Taking ativan says he feels worse?

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Gina

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Hi all,my husband was put on artivan last week for his breathing which is very shallow.It looked to me like he was suffering and he agreed.He often has trouble expressing himself and his whole life i think he was encouraged to ignore pain,not by me by his familly.....anyway this morning he could not get out of bed looked like he was struggling to breathe again i asked him if he wanted another pill and he said no.Do you think that it is the pill that is making him feel worse or just the progression of the disease.He was up the night before with bad heartburn which he has never had before.I will phone the doc.and see what she says but i just wondered if anyone else had,had the same experience.I just do not want him to suffer so i dont know what to do......thanks for listening.....Gina
 

brooksea

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Gina,

Ativan is for anxiety. Did the doc think your husband was maybe in a panic and this caused his difficulty breathing?

Here is some info on Ativan: www.drugs.com/ativan.html

Before taking Ativan, tell your doctor if you are allergic to any drugs, or if you have:


asthma, emphysema, bronchitis, chronic obstructive pulmonary disorder (COPD), or other breathing problems;


Hope you can get your husband the help he needs!
 

Gina

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Hi jimercat!Thanks for your quick response.My husbands resperatory has been of the biggest concern for the last year....a little over a year ago he was given only 2 wks to 1 mont by not just one but two docs.One being the lung specialist and the other was dr.strong in london.He seemed to stay about the same for the last year but now he seems to be struggling more to breath.I took him to our gp. last week who now looks after him and she consulted with the lung specialist and they felt that ativin was the best choice to make him more comfortable.He was doing fine on it and seemed to be getting the relief he needed but did sleep more.This morning however he did say that he thought that the meds were making him worse.At this point i am not sure whether his disease is progressing more rapidly or it is the meds...i fear that it is the first...thanks for the info. i checked out the site....yes i also know that it can be used for anxiety ....thanks again ...Gina
 

brooksea

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Gina,

Is he on a Bipap or does he want to be? I hope he is not declining further. Good Luck and let us know how y'all are doing.
 

Gina

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oh yes been on bipap for couple of years now and oxygen during most part of the day....his appetite not good either right now so maybe could be touch of the flu or something...any thanks and i will keep you posted.....gina
 

landscape

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Hi Gina
I can appreciate your problems. My PALS has been on Bipap for 5 months approx, his appetite is almost nil and he recently had a urinary infection which caused a respiratory crisis. He is now on morphine for his breathing difficulties and that has helped a great deal.
Has your husband had a injection to protect him from 'flu? It would seem that when people are in such a precarious state any small difficulty can push them into a very difficult situation.

We are fortunate in having very good palliative care support. They do say they wish they'd been involved earlier so don't leave it too long before you get them involved--they are so much help!
p.s. how are your PALS carbon dioxide levels? It's normally the CO2 levels that are the problem. Do you know for sure that your PALS oxygen levels are down?
My PALS oxygen levels are fine.
 

quadbliss

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Hi Gina,

Is your husband's Bi-Pap inspiratory pressure setting maxed out? If not, it probably needs to be turned up (immediately). Also, I believe Ativan relaxes the muscles. This could result in a temporary weakness of his breathing muscles.

Mike
 

Gina

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landscape thankyou for your input!His oxygen levels are fine but they did check him while on the oxygen machine.....is that normally how they do it? the people from pro resp were in on wed.to check via docs.orders...i have ho ideal what his co2 levels are.Where do you get that info.?Yes we both had a flu shot last week. Quad I hadnt thought about the bi pap settings you could be right but im sure the people who came in to check his oxygen levels would have mentioned that as they provide the machine.We do have the case worker from hospice coming in next week to match him up with a suitable companion so that i may get out to do some errands if none of my family are available....Some of this is just so overwhelming and i pray that i am doing a good job taking care of him but i get so confused with everything at times....do you think it would be a good idea to add the oxygen to his bipap at this point...p.s. forgot my doc.had fri.aft.off so couldnt get a hold of her but i will if anything gets worse.He says now that he only wants to take the ativan at night before he goes to sleep.....thanks all and any further info is appreciated i feel like im swimming in a pool of paperwork and doctors and everything else!I know in need to relax but dammit thats easier said than done.....thanks ...gina
 

landscape

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Gina, it does not make sense to me that they check his Oxygen levels at the same time he is on supplementary oxygen. That doesn't tell them whether, or when he needs it .

The carbon dioxide levels have to be checked by taking blood from an artery in the wrist.

Do you have access to an ALS clinic or a doctor who is very familiar with ALS?
Here's what I would do on Monday (unless you have an emergency) when everything is open again :

1. Call the medical person who has most knowledge about ALS and tell them that you want your husband's carbon dioxide levels checked. Don't give up until they have done it.
If you have access to a specialist in ALS and lung function, that's the person to contact.

2. If they check his oxygen levels again make sure they do it at a time when he has been off the oxygen for as long as possible. If they are normal at that time, ask some questions as to why he is on the oxygen and when he needs it. Activity (even talking) will change the levels of oxygen so a reading at one time may not be the same as a reading at another.

With ALS the lungs themselves are normally healthy, it's the mechanism for drawing air into/letting it out of the lungs -- the muscles including the diaphragm -- that's at fault. The most frequent result of this is increased levels of carbon dioxide that make people sleepy, fatigued, and less alert.

If the lung tissue is healthy it is my understanding that most PALS can usually make good use of the oxygen that is present in the normal air if they are using a Bipap to pull that air in.

My husband's Bipap levels were prescribed by the pulmonologist and cannot be changed by the Respiratory tech. without another prescription or discussion with the doctor. Do you know who prescribed the levels on your husband's Bipap?

The use of oxygen can increase carbon dioxide levels in the body so I'd really push getting carbon dioxide levels done.

I am certain you are doing an excellent job caregiving--and yes, it is overwhelming. Be comfortable with what your husband chooses to do about taking the Ativan.

I hope your weekend is a calm one.
 

Gina

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Hey landscape thanks for all your input a little busy now so i will post again maybe tonight when i get more time...Glen is feeling a little better today thinking maybe now could have been a touch of the stomache flu!You raise some really interesting points and questions...ill get back to you....Gina
 

Gina

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landscape &quad...O.K here i am again husband busy watching the hockey game so now i have a little more time to respond to your questions.First let me start off by saying that my husband was given 2-4 wks a year ago november.At that time he was also sent to a lung specialist in our area who basically said the same thing.Since that time we have not gone back to the als clinic because he just did not have the strength to go anymore.Our g.p. is our primeary dr.and an advocate for us.Glen is her first patient with als but when a problem arrises she consults with the als clinic and the lung specialist.She is such a kind,compassinate woman and ready to go the extra mile for us concerning my husbands care.The last time i saw her she told me we need to keep in closer contact..hmm what doc. says that anymore?So armed with all the questions that you landscape and quad having given me i will be able to ask the right questions and get some answers.My husband says that his bi-pap is already at max settings,he has a better memory than i,and the last time he was given any blood test was when he was last seen by the lung specialist a year ago.She at that time told us that if he indeed used the oxygen it may quicken his progress.Those two appts. were almost a blur to me because of the bluntness and willingness to give a time period for his prognosis and i am afraid i totally lost if and had to leave the room.Fortunately my daughter was with me so she stayed with him while i tried to pull myself together.Damn docs. why do they say stuff like that it is now a little over a year and he is still here ....a whole year for me sleeping beside him wondering if he were going to wake in the morn.and a whole year for him to replay those words in his head.Like i said in my earlier quick post he is feeling a little better today thank goodness but still will not take the ativin.....thankyou for all your concern and guidance through another tough time.....god bless ....gina
 

landscape

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I'm sorry that your experience with the lung specialist was not a good one, Gina. We are fortunate in having a pulmonologist who is works in the ALS clinic and so is very good. I think it is important to have a lung specialist who is thoroughly familiar with ALS.

You might wish to print off the article below and give it to your GP. 'Hypercapnia' just means 'too much carbon dioxide in the body' and the article is about the effects of using oxygen if your breathing muscles are not working well because of neurological problems.
http://www.mayoclinicproceedings.com/inside.asp?AID=3830&UID=

Do you have Palliative care teams in your area? I can't say enough good things about the support they have given us. Could you ask your GP about them?

Let us know how you manage next week.

Many people are surprised that morphine can be used to treat breathlessness. Obviously it is only used in certain circumstances and would not be prescribed early on with ALS. At my husband's stage of the disease it has been very helpful and has had no side effects . . . other than constipation . . . but that is easily fixable!
 

Gina

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Hello again landscape thanks again for all the info.and concern.My husband seems to be doing much better tonight....must have been a stomache flu!We did consider morphine for him and our gp.did consult with the lung specialist whom he was referred to by the als clinic and they both agreed on ativin at this time.I think because of the prognosis that he was given i was not concerned about his use of the oxygen but upon further examination and reading of your post maybe i should be discouraging him from using so much of it during the day.My gp. is so approchable that i am sure she will be willing to listen to my concerns and she has even voluntered to make a house call if need be.I have warned him about the use of oxygen and so did the lung specialist but i figured at this stage of the game whatever makes him more comfortable.I am tottally confused now as to what to do and if i should have not let him use it....damn doctors if they hadnt given me a time limit im sure things would be different now.He has suprized all of them !I will let you know what our gp. has to say....p.s. he did ask for his pill again tonight!he is a veeery stubborn man so im sure hes gonna be around for a while just to spite them all!.......thanks again Gina
 

brooksea

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Gina,

I'm praying for y'all! Good luck!Wonderful you have a great GP!
 

landscape

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Gina, I agree with you about letting people (particularly husbands!) choose what they want to do. I think it's important that we have control over our own situations whenever possible. Your husband has all the necessary information so it is in his hands in terms of what he wants to use to make himself feel comfortable. For all of us, being in the driver's seat reduces anxiety.
. . . and stubborn is good!
 
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