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Thread: "Our goal is to make your pain tolerable"

  1. #41
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    @tedh...oh no no no, we can't let them know when we help others with their pain. It only would we get in trouble but we'd get the person we're helping in trouble too and it would go on their "permanent medical record"!
    @Ellyn...I agree with you that a number of surgeries only need a 3-5 day supply although I'd say it depends on the patient and their overall condition. I've had multiple survives and I'd say a hysterectomy done with laparoscopy, uncomplicate, sure 3-5 days.

    I've had a lung removed and had a continuous epidural spinal infusion for 2 days until the surgeon who didn't believe in anything other than ibuprophen had them pull it out. After that it was begging for pain relief IF I could get a nurse's attention. The hospitalist finally stepped in and said this was ridiculous and had a pump put in. I was sent home on day 5 with a week's worth of pain meds!

    Then I had a hip replaced at a major hospital in Boston and was sent home with a month's worth of meds and instructions to call a week ahead when they were low so they could mail me a new written script. This allowed me to be comfortable AND do my PT which got me back on my feet and moving along well at 6 weeks.

    So if someone is going to remove a major organ from my chest, you'd better believe I'm going to ask for those meds up front.

    If someone is going to saw off the top of my leg bone, screw in a new ball joint, and put a new hip in, then yes, I want adequate pain meds appropriate for the assault on my body.

    And that's exactly why I think this all needs to be individualized and between the doctor and patient. I don't need a congressman to approve anything.
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    Quote Originally Posted by Bawston View Post
    @tedh...oh no no no, we can't let them know when we help others with their pain. It only would we get in trouble but we'd get the person we're helping in trouble too and it would go on their "permanent medical record"!
    @Ellyn...I agree with you that a number of surgeries only need a 3-5 day supply although I'd say it depends on the patient and their overall condition. I've had multiple survives and I'd say a hysterectomy done with laparoscopy, uncomplicate, sure 3-5 days.

    I've had a lung removed and had a continuous epidural spinal infusion for 2 days until the surgeon who didn't believe in anything other than ibuprophen had them pull it out. After that it was begging for pain relief IF I could get a nurse's attention. The hospitalist finally stepped in and said this was ridiculous and had a pump put in. I was sent home on day 5 with a week's worth of pain meds!

    Then I had a hip replaced at a major hospital in Boston and was sent home with a month's worth of meds and instructions to call a week ahead when they were low so they could mail me a new written script. This allowed me to be comfortable AND do my PT which got me back on my feet and moving along well at 6 weeks.

    So if someone is going to remove a major organ from my chest, you'd better believe I'm going to ask for those meds up front.

    If someone is going to saw off the top of my leg bone, screw in a new ball joint, and put a new hip in, then yes, I want adequate pain meds appropriate for the assault on my body.

    And that's exactly why I think this all needs to be individualized and between the doctor and patient. I don't need a congressman to approve anything.
    It really is a crap shoot, unfortunately. I get a VERY small dose of PK from my doc. If she ever cuts me off, I'll likely tell her I'll be buying it thru the net. I WANT them to know what people are doing and are having to do. I think I'm lucky with my doctor tho. At my last "yearly" I had been going thru a lot of anxiety and my doc asked how I was dealing with it. I told her I was meditating (they always love that, but it was true too,) but I also told her when I was really spun out I took some klonopin that I had left over from many years ago (14 or so.) She surprised me later in the appt. and offered me a new prescription for the benzo since she thought the old ones probably weren't even effective any longer (they are tho.) Anyway, I don't like benzos unless I'm really anxious, so it won't be an issue, but I'm very happy to have a doctor that would actually give me those along with giving me some pks. (She may've forgotten I get those too tho.)

    I broke my wrist last year and I feel like I got pretty adequate pks too, from the orthopedist. The ER doc gave me 24 percs but cautioned me to try to tolerate some pain, as "this med is very addictive."

    One day I am sure we are going to finally find that it's a BRAIN ISSUE why some drugs cause addictions in some folks, and other folks take the meds without any issue at all. It's just not THE DRUG, imho. I'm quite certain I could take meth every day for a month and would hate every minute of it. That was certainly true for me in my younger days when I imbibed cocaine just because it was cool. I couldn't WAIT for the effects to wear off altho I could sense in the beginning the positive "hit." To me, the folks that get "hooked" are obviously missing something that the drug fills. Personally, I am as certain of this as I am my name, but we continue to assume it's the drug itself. I'll probably be long dead before they figure this out, but the fact that medication-assisted-therapy is getting more and more popular - that might finally lead to thinking this issue out in new terms with better solutions.

    I sure fear getting old in this climate of pk fears tho...I continue to wish there was a way to "unite" and fight back!!
    Last edited by jaders; 04-14-2019 at 06:42 PM.
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    @jaders... you are lucky and it sounds like you have a doctor who actually listens to what you're saying. Right now though I think what we can have as far as painkillers depends on what state you live in.

    In my state they've taken it completely out of the doctors hands and have issued 'guidelines'...not really, it's law - as to how much can be prescribed. Even then a pharmacy can step in and deny you a prescription if they decide it doesn't meet their corporate guidelines.

  4. #44
    Definitely depends on the State. I've talked to several friends who have undergone knee replacements and shoulder surgery and they were sent home with just a few days of pain killers. Docs now say take ibuprofen.
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    Quote Originally Posted by catboy View Post
    Definitely depends on the State. I've talked to several friends who have undergone knee replacements and shoulder surgery and they were sent home with just a few days of pain killers. Docs now say take ibuprofen.
    Sorry Dr. I'm going to pass on the surgery if I'm denied decent post surgery pain control. Of course there are the times when we don't have a choice about denying surgery. Like most of the time.
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  6. #46
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    Well I had an appointment with my neurologist who was not the doctor prescribing my pain meds. As I've mentioned on other posts I've tapered myself on my own initiative because I wanted to do it on my own terms in my own sweet time (and bank some backup meds for future emergencies). Although this doc wasn't the prescribing doc she always asked if I was STILL on THOSE meds.

    Well I was able to tell her that I was off them. She just lit up like a Christmas tree and exclaimed "congratulations! That's great!"

    She was so happy with the big smile until I looked at her with as perplexed a look as I could and wiped the smile off by saying ... "now why are you so happy that I'm in pain?"

    She looked shocked then perplexed and said, well it's good to not be dependent, to which I explained that unfortunately my quality of life is less and my activities are very limited.

    At least we then had a decent discussion about how I wasn't responsible for this "epidemic" and that I have too much pride to be subjected to the treatment people in pain are now subjected to. I also detailed how the required appointments, travel, and tests wiped me out for that day. I told her about the things that I no longer do and events that I have to pass on.

    I was surprised that she seemed to finally be listening and asked if I had talked to my primary about staying on. I again explained that I was the one who had decided because I didn't want to be in the situation of a forced taper or being pushed to a warehouse pain clinic. Also, if I move there is no way I'd find another's doctor is this state who'd prescribe or even take me on as a patient - she even agreed about that.

    So I guess maybe we just need to keep raising our voices, being calm but firm in how we're affected and maybe someday someone will listen.

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    People really don’t get the whole pain thing. I’m in very little pain lately so I don’t need a lot of meds. But it’s not that I got better, it’s because I literally don’t do sh*t anymore. I sit and read most of the time, get out an walk several times a week, and quit candy so I can maintain a minimum amount of gut weight. It’s either meds or a sedentary lifestyle. So, if I have to die early, at least I won’t hate the wait.
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    Quote Originally Posted by MRNUTTY View Post
    People really don’t get the whole pain thing. I’m in very little pain lately so I don’t need a lot of meds. But it’s not that I got better, it’s because I literally don’t do sh*t anymore. I sit and read most of the time, get out an walk several times a week, and quit candy so I can maintain a minimum amount of gut weight. It’s either meds or a sedentary lifestyle. So, if I have to die early, at least I won’t hate the wait.
    Yes, and now we're all back where we started about 15 - 20 years ago, when it was "discovered" that so many folks had untreated pain. That was big news, and about the time doctors actually started giving out narcotic pain meds with much greater ease. Now almost everyone is going to be back in the "untreated" situation again. I'm hoping the pendulum swings again because I'm just entering my "twilight" years and I'll buy street drugs before I live with untreated pain...
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    @MRNUTTY...that's the exact situation I'm in too. It's also what I explained to my neurologist the other day when she was so joyful about me stopping my prescription.

    As I explained what I used to do and what I now do - same as you...read, occasional walk, make a meal if I've got the energy... vs what I had been doing I saw that it started to dawn on her the impact it was having on my life. She actually suggested I have a talk with my primary care doc about going back on to which I told her that the new rules were humiliating and the appointment requirements aggravated my pain.

    I'm in a fully legal weed state but frankly I haven't found a dose that helps my pain yet allows me to function. When I was on OxyContin, I was clear headed, relatively pain free and able to live a full life.
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    @Bawston, I stopped asking for meds when it got too stupid with the checking. I was on a random pee test that they never took because I just didn’t fit the stereo type meds seller - but, like you, it’s a personal harassment I can do without.
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    Just printed out this article for a friend of a friend who's being forcibly tapered completely off her hydrocodone, with nothing to replace it. I'm hoping she takes this to her doctor and if I help just one lousy person reverse this insane policy, I'll feel VERY happy...
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    @jaders...it would be great if it helped even one person. Sometimes it's hard to figure out where the pressure on the doctors is coming from ... state laws, the practice the doctor is in, hospital affiliation, or just news scare headlines. I'm very surprised to see some of the reports that are being published in medical journals though because for some doctors that really has an influence.

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    @MRNUTTY, @Bawston, @jaders: Oh, I wish so much things could be different for you! You don't deserve this kind of struggle.

    I discovered the beauty of opioids some 30 years ago when I realized these meds allowed me to do my yoga & stretching, which allowed me to work out, which allowed me to continue riding & teaching into my late 50s... IOW, to live my life!

    I more or less gave up on doctors some 20 years ago, for all the reasons you've stated above. For me, the worst is the abject humiliation of peeing in a cup, and of being assumed a liar and a cheat who simply wants to get high (seriously??!). Until you can prove otherwise, that's the starting line if you are foolish enough to tell a doctor right up front how well opioids work for you. And I was that dumb, initially. They don't see two postgraduate degrees; they don't see the beautiful, successful children, all now in their 20s & 30s (all raised and educated while I was "high".) They don't see that 30 years of physical activity trying to combat chronic pain is what allowed me to carry on up to this point amazingly well: Because I was taking the pain meds that allowed me to be active, to do my own PT essentially, my body was prepared for the catastrophic illness that struck 4 years ago. Otherwise, it probably would've killed me.

    At any rate, my point is I got to live my life. I suspect I'm a bit older than most folks here...just a bit lol! It breaks my heart to hear you all talk about being forced to slow down so dramatically, doing less & less because you can't bear the pain of doing more, and the means for dealing with it have been stripped away from you. So unfair and SO unnecessary!
    @Bawston, I can't tell you how much I just wanna slap your neurologist...unfortunately, I don't think anything will cure her attitude but age; however, you may have helped open her eyes a little bit; won't do you much good but her next patients will sure owe you one!
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    @blueroan17... very well stated and yes, you are correct about the humiliation of "donating" that urine sample! At my last visit with my primary care (face to face required every 3 months in my state & a minimum of yearly urine sample) she said "well next visit I'll be needing a sample". Thing is I'd already done that and shouldn't have needed to do it again for 6 months. It would have been the beginning of the year but not a year from the last sample.

    That was when I just got fed up & took advantage of the next 2 refills that I could get without the face to face visit and decided I'll take myself off and be done with this dog and pony show. I'm with you...been around long enough to not want to play these stupid games.

    As for that neurologist, my opinion of her is pretty low anyway and far as I'm concerned she had no business commenting on my prescription at all. She's there for the Botox for my migraines - nothing more. I really hate when another doctor puts their 2 cents in on what a different doctor's doing!
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  15. As a Paramedic I usually deal with people in acute and severe pain (ie: fractures, dislocations, stabbings, gunshot wounds, massive trauma, burns, etc); sometimes from injuries that they will die from in the proceeding minutes or hours. I always tell patients the same thing. In most cases I cannot take all their pain away, unless I am going to perform a procedure called rapid sequence induction, in which i place them into an anasthetic coma and put a breathing tube in and put them on a vent. I rarely do this and have to justify why I do it since it is very risky.

    So for the other patients i tell them that their pain will not go away, buy I do hope to make it manageable. I carry multiple medications and can mix and match for what I know is best based on each individual patient, and for what their injuries. The fact of the matter is that no matter how much pain medication I give to someone, especially if they have a tolerance to opioids (like myself) or massive burns, I would have to almost stop their breathing to get them to no pain.
    That just isnt an option sometimes and it sucks, but I do the best i can with what I have! :/
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    Quote Originally Posted by Juju62861 View Post
    As a Paramedic I usually deal with people in acute and severe pain (ie: fractures, dislocations, stabbings, gunshot wounds, massive trauma, burns, etc); sometimes from injuries that they will die from in the proceeding minutes or hours. I always tell patients the same thing. In most cases I cannot take all their pain away, unless I am going to perform a procedure called rapid sequence induction, in which i place them into an anasthetic coma and put a breathing tube in and put them on a vent. I rarely do this and have to justify why I do it since it is very risky.

    So for the other patients i tell them that their pain will not go away, buy I do hope to make it manageable. I carry multiple medications and can mix and match for what I know is best based on each individual patient, and for what their injuries. The fact of the matter is that no matter how much pain medication I give to someone, especially if they have a tolerance to opioids (like myself) or massive burns, I would have to almost stop their breathing to get them to no pain.
    That just isnt an option sometimes and it sucks, but I do the best i can with what I have! :/
    I have limited knowledge compared to yours, but have had many "opportunities" to have needed pain management. I think one of the reasons opiates ARE so effective, is that opiates definitely help eliminate pain, but also seem to make the pain you still feel, feel less difficult to bear, and that is why the euphoric/mood piece is both one of it's best and worst qualities. It's probably also why it can become addictive, and why other pain meds may lessen pain too, but still don't "work as well" since they don't make you feel more able to bear it. JMHO...
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  17. Quote Originally Posted by feisty View Post
    Yes our country is in the crapper over a lot if different reasons I don't care to discuss but yes it is awful especially for the chronic pain patients that really truly need pain medicine every day just so they don't put a bullet to their head......and is very sad.....
    Unfortunately, based on what I'm hearing, many chronic pain patients are ending their lives. The CDC even factored this in as an acceptable possibility when they changed the prescribing guidelines.
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    Quote Originally Posted by Juju62861 View Post
    As a Paramedic I usually deal with people in acute and severe pain (ie: fractures, dislocations, stabbings, gunshot wounds, massive trauma, burns, etc); sometimes from injuries that they will die from in the proceeding minutes or hours. I always tell patients the same thing. In most cases I cannot take all their pain away, unless I am going to perform a procedure called rapid sequence induction, in which i place them into an anasthetic coma and put a breathing tube in and put them on a vent. I rarely do this and have to justify why I do it since it is very risky.

    So for the other patients i tell them that their pain will not go away, buy I do hope to make it manageable. I carry multiple medications and can mix and match for what I know is best based on each individual patient, and for what their injuries. The fact of the matter is that no matter how much pain medication I give to someone, especially if they have a tolerance to opioids (like myself) or massive burns, I would have to almost stop their breathing to get them to no pain.
    That just isnt an option sometimes and it sucks, but I do the best i can with what I have! :/
    @Juju62861... you sound like someone who really does understand and wants to do what’s best for the patient. The way you describe your decision process makes a lot of sense, is reasonable, and I don’t know of many people who would complain about your approach. I’ve been in a variety of acute and chronic situations and I’ve talked to the anesthesiologist before surgeries. Nicest guy who handled mine said basically the same thing...”I want you to be pain free during surgery but I also want you to wake up from it.” Definitely something I agree with.
    Likes Stevo1 liked this post

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    Quote Originally Posted by catboy View Post
    Definitely depends on the State. I've talked to several friends who have undergone knee replacements and shoulder surgery and they were sent home with just a few days of pain killers. Docs now say take ibuprofen.

    I’ve heard the same from a nurse that used to work the Orthopedic ward. I asked her about hip replacement and she said some get discharged with ibuprofen. I specified hip replacements as my understanding is the top of the leg is cut to get to the joint, sounded very painful to me. She said some patients have been in so much pain prior to surgery the do ok with ibuprofen. Idk, seems cruel to not adequately treat after. I’d say if going in for something to force the conversation with that doctor before hand and try to have someone come with for support and to ask what you don’t think of . I was with someone thru this process last winter and in this case the surgeon was very rushed when asked questions.
    Helpful Bawston, Binky, El Grandote Rated helpful
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    I had a doctor say the same thing when I was treated in France, The UK NHS also has strict rules about pain management- up until recently the US were very generous with pain medicine, obviously due to the sitiution with opioids.
    Crisis they are reining in and applying limits . I think they are now only generous with the pain mess in palliative care. It sucks for people that are in pain , but this stance seems to be a regular thing in Europe and I imagine Canada and other first world countries. I hope your daughter heals well.

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