There is a new nurse at mom's SNF. He seems overly interested in getting morphine on board and Xanax and calls me every time mom is struggling. It's a fairly straightforward matter of draining the fluid off her lung and then she's comfortable and can breath. But each time the fluid builds up, instead of getting it drained he talks about her need for morphine. I thought it was just me that found him overly pressuring about it but when my son met him tonite he said he wanted him off my mom's care. Hes very nice but I feel he's either new or possibly a problem..
Let us know how the procedure goes tomorrow
Your nurse may be new or overly aggressive but he probably knows that once fluid keeps recurring it tends to come back very frequently like daily. Are they giving her strong enough diuretics. I had what is called a pigtail when I was in heart failure for a few days and they drained a great deal of fluid through that. they were going to put in a pleural but said there was too much risk of infection with a permanent drain so they just removed the pigtail and stepped up the Lasix IV which worked pretty well. The nurse wants to give Mom the morphine because it will ease her feeling of breathlessness so she is more comfortable. of course the Zane is for anxiety and everyone is anxious when they can't breath.
If you feel Mom is close to death my decision would be to encourage the morphine and although it won't hasten death will certainly keep her a lot more comfortable. By the way a Pleurex is not difficult to remove and can be done by a Dr in the SNF. Much easier to take out than put in. if you think Mom may have some time left it might be worth replacing the pleurex so the fluid can be drained daily. it is a very simple painless procedure. they just put a vacuum bottle attached to the tube and the fluid runs into that. A lot depends on the reason for the fluid build up and how close to death the family and Drs feel rather than what Mom hopes will happen. Repeated thoracentesis can be distressing and exhausting. Hope this all works out for you. You need to question Mom's Drs and get their honest opinion on Mom's prognosis.
We went through this with my mom about a year ago. After her chest had been tapped several times ( including one situation where, as mom's lung reinflated, a pocket of bacteria " bloomed", sending her into septic shock) we sat down with her pulmonologist, who said to me " stop poking holes in your mother. The next time this happens, call in Hospice, get her on morphine and let her down gently".
That is what I'll do.