Elderly Health Care for an Addict

Caregiving for the Elderly Addict

My elderly mother moved in with my husband and me and our kids in December 2008. When she did, there came many changes in what we are used to in our family, including Medicare and a slew of doctors and medical things and even detox, twice.

Today I transferred her 14 prescriptions from a Rite Aid pharmacy to a Kroger pharmacy. By doing this, I hope to save a lot of money. For instance, one prescription of Lyrica was $138.48 at Rite Aid, and that was after repeated attempts to file through Medicare and AARP supplemental insurance coverage. We shall see what the savings is with Kroger.

The other night, my Mom had to go to the emergency room with what we thought may have been a spider bite. She had severe pain emanating from her big toe. It was dark red then purplish and swelling up to her ankle. The ER doctor dismissed the bite concept and said it was either gout or an infection. He did not do an x-ray or bloodwork (in fact, no testing whatsoever) but sent her home with a shot and pain pills, even though she's an addict, (She has had severe problems with recent detox and is elderly so she is even more affected by narcotics).

We left the ER with the ER doctor's narcotics prescription. We went to a 24-hour CVS to fill the prescription. I provided my Mom's Medicare insurance information and AARP supplemental prescription coverage card when filling the prescriptions., as always The pharmacist incorrectly thought that her ss number was on the front of the Medicare card. When that was cleared up, the claim went through correctly and the two prescriptions were very cheap; one was $3.18 and the other was $3.42 - I was impressed.

We followed up with an appointment to her PCP (Primary Care Physician) the next day. He did an x-ray and said there was a swelling on her bone. I saw the x-ray and it was clearly evident. He said she has arthritis at 76, out of nowhere. So he said to prop her foot up when she is seated and soak her foot 3x's/day and that's it, no more. She should stop the pain pills right away that the ER doctor prescribed, due to her dependence problem (thank you). Her foot looks awful and this is from following the 'doctor's orders'. Ha!

I am surprised that with my age of 33, my Mom would have moved in with my family and I would have been learning so much about elderly health care. I have had to do so out of necessity. Needless to say, we had to take her off of the pain pills and 'trick' her into thinking she was taking them still. We have had to do this other times with different types of pills. Now she is taking prescription ibuprofen instead of Lortab. I am sure she knows the difference but a big white pill that is new is better than nothing. It is just so pitifully sad. I feel awful that she is in pain but if she starts on a narcotic now she will be on a downward spiral, her doctor said. He also said that the Lortab will do her absolutely no good so I do not feel so badly about that part. We are actually doing good and doing her some 'elderly health care' at the same time, in a way. Ack. It's so messed up.

SLM 6.12.09

I Get So Tired Of My Headaches

My Head: I have mentioned before that I have had daily chronic headaches for about 17 years. A friend of mine said, funny enough one week ago, that she thinks my headaches might correspond with the fact that I still have all of four of my wisdom teeth. My wisdom teeth came in when I was 16 and that was when my headaches started. I never thought about it, but that could be something. I have put up with some of the most excruciating headaches that have changed my life. The neurologists have told me that the headaches have caused depression and the depression can cause headaches. The headaches have been diagnosed as sinusitis, migraines, tension headaches, cluster headaches, or a combination of any of the above. I have had CAT scans, MRI scans, EKG scans, and many tests. My teeth ache, my face aches, my neck aches and my head aches all over the place at any given time of the day or whatever, it changes.

My History: I have taken medication for years. I have been to several neurologists and several medical doctors who have referred me around. There are so many medical receipts in my file that it is not even funny. I have been to a psychiatrist who gave me medication and for some time I even had panic and anxiety/depression so I can feel for people who experience this. My headaches do not have a label even though people seem to want to label them. No one has ever understood them. Our world moves way too fast for that and friends do not even seem to want to take time to want to understand or slow down to hear us out.

The Effects of Pain: I do not talk about try not to complain about my headaches to people. My in-laws think I am a complaining idiot for ever having a problem or being weak enough to have something wrong with me. Especially am I too weak, to them, to have a problem that does not show, like something that is not physically showing. Headaches are that awful thing like depression sufferers or other neurological patients have; no one sees your pain or your suffering. No one can actually really relate. I have often wished someone could plug me into a pain gauge so that they could see how badly I am hurting and that I am not making it up. Then I go through times where I think, "You know what, it doesn't matter what they think, forget them!" But it does matter to me what they think; I have always been like that. So it goes around in a cycle with me and my headaches continue.

Daily Life: Sometimes it hurts to move my eyes or turn my head. Sometimes getting out of the bed is out of the question, although this is rare, so I function on an irritated level. I have rebound headaches from medication as well. These are a different kind of headache and they can be as bad, sometimes, as the usual daily chronic headache. My typical headaches make me snappy. Sounds, especially loud abrupt ones really are awful. Bright lights can be bad but heat and cold really get to me, like a cold wind outside. I am just a waste for doing stuff because my heart rate cannot go up as my head will explode in a burst of pain. I have to take medication to function through the pain. It is blinding sometimes. I see lights, I cannot stand strong smells. I never get sick and throw up or get relief like that but I spend plenty of time nauseous. I would like to lay in a cold dark room but who gets that much luxury? I have to work, I have a husband and a family. I have to maintain a clean home and some semblance of a peaceful life. The pain gets me down in the dumps a lot and it is hard not to let the pain overwhelm my daily life.

As a Child: I fell when I was three, it was a story level in a house (or ten feet) and landed on concrete. What happened was my family had just moved into a house and my brothers were playing hide-and-go-seek. One brother hid me in a closet and told me to be quiet. I did just so but the bottom of the closet gave out since it was just cardboard and not a secure bottom at all. I fell and hit concrete. I hit my head but my neck healed rather straight instead of healing in the normal curve like everyone else (like on x-rays). So I do not know if that has anything to do with my headaches or not.

Optimism: I have been told many times, "I can help your headaches" or "This will help your headaches, just wait and see." I am very skeptical now. I was in one minor car accident with my brother where he was horsing around in his Mustang and my back got hurt and my leg ended up going numb and we went to the chiropractor. My brother felt really bad but who knows if this has anything to do with my headaches, I do not think so at all. That was when I was 13 and my headaches did not start for three years. My brother always wanted me to get help for my headaches and made my now-husband promise before we were married that he would help me with my pain. My husband has done everything he can and spent thousands of dollars of his own money trying to get me the best help he can for my headaches. He has been optimistic the whole time, trying.

What I Have Tried: Over the years, I have tried chiropractors, optometry for glasses and contacts (once they were off 8 clicks), a dental piece for my grinding teeth and TMJ, even a podiatrist for my feet, an attempt at acupuncture, a psychiatrist who recommended long-term methadone for chronic pain and a whole slew of medication at many neurologists in 13 years. It is so funny how many people have nicely and in the most naive way said to me, "Have you ever tried aspirin?" Ha! I just smile and pretty soon the conversation is over. I have been on percocet and vicodin - aspirin isn't going to cut it. I have tried completely coming off of any medication all together, for over a year at a time more than once, and so far nothing has worked. I am just about 'suggested' out by now, after 17 years. But when my friend mentioned my wisdom teeth, I actually got the chills. I never thought about it. The timing is right for when my headaches started and the thought of something possibly helping had almost completely gone out of my life.

What the Future Holds: I am going to have all four of my wisdom teeth pulled. I do not need them and they are just more maintenance. They have abscessed on me a few times and they can get cavities any time. On the other hand, I have never wanted to just go and get them yanked out, for one thing out of fear of dry socket, which can happen. I did not really see a need to just get them yanked out before my friend mentioned what she did. I thought I was just fine before with four wisdom teeth; hey they are called wisdom teeth right - more wisdom for me! Hardy har.

Teeth Headaches: Sometimes my headaches do seem to come from my face, right from my actual teeth. My husband knows my head is bad when I tell him my head hurts like this. I told this to my neurologist the very last time I went to see him on March 7th. Right then and there he said, as usual, "sinusitis" and said I should have a scan ordered up. That is too expensive with my insurance and unnecessary because I know I do not have sinusitis. I have had this scan many times and I know it will show I do not have this sinusitis. I am not going to pay to be misdiagnosed yet another time. I do not need to be patronized and he was amazingly fast at diagnosing me in our uber-fast appointment that day anyway. I wish I could make what a neurologist makes for what they can get away with in such a politically incorrect way. My head hurt too bad that day to let him know how completely incorrect what he was doing was. As a man, as a doctor. No way man, no way.

We Shall See: Anyway, my future plans are to get my wisdom teeth removed because it is almost as though I think the crowding could be, if nothing else, adding to my headaches that NO ONE seems to be able to diagnose. The mystery headaches - wow how cool to have them at least better. Then I would not have to take so much medication that is so hard on my insides with the side effects that it has. So, we shall see.

Cymbalta Trial Then It Dropped

What Happened: I went to the neurologist for my typical headache appointment. I have had headaches for roughly 17 years. This is my second time seeing this particular doctor and it is within the usual two month time span seeing him. The neurologist asked if I am sleeping good and he moves uber fast in his appointments, of course (all at a $50 copay for me of course). So I said, actually I am not. He suggested, literally that fast, that I must be depressed. He then said I should try anti-depressants (again in my life I cycle this way, since chronic daily headaches can make a person depressed) and he said Cymbalta is a good way to go. I agreed because of the pain relief factor Cymbalta provides. I do no know if I am really depressed or not, who knows anymore, but this is just what happened. It really happened that fast and just that way.

The Trial Medication: This neurologist was kind enough to give me medication samples to get started on 30mg of Cymbalta for one week to start up and then build to 60mg daily, which is what I used to take a few years ago. I asked the doctor during the appointment what I should do if my insurance company (Kaiser Permanente) does not approve this medication, as they often do not do with medications. This becomes a difficulty because I start on a trial and then my insurance company gives me the runaround. The doctor said this should not be any problem with my insurance company. I told him when I took this medication a few years ago there was a problem so what alternative is there? He offered nothing and sent me packing with my trials for this and another medication.

As a Patient Now: The medication trial period is now over (March 7th was my appointment) and I have been on the phone several times with my neurologist, Kaiser Permanente and Rite Aid. No one can answer my questions about why I cannot get my prescription filled. I had this medication in the past and now I cannot seem to get it approved through this "prior authorization" mumbo jumbo. I was starting to feel a little better from the Cymbalta after a few weeks but the trials have all run out. Now I am snappy and my family does not appreciate it very much. I do not appreciate it at all. Rite Aid gave me an 800 number at Kaiser Permanente to call to "push it through" to get prior authorization on the Cymbalta with Kaiser Permanente. They told me that if enough people call then it might get this medication approved (??). I do not know what in the green earth that is supposed to mean. That sounds like getting a bill passed through congress or something, like years.

Rite Aid has been telling me along the way that there are alternatives to Cymbalta that I am approved for, like Prozac, but I prefer Cymbalta because it also relieves pain. Now I am stuck because I have paid the $50 copay and told the neurologist this would/could happen, that Kaiser likely would not cover Cymbalta and now I am flailing around trying to be my own advocate in this cycle.

Dropped and Cycling: I do not go back to the neurologist for my typical two-month span now, and they are not returning my calls. Kaiser Permanente is not interested in returning my calls either. Rite Aid has done everything they can and has been very nice about helping me. Can you believe I have been run around as a potential anti-depressant patient? Wow, I could be on anti-depressants and I have basically I would like to hire a medical advocate if such a thing exists. Doctors think a person is a nut (or love to condescend - speaking down to a person) whenever someone speaks their mind a sounds like they actually know what they are talking about. I think a person knows what is going on for themselves, no matter what young medical students are told in school or before they are doctors or how cool it is while they are doctors. Even if doctors get tired of hearing patients diagnose themselves, and I am sure they do get tired of it; I get sick and tired of getting the run around in general as a patient. I have been dropped and I am cycling.