Help me.

[kslib]

Posted this in Mental health/support as well. Thought someone here might be able to help too.

My mom is in the hospital for suicidal ideation. She has had major depression for a long time, and is now suffering from chronic pain due to cervical spondylopathy. She has completely given up hope of finding pain relief. She is calling me saying that she wants to go home and that they aren't doing anything for her pain. When she was home with me, she was violent when I tried to take her meds with me and give them to her on a schedule (so she wouldn't commit suicide with them).

I just don't know what to do. Should I take her home? I can't be with her 24/7. I work full time and am in school also. She'd be by herself a lot, and I think that's bad. She can't work, she's on FMLA right now because of the pain. Her sisters have offered to pay for a plane ticket for her and one other person (whomever can take off) to go up to Mayo Clinic and try to conquer this pain. The nurse at the hospital suggested that she go see a neurosurgeon in Kansas (where we live). My dad isn't too much help. He's sort of afraid or intimidated by doctors, and is on the road trucking a lot. He would love to take off work and take care of her, but they can't even afford groceries right now (with only one income), so he feels like he has to work so they can pay the bills. If he knew I was buying groceries for them, he'd just die. He loves her a lot, but she's so mean and hateful right now. She told me just the other day that she hated me.

If mom loses her job, they both lose their health insurance, and that would be a disaster.

What do I do? I can't bear to hear her sob on the phone about how much she hates it there, but I can't leave her alone either.

[LynzM]

1. I don't know what you should do

But I will send you a big, huge :hug: That sucks so much that she (and you guys, as a family) are going through that. Does her health insurance provide for any kind of in-home care? Has she seen anyone who does accupuncture for pain relief? Those are my only suggestions, sorry... here's another :hug:, though.

[kslib]

7. Thanks!

I needed that. We have Blue Cross/Blue Shield. They're pretty good I think. She's tried chiropractic, massage therapy, Cervical Epidural Spinal Injections, Physical Therapy, Traction, Analgesics, Narcotics, but I'm not sure about acupuncture. We're pretty rural, so that may not have been a readily available option, but I'll check.

[elehhhhna]

2. Demand a pain specialist first.

Chronic pain as I'm sure you know by now is under treated and a great cause of depression. You must demand a consultation w/a pain-control specialist ASAP. Talk to the top dog at the Hospital if need be. Get the pain under control.

[fertilizeonarbusto]

4. YES!

I have gout. I've had a bit of a rough and sad life, but the only time I ever considered suicide was in my sixth straight month of gout. Address that pain before everything else. Meanwhile, :hug:

[kslib]

9. She's seeing two specialists

an orthopaedic surgeon, and an anesthesiologist. See above post for treatments. The anesthesiologist works out of a pain clinic. I think that things are just moving really slow for her. It seems pretty fast to me, but when you're living with pain, everyday must seem like an eternity.

[Ladyhawk]

3. I can't give advice, but I can commiserate. :(

I have serious depression and chronic neck pain, too. It isn't a good combination. I'd suggest that you get her to a neurosurgeon who can perhaps give her some hope for the alleviation of pain.

It's taken me a year to get an MRI, but I finally talk to a neurosurgeon about the results on Thursday. The hope of getting rid of the pain could count for a lot. The problem is that it takes time to get in to see the specialists and if you're poor, good luck getting any expensive tests. :( It shouldn't have taken over a year for me to get approval for the MRI.

LH

[mongo]

5. All I have to offer is my support and prayers

Wow - I don't even know what to say.

It doesn't sound like it's a good idea to let her come home right now.

If you can get the Mayo Clinic trip arranged, they may be able to provide some help - and maybe give your mom a reason to at least agree to not hurt herself until after they check her out.

hang in there.

[Heddi]

6. Is there any way you can set up a home-health nurse

if for nothing else than to
1) be with her throughout the day/night
2) ascertain that she takes her medications on time

I know you're concerned about her suicide, but if she's in chronic pain, it is IMPERATIVE that she take her medications ON SCHEDULE. The thing about pain is that if you dont' load up BEFORE the pain hits, it takes sometimes 3x's as much medicine to control the pain than it would if she took the meds on schedule.

See if the Dr can Rx IV or IM (intravenous or intramuscular) injection of pain meds that can be administered by a home health nurse. That way, she gets them on schedule, and gets them when she needs them (as opposed to when she wants them)

I don't know if your mother's chronic pain has anything to do with her suicidial wishes, but those two (chronic pain & suicide) go HAND IN HAND. It's really impossible to imagine what it is like to live with pain 24 hours a day. Pain that NOTHING can combat. Pain that only goes away when you're in a stupor from Morphine or stronger meds.

I know it's hard, but don't take what your mother says to you personally. I don't know what your relationship is with her, but most likely she does'nt hate you. She's going through the steps that we all go through when we're faced with horrible news--you know, denial, barganing, aceptance...all of that stuff.

As a nursing student (bing!), you and your family are at risk for Caregiver Role STrain---it's a very powerful thing and can completely devistate families. That's why I suggest home health care if at all possible, even if temporary. It'll take alot of the stress and responsibility off of you, and that will greatly improve YOUR life.

The hardest things to go through sometimes is having to take care of an ill family member. My family had to go through it when my great grandmother had Alzheimers. It was so overwhelming physically, emotionally, mentally, finanically.

If at all possible, I would have YOU speak to a health-care provider (her doctor or nurses if possible). They can give YOU resources to help You out as well as her. She can't get well if the family is falling apart.

Sadly, many health care professionals never see beyond the person lying in the bed. THey have no concern for family dynamics, family interactions, family stress. ALL of those impact the patient and how well they recover (if any).

Please talk with her Dr/Nurse and explain your situation to them. I guarantee you that you're not the first person who has had these concerns and issues. They may not be able to give you 100% of the answers you're seeking, but they most likely have TONS of resources available to you--if nothing more than a supplemental free insurance for your mother should she lose her job, or supplemental insurance so that she can have home healthcare for her while she's at home recovering.

Good luck to you and your family. Feel free to PM me if you need to.

[kslib]

10. Thanks!

Part of the problem is that she is a nurse (I'm a future nursing student too! Starting 8/06, currently a licensed health care administrator, but working in veterinary medical records). It's really hard for her to let others take care of her. She's finally starting to let us do for her, which is, ironically, how I know how bad she's feeling.

I used to work with dementia patients too, and know the risks for Caregiver Role Strain, and know that I was dangerously close to it until I decided to go to church (even though I'm agnostic, the fellowship helps, and since it's UU, I don't have to deal with my "god" issues). I'm trying to get out and do stuff when dad is there, so I can preserve my own sanity.

The really frustrating thing for me is that I know pain is supposed to be a "hot" issue right now. People are supposed to be taking it seriously and it's all over MSM. That's crap; just a bunch of lip service. They see "clinical depression" in her history and assume she's overreacting or making stuff up. She had her depression under control with the right meds and the right therapist, until this pain stuff hit. Now she's worse than I've EVER seen her, and I've seen her pretty bad.

Right now, the physical therapist, neurologist, anaesthesiologist and ortho doc are in a male pissing contest. They don't communicate with each other, and poo-poo the others' recommndations. Ortho guy ordered traction and P.T. from P.T. guy. P.T. guy tells mom that it's not her neck, it's her shoulder and puts PT on hold and won't give her the traction. (w/o consulting ortho guy) Ortho guy is pissed. Ortho guy refers mom to neuro guy for MRI. Neuro refers to Anasth. guy for spinal injections. Ortho guy doesn't know about injections and doesn't get results from neuro guy. Ortho is mad at Neuro and doesn't see the need for Anasth. And it just goes on and on. I tell ya, modern medicine sucks.

We kind of thought that at least at Mayo, everything is centralized and we wouldn't have to deal with Specialist wars.

edited for typos.

[Heddi]

12. I agree with you about the pain thing

We are lectured on it EVERY SINGLE QUARTER---pain is subjective--if people tell you they're in pain, you must believe them---you cannot ascribe your own pain measurements to someone else--yar yar yar yar.

But once we get into the hospital setting---which is SO different from the 'utopian' scenario we're taught in school, EVERYTHING about pain and pain management is thrown out the window.

I've seen otherwise GOOD nurses just completely blow someone off who's having post-surgical pain. I've had a patient with pneumonia and asthma. The pt was coughing so hard that he broke a rib (you could feel it creaking around if you felt his chest). He was in so much pain that he couldn't keep coughing (which made his pneumonia/asthma that much WORSE) --so I call the Dr to get an order for pain meds and the Dr just blew me off. The only thing the pt had ordered for pain was Tylenol 3. I gave him that and it didn't help at all. The doctor was SUCH an asshole about it and refused to give the man anything stronger for pain---which this guy was obviously in---and the pain caused him to go into respiratory distress b/c the mucous was building up in his lungs b/c he couldn't cough.

frustrating!!!

I'm sorry for the frustration you have to go through with this. I would highly reccomend a facility that is centralized so, just like you said, you don't have to go through this 'Well, the other doctor told me this..." bullshit routine that does NOTHING but eat up your time and your patience.

Good luck with all of this, and I hope you can find some solution. Oh and good luck with nursing school. Are you going for a 2 or 4 yr degree? I'm in a 2-year RN program and I just started in Steptember, so I'm about to end my 2nd quarter. It's so fun and exciting and frustrating and everything!!! Good luck, it's very enjoyable (aside from all the studying!)

[kslib]

13. reply

I looked up KU Med center, and they have a few neurosurgeons who seem compitant. We may try there since it's closer, but it will depend on who (KU or Mayo) can get her in first. Perhaps Mayo is the better answer since they have a really good rep. and it seems like they can really get you in and out efficiently. Also, since she's had a few x-rays and MRIs, this might help speed up the process.

I'm going to get a 2yr. RN, and try to bridge to BSN later (I have a bachelor's, so it shouldn't take all that long, but you never know). Did you have to wait for admission? Our waiting list is 2 yrs. long.

How was everything? I'm in a CNA class right now (prereq. for nursing), and I like the hands on stuff so far, although I must admit it's harder than I thought it would be. How was starting IVs? I'm really freaked about needles, I'm afraid I'll suck at it!

[Heddi]

14. Well, my wait wasn't that long

I finished my pre-req's in March 2004 and was admitted to the program that September. I'm in Washington, and the school I got into was the only one with a wait list. The other schools in the state all admit via a point-based system (so many points for GPA, so many points for work experience, etc). I had good grades, but not good enough to get in on point-based.

So I got in in September, and my husband is trying to get into the program--only just this quarter, they changed from wait-list to point based system :eyes: But his grades are super so hopefully he should get in around September (hopefully) or next January (not first choice, but that's okay).

He's got a bachelor's too and was looking at the BSN option, but his BA is in advertising, so he'd have to take alot of classes like Organic/Inorganic Chem, Statistics, BioChem...he decided to do the 2 year first then transition into the 4 year. Across the street from my community college is WSU (washington state univeristy) and they offer the BSN, and from what I hear, they're offering 2-year RN's the opportunity to go straight into the BSN program WITHOUT having to meet the pre-req requirements...but that's just hearsay and I've never had anyone from WSU tell me that.

My husband just got done with a CNA class---I didn't take anything like that, but I did take a Phlebotomy class (drawing blood). I worked in Seattle for a while for a cancer reasearch center drawing blood for studies. It was great.

I've not learned how to start IV's yet--we don't get the opportunity to do that until we're done with 3rd quarter. And it's not a required class, it's just optional. Even with that being said at the hospital I work at, RN's can start IV's unless they actuall work with the IV team and that takes like 6 months of hospital-training just to get certified or whatever. I know hospitals in Seattle have the nurses start IV's, but not out here.

It's REALLY great being in the program. First quarter, we did our clicnial hours at a nursing home, which was so-so as far as 'excitement' goes. Alot of butt-wiping and moving from wheel-chair to bed, from bed-to-wheelchair.

This quarter we started working in the hospital and THAT IS SO MUCH FUN. Your interactions with people are TOTALLY different, and you can do so much more. Like, my 1st day at the hospital I had to give an enema! Whoah! And before I did that I had to insert a rectal suppository. Freaky to the MAX. I've not had to insert catheters yet, but I've removed one, and done some wound-care.

Check out my blog---it goes through painful discussion about nursing school day-to-days http://www.livejournal.com/users/heddi/

And at any time feel free to PM me about anything nursing school related.

Good luck!!!

[Warpy]

8. First, leave her where she is until they discharge her

She's in a safe environment where she can't hurt herself.

Second, enlist your dad any way you can to insist she see a pain specialist while she's there. I can tell you from experience that treatment for depression doesn't do much unless the underlying cause is treated, too.

Third, when she's stabilized enough to think a little more clearly and participate in her own care, get her to a neurosurgeon, either in town or not. Take your aunts up on that offer of plane fare. If she's thinking clearly, she can go by herself.

Finally realize that if you've done the above and tried to get her the help she needs, that is all that is expected of you. You did your best for her.

Doctors are finally beginning to realize that chronic pain kills people through social isolation and depression. Things are beginning to change but they're changing slowly, mostly due to the drug war.

You can't control your mom. You can only try to get her some help, which it looks like you're doing right now. I wish you the best of luck.

[Spinzonner]

11. This might have some useful information / resources

http://www.painfoundation.org/

[applegrove]

15. I have no idea what to do or what that is like. Professional help &

clear information to the doctors is best.:hug:

[Dear Maggie]

16. When did this all start?

Pain and depression and bad, mean personality changes can be part of CFS or Chronic Fatigue Immune Dysfunction.

Root cause is from exposure to a cleaning type chemical. And often starts with 'flu-like' symptoms. Just wondered whether or not any of this is part of the picture?

Most of the time they say to see a neurologist, but the primary cause of all of this is the immune system becoming autoimmune. Does she have fatigue? That would be the common denominator