Okay, first, I have read the archives and see that Vicodin can cause issues. My 86 yo mother was just today prescribed Vicodin, 500 mg paracetamol and 5 mg hydrocodone, BID for joint pain (some joints have bursitis, some have arthritis). The doc tried other things first (and Mother is still on Celebrex) but they did not relieve the pain. It is getting really bad, especially in the morning. I am concerned about potential side effects. However, she is in a nursing home that is very concerned about the residents taking anything that will be too sedating, and on admission she was taken off other pain meds for that reason, so it seems the nurses would have challenged the Vicodin if they thought it was a problem. She is still ambulatory with a walker and I am concerned about falls in addition to hallucinations or other issues. I am wondering what else could be done for pain relief that might not be as risky.

Have they tried just Tylenol, these other meds just might cause some major issues, maybe some PT for the stiffness which might be from the diseaase itself!

Could it be bad in the morning because she's sleeping on a joint with bursitis? Is there any way to prevent this with pillows? I use a frozen gel pak on my bursitis and it helps a great deal. If I still have pain after icing it, I use Motrin (ibuprofen). There are lots of non-narcotic pain meds to try.

Irene and Robin, thanks for your replies! She used to take Tramadol, which seemed to help a lot, but she was taken off of it when she entered the NH. The doctor has had her on just Tylenol, and that was not working. She has arthritis in her knees and bursitis in both hips. She's also on Celebrex and Neurontin, both of which are also supposed to help. As far as ice packs, I don't know which joint they should ice first! The NH and my mother both report that she cries in the morning due to the pain when she first wakes up and tries to get up, apparently from being still for several hours. Today, I asked the charge nurse to schedule a dose of her PRN Tylenol for 3 a.m. so it can start to work before she tries to get up, and the nurse agreed that might help. She walks quite a lot with her walker in the NH halls, so she does get exercise. So far, she does seem somewhat subdued since taking the Vicodin but not really any more confused. My niece who is a nurse practitioner says that the elderly usually tolerate Vicodin well, but she's not used to LBD. Next week, I have a care conference at the NH so I will ask about all of your suggestions. It just doesn't seem like a good idea for her to be taking narcotics, I agree. What a juggling act with all the meds and issues!
Thanks again,
Julianne

Jilianne,
I think the idea of giving her something before she gets up for the day is something worth trying or even some exercisers before they get her up to try and help with the stiffness, when you go to the meeting next week see also about some PT for her I am sure it will be short lived but certainly worth it if it gives some relief.
Good Luck!

My dad has been on the Fentanyl patch for over a month now and it has kept his pain at a minimum from what we can tell (he has a pressure sore that just won't go away). Don't know if that could be an option for you, but you might ask the nursing staff or dr. Lynn

Lynn,
Do you mean Fentanyl? Risperdal is an antipsychotic and doesn't come in patch form. Never heard of Resperdal.
Robin

That's right, Risperdal is a neuroleptic drug which probably shouldn't even be used for LBD or PD patients. Could it be fentanyl [Duragesic]?.

oops, Robin and Pat, thanks for correcting me. I knew I should have looked that up before I wrote it. You are right - it's a Fentanyl patch. Sorry. I'm editing my previous post if that will work! Lynn

It did work, Lynn. But now our response posts don't make any sense! LOL!. That's OK---I'm sure a lot of my posts don't make any sense!

I guess the 3 of us could just delete our posts!

As it turned out, last night the nurse suggested the Fentanyl patch because my mother's worst pain is in the early a.m., before she has eaten so she can't have Vicodin yet. The idea of a steady delivery of pain killer made sense to me, so I agreed that the nurse should request an order, which she did, and the doctor wrote it this morning. I am really hoping this will work!

Thanks,
Julianne

Hope it works for your mother! It can be a wonder-drug for many and the patch application has benefits.

Thanks, Robin! I hope so, too.

The absolute best thing for pain with my dad is Advil/Ibuprofen plus it helps with inflammation and clears up his thinking a little.

Various doctors and nursing homes say you can't use it if you have kidney function <60 GFR but I insisted they take my dad OFF vicodin which gave him nightmares and made him have hallucinations, he started seeing people and thought they were real.

His GFR is measured weekly and the Ibuprofen has not hurt at all and he has much less swelling and pain.

I think tylenol is much more dangerous than ibuprofen and it angers me how bias the medical profession is against ibuprofen. I worked in a hospital a long, long time ago (just in Admin) and was told they used tylenol because it was cheaper and in some cases free. This was back when tylenol had the commercials on which said " hospitals prefer tylenol" ....

ANYWAY, push for Advil/Ibuprofen for effective pain relief, unless there is a REAL reason your LO cannot tolerate it.

It is worth a try. My whole family takes it and none of us have problems except my mother who says that it upsets her stomach so she cannot take it.

My mother-in-law was having numerous mini back surgeries and terrible pain until FINALLY we got a doctor to prescribe ibuprofen... she has less pressure, inflammation, swelling and can now walk again without horrible pain and no new surgeries since starting ibuprofen.

All it took was for me to go with her to the doctor and say " wouldn't ibuprofen be the best thing for her to take" (before they had her on a narcotic which gave her relief but made her dizzy and relieved none of the swelling and inflammation just masked the pain)