Tramadol, Ultram, Morphine or a Stroke (TUMS), which one is causing my sweet, caring, thoughtful mom to act this way? Mom had her surgery just last Tuesday (April 1) and the person she is today is no April Fool’s Day Joke and is at time hard to stomach. After the surgery the doctors started mom the Tramadol and Morphine for her pain control. After only a day we noticed that mom was slurring her words, she was argumentative, having to search words, transposing words such as he/she, him/her of just her B’s and P’s were flipped around. She even argued and distrusted me on several things, even when I would tell her, “Mom, you need to trust us that we have your best interest at heart and that we’re not going to have them give you something that’s not 
been approved by the doctors and has not been explained to us the reason they feel you need it.” Even just under a week after the surgery, three days off the Ultram and 36 hours on only low doses of Morphine which is only being used for major pain, other than that she has been prescribed Extra Strength Tylenol (EST). She is still this way and at times worse. It may sound cruel that we’ve not approved more pain meds but the reality is mom is allergic to all the other classifications of pain meds, they make her break out in hives, itch extremely bad and others make her sleep to a point you can’t wake her up, once she slept for four days and another two in and out until the med was out of her system.
She is in the rehabilitation facility (RF) now since Friday afternoon. Now originally the surgeon explained to us that he was going to make a small incision on the top and bottom on the outside of her leg to inset the rod, plate and screws, on intake at the RF they exposed her leg to inspect, catalog and clean the incisions and was I shocked to see (1) 5” long, (2) 3” long and (4) 1-1/2” long incisions on top of the (2) 9” incisions from her knee replacement surgery. Back to TUMS, The intake nurses are asking mom background questions and since the hospital I have now heard five different versions of what exactly happened all from the grape slip, she stumbled to miss the grape or Taffy (mom’s Shitz Tzu), she turned and lost her balance and she weaved to avoid Taffy and hit a grape on the floor. Our theory it, she “Possibly” had a stroke and that’s what caused the fall. The hallucinations are continuing here in ManorCare (MC), on top of the pastor wheeling mom down to see the children’s choir which mom says was so beautiful, the wine colored rug that kept showing up and the nurses walking like penguins, here at MC so far she has seen Trish’s (my wife) parents and grandma at the end of her bed singing pop songs and dancing, her own mother has showed up as well as that darn wine colored rug. There has been several times when she will argue that she wants to go to Travis AFB and have the leg and knee treated and I’ve had a hard time with trying to explain to her that the leg is already fixed and the knee was not injured. I keep being told that when she gets like this I should just let it go, but then she elevates her determination to find someone to get it taken care of. An example of this is yesterday with her morning meds which were Vitamins and EST, she was angry that they were trying to get to take her anxiety pill which was not even in the container, she noticed an iron pill that is blue and is a regular pill, she was set it was a gel-cap which is her anxiety pill this one was only iron, the event went on for 5 minutes before she finally took it.
On check in mom asked when meals where and the intake nurse explained that they were 7am, 12pm and 6pm. So yesterday myself and Jimmy (other brother) were there around before 
6:45am so we would be there when the Occupational Therapist showed to evaluate her and by the time they made it to her room breakfast arrived between 7:05-7:10am, however when Trish and the kids went and visited her, she apparently complained that we had to argue, fight and complain to her breakfast. She also told then that the graveyard nurses were giving her a medicine that “Is Not” on moms list and she thinks its only purpose was so that they would not have to deal with her. Mom is under the impression that everyone is against her and that we stand just outside her room and talk about her just loud enough for her to hear a few words but no loud enough for her to hear everything. Yesterday, Jimmy and I are sitting there talking with her and she yells out “You don’t have to talk behind by back, you can do it to my face you shits.” We ask her what she’s talking about and she says that “Richard and Sue, they can talk in her to my face and not right outside the door.” With a dumbfounded stare to each other we ask a second time and receive the same reply. Jimmy follows with, “Mom, Richards sitting right there” and points to me. Her comeback was a bit scary, “No he’s not he’s in the hall with Sue talking about me, I’m not a child.” This took 5-10 minutes and she gave up without accepting that there was no one else there but Jimmy and myself.
On Saturday when the Occupational Therapist came to evaluate her, of course all the normal questions are asked, name, birthday, what city, where’s it hurt, what happened. And then she asks mom, “Carol, what day is it?” It always seemed to be Sunday or Monday. The therapist completed her evaluation and they needed to see mom stand up if possible so she calls in mom’s Physical Therapist and they proceed to do so with little success, but mom did make it to sitting on the edge of the bed. After everything, it was evaluation truth time. With everything we said regarding mom’s before and after fall status and what she’s seeing, see expects mom to be there for two months and if mom proves her wrong, excellent. She also agrees with our assessment of mom and the in house doctor agrees that we need to stop the Tramadol (which we Sutter, Roseville did) and try to use in very limited doses and for extreme pain only the Morphine if not stop this also so we can see if it is the Tramadol still in her system or is it the Morphine or an actual stroke, causing mom to act this way? When mom had her first stroke back in 2005 within a day or two this is exactly how she was and with speech therapy then and the therapist now going to request it for her, hopefully we can stop this before it’s too hard to stop. Now we are in the hurry up and wait line and should know more in the next several day.
Thank you
Richard (Kreisler)
iCareTalk.net 