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Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 31315
Experience:  MBBS, MS (General Surgery), Fellowship in Sports Medicine
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My wife has a very bad back and has had shots, etc. but does

Customer Question

My wife has a very bad back and has had shots, etc. but does now want surgery at 74 so was sent to a "pain clinic" and they wanted to implant a stimulator in her spine and she said no. In the last 10 days or so she is so bad we have to use the wheel chair up stairs and downstairs and it scares me to death when she climbs and descends the stairs with my help. I hate to go on and on but the latest thing is she is totally disoriented most of the time now. At her worst she does not know where she is, or what story of the house she is on. I have seen her like this in the past when she had surgery on her knee and hip, but I don't know what to do. She says if I call 911 she will not go. She has taken one bad fall in the bathroom already, but most of the time her legs give out even with the walker and she sort of wilts to the floor even with me and my son holding her up. I have read patients have the right to refuse care but I don't know what to do.
Submitted: 3 months ago.
Category: Health
Expert:  Dr. Arun Phophalia replied 3 months ago.

I am Dr. Arun and will be helping you today.

I am sorry about your wife's significant pain. But concerning is her disorientation about the time, place and person. The most likely reason may be the medicines she must be taking. Narcotic analgesics can cause disorientation. So you need to get her doses modified. Surgery in her age group may not be helpful, so opting out of that is not wrong. Following should be integrated in her management;

1) Physical therapy and occupational therapy, plays an important role in functional restoration. The goal is to increase strength and flexibility gradually.

2) Recreational therapy; take part in pleasurable activities that help to decrease pain.

3) Vocational therapy; provide work capacities and targeted work hardening.

4) Continuous epidural infusion

5) Spinal cord stimulator

6) Baclofen pump; Intrathecal infusion (Intrathecal bupivacaine infusion or Morphine pump are the other alternatives)

7) Acupuncture

8) Relaxation techniques; associated with the above treatment.

9) Biofeedback training

You need to consult following specialists (if not yet done);

a) Pain management physician

b) MD in physical medicine and rehabilitation.

Lastly coming back to disorientation again; if this lasts for more than 5 minutes or more or is recurrent; she needs to get an MRI of brain. This may be TIA (transient ischemic attacks). This is precursor of stroke, so you may consider going to emergency room.

Please feel free for your follow up questions.

I would be happy to assist you further, if you need any more information.

Thanks for using Just Answer.

Expert:  Dr. Arun Phophalia replied 3 months ago.

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Expert:  Dr. Arun Phophalia replied 3 months ago.

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Wishing you all the very best in life.

Expert:  Dr. Arun Phophalia replied 3 months ago.

Best wishes,
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