEED HELP. I can even take the poise pad off her. There are just some things I cannot do. And a lot of things we do not know HOW TO DO.
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I'm so sorry your mom is in such pain. The fact that she was prescribed Tramadol is absolutely ridiculous. That medication is for mild to moderate pain. It is not to manage the pain from the serious injuries your mother has.
See if you can take her to a different doctor. I'm going to tell you honestly about what visiting nurses are going to do for your mother which is pretty much all of nothing. I've been an in-home almost 25 years and can say in all honestly that 99.9% of the time visiting nurses are completely useless. You may be able to get some aide hours if your mom has nursing care.
As for her depression. This what is what they're going to offer. They will put her on meds. Your mother has legitmate reason to be depressed. When a person is in constant physical pain like she is, it's very depressing. Popping a Lexapro is not what she needs.
What she needs is pain management which will help with her depression and anxiety. If there's a pain management doctor in your area, make an appointment.
In the meantime I would strongly suggest you visit a marijuana dispensary with your mother and the two of you talk to the in-house pharmacist on what your mother's conditions are and what can he suggest that would help with the chronic severe pain and her depression/anxiety. I'm being serious here. I've had clients with chronic and severe pain and medical cannabis was like a miracle to them. I hope this can be a possibility for your mom.
Also, you have to stay on her doctors and nurses and be a downright nuisance to these people. It's the only way you'll get anywhere with them.
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Your Mom needs a pain management specialist. And I agree, she could have a hairline fracture in a disc. This is very painful, my Mom had it. There is a procedure where a cement type stuff is put in the fracture and takes away the pain.

I live in NJ and live in the Southwest. My Moms problem was found in a hospital in Delaware. All I can tell you is you need to be the squeaky Wheel. You need to demand answers. Because of the Opioid epidemic they are cutting down on prescribing it. Not sure what a Visiting Nurse will do. They work under Doctor's orders. They can evaluate and recommend but the doctor but the makes the final decisions.

Tramadol caused hallucinations in my Mom and had to be stopped.

My daughter, an RN, says you can take pain killers every 2 hrs if different pain killer. Ex: you start with Ibuprofen and 2 hrs later if still in pain u take acetimetiphin. Can't remember which Tylenol is but its bad for your liver.
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Please send mom back to the hospital and tell them not to release her to you because you cannot provide care. Just say, "NO!" Ask them to call in a Pain Management Doctor: if they refuse, then call her doctor and beg him/her to treat your mom the way he/she would treat his/her mom. Call Adult Protective Services and ask them to evaluate her for placement. YOU are not the solution, so let the professionals get involved.

P.S. Tramadol doesn't work if used as prescribed. CBD might help. Real marijuana cookies or lollipops may offer remedies, but may affect her medications and stability: maybe you could consult with a pain specialist. Please do a search in your area for a top notch pain specialist and look into a tens machine for her.
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lealonnie1 Nov 2022
I've taken 1 Tramadol a day for years & it works just fine for my arthritis pain.
CBD w/o THC acts like a placebo.
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James any updates? Could one of the rods in the bad leg gotten out of place in the fall? Did they do an MRI? My mom had a fracture caught by an MRI several years ago she was in so much pain and they sent her right to the hospital.

I pray your mom gets some relief. My mom had spinal surgery recently and came out of it in agony we had to demand something stronger than Tylenol and she finally got relief with dilauded and no she didn't become an addict.

As some have said here how she presents is everything... Like your mom mine would be in agony wanting to die and when the doctor came in she'd smile and say "I'm good" and he'd walk out and of course then he wasn't accessible for hours after that or another whole day, the windows are short! She was not wanting to make a fuss or bother anyone.

Your mom sounds like just such a beautiful soul and of course even mean souls don't deserve pain but you know what I mean. I hope you took her to a different ER. I was crying so hard when I took my mom back in her pain bc I promised her relief and instead they gave her a CT scan before medicating her, it was like they wanted to torture her.

I hope they've figured out what is causing the pain and have a plan to manage it.
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