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Thread: ?'s about medications

  1. #1
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    ?'s about medications

    I hope that I am posting in the appropriate forum. My brother-in-law has been experiencing anxiety and sleeplessness. In addition to weight loss (which I would suspect typically for SKI patients). It has been approxitely 45 days since his injury. If you read a previous post you will learn he has been making some important progress.

    The medical team has him on anti-anxiety medication (perhaps lexapro only about 2 days), as well as giving something for not being able to sleep. The sleeplessness and anxiety are likely coming from many different places. The biggest being a problem with not being able to cough up muscus, he needs assistance getting it out. I believe he is being awaken by the cough and then he gets to the point of worry when he is in distress about being able to breath (and who wouldn't?!). Per report, he calls for help from the nurses and his opinion is that the response time is pretty lengthy (apparantly one time is documented to be 35 min.). Once he is suctioned, he has relief. So if this goes on frequently throughout the night, how does he get any sleep? And then how can one function throuhgout the day?!

    Ok now that I am proofing this posting, I see that most of it is a rant & rave (only out of concern). Are there any tests that my sister or brother-in-law can request to have done. Any suggestions are welcomed.

    Thanks for listening.

    Rose

  2. #2
    Hi, Rose,

    If the response time has been that long for a nurse to come and do suctioning, you/he need to speak to the charge nurse, or supervisor. That's a potentially life-threatening situation, and needs to be attended to immediately.

    As far as some sleeping medication or anxiety meds, let him be the guide for whether or not he wants/needs to take those. Sometimes a short term dose of these meds and help greatly in the 'acute' phase, to both help him sleep and reduce the anxiety.

    Hope that helps!

    _____________
    What people say, what people do, and what they say they do are entirely different things. - Margaret Mead

  3. #3
    I would recommend that you have a meeting with the head nurse on his unit. Shephard should know how important it is for him to get his sleep, and to get appropriate and timely response to his needs for suctioning, as well as other methods for clearning his secretions (quad coughing, Cough-Assist machine, etc.). If this does not resolve the problem, then go on up the "chain of command" for nursing to the director of nurses, and if needed to the director of the hospital.

    Sleep medications have a limited usefulness. Most really only help for a week or two, and if you have been on them for some time, if you try to come off this can cause serious insomnia. Most also interfer with REM sleep, which is needed both for mental health and for body tissue healing.

    Medicating him for anxiety that is caused by lack of quality care is also not good practice (does he have anxiety issues during the day too???). Is he working with a psychologist to learn non-medication ways to manage any anxiety and to also talk about his fears and adjustment concerns?

    Fearfulness of sleeping is common in people with SCI who are still dealing with respiratory issues. Napping during the day will only make insomnia and sleep pattern disruption worse. It will be important to avoid this by working on his night-time issues with his entire team.

    (KLD)

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