4'9" mother fractured 3-4 ribs and her collar bone July 9th. Doctor now wants to lower the Fentanyl dosage to 50 for 6 days and then 25 for 6 days, to wean her off Fentanyl... but he wants to add an anti-depressant/pain pill called Cymbalta at 30mg, 2x/day. Does anyone know if this is a good decision. I have a high aversion to anything "anti-depressant" because we have been that route before, and she's done way better without anti-depressants. Any recommendations/input, please?
After my father had several acute and life-threatening illnesses, he spent 7 months in a total of 2 hospitals, 2 long term care hospitals, and a SNF before he came home on tube feeding, unable to eat anything as a result of having been on a ventilator for about 6 months.
His doctor wanted him on Buspar. I'm theoretically opposed to anti-depressants unless natural remedies (music, pets, meditation) don't work, so I wasn't necessarily agreeable. However, at that time Dad was 86, was relieved to be home but had been told by each of his speech pathologists that he likely would never be able to eat but would be on tube feeding for the rest of his life. He was very concerned about this, but intended to do everything he could to reverse the situation.
So I agreed to the Buspar. After Dad got home and we started pet and music therapy as well as home OT, PT and nursing, his mood began to improve. He did have some depressing days when the home speech therapist also said she didn't think he could compensate for the muscle deterioration, and agreed that tube feeding was the likely outcome for the rest of his life.
After a few depressing days, he aggressively threw himself into the speech exercises, doing them faithfully 3x daily. Eventually he began to improve and was subsequently relieved of the feeding tube.
Sometime during that process I asked and the doctor advised how to D/C the Buspar. I don't remember if was a few weeks after he first came home or after he began to make improvements during the speech exercises, or even if it was after the pet therapy began.
I do think it helped at that time b/c of the situation, but I also think that just being home and back in a neighborhood setting helped immensely.
But this also was a very unique combination of circumstances. Dad's since had 2 hip fractures and took only Oxy for about a month, then gradually decreased it himself. Never once did I notice that he was depressed; in fact, he relished in the attention he got in the SNF, but he was elated when he was discharged.
I should add though that he has a military attitude - he's tough and he's not going to rely on medicine other than the absolute minimum. At almost 97, he still plans to continue working in his beloved workshop.
If sounds like you're leaning toward not adding an anti-depressant. You know your mother better than anyone else. Perhaps you could raise your concerns to the doctor and suggest that because of past problems, you'd prefer not to add it right now, but reserve the right to ask for it later.
Will she be coming home to live with you when she's discharged?
His oncologist congratulates us very often on the fine results from our natural approach to treatment. My husband continues to take his 10-12 vitamins a day and his cancer has not showed up on tests in the last 3 visits. Appointments been changed to every 4 months instead of every 2 months. We are really grateful.
Peace.