A dentist came to see mom today

[mamasbabygirl]

I was at work, but the first think he asked my SF was "How long does she have?" He was livid. He politely sais that we have not talked about that. What an idiot!! Anyway, I guess mom has a tooth that "gone south" whatever that means, so they are starting antibiotics today and have doubled the oxycontin. He said that it needs to be pulled. Should we push for that? Ouch!

Quick question-is it acceptable that hospice does not cover things like the antibioctics and lovenox? In other words, SF has to go to the pharmacy to get them. I can understand the antibiotics, but the blood clots are cancer related. Does this sound right?

[EastCoastLadi]

Lori,

I'm glad at least the dentist got to see your mom. I'm not too sure about the meds. Do the hospice nurses bring your moms' med or do you have them delivered to you. Because if you have them delivered, maybe you can get the new meds delivered too.

I think you should talk to your moms' dr. about if he/she advises having her tooth pulled. I don't know if she could handle the procedure, with the medications such as novacaine.

I wish you all the best, pray for comfort for your mom.

Grace

[gail]

Glad you finally got an answer.

I had a tooth pulled, and with an ativan and novacaine I was fine once it all wore off. Tooth pain is the worst.

good luck

gail

[Treebywater]

Lori--

It seems like OUR hospice organization had a policy that it was anything related to her disease AND not considered a life-prolonging measure. I'm not sure if Mom continued with her anti-coagulants at that time or not... If she did it wasn't for long because soon she couldn't take the pills and the liquids we had were only for pain control. Sorry I'm not more help.

[KerryToo]

I used to be a dental asst. A big part of why they would want to go ahead and pull the tooth, is that dental infections can enter the blood stream. (It's not just for the comfort of getting rid of a bad tooth.) You don't want to introduce any additional infection into the blood stream.

Hugs to you both.

[Linda661]

I'm glad your mom was able to be seen by a dentist -- tooth pain is nasty and she shouldn't have to suffer with that.

As for what meds should be covered by hospice: anything related to the management of the disease symptoms that brought her to hospice should be covered by hospice. The antibiotics for the tooth would not be as the tooth issue is not from her dx. The lovenox should be from what you describe if it is a standard med of hers in the management of her cancer dx.

Hospices can be funny about what meds they cover or not, however, based on their interpretation of what constitutes "treatment" rather than symptom management for comfort. I wouldn't think a blood thinner is "treatment" oriented, but I really don't know -- best to ask your hospice RN specifically why it is not being covered.

Also, FYI, your hospice should be fully covering all durable medical equipment needs including bed, wheelchair, transfer/safety equipment, O2 needs, bedside commode, etc.; ours even covered some consumable "comfort/dignity" supplies such as the adult diapers mom needed.

Linda

[marym]

Hi Lori,

Soon after my diagnosis, I had a dental appt. My doctor said it was fine to go, so I went and told the dentist that I had just been diagnosed. His first question was "how long do you have". I was amazed. I had not fully accepted the diagnosis and here is someone in the medical profession asking such a thing.

Anyway, I would make sure the doctors are in agreement on what should be done and most importantly what drugs need to be stopped beforehand. My dentist now, talk with my oncologist if I need any treatment beyond cleaning.

Mary

[cindy0519]

Lori,

I recall reading in several cancer related books that the drugs ect associated with cancer treatment can cause dental problems and that one should consult with thier dentist on a very regular basis during treatment. This being said I suppose a tooth gone south is somewhat to be expected. Certainly mom's oncologist and the dentist should be able to determine the best route to resolve her tooth pain. I can say from experience (unfortunately) that an infected tooth left untreated can cause a world of problems.. so unless it is just really risky I think getting the tooth pulled is certainly the best thing.

Wanted to comment on the lovenox -- my Dad was on this drug (and about 11 others for pain, heart rate regulation, blood pressure and two inhalers) to prior to being admitted to the hospice house. I do know that they said they would continue to get any meds related directly to his cancer and when we went over the Excel spreadsheet that I kept of his meds - there were many they felt were not related (all the heart meds and blood pressure were ones I can specifically recall discussing -- and we did "discuss" them..lol). They said they would discuss his meds with the hospice doctor and there "might" be some that they would continue to provide even though they were not directly related to his cancer (in their opinion). After all of these discussions, they discontinued all of his medicines but pain control meds and the stool softeners. Not sure if this was something that they do as a routine or if it was something that they discussed with Dad while we were not there (which was next to never). They did tell us that if Dad wished to continue the other meds the choice was his and we could bring them in ...but he chose not to continue them.

My advice is to talk to them about your concerns. Maybe ask specifically about the Lovenox and explain why you feel is it part of her cancer treatment. One of the nurses that we had (our favorite one actually) told us that sometimes they do just go ahead and order meds such as Lovenox if the patient wants to continue to take it, so I know it isn't totally out of question.

Good Luck to you and Mom ~ you both are amazing!!

Cindy