* Mom's medical history

My Mom is 79 years old. She has COPD and lung cancer. She is a survivor of a massive heart attack and a hospice administered morphine overdose. I’m telling her story in the hope that others may be spared the lessons that she has learned the hard way.
My Mom smoked most of her adult life. It was not until she had a massive heart attack at age 66 and underwent triple by-pass surgery that she decided she had to quit smoking. The next twelve or so years were probably the most healthy years of her life. She made lifestyle changes, started eating healthy, and exercising regularly. Then she was diagnosed with COPD. She never remembered being told she had COPD. She found out when she was contacted by an organization conducting tests on people with COPD. This organization acquired my Mom’s name and contact information from Medicare. The organization explained that Medicare had just changed its policy on certain treatments for COPD patients and they were running tests to see who could benefit from the new policies. Based on only one blood oxygen level test and lifestyle history, this organization told my Mom that she needed to be on full time, 24 hour oxygen. They stated this with such urgency that my Mom was greatly alarmed and oxygen delivery was set up immediately. Up to this time Mom had experienced shortness of breath to a small extent but she was still exercising regularly in a monitored environment and at no time did her vital signs appear out of the norm. Mom continued her exercise routine on a regular basis while using a portable oxygen tank.
Mom had been on full time oxygen for about a year when she checked herself into the hospital because of chest pain. It turns out that she had pneumonia but they also found a 5cm cancerous tumor in her right lung. I’ve always felt that if more tests had been run when they first put her on oxygen the tumor would have been found earlier, and may have been the cause of her shortness of breath.
After consideration of both traditional and naturopathic cancer treatments, Mom opted for chemo and radiation. After 7.5 weeks of radiation and 12 weeks of chemo all Mom had to show for it was a tumor that had increased in size, burned, damaged lungs from the radiation, and extreme fatigue and weak immune system from the chemo.
After the traditional treatment failed, in June of 2005 Mom was put in a watch and wait mode. By December of 2005 her tumor had grown to 7cm and Mom was told by her oncologist that there was nothing more he could do for her. She was told that her life was measured in months, and hospice was offered as an option.
Mom decided that she was not going to just roll over and wait to die. We aggressively started investigating naturopathic options. I found a hospital in Mexico who’s approach to cancer treatment made perfect sense. We made arrangements to travel to Mexico in March of 2006, a major challenge when needing full time oxygen. Her treatments there were very aggressive while being totally non-invasive. After three weeks of treatments, she returned home feeling better than she had in months. Unfortunately, she returned home to a multitude of problems.
Here is a record of the chain of events that led up to my Mom collapsing and ending up in the emergency room:
Mom returned home on Sunday March 19, from an alternative cancer treatment center in Mexico feeling better than she had in many months, with more energy, and breathing better. On her way home she had trouble with the altitude but stabilized once she got home. Over the week her energy and breathing slowly declined to where on Friday March 24 she checked into the ER and found that her oxygen level was extremely low - in the 50s. Once she was warmed up and on hospital oxygen her level stabilized in the 90s. An X-ray was clear other than expected cancer and COPD – no pneumonia. An EKG came back normal. Once stabilized, she was sent home. The oxygen company was called to check out her equipment. The concentrator was checked and calibrated and her oxygen tube was switched to a liquid oxygen tank as a precaution. The tubing and cannula were NOT checked or replaced. By Saturday April 1 Mom was again feeling a lack of energy and shortness of breath but decided to keep a previously planned shopping trip with a friend. While shopping she was using her portable oxygen unit and started feeling better. Sunday morning April 2 Mom was again having a very difficult time breathing and no energy. I had her call the oxygen company and the hospice nurse. The oxygen company said that her tubing was clogged and replaced it along with the cannula. The hospice nurse started administering Morphine AND Lorazepam to help with anxiety and breathing. When I arrived I questioned the Morphine because my Mom was not in pain or had she ever been in pain due to the cancer or COPD. I noticed that Mom was breathing through her mouth and repeatedly reminded her to breathe through her nose. After the oxygen company brought a mask at the request of the nurse, Mom’s oxygen level finally stabilized in the 90s. By this time she was pretty well out of it from the Morphine and slept most of the afternoon. On Monday April 3 the hospice nurse came by to check on Mom. She administered more Morphine AND Lorazepam and then left my Mom by herself. My aunt brought dinner for my Mom later and she ate most of it. About 9:30 pm my aunt tried calling Mom and it was busy. Since it is unusual for my Mom to be on the phone at that time of night, my aunt got concerned and went over to her house. She found my Mom collapsed on the floor and only barely conscious. She was taken to the ER where the ER Doctor ordered an X-ray to evaluate her condition but the hospice nurse canceled the order stating that it would not be paid for by Medicare. She was moved to a private room where more Morphine was administered on a regular basis. Albuterol nebulizer therapy was the only treatment administered, and no tests were ordered to evaluate her true condition.
Throughout her treatment both at home and at the hospital I continued to question the use of Morphine. On April 5th Mom said that she did not want any more Morphine because of the way it made her feel. At the same time, hospice was discontinued and Mom’s lung specialist was called in to take over her care. A Dextrose drip, antibiotics, and Prednisone for her breathing were ordered and administered. A blood work and CT scan were also ordered. Mom made a remarkable recovery, was discharged from the hospital on April 8th., and has continued to improve on a daily basis.
On the evening of April 16th yet another problem was avoided when we noticed that the oxygen tank was dangerously near empty. The oxygen company was called and the tank was filled.
Many issues came out of this chain of events. Mom started having problems due to faulty oxygen equipment. Tubing and cannulas which were scheduled to be changed at least once a month had not been changed in over four months. Then due to recommendations from friends and family Mom decided to sign up for hospice because of the many “benefits” that they provide. During their “sales pitch” there was no hint that you were giving up all rights to medical care except what “they” consider comfort care. At the time that Mom was considering going on hospice I specifically asked “what would she be giving up”. I was told “nothing”, she would only be receiving all of the benefits that hospice has to offer. While Mom was in the hospital, I ended up firing hospice to get the tests and treatments she needed.
Not having any answers as to why Mom collapsed, I began researching all of the medications that Mom was / is taking and found some very disturbing information about Morphine and COPD. Morphine should be used with “extreme caution for patients with COPD”. It can cause apnoea and heart failure. Also, Morphine should never be administered along with other benzodiazepines such as Lorazepam, which is a common practice for hospice nurses.
I believe that Mom’s body was already compromised by the two weeks of oxygen level fluctuations and slow oxygen depravation due to oxygen equipment failure. Her condition was then compounded by the administration of Morphine. The night that Mom collapsed it was apparent that she had thrown up. I feel that the Morphine made her sick and also caused her to pass out and possibly stop breathing for a short time. Continued administration of Morphine in the hospital only hindered her recovery progress.
Also, due to oxygen depravation from both the equipment failure and the Morphine overdose, Mom’s short term memory has been seriously damaged. At times she will remember nothing about the day before. At other times she will remember some but be confused about the details. Hopefully over time this condition will heal itself.
Fortunately several positive things came out of her fight with Morphine. First, the CT scan that was finally done in the hospital was compared to the PET scan done in December and it showed that the cancer tumor had shrunk by almost 30%. The treatments in Mexico were definitely doing some good.
During my continued research, I found that Morphine, Prednisone, and lack of oxygen can all cause and accelerate the formation of cataracts. Mom has had slow growing cataracts for a couple of years. During her stay in the hospital, Mom’s eyesight became extremely hazy. She went from reading four books while in Mexico to not being able to read the newspaper almost overnight. Mom is now scheduled to have the cataracts replaced with implants that will allow her to continue the reading that she loves.
I know that this account is long and drawn out but I would like others to be aware of some of the pitfalls that can be avoided when dealing with COPD and hospice.