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Ask Dr. D. Love Your Own Question
Dr. D. Love
Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 18423
Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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my 93 year old mother has alzeimers and a crumbling spine.

Resolved Question:

my 93 year old mother has alzeimers and a crumbling spine. Historically she has been given tramadol as and when required for pain. She is now in a nursing home and had to change surgeries and doctor. She has just been taken off tramadol and been given co codamol but she is in a lot discomfort across her shoulders and has a tingling in her body. I have enduring power of attorney and this was not discussed with me prior to the action. I am distressed that my mother is in trouble and wonder what i should do. I did have a very unsatisfactory conversation with the doctor that took the action.
Submitted: 2 years ago.
Category: Medical
Expert:  Dr. D. Love replied 2 years ago.
What did the doctor that prescribed the medicine say?
I understand that he was defensive, but what medical reason did he give for the change?
Customer: replied 2 years ago.

that it is now a "controlled"drug......hope I have used the right term

Expert:  Dr. D. Love replied 2 years ago.
Yes, it is correct to say that toradol is a controlled drug, but so is co-codamol.

At this point, you can try to discuss the issue with the same doctor again, emphasizing the inadequate pain control from the co-codamol. Explain that you know that the toradol is controlled, but since the co-codamol is also controlled, it would be preferable to use the controlled drug that better eases her pain.

However, since he was defensive during your earlier discussion, it may be difficult to have a meaningful discussion with him. So another option would be to ask the manager of the nursing home if the care of your mother could be transferred to a different physician, and then have the same discussion with the new physician.

If I can provide any clarification, please let me know.
Customer: replied 2 years ago.

is tramadol more powerful than co codamol? Also I forgot to say that there was a concern about my mother falling?

also what requirement is there on the doctor to discuss my mother with me given I have enduring power of attorney?

Expert:  Dr. D. Love replied 2 years ago.
Tramadol has two mechanisms of action - it is a weak opiate and it affects serotonin levels in the brain. The toradol is a weaker opiate than the codeine in the co-codamol, but is stronger for pain relief for many people because of the second mechanism of action.

It is true that many pain medicines can increase the risk for falls, but this also would be a potential concern with the co-codamol, so again if a medicine that creates a risk for falls is to be used, it would be appropriate to use the one that is better at easing her pain.
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Customer: replied 2 years ago.

thanks....and the power of attorney question?

Expert:  Dr. D. Love replied 2 years ago.
I'm not sure what question you mean. If you are asking whether the doctor is obligated to discuss every medicine that is ordered for your mother with you prior to the order being implemented, the answer is no.
Customer: replied 2 years ago.

ok that was the question thanks...you have been helpful..

Expert:  Dr. D. Love replied 2 years ago.
You're welcome.

If I have answered all your questions, please remember to provide a positive rating so that I am credited for assisting you.
Customer: replied 2 years ago.

I have done

Expert:  Dr. D. Love replied 2 years ago.
Thank you.