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Her pain is terrible and she has to take Codeine and Paracetamol (she's tried other painkillers with bad side effects). She wants to avoid an operation due to having a stroke and age, but she is so sick of taking painkillers all day - they are making her sleepy and feel crazy! Any advice or help would be really appreciated.

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(cont.) ... HE would not cooperate with any of her needs. I called her ortho doc in frustration and the DEAR man made a "house call" to the nursing home (completely unexpected and irregular), overrode the resident doc, upgraded her pain med 2 MS-Contin (a pull form of morphine) AND ordered that she either be given her pain med EXACTLY 1/2 hour BEFORE PHYS THERAPY and if the nurses were off in their schedule for any reason, that phys therapy verify that they are taking her EXACTLY 1/2 hour after med administration. Mom miraculously began to "cooperate" with her rehab & her recovery started going smooth as glass.

You just have 2 stay on top of everything and everybody to make it work.
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Your mother is right to be cautious about having surgery. How old is she? According to our primary care doctor, who works a lot with the elderly, "they don't come through the anesthesia very well." We were considering having a repair done to my mother's 18-year-old prosthetic hip so I researched this and found that general anesthesia can have a devastating effect on an older person's mental capabilities. A local surgeon was ready to cut, but we took Mom back to the Mayo Clinic in Jacksonville and saw the surgeon who did the original operation. Dr. O'Connor said there were way too many risk factors and strongly advised against it. We agreed, even with a spinal rather than general anesthesia. And then, amazingly, Mom gradually recovered. Apparently her muscles compensated for the deterioration of the prosthetic device and to see her walk, you wouldn't know anything was wrong. She will be 95 this week. Go Mom!
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CaroLynn ... our doctor prescribed "lidoderm" patches to help control the pain of compression fractures in her spine. We've been using them for about a year, with no noticeable side effects, like sleepiness or constipation.
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Pain relief can happen using a number of various alternatives that have far less adverse effects.
Any that decrease inflammation, help both to lower pain levels, and also, help body repair itself.
Hospice practitioners know, that dosing anti-inflammatory agents is FIRST choice, to reduce inflammation, THEN see if further pain meds are needed...that tactic usually allows far less narcotics to be used, which increases quality of life.
Some non-drug anti-inflammatories include:
==TURMERIC. For large problems, one might need to use larger amounts. capsules that equal about 1 tablespoon a few times a day, if pain is real bad, then decrease it to learn what is best for person. Take it with food. It tastes like Curry, because it is part of what curry is made from.
==OMEGA 3 fatty acids: for greater pain, one may need to consume 1000 mg. per day or more, of only the omega 3's. this stuff not only lowers inflammation and pain, but it helps mental processes, helps overall health. It can be got from fish oil, flax seeds, chia seeds.
==MSM: Methylsulfonylmethane. This is fundamental sulfur--NOT sulfa drugs. One cannot be allergic to MSM, or they pretty much cannot be breathing!
Fundamental sulfur is one of the body's main building blocks.
It can help decrease inflammation, decrease pain, and helps rebuild/repair body. I have started with a lower amount, like 1000 mg daily, then built up to several grams daily. Maintenance might be 1000 mg daily, and can be split over the day.

Acupuncture is great stuff, done right.
You could see if an acupuncturist in your area would teach you to do the required points, and/or, show you how to use magnets instead of needles--that way, fewer office visits to pay for.
SOME insurances DO cover acupuncture, particularity for pain control--while Medicare does not, if one is enrolled in a Medicare Advantage Plan, some of those plans DO cover it.
Group Health, in WA does, for instance...if they lack in-house practitioners for it, they will refer a person to an outside practitioner, and cover it as if done in-house.
Kaiser Permanente might do that now, too--years ago, they were just starting to get their feet wet in that art, so didn't really offer it then--they might, now.
Ask around!

She's got rheumatoid arthritis...an auto-immune issue. Which might men she is more sensitive to many medications. Talk with the Docs--they know how to arrange these things.
While there is a potential that surgery might stir up/aggravate an auto-immune issue, it is more likely that removing inflammatory issues, by replacing the deteriorated hip, might help calm down the auto-immune issue with the rheumatoid arthritis, simply by decreasing the amounts of chemicals that rattle around in the body flaring things up.

The real key is, your Mom sounds like she is raring to get out and do things--tht means she is still motivated.
Those already impaired too much by illnesses, lose motivation, and stop doing their exercises or complying with protocols that would help them--or else, they are too confused or tired to do it.

OTHER pain meds: non-standard:
While many do not live where it has been allowed for medicinal purposes,
SOME do.
It requires a medical recommendation to get Medical Marijuana.
It can be got as a Creme, which, applied to skin over painful areas, does a remarkable job of killing pain, with few side effects. Those types with higher CBD's are most medicinal and less sleepifying.
Got as a liquid, it can make some folks very sleepy, kills pain, can reduce gut irritations, relieve some asthma, and can decrease some myoclonic seizure activity.
And no, it does not cause "munchies", but, it can allow those who have stopped eating related to nausea from chemo or other ills, to eat.
It is less addictive than harder drugs, and has far fewer adverse effects.
Seriously.
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As far as the pain goes they have had much success with the patch. If she is tired of taking the pill forms inquire with her Dr. if this is an option for her. They are time released and will keep her comfortable. She would have to have pain meds with either choice so I would look into it for her.
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Pain patches - there r only 2 types: a "counter-irritant" type containing camphor, menthol, capsaicin, etc (not generally effective 4 much more than mild pain) and a narcotic called fentanyl (Dura-gesic & generic patches) that comes in several strengths & is effective but has narcotic side effects, the most diff is, IMO, to get enuf to control pain w/o making the elder woozy, which could lead to falls, already a concern with the elderly & bad hips.
So, you didn't mention mom's age?
My mom had her Rt hip done in 1996 at age 78 and her Lt done in 2003 at 85.

To be sure, my mom was in relatively good health other than her need for jount replacement. But what the anesthesia doc decided to do was give her a heavy tranquilizer intravenouslyink) + an epidural, saying that there is a dementia threat to elders with general anesthesia.

Rehab was tougher on the 2nd hip b/c of her age. The medicos seem 2 b in constant fear if addiction 2 pain meds, so tend 2 under-prescribe for pain. Many of them don't seem 2 have the sympathy or empathy 2 appreciate the pain these elders have ALREADY been thru and that they need 2 more responsive 2 the pain adjustment needs of the patient.

In my mom's case, she was in rehab @ a Skilled Nursing Facility & they were giving me notice that she needed 2 b discharged b/c she wasn't "cooperating" w/ her rehab & wasn't "progressing", a medicare requirement to stay in a SNF for rehab. I knew & could see that she "wanted" to cooperate but she was in too much uncontrolled pain when phys therapy came 2 work w/ her. I talked 2 the doc in charge of the patients at the nursing home and HE would not
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Corrections 2 my previous posts above: part 1, the tranquilizer given in conjunction w/ the epidural was Demerol l believe; part 2, MS-CONTIN isn't a "pull form", it is a "pill form". V. sorry, typing from my Android is challenging.
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+I am 79 yrs. old had two knee and one hip replacement two years ago, also have Afib and high blood pressure. Best thing I have ever done health wise. Hip replacement was a snap, no pain and quick to heal. Knees take a little longer with some pain. If you have a good Doctor and good Hospital it can be possible and make you a new person. Make sure they give you Coumadin for several weeks to keep blood clots at bay. Good Luck. Marion Oppenheimer
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My mom uses the Lidoderm patches for the pain in her shoulders due to arthritis. Mom says they help relieve the pain and she goes around doing whatever she wants w/no sleepiness. She doesn't drive when she is wearing one of the Lidoderm patches though.
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LadeeC - yes, lidoderm patch is lidocaine, a numbing anesthetic. There are other pain reducing products or methods, such as prolotherapy injections and voltaren gel that l didnt mention b/c hips are diff. I've had prolo for knee arth & tendonitis in thumb joint. So successful, wanted 2 try on my hips eventho my doc said hips r the hardest. She was right, didnt work and was costly b/c it is not covered by ins. As for Voltaren gel, it is a topical NSAID, very little of which absorbs into bloifstream, so generally ok for ppl who cant take oral NSAIDS. Some success w/ topical & sub-cutaneous pain but not so effective with deeply aching arth such as in hip. Seems 2 b what many report when it comes to using lidoderm for hip arth. B/c if the on & off nature, if relief is obtained, it isnt continual. Some that have reported it useful have said they r using in conjunction e/ other modalities such as cortisone injections & NSAIDS. Chronic use if NSAIDS or Cox-2 inhibitors(Celebrex) is necessary 2 control serious arth pain, however longterm use is not generally a good plan for elders due to the risk of hemmorage, multiplied even more if blood thinners need 2 b used. One never knows in each particular case. The orig post was querying surgery or not. I'm the one who brought up the Duragesic (fentanyl) patch. But lidoderm is an intetesting suggestiin. Maybe the folks could ask the doc if they could give it a try. ANYTHING safe is better than unnecessary surgery.
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