Question
Dear Ms. Ware,

My mother is 72yo.  About 1 ?years ago she was hospitalized for a week, and diagnosed with emphysema, severe osteoporosis, diverticulitis, and has a small (3cm) lesion on her one kidney.  She stopped smoking and went on oxygen therapy 24/7.  She also decided to do nothing about her kidney cancer, and since then has been taking different medications for her various problems.  

We are interested in more, and better, pain control for Mom.  She has tried prescriptions for Darvocet-N 100, Ultram, and a few others which did nothing for her pain.  Now she is on something called Lortabs.  She was on a fairly high dose of the Lortabs, but told the doctor that by the time 6 hours was up, she was in extreme pain, so he put her on a more frequent lower dosage.  It doesn't completely take away the pain, but does take the edge off, and sometimes she says she can go 5 hours before taking the next dose.

The problem is that the Lortabs are causing delusions, and Mom's long-term medical history includes previous delusional (though untreated) thinking.  So we're looking for a prescription regime that works to alleviate her pain, as well as not aggravate her many health challenges.  For example, it can't depress her breathing.

Mom recently told one of my sisters to take out a telephone that I had given her.  She got a phone call and said that 揑t?had told her that she was a telemarketer.  She asked if we had cameras set around her home, to watch everything she does.  Mom needed to turn in a urine sample last week and due to how she was feeling, she had that same sister deliver the sample to the hospital for testing, as per my mother's doctor's orders.  Mom asked her if instead, she wasn't going to sell it to 搕he drug dealers!? We're not quite sure where that particular thought came from.  We've been accused of putting stuff in her food, and once she accused someone of pouring their own old milk into an empty container, and trying to pass it off to Mom as the new milk she'd asked to be picked up.

We've discussed with Mom the different side effects some medicines have, and have even read to her the information provided in the PDR.  Mom understands that some medicines can change how a person thinks, but she still has these thoughts.

What remedies for pain would you suggest without the side effect of delusional thinking?  Any help would be greatly appreciated!  

Thank you for your time, and for donating your expertise on this web site!

Sincerely,
Linda  

Answer
Hi Linda and thanks for writing,

With your Mother's complex history you really need to speak to a specialist about getting her on the proper medications that can safely control her pain and not interfere with other complications. Any time you have Kidney or Liver involvement you have to be really careful.

Sorry I can't be more help, I wish you all the best,

Margot