Are opioid medications good for chronic pain in older adults?

Chronic pain is common among older adults. Sometimes it is severe and other medicines “don’t work”. A narcotic pain reliever is then often tried. Is this good or bad? More than 10% of older adults have had a prescription for an opioid in the past year. Almost 25% of long-term users of opioids are older adults. Are these numbers cause for alarm?

Part 2: I Need Something Stronger

My elderly mom has pain in her calves and feet. She uses Tylenol® every day but some days the pain is so bad that she doesn’t leave the house. Like many frail adults, my mom has chronic pain that has an impact on her quality of life. What would help her? …. Is it time to try cannabis? The last post was about first-line medicines for chronic pain. Acetaminophen is safe and effective for mild to moderate pain. NSAIDs sometimes work better but have more side effects, particularly among seniors. What’s next when more pain […]

The Role of Medicines in Pain Control: Part 1

Older adults take more medicines and are more likely to have problems due to using them. Medicines should be avoided if possible. But pain is also more prevalent among seniors and medicines are the most effective way to control pain. This post will be part 1 about medications for chronic pain in older adults. Let’s start with some basic concepts: Acetaminophen: “Pain Relief You Can Count On”, Partly True Acetominophen has been the most common over-the-counter pain reliever since the 1970’s. (Outside the United States it is called paracetamol). The most well-known brand is Tylenol. It […]

It hurts so much I can’t walk

“My 82-year-old Mom has had back pain for decades. She had back surgery, but the pain came back after 5 years. Then she had kyphoplasty but that only helped for about a year. Since then, she’s had injections and taken many pain medications including narcotics. Sometimes I think she’s drugged. Now she also has neck pain. She’s investigating stem cell therapy. What do you think?” Stem cell therapy has been used for degenerative disc disease of the back. The intent is to grow cells that restore the disc and decrease inflammation. Patients with less severe […]

What should I do when I see a pressure sore?

Pressure sores need close attention as soon as they are noticed. This post discusses the management of Stage I and II pressure sores. At these stages, the skin is not broken open or the wound is very shallow. With good care, these wounds should look much better within a week. Follow-up with a healthcare provider is needed if there is no improvement. This is especially true for patients with diabetes or any advanced illness. 

bedsore at heel

And Then He Got a Bedsore

One day, Mom noticed that his heels were a bit red. A couple days later he had some oozing blisters. Then, when the blisters broke open, there was a hole all the way down to muscle and I could feel the bone underneath. A “bedsore” is a disastrous wound. In the last several posts I have discussed skin tears. They are common as people get older. Fortunately, bedsores are less common than skin tears. But bedsores, now more commonly called “pressure sores”,  are much more serious. They often result in prolonged hospitalization and nursing home […]

Yikes, a skin tear!

In my last post, I discussed preventative care for fragile skin. But even with extra care, skin tears happen. Healthy skin stretches when bumped or pulled. Fragile skin rips open. This is especially common on the forearms and calves. We managed many skin tears in our clinic. In fact, we had a ready to go skincare equipment tray. There’s a right way and a wrong way to manage a skin tear. This post will cover both. We saw skin tears managed the wrong way all too often. When a skin tear isn’t managed correctly it […]

I’m always worried about her skin; it gets bruised just like that

Do you know of, or care for, someone who has skin as thin as tissue paper? Even a slight pinch or an accidental bump can result in a skin tear that just bleeds and bleeds. Large brown spots called hemosiderin spots can form on the skin over time (1). That’s when blood gets into the skin but is not completely reabsorbed. Residual iron from the red blood cells results in the brown color. Damage to the skin can also result in irregular white scar tissue that is not elastic and pulls at the skin (2). […]