i have observed a pattern in my mum's sickness. she has been going in and out of the hospital almost every 2 weeks. and i asked myself why. piecing all the symptoms together, i concluded it was due to morphine (i will refer to it as painkiller "m") intake. you see, she often get admitted due to water in her lungs, or constipation, or high level of toxins in her blood (as a result of prolonged constipation), etc. but when she was in the hospital, she would be perfectly fine. no pain in her knees, no issues with her health, no problems with her voice, etc but once she comes home, everything will go haywire again. and the only difference between the hospital and the home was her medication - she was given painkiller "m" at home. i came to this conclusion because when she was admitted for constipation a couple of weeks back, i learned from the doctor that taking painkiller "m" could result in constipation in many patients. hmmm... well, of course this couldn't really explain my mum's breathlessness, the water in her lungs, pneumonia and other complications related to breathing of late. nonetheless, i was very certain it had to do with painkiller "m".
to me, it was very clear there was a negative reinforcing loop happening - and it all started with her knees. and it went this way - when she complained her knees hurt, she would be given painkiller "m", then she would got drowsy, (and at times, hallucination and confused), and she would also suffer constipation, and when that happened, her blood gets poisoned. as a result, she got weak, she couldn't walk or exercise, her knees would then weaken further, with a further weaken knees, it would hurt when she tried to walk, and then my brother would feed her with more painkiller "m"... and the loop goes. to worsen the situation, i noted a couple of other negative reinforcing loops - eg, when she gets hallucination, my brother would sent her to imh, she would be given more medication, then she would get drowsy, and weaker, and she couldn't exercise, and her knees weakened further, and then it aggravated the pain, and she would be given more painkiller "m"... and one more - under the drowsy state, she would often behave in a confused manner, she lost her ability to recognise people, she couldn't sleep at night, she would then be drowsy in the daytime, and she would sleep more, when this happened, she would be too weak to exercise, and her knees weaken further, and the pain would worsen, and then she would be given more painkiller "m". and the loops continued.
no win. totally no way to get out of the loop. my only conclusion was that my brother should stop giving her painkiller "m" altogether and start to tackle the core issue - to make her knees stronger and to make her exercise. but he refused citing her painful knees and that he felt bad seeing her suffer. also, he insisted that the pain management doctor had asked to administer painkiller "m" whenever she feels pain. and so, he kept giving her painkiller "m". the dosage given was up to 15mls a day.
2 days ago, mum went into a state of high confusion again. she couldn't really talk, her voice was hoarse. she was terribly weak and her knees hurt so badly she couldn't stand up. yet, she insisted on heading to the polyclinic as she insisted her toes and soles hurt badly. in fact, she made so much noise until the domestic help as well as my sister-in-law couldn't manage her. they ended up calling my brother non-stop at his office. he was totally flustered and asked me to talk to her. i called her every half hour, spoke with her and tried to calm her down.
yesterday, my brother brought her to her specialist. and when told of all the symptoms, the specialist's conclusion was - it was due to painkiller "m" and that we should stop administering it altogether. and he added a new input that cleared all my questions regarding my mum's breathlessness. he said that for some people, taking painkiller "m" would result in formation of thick phlegm and that might lead to breathing difficulties. suddenly all pieces fitted together. mum's complain of phlegm, breathlessness, etc was due to painkiller "m" too! and this breathlessness added to all the loops i mentioned above. the lower oxygen intake due to the presence of thicken phlegm has resulted in increased sensitivity and a decrease in pain threshold (ironically), it also made mum weaker as her body system literally started to shut down as they were all starved of oxygen... this led to her totally weakened. and when all these happened, her knees could no longer support her and she simple collapse. and the doctor's advise was to stop administering the painkiller "m" immediately. he added that the focus should be to strengthen the knees by exercising it rather than trying to stop the pain. also, he cautioned the administering of such high amount of painkiller "m" becos a person's threshold to painkiller "m" will increase and that over time, the body will need a very high amount of painkiller "m" to manage the pain. he also commented that painkiller "m" is usually used for terminally ill patients and for healthy people, it should only be used as a last resort. and even then, the dosage should be kept as low as possible, say about 2.5 to no more than 5mls a day.
sighs. after the doctor's explanation, my brother finally accepted the fact that his insistent on giving painkiller "m" had been misguided all along (despite the fact that it was suggested by another doctor). i am just glad this issue is clarified. moving ahead, i hope mum will understand that she could get out of the cycle of hospitalisation only if she placed efforts on exercising her legs, even if it means she has to endure the pain a little bit more. the way out of suffering is not easy and one has to suffer in order get out of the cycle. the path out of this cycle of hospitalisation is through proper exercise and no trying short cuts of taking painkiller "m". and of cos i am reminded of the cycle of samsara, the four noble truth, and the noble eigthfold path. also, one needs to adopt the have right action can only happen if there is right views and understanding.
to me, it was very clear there was a negative reinforcing loop happening - and it all started with her knees. and it went this way - when she complained her knees hurt, she would be given painkiller "m", then she would got drowsy, (and at times, hallucination and confused), and she would also suffer constipation, and when that happened, her blood gets poisoned. as a result, she got weak, she couldn't walk or exercise, her knees would then weaken further, with a further weaken knees, it would hurt when she tried to walk, and then my brother would feed her with more painkiller "m"... and the loop goes. to worsen the situation, i noted a couple of other negative reinforcing loops - eg, when she gets hallucination, my brother would sent her to imh, she would be given more medication, then she would get drowsy, and weaker, and she couldn't exercise, and her knees weakened further, and then it aggravated the pain, and she would be given more painkiller "m"... and one more - under the drowsy state, she would often behave in a confused manner, she lost her ability to recognise people, she couldn't sleep at night, she would then be drowsy in the daytime, and she would sleep more, when this happened, she would be too weak to exercise, and her knees weaken further, and the pain would worsen, and then she would be given more painkiller "m". and the loops continued.
no win. totally no way to get out of the loop. my only conclusion was that my brother should stop giving her painkiller "m" altogether and start to tackle the core issue - to make her knees stronger and to make her exercise. but he refused citing her painful knees and that he felt bad seeing her suffer. also, he insisted that the pain management doctor had asked to administer painkiller "m" whenever she feels pain. and so, he kept giving her painkiller "m". the dosage given was up to 15mls a day.
2 days ago, mum went into a state of high confusion again. she couldn't really talk, her voice was hoarse. she was terribly weak and her knees hurt so badly she couldn't stand up. yet, she insisted on heading to the polyclinic as she insisted her toes and soles hurt badly. in fact, she made so much noise until the domestic help as well as my sister-in-law couldn't manage her. they ended up calling my brother non-stop at his office. he was totally flustered and asked me to talk to her. i called her every half hour, spoke with her and tried to calm her down.
yesterday, my brother brought her to her specialist. and when told of all the symptoms, the specialist's conclusion was - it was due to painkiller "m" and that we should stop administering it altogether. and he added a new input that cleared all my questions regarding my mum's breathlessness. he said that for some people, taking painkiller "m" would result in formation of thick phlegm and that might lead to breathing difficulties. suddenly all pieces fitted together. mum's complain of phlegm, breathlessness, etc was due to painkiller "m" too! and this breathlessness added to all the loops i mentioned above. the lower oxygen intake due to the presence of thicken phlegm has resulted in increased sensitivity and a decrease in pain threshold (ironically), it also made mum weaker as her body system literally started to shut down as they were all starved of oxygen... this led to her totally weakened. and when all these happened, her knees could no longer support her and she simple collapse. and the doctor's advise was to stop administering the painkiller "m" immediately. he added that the focus should be to strengthen the knees by exercising it rather than trying to stop the pain. also, he cautioned the administering of such high amount of painkiller "m" becos a person's threshold to painkiller "m" will increase and that over time, the body will need a very high amount of painkiller "m" to manage the pain. he also commented that painkiller "m" is usually used for terminally ill patients and for healthy people, it should only be used as a last resort. and even then, the dosage should be kept as low as possible, say about 2.5 to no more than 5mls a day.
sighs. after the doctor's explanation, my brother finally accepted the fact that his insistent on giving painkiller "m" had been misguided all along (despite the fact that it was suggested by another doctor). i am just glad this issue is clarified. moving ahead, i hope mum will understand that she could get out of the cycle of hospitalisation only if she placed efforts on exercising her legs, even if it means she has to endure the pain a little bit more. the way out of suffering is not easy and one has to suffer in order get out of the cycle. the path out of this cycle of hospitalisation is through proper exercise and no trying short cuts of taking painkiller "m". and of cos i am reminded of the cycle of samsara, the four noble truth, and the noble eigthfold path. also, one needs to adopt the have right action can only happen if there is right views and understanding.
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