I recently met a 45 year old lady; she lives downstairs from me in the same apartment building. She states that she has been suffering from lupus, rheumatoid arthritis, and chronic pancreatitis for around 15 years. I am a nurse so I figured I could help her out here and there, take her to dr's appointments, and, help her with shopping and house cleaning, etc. She is extremely edematous, mostly hands, legs and feet. She told me she was taking Plaquil, lasix, and pain medication for her pretty much all over the body pain.
I worried a lot about how the narcotic pain medication affected her, often she will be sitting up, but leaning forward almost to the point of falling. She states it is because of her "cataplexia" that she appears so "out of it" at times.
Her diet is terrible, she hardly drinks any fluids at all, her urine is dark amber, and she urinates very little, about once a day.
A couple of weeks ago she ended up in ED with kidneystones. She was instructed to strain her urine, and follow up with a nephrologist and a rheumatologist, the ED doc. even made appointments for her.
She was also told to pick up her prescription for Plaquil and Lasix.
Long story short; I found out that she had not been taking her Plaquil, her Lasix, her Prednisone, and NSAIDS for almost a year, according to her, I assume it's been much longer after finding out how non-compliant she was. Her creatinine level was 4.
She had however, been taking, and still is taking; massive amounts of pain and anxiety medications prescribed by her "Pain Management Doctor" the only dr's appt. that she keeps!
Her daily medication regime is as follows:
Oxycodone IR, 30 mg PO q4hours Around The Clock
Methadone 10 mg PO q$hours Around The Clock
Valium 10 mg PO q8hours Around The Clock
Zanaflex 4 mg PO q8hours Around The Clock
Phenergan 25 mg PO q12hours Around The Clock
She is 5'4, and about 165#.
I don't know what to do.I have NEVER met a person in that much denial. I am pretty sure she knows that what she is doing is going to kill her, but she has no idea how soon. I guess the family has given up on her too,because she is doing 'SOOOO much better". I found out that the pain medication abuse was present before the lupus and rheumatoid arthritis diagnoses. Is it possible that all those medications caused the lupus?
She was a "shut-in" for many years, but has 3 supportive children, who I just don't think gets the whole picture.
In your opinion, Dr, if she keeps masking her pain with all these narcotics; and meanwhile not taking the medications she is prescribed for her lupus; how much time would you estimate she has left before she needs regular dialyses. And, who should I talk to in order to stop this madness???
Sincerely; Ulrika, RN