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Old 01-18-2009, 11:17 AM   #1
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crhill3 HB User
end stage osteoporosis

My 85 yr old aunt has osteoporosis. She had very little calcium growing up, has had several fractures and has great difficulty taking medications. Now she has a very curved spine, has lost considerable height and is having trouble eating. Apparently because of the curvature of her spine, her abdoman is protruding. Is frequent vomiting and inability to eat going to be the ongoing future for her? Obviously, if she is getting no nutrition she will eventually starve to death. I just want to know what to expect. My mother is frantic and unprepared to deal with any of this. Thank you chill

 
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Old 01-18-2009, 04:06 PM   #2
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Re: end stage osteoporosis

Hi: Has your aunt looked into getting the fractures repaired? Once the spinal curve starts, it will affect your abdomen, heart, etc. There are minimally invasive procedures than can correct that spinal curve, but it might depend on how old the fractures are. Look into Kyphoplasty and Vertebroplasty. I don't know if this will help but it worth looking into. There's also a brace that is used for this problem, but it has to be ordered by a Dr and fitted by an orthotist (SpinoMedIII) kyphosis brace.

Until you can get her checked by a Dr that does one of these procedures, can she tolerate drinking something like Ensure? At least that would give her some nutrients, calcium, vit D, and it's easy to digest. I don't know if she has trouble swallowing, but she needs to get some nourishment even if it's a prepared drink that is especially for this type of problem.

If Kyphoplasty or Vertebroplasty aren't an option, there are also other types of spine surgery where they use rods/screws to straighten the spine, similar to what they do with scoliosis--and straightening the spine.

If she continues to fracture she will have these problems with any organ adjacent to the spine from the spine compressing on the core.

Good luck and look into some kind of surgical repair, but be sure that whoever you choose has a lot of experience in this area, like from a well known spine clinic near her. Kyphon Internationals web site has a listing you can use to look up surgeon/radiologists that do Kyphoplasty. They may even be able to direct you to some one else if they can't do this procedure.

One other thing is looking into why the Dr hasn't suggested getting nourishment in some other way. If she looses too much from a lack of food, then feeding tubes are usually considered, although that is a unpopular approach, sometimes it's needed to keep nutrients going into the body, since you can't go long without them.

Last edited by DesertBloom; 01-18-2009 at 04:13 PM. Reason: additional thought

 
Old 12-30-2009, 07:56 AM   #3
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Re: end stage osteoporosis

We are facing a very similar thing with my 88 year old mother in law! I googled "end stage osteoporsis" not thinking I would find anything, but here we are!

My MIL has mulitiple things wrong with her back - and yes, has had fip and femur fractures. She has lost about 7" of height. She has spinal stenosis, compressed vertebrae, I dont know all what else....

The bottom line is she is NOT a surgical candidate due to her age, and other health conditions (renal and heart related) AND is in "excruciating pain." Right now, she is in the hospital. She went to the hospital a couple weeks ago, for pain management, and then went to a skilled unit for rehab. She was readmitted to the hospital for sepsis, which she seems to be recovering from. They have her on Vicadin for pain, but now she is totally "gorked out" and not in her right mind. They have tried darvocet, ultram, and I am not sure what else.

The sad part is I am not sure she can be BOTH in her right mind, and out of pain!!! She has been marginally living at home on her own, but I think that is going to be out of the quesstion now.

They just tried her on the Ultram, and it will be interesting to see if her brain clears. Its very, very scary.

I have tried to talk my husband into putting her in hospice mode, and I think he is getting close to doing that. In other words, if she "crashes," we will not rush her to the hospital for treatments.

She also is not eating, but we will NOT start a feeding tube. She is getting some Ensure, and we coax her to eat a little, but she is probably slowly starving to death.

It so sad, because its a case where there is no good outcome - either a life of pain, or a life of being not in her right mind. And she always said that she would rather "die" than go to a nursing home or assisted living.

With her still in the hospital, we need to get the pain management team in, but I think all the doctors are clueless how to help the poor woman.

I NEVER thought of osteoporosis being an "end stage disease."

 
Old 12-30-2009, 08:20 AM   #4
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Re: end stage osteoporosis

Often people do stop eating when nearing the stage of passing on. It seems natural that the body does this as a part of the departing process. Just try to give her sips of water and don't try to force feed if she doesn't want it. Water might be taken more easily in a teaspoon. Anyway, these are things I've found from being with a number of people when they were in the final stages of their life. I am not saying this is the case with the aunt or mother-in-law (that they are passing on) but that the usual way we might handle illness might not apply here.

In the case of the mother-in-law, Hospice has specific guidelines that must be met before they will accept someone for care. If she meets those guidelines wouldn't it be best to give her that care?

All the best!

 
Old 01-01-2010, 09:11 PM   #5
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Re: end stage osteoporosis

I dont know if mom is just "declining" or dying per se. She is off the vicadin, and a little more in her right mind, but not entirely. They were going to discharge her to the nursing home today, but her kidney levels are off, and they need to check that out first. She is definitely declining. If she so much as moves in bed, she is in pain. She is not ambulating at all right now, although prior to all this, she was meagerly getting by in her own home. Dont know what the future will bring.

Wondering about the whole issue of pain relief for her multiple back issues - how much to medicate? And what pain meds will work? Even "pain management team" doesn't be suggesting much.

CRhill, how is your aunt doing?

 
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