A question for vrzirn

[pele]

What is the name of your state? Hawaii

I would like your medical opinion please. I had a friend who died last year. She had metastatic breast cancer for three years, unfortunately diagnosed way too late because she did not see a doctor when she had unremitting pain in the hip. Her cancer was metastatic to the bone, and a few months before she died, to the liver and lungs. How compenent was she to sign a will being on Fentanyl patches and Tylox for at least 9-10 months. She signed the will in August and died in November. Her attorney's secretary wanted to me take an addendum to the will to the hospice for her to sign, I would not do it, by that time she was on sublingual morphine and hallucinating. I would appreciate your opinion on long-term narcotic use and what it does to someone's judgment. I think she was taken advantage of. I value your opinions on this site. Much Aloha from Hawaii.

 

[David.v.Goliath]

tylox

i know your question was directed at another person but i will throw my opinion in on this one.

i have been on tylox since Sept '97 8- per day. I have a severe pain syndrome from a non autherized surgery done in March of that year. I can tell you from first hand experiance that long term use of the drug does affect your memory. I think the pain affects your thinking more than the drugs do.

 

[vrzirn]

Metastatic involvement of the bone is one of the most frequent causes of pain in cancer patients and represents one of the first signs of widespread neoplastic disease. This means that by the time your friend had pain in her hip it was already too late.
Adequate control for intractable pain is a major concern because it significantly affects functional capacity and quality of life. In advanced cancer, opioid induced cognitive dysfunction usually occurs in the form of delirium. In patients with less advanced disease the evidence of cognitive impairment is subtle, largely related to inital dosing and dose increases.
Oral morphine is the narcotic standard in severe cancer pain. Many cancer patients die after a prolonged period of deterioration marked by physical and emotional suffering. It is the use of opioid analgesics in sufficient dosage that can improve the quality of life of these patients by alleviating cancer pain.
In other words, the pain is so intense and debilitating that their ability to reason is severely impaired. Although the narcotics affect them likewise, it is to a much lesser degree.
Your friend had a great deal of time to come to terms with her illness and pending death. Since she had an attorney I presume she had her affairs in order. Any last minute changes in her will may have been made by "advance directive". If her heirs are not complaining and are satisfied with the settlement of her estate, it is not your business.

 

[pele]

Thanks for your answer. I didn't tell you the whole story. She did not tell her family (who live on the East Coast) until three months before her death. Her brother obtained the attorney, an old school friend, once she signed the will, her brother refused to return the attorney's calls and was out of the picture I did not even come to see her. I got involved because the attorney's office was asking me about funeral arrangements. Her friends from work and I supported her while she was ill, that's what friends are for. I have just had this nagging feeling that her brother took advantage of her.

Once again, I value your opinions.

 

[vrzirn]

Thank you.
You were a good friend and that is all you need to remember.Let the rest go.