Tramadol, Ultram, Morphine or a Stroke?

question-mark2Tramadol, Ultram, Morphine or a Stroke (TUMS)?

Which one is causing my sweet, caring, thoughtful mom to act this way? Mom had her surgery just last Tuesday (April 1) and the person she is today is no April Fool’s Day Joke and is at time hard to stomach.

After the surgery, the doctors started Mom on Tramadol and morphine for her pain control. After only a day we noticed that Mom was slurring her words, she was argumentative, having to search words, transposing words such as he/she, him/her or just her B’s and P’s were flipped around. She even argued and distrusted me on several things, even when I told her, “Mom, you need to trust us that we have your best interest at heart. We’re not going to have them give you something that’s not been approved by the doctors. They’ve explained to us the reason they feel you need it.”

Even just under a week after the surgery, three days off the Ultram and 36 hours on only low doses of morphine for major pain, other than that she has been prescribed Extra Etrength Tylenol (EST). She is still this way and at times worse. It may sound cruel that we’ve not approved more pain meds but the reality is mom is allergic to all the other classifications of pain meds. They make her break out in hives and itch extremely bad. Others make her sleep to a point you can’t wake her up. Once she slept for four days and was in and out for another two days until the med was out of her system.

She is in the rehab facility since Friday afternoon.  Now originally the surgeon explained to us that he was going to make a small incision on the top and bottom on the outside of her leg to inset the rod, plate and screws. On intake at the facility, they exposed her leg to inspect, catalog and clean the incisions. I was shocked to see one, 5-in. long, two 3-in long and four 1-1/2-in. long incisions on top of the two 9-in. incisions from her knee replacement surgery.

Back to TUMS. The intake nurses ask Mom background questions. Since the hospitalization, I have now heard five different versions of what exactly happened–from the grape slip, to she stumbled to miss the grape or Taffy (mom’s Shitz Tzu), to she turned and lost her balance, to she weaved to avoid Taffy and hit a grape on the floor.  Our theory is that she possibly had a stroke and that’s what caused the fall.

The hallucinations continue at the facility. On top of the pastor wheeling Mom down to see the children’s choir which mom says was so beautiful, the wine colored rug that kept showing up and the nurses walking like penguins, so far she has seen Trish’s parents and Grandma at the end of her bed singing pop songs and dancing. Her own mother showed up as well as that darn wine colored rug.

Several times she argued that she wants to go to Travis AFB and have the leg and knee treated. I’ve had a hard time with trying to explain to her that the leg is already fixed and the knee was not injured.  I keep being told that when she gets like this I should just let it go, but then she elevates her determination to find someone to get it taken care of. For example, she was angry yesterday that they were trying to get to take her anxiety pill which was not even in the container. She noticed an iron pill that is blue and is a regular pill, she was determined that it was a gel-cap which is her anxiety pill. The pill was only iron. This went on for five minutes before she finally took it.

At admission, Mom asked when meals where. The nurse explained that they were 7 a.m., Noon and 6 p.m.  So yesterday Jimmy (other brother) and I arrived before 6:45 a.m. so we would  be there for the occupational therapist’s evaluation. Breakfast arrived between 7:05 a.m. and 7:10a.m. However when Trish and the kids visited her, she apparently complained that we had to argue, fight and complain to get her breakfast. She also told then that the graveyard nurses were giving her a medicine that “Is Not” on Mom’s list. She thinks it’s only purpose is so that they would not have to deal with her.

Mom is under the impression that everyone is against her and that we stand just outside her room and talk about her just loud enough for her to hear a few words but no loud enough for her to hear everything. Yesterday, Jimmy and I sat talking with her and she yells out. “You don’t have to talk behind my back. You can do it to my face, you shits.” We ask her what she’s talking about and she says that “Richard and Sue, they can talk to my face and not right outside the door.”

With a dumbfounded stare to each other, we ask a second time and receive the same reply.  Jimmy follows with, “Mom, Richard’s sitting right there” and points to me.  Her comeback was a bit scary, “No, he’s not. He’s in the hall with Sue talking about me. I’m not a child.”  After almost 10 minutes, she gave up without accepting that there was no one else there but Jimmy and myself.

On Saturday, when the OT evaluated her, of course all the normal questions are asked: Name, birthday, what city, where’s it hurt, what happened. And then she asks Mom, “Carol, what day is it?” It always seems to be Sunday or Monday. The therapist completed her evaluation and they needed to see Mom stand up if possible. The OT she calls in Mom’s Physical Therapist and they proceed to do so with little success. But Mom did make it to sitting on the edge of the bed.

After everything, it was evaluation truth time. With everything we said regarding Mom’s before and after fall status and what she sees, the therapist expects Mom to be there for two months. If mom proves her wrong, excellent. She also agrees with our assessment of Mom and the in-house doctor agrees that we need to stop the Tramadol (which the hospital started) and try to use in very limited doses, and for extreme pain only, the morphine. If not, stop this also so we can see if it is the Tramadol still in her system, the Morphine or an actual stroke causing Mom to act this way.

When Mom had her first stroke in 2005, within a day or two this is exactly how she was. With speech therapy, hopefully we can stop this before it’s too hard to stop.

Now we are in the hurry up and wait line and should know more in the next several days.

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About Richard

My name is Richard (@kreisr1), I am a Tri-Fecta caregiver, for my mother who has COPD among other health issues. I co-care for my brother in-law who has epilepsy and co-care with my wife's for myself, I deal with Chronic Back Pain. entire life and now after living alone, in a care facility and a group home setting we had to move him in with us to provide him with the care he needs.  Finally, with my wife who is also my co-caregiver I care for myself, I have had chronic pain (mid-low back) for 21-1/2 years thanks to a drunk driver.  I write my own blog, pickyourpain.org where I share my pain with humor, as I see thing, "Pain Without Humor is Just Painful."  I am involved with caregiving.com in several ways, as well as participating in several of the weekly caregiving.com blogs, I also am involved in their Twitter chats, I also host the following groups, SPOT (Stamp Procrastination Out Today), A Task A Day, The Men's Group, Healthy Caregiver and several others.  I am also the moderator for the Caregiving.com Quiz Show and have a seat on the bi-monthly Hot Topic's show. I'm here to not only improve Roberts life, the lives of those I touch on caregiving.com and pickyourpain.org but to find a way to improve my own live.

3 thoughts on “Tramadol, Ultram, Morphine or a Stroke?

  1. Richard

    Pegi, Thank you so much for everything. It is heart wrenching at times but what can you do except kept moving forward, it’s what caregivers do. Stay Strong, Stay Positive.

    Reply
  2. Avatar of EllysGdaughterEllysGdaughter

    Richard, you are such an important, level-headed, asset to your Mom’s Care! I am glad you took the time to take care of your back but like me, don’t like to have to always set things straight when we come back! Our time is like a puzzle, trying to keep it all in perspective and in the right fit!

    Reply

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