I need some serious and honest advice please, regarding fibromyalgia and methadone

Nurses General Nursing

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My sister has been telling us for about 4 years that she has fibromyalgia. She does not work or go to school. She is 27 years old. She is on a variety of meds....from valium to methadone to paxil to regular tylenol/advil and others that I dont even know about.

We (as a family) have come to the conclusion that she is hiding something from us. She will not let anyone attend a doctors appointment with her, and makes up excuses as to why. I've offered her several options to help control her pain (massage, accupuncture, exercise etc...) and she flat out refuses it all claiming that it doesnt help, yet every page of research i've read says that it will.

We have feared in the past that she was on drugs and addicted to various ones, but nobody could ever really prove it. We are all in agreement that she is very much addicted to the methadone and we don't know how to help her. We are aware that fibromyalgia does exist, but we are unsure if this is really what she has, or if this is all just an act. (please note that it is in her history to make things up to be the focus of everyones attention).

Anyway, the final straw came about an hour ago when she called and asked if I could "offer up my husband" as she is incredibly lonely. Yes. She asked if I could send over my husband to pleasure her. What the heck?? I dont know if she was serious or just high!

Please. Can someone, anyone help me here? My sister is very important to me, but I just dont know how to help someone who does not want help. Are we all being a bad family in thinking this is all an act? Or are we actually being smart in thinking this? I have been in tears for the last hour because of her phonecall and I cant keep doing this. I just dont know what to do.

For anyone who thinks this post is a joke, please, I swear on my life that this is not a joke and I am honestly looking for some advice. I've made an appointment to see my doctor regarding this, but in the mean time...any thoughts would be appreciated.

thank you.

Marina

Specializes in Rodeo Nursing (Neuro).

There are good reasons doctors and nurses don't treat their own family members! Despite some good advice, here, about stepping back from the problem and not accepting responsibility for things you can't control, the plain truth is that you can't be objective about your sister, nor could any of us in the same position. I have been going through some issues with my father over what I fear may be problems related to his coronary artery disease, torn between my concern over what may be versus what I hope it might be, mixed with his unrealistic ideas of what I can do for him (I'm not a cardiac nurse, and even if I was, I don't have so much as a pulse oximeter at my disposal, nor could I prescribe meds even if I could diagnose him with a stethoscope).

Of course, the situation is all the more complicated where questions of psychiatric health are involved. How do you tell someone you love you think she may be mentally ill? How do you differentiate the garden-variety craziness we all live with from an actual psychiatric problem?

I don't have the answers to those questions, but it may be helpful to be very clear with the rest of the family that your sister's needs are way beyond the scope of practice of a nursing student. Your role in this is no different from theirs, that of a loving family member.

In my work on a neuro unit, I routinely deal with patients with impaired mental status as a result of physiological disorders such as stroke, brain tumors, etc. Inevitable, some of these people have psych issues, as well, and some are just stubborn or have poor judgement. We have real problems with things like fall prevention, but in some instances we have to recognize that a patient has a right to fall and hurt himself, if he so chooses. Not every foolish decision is incompetent. It sounds like you are in a similar position--your sister may be fully capable of making an informed decision, in which case your options to decide for her are very limited, even if her decisions are obviously dumb.

I do hope things work out for the best, but the only real advice I can give is to echo what others have said, there may just not be a lot you can do about this, and certainly nothing in your nursing background makes you more able or responsible than anyone else. (I suspect, though, that that's a problem a lot of us have with our families.)

Please listen to the advice given. To expect YOU to fix her isn't reasonable. No one can fix another person. NO human being has that kind of power! The committment and action to change circumstances has to come from the person in need of change.

An intervention is a great idea! It puts EVERYONE on the same page. It gives direction to the person needing it and spells out what is and is not appropriate. It states the boundaries of support and the needs of the patient. It can be a defining and empowering event to the person in need as well as providing relief to those that are currently scrambling to "fix" the problems. The supporters learn that they cannot "fix" things, but, they can facilitate a healing process. If and when your sister decides that she really wants to help herself she knows that you will be there for her as a facilitator within the boundaries you've set.

I'm sorry about losing a sister to suicide. You are NOT to blame and should NOT shoulder that responsibility. You did NOTHING to cause your sister's death. This was a decision your sister made. I can't imagine the horror you feel over all of this. I can just tell you that it isn't your fault. I offer you a sincere and heartfelt hug.

There are good reasons doctors and nurses don't treat their own family members! Despite some good advice, here, about stepping back from the problem and not accepting responsibility for things you can't control, the plain truth is that you can't be objective about your sister, nor could any of us in the same position. I have been going through some issues with my father over what I fear may be problems related to his coronary artery disease, torn between my concern over what may be versus what I hope it might be, mixed with his unrealistic ideas of what I can do for him (I'm not a cardiac nurse, and even if I was, I don't have so much as a pulse oximeter at my disposal, nor could I prescribe meds even if I could diagnose him with a stethoscope).

Of course, the situation is all the more complicated where questions of psychiatric health are involved. How do you tell someone you love you think she may be mentally ill? How do you differentiate the garden-variety craziness we all live with from an actual psychiatric problem?

I don't have the answers to those questions, but it may be helpful to be very clear with the rest of the family that your sister's needs are way beyond the scope of practice of a nursing student. Your role in this is no different from theirs, that of a loving family member.

In my work on a neuro unit, I routinely deal with patients with impaired mental status as a result of physiological disorders such as stroke, brain tumors, etc. Inevitable, some of these people have psych issues, as well, and some are just stubborn or have poor judgement. We have real problems with things like fall prevention, but in some instances we have to recognize that a patient has a right to fall and hurt himself, if he so chooses. Not every foolish decision is incompetent. It sounds like you are in a similar position--your sister may be fully capable of making an informed decision, in which case your options to decide for her are very limited, even if her decisions are obviously dumb.

I do hope things work out for the best, but the only real advice I can give is to echo what others have said, there may just not be a lot you can do about this, and certainly nothing in your nursing background makes you more able or responsible than anyone else. (I suspect, though, that that's a problem a lot of us have with our families.)

So well said.

Specializes in ER, ICU, L&D, OR.

I see where it sounds like its time for all of you to get om the same page. Get the family togather, if she wants to be there fine, if she doesnt fine. You all need to come to some basic truths.

Truth 1= You can't fix her if she doesnt want to be fixed.

If your not very carefull here, than any attempts to fix her become ENABLING. Dont Enable and Empower her.

Truth 2. You can only help yourselves.

Do whats good for you. If she doesnt want to change then leave her behind. She can only drag you down, wear you out, tire you, burn you out. Take care of yourself. If you cant take care of yourself you cant help amyone else.

Someone mentioned interventions. That never has impressed me, good for some cute TV series with maybe Dr Phil. Im more from the Tough Love Generation. Sometimes you have to cut losses to avoid faceing major losses to your self.

enablers are good in heart but rarely effect change

i hae fibromylagia and i have found that the things which have helped are low carb and walking..of course i do take naprosin, tylenol, motrin evry day but i wa taking them before w/o much help/ low carb and walking don't eliminate pain but they do help

don't take any narcotic meds because once i was on lortab after a surgery and it put me to sleep within half hour of taking .

i don't know what your sister' problem is but i think that she needs a full

mental/physical eval

good luck

tragically, the nature of addiction wreaks more havoc than the physical disease process itself.

so while pts w/fibromyalgia have physical and psychosocial issues that can last a lifetime, it still pales in contrast to the damage done in loving someone with an addiction.

the extremes these people go to, just to keep the focus off of them-it's truly mind boggling.

i'm with tom, where i'm a tough love gal.

i think family counselling is in order, to learn how to deal with your sister-not how to fix her.

narc-anon also....al-anon, same concept.

but in no uncertain terms, NO she cannot borrow your husband, and NO she does not have permission to destroy others' lives.

YES, we will love and support you when you are ready to seek the serious help you need....

sometimes the most loving thing you can do, is to let them hit rock bottom.

they're going to get there, whether you 'let' them or not.

be strong, be united and be well....

leslie

Specializes in Nursing assistant.

So sorry you are going through this with your sister. I am many years down the road with a similar situation with a sibling . She has so many regrets now, blames family members for not rescuing her from herself, blames parents for causing her to make the decisions she made. There is so much damage.

And I am totally powerless to change a thing.

I can love her and show her mercy, and grieve for her loss.

Your sister could change her course, she is still young. Some how, some way she may finally realize there are other people, other lives out side of herself. She lives in that center, and until someone elses welfare means something significant to her, she will stay there.

I am not certain if addiction causes this, or is a result of this. Of course, people who have chronic pain can develop an addiction without these traits and in no way is this a comment on their character, but in your sisters case, she clearly is totally self absorbed.

If you can, warn her. But do not take responsibility. Do not take the blame. You have chosen, and so has she. Love her and pray for her. But guard your own family!

You stated that your sister needs to be "the center of attention." This sounds a lot like someone with Borderline Personality Disorder. BPD's can't distinguish between positive or negative attention, they simply crave attention by any means necessary. They usually don't believe that they have a problem, unless they are high functioning or have been in therapy for years. The request re: your husband is classic - it's like they don't have a conscience. When you talk to one, it's all about them, and they can go on for literally hours about themselves, ailments etc.

I suspect, as you do, that she also has a chemical dependence co-morbidity. While chronic pain can affect anyone, BPD's tend to be typically adept at "working the system" to get what they want by either playing coy or outright demanding/threatening lawsuits. I know of one BPD man that has a Dilaudid pain pump implant, is "allergic" to anything else (including Morphine, Toradol, Codeine, Naprosyn, Tylenol, etc) except Buprenorphine. There were some major threats to get that, and docs are intimidated into accomodating him.

I know very little about your sister, but as others have said, you need to either make an effort to have a family intervention or cut yourself off from her until she is finished with treatment/therapy. With these folks, as difficult as it is, tough love is the only thing they understand.

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