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 Please Advise me as I am at my wits end! 
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Joined: Thu Oct 23, 2008 4:25 pm
Posts: 2
Post Please Advise me as I am at my wits end!
I need advice very quick like........ TIA!!!

My mom has Lewy Body Disease or whatever you want to call it. She is in a long term skilled nursing facilty.

She has been there since mid October. She was there for ten days before I discovered that her teeth had not been brushed not one single time since her admission. Since that time she developed an infection in a tooth, and approximately three weeks ago, had said tooth extracted. She developed an even further infection, and a dry socket!

My mother is on Celexa for depression, and my dear darling sister who never visits our mother, took it upon herself to contact the facility and spoke to my mom's doc and convinced the doc that my mother needed an increase in her celexa, which was started several days ago. as my dear darling sister seems to beleive that mom's probs are all related to depression.

Meanwhile, my mother's mouth is killing her, and tylenol is not cutting the pain, and the dentist that extracted her tooth, noted she had exposed roots in the other surrounding teeth.

So, today I get a phone call from the Facility, and they are contacting the facilty's physician for an order for Tramadol...25mgs. I looked it up on the net, and along with a nursing drug handbook it has warnings for SSRI's and Tramadol in combo. And this is just for the normal population, not someone with Lewy Body Disease.

So, what should I do? The nurse today when I visited my mom was also suggesting getting an order from the doc for an anti-anxiety agent such as Ativan.

Gawd, I am at my wits end! What should I do? I don't think she should be getting the tramadol. Does anybody know if
Tramadol, and Celexa are a ggod combo for Lewy Body Disease?

Please help me, as I am ready to call up and blow a rod! I am crying as I write this as I do not know what to do!


Sat Dec 27, 2008 7:14 pm
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Joined: Fri Aug 11, 2006 1:46 pm
Posts: 4811
Location: SF Bay Area (Northern CA)
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Katrina,

I don't know anything about tramadol. One pain med that is supposed to be safe in LBD is Ultram. (The drug names look similar.) Have you tried ibuprofen (Motrin) as well?

Find out from the dentist what pain meds he used during the tooth extraction. That may give you a clue as to what can be helpful now.

You and your sister need to figure out who is in charge, and that person needs to communicate with the facility. Who has the healthcare POA? Put your decision in writing with the SNF.

Did the dentist say if the no-teeth-brushing caused this problem? Given the extent of the problems, I'm wondering if the no brushing has anything to do with it. I would document this in writing with the SNF, and ask them what their plan is to get your mother's teeth brushed.

Most cannot handle Ativan. Some can. It's a crap shoot. The main danger with Ativan is that it has a sedating effect and makes walking a dicey situation.

I wouldn't think that an increase in Celexa would necessarily harm your mother.

Before proceeding any further, read Boeve's "Continuum" paper on the LBDA website. Is your mother receiving any dementia meds? Does the SNF have a psychiatrist who can evaluate her for LBD?

Robin


Sun Dec 28, 2008 3:21 am
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