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My mother, 89 years old, has a herniated disc. She aggravated the disc two weeks and has been in constant agony since. The pain led me to take her to Emergency at our local hospital. They diagnosed the slipped disc, told her to take Tylenol, prescribed muscle relaxants, and sent her home. Tylenols and muscle relaxants are not making a dent in her pain. Called her doctor on Monday, two days after her ER visit. Her doctor is fully booked, does not want to prescribe any pain medication without seeing her and finally, begrudgingly, agreed to see her on Thursday, 6 days after her ER visit. In the meantime, she is whimpering in pain, stays in bed, has no appetite, and is totally miserable. I asked my sister to come over and help her shower, which she did fairly unwillingly. This a vent, but I cannot believe the doctor has waited this long to see her. He is unwilling to see her outside his regular hours and has only agreed to refill the muscle relaxants. I am at my wits end, trying to deal with her pain. Any ideas? She cannot take Ibuprofen or ALEVE due to stomach bleeding issues. The Tylenol is useless.

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Take her BACK to the ER--maybe a different one this time. Tell them what's going on. INSIST on something better than Tylenol for pain. (Personally, I find Tylenol to be completely worthless). AND file a formal complaint about your lazy dr!

Sometimes we have to be a little pushy to advocate for our LO's. Your mom should not be suffering b/c her doc is stingy with pain meds.

Even IF she got addicted to something--at 89? Who cares??? Sorry, this 'opioid crisis' is such a farce. You know who the biggest abusers are? DOCTORS AND NURSES. And that comes from 2 doctors who KNOW.

Street drugs are another thing. Prescribed narcotics taken correctly can remediate pain and allow your poor mom to heal.

Her dr sounds like and idiot.
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Kaki, I checked your first thread:

https://www.agingcare.com/questions/help-with-89-year-with-severe-pain-468773.htm

I see you're in Santa Maria, CA, with a population of a little over 100K.  I checked this b/c my first thought was to find another hospital and ER, and equally as important another doctor who's more responsive.  

Even if it's a long drive, and out of pocket cost,  I would consider calling an ambulance and asking that she be taken to a larger hospital, a teaching hospital perhaps, and seen in their ER.   

Forget about showers; use no rinse soap and shampoo.   If your mother is already in agony, she doesn't need the challenge of getting in and out of the shower; bathrooms can be dangerous especially for someone in agonizing pain.

Other than quickly finding another ER, or Urgent Care, and/or another ortho doctor, I don't know what else to suggest.    And personally, if this doctor doesn't seem to be very interested, I'd certainly dump him and find someone else.

I do know how painful it is to see a loved one in agony, and aggravated by a doctor displaying limited responsiveness.   Other than going elsewhere, I don't know what can be done.   

Is this current doctor an orthopedic doctor?  Personally, any doctor who treated my family or me as yours has been treated would be on the "fired" list by now.
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Take her to an orthopedist, not her general practitioner. She probably needs a cortisone shot. Pills won't do anything. (I've had a herniated disc that finally blew, so I'm speaking from experience.)
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GardenArtist Jul 2021
MJ1929, good suggestion on the cortisone.   I've only had one, for a torn rotator cuff, but the relief it provided was amazing.
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If you said to the doctor: "my 89 year old mother has been in pain since [date] following [describe incident/injury]. The ER found a herniated disc and prescribed Tylenol and muscle relaxants. In 3 days these have done little to alleviate the pain, and she remains unable to sleep, eat or move around for ADLs. On a scale of 0-10, her pain level is [ask your mother for the number], she is becoming exhausted, and she is urgently in need of relief" and he still refused to see her for another three days or to recommend an alternative, then I would be making a formal complaint.

But unless you were very clear and very specific about what you wanted and expected him to do, you'll just have to hang on 'til Thursday (unless God forbid anything gets worse). There are anti-inflammatory gels which might help, get advice first because if she's not allowed to take NSAIDs some of these won't be suitable for her; but anyway I often think it's the massage that comforts rather than any magic ingredient.

What kind of bed is your mother on? Is she able to adjust her position, with or without help? You may find it better if two of you assist her when moving - many hands make lighter work of this.
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XenaJada Jul 2021
It might be worth it to rent a hospital bed, private pay if necessary
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HI Everyone,

I took her back to the ER. Her doctor's assistant informed this would be the vest course of action. He doctor is out tomorrow completely and wont be back until Thursday. I don't have the ability to monitor her health given her problems. I am seriously considering finding another doctor.
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BarbBrooklyn Jul 2021
Kaki, you need a doctor who has a covering physician, at the very least.
Consider finding a geriatrician.
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I hope you are VERY seriously considering firing this doctor. He works for you, after all.
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Sarah3 Jul 2021
?? He has other patients that had scheduled appointments with - he can’t shorten or cancel their appointments. Re read the op- it says she waited 2 days after her mom got out of the Er to call the doctor, and he offered a time to see her on Thursday which was 6 days after her visit to the Er! What are some of you people expecting a doctor to do other than what he did? If one demands personal immediate attention they need to hire what’s called a concierge physician or go to Er or urgent care. Doctor offices don’t accommodate patients outside standard practice hours, her mother was offered an appointment within 6 days of her visit to the Er
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Kaki, when you refer to the "assistant", are you referring to another doctor in the practice, or a Nurse Practitioner or Physician's Assistant?   And, since it was suggested that you not see a GP, what exactly is this doctor's specialty?   If he's a GP, he may be out of his league in treating your mother's type of back condition.
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Contact the office manager at his/her clinic or just show up at the clinic. If this doesn't work, you can contact her insurance company and file a grievance against the doctor. Drs hate hearing from the insurance company, especially Medicare. If this doesn't work, you can call the medical board to file a grievance, but this can take a while but it is highly affective.
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Sarah3 Jul 2021
In a doctor office setting one needs to have an appointment- other patients times can’t be shortened or cancelled to satisfy the request of another person. The op waited 2 days after her mom was discharged from the Er to call her doctor- doctor said the soonest he could see her would be Thursday 6 days after her visit to the Er and only 4 days after she called there.
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Short and simple answer, get a new doc!
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Yes this is now a common- backed -up- too- many patients to get into a primary care doc thing going on here in Michigan too. My husband's numb hand has a two MONTH wait to get into his surgical consult.
Maybe the PCP will order physical therapy in the mean time. They will most likely not prescribe narcotics to a 89 yo. Due to the new narcotic prescription as too many people have gotten addicted to them so the standards of care have changed. Try heat or cool packs. Tylenol is better than nothing.
Best wishes.
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GardenArtist Jul 2021
Patti2021, are you anywhere near Novi?   I found a good hand and arm doctor affiliated with what was then known as Providence Hospital (now Ascension Providence Hospital) in Novi.    He also had a physical therapist on staff, so I could get PT right there in the office.
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My Mom 95 was given CT at the ER when in screaming pain, then referred to pain Dr. who did facet joint injection. Pain still there so he ordered a special type of MRI so he could find out more. Finally found old compression fracture that had been hidden and then exacerbated by a history of falls. She had Kyphoplasty surgery (no anesthesia) and pain was gone and stayed gone! Scary at 95 but worth it, and recommended to relieve pain by all medical people I talked to.
Make them keep at it to find what is really wrong.
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Chickie1 Jul 2021
What is kyphoplasty ? Is this where a substance is injected?
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Having been through something similar with my 85 yo sister, (ER visit, sent home with meds) first thing I want to say is be careful with the prescribed pain reliever when you do get it, especially if she is not eating much. My sister, who broke her sacrum, ended up with a bleeding ulcer after taking percocet for pain, while she was resisting eating and drinking. Also, I never could even get through directly to her doctor, only a nurse who contacted me only after I had to leave a voicemail. She advised taking my sister back to the ER regarding her pain and other physical problems, which I did, and she was admitted to a skilled nursing facility upon release from the ER. It seems you can't get through to the doctors anymore because of the layers of assistants and nurses and voice mail. He never did see her personally, as far as I know. She passed away months later this past January,.
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Update- She went back to Emergency and they prescribed Norco. This has proven effective in lessening the pain so my Mom can relax. Lidocaine patches for sleeping. She is having problems walking so I have to stay at home 24hrs to help her. My sibling (sister) refuses to help as she and I cannot get along. As usual, family crises bring out the fissures in family structure,
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You are shouldering a lot of responsibilty. Kudos to you! When you speak to her doctor, discuss what her options are for pain management if this goes on for a long time. Would physical therapy help at some point? Is it worth considering an operation to immobilize the disk; is she capable of having an operation safely? Can you get her a referral to see an orthopedist?
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Five years ago I had a severe herniated disc in my lower spine, radiating down to my right leg. The pain was so bad I couldn't eat, sleep and could barely walk.
I went to my neurologist and he did, state of the art traction on me for months followed along with a medication called, Arthrotec 75 mg., 3 times a day.
Just recently I had my primary doctor prescribe it to me and was amazed he did.
I have major stomach issues and this by far was a blessing since I have horrible reactions to practically every drug and severe stomach issues as well.
It's also great for osteoarthritis as I have that really bad as well and due to being on medicare now, they always give you the generic drugs.
It is not a narcotic either. But if she's on any blood thinner's then you can't take this drug. Check it out on webmd.com as I always use this site to see other reviews from people for any kind of new medications.
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A disc is probably pinching the nerve and no pain med will eliminate that pain!

Recently my 84 year old Mother contracted RSV. It nearly killed her! She had to be intubated for 2 days & spent ten days in ICU! The Dr. flat out told me, “We won’t be doing that again. “!! They felt obviously at her age I should not be having her shaken up in a mechanical vest to loosen the phlegm. I should not have had her intubated I told him last time I heard murder is still illegal.

You must be your Mothers advocate! Insist on immediate care as this disc pain is real & it’s bad! Drs are reluctant to use a general anesthesia on a very elderly one. I don’t know if your Moms state of health could handle a surgery. I do know that Drs rush to having a DNR signed for the elderly. I really don’t know the perfect solution to do when one becomes really aged. I do know that we euthanize our pets & hover over them at the vets until they peacefully pass. Humans no matter what age deserve medical treatment!!!!

Mother did fully recover. She does have a fulfilling life! I didn’t throw in the towel.
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I have had a bulging disc several times. The disc inflames the nerves and it is excruciating pain. The best relief I found was a short source of a steroid called Prednisone. It relieves the inflammation. Also certain stretches can help once she is out of such pain that she can do them. I too can’t take NSAIDS but extra strength Tylenol and also use a CBD gel on the skin around the area. That doctor needs to be fired…he is not compassionate and obviously has never had a bulging disc.
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Sarah3 Jul 2021
Yet the Er doctor didn’t prescribe that. Op waited for 2 days after she got out of the Er to call and make an appointment w her doctor - he was fully booked and took her at the soonest time which was only 4 days after she called. I don’t see this as refusing to see her mom. She was able to get a time for her mom to see him within only 4 days of her calling.
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I’m sorry she’s been in so much pain first of all! It sounds like you now took her back to the Er and they gave her a narcotic pain killer. As far as your complaint about her doctor, you said you waited 2 days after she got out of the Er to call and make an appointment - he was fully booked. Since he’s not an Er he can’t see patients outside regular hours but he offered an appointment within 4 days of your calling there( which is usual most doctor offices by the way don’t see patients outside of regular hours) I don’t know what else you would expect him to be able to do- obviously he can’t cancel other patients spots to fit her in yet she was offered a time only 4 days after calling his office. Since your sister has offered to help you state you can’t get along with her, you should take a break and allow your sister to come for a bit. Did urgent care talk about any need for physical therapy for her? For those who have mentioned if surgery is an option, I have no idea if that would be but it seems like a lot to put an almost 90 year old through that but it depends somewhat on her overall health and if the benefits outweigh the risks
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Isthisrealyreal Jul 2021
Sarah, I agree with you. 4 days after contact, for an appointment, with the doctor being gone 1 of those days is pretty good service.

I have just scheduled an appointment for a new doctor and I won't be seeing her until Jan 2022.

Kaki, you should really look at how all of this went down. The ER doctor is the real issue, not your moms PCP. They have to assume that the ER did something to stabilize her for the few days it took to get her in. You also need to remember that doctors have lives and families and can not always be available when we think we need them. It's unfair to expect that and you will always be disappointed and aggravated if you don't change your expectations. Especially since this is something that has been going on for a while. Why hasn't any more permanent treatment been pursued? See how different views change the situation? I would consider the overall care before I go doctor shopping. They did refill the meds prescribed by the doctor that saw her, they did get her scheduled within days of contact, they did guide you to go back to the ER if she couldn't wait, this isn't the behavior of a doctor that doesn't care.
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Since there are people that seek out pain meds due to them being dependent on them, that is why doctors hesitate on giving anything, especially without seeing them. However I would try to get in with an "orthopedic specialist" asap. it might be hard due to everyone scared to go into doctors offices (not me, i just wear a mask) but if both doctor and patients wear masks, i personally don't see a problem. But IF you are new to a specialist you still might have to wait. But I would still call, explain the situation and get on a list or make an appts. Is there anywhere that gives accupunture treatments, sometimes these help. my husband had a herniated disc years ago and it is painful and he worked at a job lying tile on floors but he forced himself to work until it got so bad that the pain was going down his leg. he eventually had surgery to fix it and has been good ever since (with the exception of getting a stiff back or it feeling tired sometimes when he does too much). Can she use an ice pack of some sort on the back to help reduce the swelling around that disc area? if so i would use an ice pack for 20 minutes.........then in an hour do it again, just make sure the ice pack is NOT directly on her skin. I sure wish her luck and sorry she is in so much pain. God bless.........
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I see you took her back to ER again & they prescribed Norco. I'm glad she is getting some relief. My mom was on that. Just beware doctors have strict rules about pain meds. The Dr my mom had said Calif laws changed & he had to see her monthly for a prescription. I know even for an anxiety drug rules are changed a person needs to see Dr every 3 months. Dr's have schedules so after your first ER trip sounds like you got in pretty fast even though you may think it took too long. It's hard when they are in pain hang in there your doing what you can.
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Are you aware that there are laws surrounding how pain medication can be prescribed? That would be why the doctor didn't give her pain meds without assessment. Pretty standard instructions on ER discharge " if pain (or other reason for visit) does not improve or worsens return to ER.
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The doctor is following the law with regard to pain medications; HOWEVER if
he/ she is too busy to treat the patient- find another doctor.
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Cover99 Jul 2021
In some places it really is true that doctors can have many patients to see,
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Do you have an Urgent Care Center where you live? They will see your mother as a walk-in or appointment.
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Is the doctor your mom's primary care physician who isn't booking your mom in willingly? If yes, do you need a referral to see an orthopedic?
If no referral is needed, seek out a spine orthopedic and tell them how urgent her need is.
Pain medication is HIGHLY regulated, and until she sees a doctor they won't be prescribed. Age of patient and other factors play into prescribing medication too, so she may not receive any narcotics.
Muscle relaxers are good, but, only certain ones can be prescribed to the older population without creating issue with confusion, balance and other health issues.
Did the ER prescribe a follow-up appointment with a orthopedic or the PCP?
Good luck
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She needs to see a physical therapist. Take her to a doctor and get a prescription for PT. I tried the medication route and it did not work. With PT my back issues are manageable.
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Compression fractures are excruciatingly painful. My orthopedist wanted to do a kyphoplasty but it would require stopping my warfarin. As that is medically dangerous due to the reason I am on very high doses, I could not have the procedure. I was given oxycodone with zero relief. I went back 3 days later in agony. Due to state laws, the PA was fearful. The physician came in and said, "Give her dilaudid. She's in agony. We're doctors, we can treat patients". As a health care professional, I truly understand the opioid crisis but we need to stop letting insurance companies and legislators dictate to medical doctors how to treat their patients. We are WAY under treating pain in this country STILL. Not giving adequate relief to patients in pain is not solving an opioid epidemic.

When my dear friend and fellow nurse was first diagnosed with lung cancer, I asked what she feared most. "When the time comes, because of the laws, I'll be in pain and won't get relief". I promised her that wouldn't be the case and I pledged to her that she would be comfortable.
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I haven't read many of the other posts, but have been there, done that.

If that doc isn't a specialist, then forget going to him. I have had spinal issues (mostly cervical, 3 discs removed/fused, but have a lower back issue where vertabrae slip out of place, not the disc - ooooeee, fun stuff!) It took over 5 years and trying various orthopedic and neurologists to get resolution for the first disc, with NO help.

My recommendation is to find a spinal orthopedist. Given her age, surgery may not be an option, but they can better locate the problem and refer her to a pain specialist. The injections they do can remove the pain, and then she might be able to do some PT to strengthen the area. I let them do one injection, as a diagnostic tool only. I was only about 40 at the time and did NOT want to resort to injections 4x/year for the rest of my life! Also, if the pain is deadened, how much more damage can I do? But, the relief was instant. It didn't last 3 months, but it was enough to convince the surgeon.
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Sounds like you need a new primary that’s uncalled for letting her stay in pain. I use to work in a Drs office call them every day two or 3 times asking about a cancellation you have to make the effort they will not . Good luck 🙏😥🙏
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Get another doctor. I use Dr Gloria Liu at Duke spine center. She is ver good. Have used her for years.
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Call her insurance for a referral to a pain clinic that is familiar with geriatric clients.

Be aware that the Norco might cause constipation issues.
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