Saturday, January 12, 2013

Sunday, January 29, 2012 Donna Smith asks

Q: COPD, heart disease and prednisone induced diabetes 2 -- stop taking meds?

My mother is 83 years old and has COPD, High blood pressure, High cholesterol, and prednisone induced diabetes 2.  She also had a mild heart attack almost 1 yr ago. She weighs 94lbs. 

My sisters wanted to stop giving her most of her pills and wanted to try a holistic approach (vitamins, etc.).  They asked her Pulmonary Doctor if they could and he said yes.  He told them to continue the metropol and her COPD medicines.

I insisted that we consult with her heart Doctor who said to continue her medicines especially since some could have a rebound effect.  I scheduled an appt and afterwhich he said to continue with all meds.  He did say that her EKG was good -- better than her last visit.

HOWEVER, I just recently found out that my sisters went ahead and stopped giving her all of her meds.

I had noticed that her oxygen levels had been very low as well as her BP was very low every two days.

So with that said, we have been playing with her health -- some days giving her meds (when I am there) and sometimes not (when my sisters are there).

My question to you is:  What are the serious ramifications of this yo-yo type of care?  Should I be concerned about this and if so need to know what to tell my sisters in order for them to stop.  Or maybe I am the one who needs to accept it.

Here are her meds: 

Prednisone 2.5 1 a day
glipizide 1/2 pill a day
Welchol 3 pills twice a day
Isosorbide 1 in the morning
Spiriva 1 inhale a day
Advair inhale twice a day
Metropol 1/2 pill twice a day
Ramiphril 1 a day
albuterol and ipratropium treatments 4 times a day

Oxygen 3.5 - 4

 

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Answers (1)
Kathi MacNaughton, Health Pro
2/12/12 9:16pm

Wow, Donna, sorry I didn't see this sooner. This is definitely NOT good, and I strongly suggest you convene a family meeting with your sisters (and possibly one of her doctors) to come to a meeting of the minds on the goals of treatment and what consistent approach can be used to treat your mom's health conditions.

 

It is DANGEROUS to play around with prednisone. You definitely can't just keep starting and stopping that at will, because it can cause serious side effects. This may be true of some of the other medications as well.

 

I'm wondering what your mom's prognosis is, because with the pulmonary specialist saying everything can be stopped, it sounds as though he might think she has come to the end of the road. On the other hand, the cardio specialist might not feel the same. But I really have no idea about that, just guessing.

 

So I definitely think a discussion with the doctors about prognosis and goals of treatment is in order. But I also think you and your sisters need to talk it out and try to see each others' perspectives so that your mother can get the best care from all of you possible.

 

Even if she is nearing the end of her battle, you want her to be as comfortable as possible, and not struggling to breathe and live. Medications can help with that... although too many medications can also cause problems. It's often a real balancing act.

 

But... communication between caregivers is key. I know you can get there if you try.

 

Best,

Kathi

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By Donna Smith— Last Modified: 02/12/12, First Published: 01/29/12