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Thread: Pain (non) management trends after surgery

  1. #21
    @north19
    I hope they adjusted your dose. Feel better soon, and hopefully they give you a prescription for when you are discharged. This stuff is really getting ridiculous. Less than a decade ago, you would have no problem with post op comfort, and reasonable meds to take home. I didn’t even ask for the IV morphine, although I would have, if they didn’t just give it to me. Before the nonsense, it was just a money maker for the hospital. I had a pain management doctor assigned to me, without even asking, and I’m sure my insurance paid plenty for it, not to mention the patient controlled medication button, and the actual medication. I read somewhere that hospitals were charging something like $8 for each Tylenol, so I can only imagine what they charged for the post op pain management.

    - - - Updated - - -

    Quote Originally Posted by north19 View Post
    Still in hospital as the hip was really damaged. Tried walking today with a walker-it was very hard. They have bumped me to Po 3mg hydromorph contin twice a day and 4 mg instant release 3 times a day also Po. Still a fair amount of pain. Really hope to get out of hospital tomorrow but with the pain and stiffness will have to see. Thanks for all your support
    I was typing when you posted. I’m glad they gave you a reasonable adjustment to your meds. With the sustained release, plus the instant release, you should be fine. Good luck, and feel better!
    Helpful Doc Rogue, north19 Rated helpful
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  2. #22
    @north19

    (((I’m so sorry you are suffering. What a world of pain you must feel))). I hope while you are in the hospital you can discuss how your pain will be managed, especially with your kidney problem, when you are discharged.

    Sending you healing energy. I wish I had knowledge to share, but thankfully there are many here that do.
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  3. #23
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    @M77,
    My last surgery was getting my neck fused, probably 6 years ago now. They gave me 1 (one) hydro 10/325 and when I looked at my hospital bill, it was $65 for that one dose. One of the cheaper pain meds on the market, boy talk about healthy markup. They wanted me to stay an extra evening but I had known what each night cost me ahead of time to stay, a little more than $1,800 p/ night. I was outta there in just over 24hours.

    That was the time I was sent home with basically 3 days worth of pain meds, hydro 10’s. What a crock, and I have no clue what the hospital charges these days for the same pill.

    How you been and how’s the pain these days?
    Hope you are coping well enough and keeping the pain under control w/ the taper and the mood levels even.
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  4. #24
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    Quote Originally Posted by north19 View Post
    Still in hospital as the hip was really damaged. Tried walking today with a walker-it was very hard. They have bumped me to Po 3mg hydromorph contin twice a day and 4 mg instant release 3 times a day also Po. Still a fair amount of pain. Really hope to get out of hospital tomorrow but with the pain and stiffness will have to see. Thanks for all your support
    What a joke! Their theory USED to be that as little of pain as possible speeds healing. They used to INSIST you take your pain meds as scheduled whether you were in pain or not, because it's easier to keep pain down, rather than bring it down. Also it allows a person to do the exercises needed, instead of lying in bed and getting stiffer, as it sounds like you're fighting.

    It makes me so angry that they are just basically LYING about these things now...
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  5. #25
    Quote Originally Posted by Doc Rogue View Post
    @M77,
    My last surgery was getting my neck fused, probably 6 years ago now. They gave me 1 (one) hydro 10/325 and when I looked at my hospital bill, it was $65 for that one dose. One of the cheaper pain meds on the market, boy talk about healthy markup. They wanted me to stay an extra evening but I had known what each night cost me ahead of time to stay, a little more than $1,800 p/ night. I was outta there in just over 24hours.

    That was the time I was sent home with basically 3 days worth of pain meds, hydro 10’s. What a crock, and I have no clue what the hospital charges these days for the same pill.

    How you been and how’s the pain these days?
    Hope you are coping well enough and keeping the pain under control w/ the taper and the mood levels even.
    @Doc Rogue
    I cannot believe the audacity of them charging $65 for one tablet. One 10 mg hydro, post op, is absolutely ridiculous. But the three days after, is just as crazy. My dentist used to give me the 10/325’s for a cavity! Maybe a week, and for a root canal, a month!

    The insurance companies are celebrating the crisis, because of the money it saves them. I hate to use the frequently overly used expression “follow the money,” but this is definitely some part of the opioid crisis. It almost seems counterproductive, as in why would big pharma want any limitations on any meds? If they only can manufacture a small amount of PK’s, for hospice use, etc., they will get away with charging thousands for the meds. They can’t lose.

    I mentioned on another thread, how the hospitals are literally throwing out new moms, after childbirth. It is now 24 hours, with 48 hours, with complications, for normal childbirth, and 72 hours for C Section birth. The only reason they are doing this, is because the insurance companies won’t pay for more. They make them do a ton of extra paperwork, to approve any extensions, and they don’t want to bother. Obviously, it is the same thing as making a doctor jump through hoops to get pre-authorization on expensive meds, or tests.

    I read an article that mentioned that almost all medical practices now have to hire a dedicated person, just to deal with the red tape, and delays, in getting paid. I forgot the exact amount, but it was something like $70,000 annually, that was the break even point, in the expense to hire that employee. I’m not crying for them, but they get hassled too. The only problem is, just like everything else, the real misery gets passed on to us. I have had meds my GP wanted me to take, but after three times of sending a ton of stuff, and not getting approval, he said he was giving up. He actually told me that he couldn’t afford the expense of tying up the “medical biller, and insurance pre-approval person” for just me, because she could be chasing other money, the practice was owed.

    As far as my situation, thanks for asking! I don’t even get enough, as it is, and the forced taper hangs over my head. Like an idiot, I thought I would get the benefit of the doubt, after purposely reducing my daily dosage, but they are still relentlessly pushing the taper on pretty much everyone, at least in my state. If they cut me off totally, which is the inevitable plan, I won’t be able to work. So, I am trying really hard to not think about it, until I have no choice. I might actually consider moving to another state, assuming that the whole thing isn’t adopted in all states. As I’m sure you know, both political parties are talking up “reducing the price of generic drugs.” I would bet anything that there is some crisis crap in any legislation that passes, so both sides can brag about addressing the crisis. It is pretty sad that we have to hope that they don’t make the 7 day garbage a law.

    I hope you are doing well yourself. I am a candidate for fusion surgery, which I don’t want, but I may have no choice. I can see that being used against me, as they force me off low dosage meds, that allow me to get up, and go to work. We are all in the same boat. I just hope we all don’t sink at the same time!
    Last edited by M77; 1 Day Ago at 08:47 PM.
    I hate to advocate drugs, alcohol, violence, or insanity to anyone, but they've always worked for me - Hunter S. Thompson

  6. #26
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    Quote Originally Posted by notcharlotte View Post
    the article says, with no citation, that 6% of people get addicted to pks!! wow!! obviously that ignores the 94% who don't. so 94% of people suffer for the 6% who become addicted (actual number is 3-5% addicted). are we the only ones who think that statistic places the emphasis on the wrong number? well, it's the huffington post so i didn't expect better.

    more than half the problem is the media focusing on medical treatment instead of the meth and heroin epidemic. i guess that 6% votes and needs to be coddled into thinking their addiction is the fault of everyone but themselves. as usual.
    I said the same thing when CVS came out with their new policy to not carry cigarettes a few years ago. You know how people hand over their entire life story by using their Extra Bucks card (or whatever they call it)? Everything you buy is tracked, analyzed and yes, sold. But they also used it in their press release to justify their decision by saying that 4% of their customers who picked up prescriptions also bought cigarettes. Well I don’t care one way or another if they sell cigarettes but for one thing it smacked me upside the head that to save 20 cents on shampoo they collected everything about me, in particular linked my PRESCRIPTION info to other buying habits. As a side note, I still have to use CVS for prescriptions but I don’t give them my card for any other purchases and rarely buy anything else there as I’ve found Target to be a couple dollars cheaper on plenty of items without having to use a card.

    The second thing I thought was that 96% of their prescription customers did NOT buy cigarettes. So it’s the same logic...some people do this, therefore we have to do something even if it makes no sense.

    As for the 6%, I was watching this Dr Phil guy in an interview where he stated absolutely, emphatically that 30% ... thirty ... people prescribed opioids became addicted. And this guy has tons of people believing him! Where did he pull that number from?
    Helpful M77, jaders Rated helpful

  7. #27
    @Bawston
    The truth never matters to these “experts.” So the 94% of people that have NO PROBLEM using their meds responsibly, are supposed to suffer. There is so much that everyone on this forum would agree with. Should a 16 year old kid get a month of Percodan? Probably not, but depending on the reason, it might be necessitated. I can even understand the 7 day rule, for a young opiate naive patient. But, as I rant constantly (sorry all) if you have used PK’s responsibly for decades, for a chronic condition, how dare they force people to get nothing, and push NSAID’s that don’t even come close to working, and even if they do, are extremely dangerous to organs, gastrointestinal systems, and cardiovascular health.

    I have said this before, but I almost wish I never was prescribed a benzo. That almost sounds like I am on the side of the CDC guidelines. I said almost wish, because I was told that these magical meds would keep me from ever having an anxiety attack again. I am actually the lucky one, in that when I first started getting anxiety attacks, I was in my 20’s, and 2 of the owners of my company had full blown nervous breakdowns. It was an extremely high pressure situation, but the majority shareholder, who greatly contributed to his partner’s getting sick, was on the golf course every single day. He used people, until they were spent, and just moved on to the next. I was lucky to get out of there with just anxiety attacks.

    So another med I never abused, and was told how great and safe it was. But now, after taking extremely low doses of first Diaz, and later Alpraz, to only be told that my GP can no longer prescribe them. He gave me a few options that I could take, so I could give him something for his file, but I know that this is going to end soon, too.

    I wonder what percentage of people have problems with alcohol? But since it is entirely socially acceptable, no problem keeping the billion dollar alcohol manufacturer’s rolling in the dough. You would think that they would have learned their lesson with Prohibition. Obviously, the biggest distinction is, when they drove alcohol to the black market, they just made bootleggers rich. I’m sure many people got sick from bad alcohol, but there is no comparison to what happens when they force legitimate pain patients to the streets. That’s not my cup of tea, I have people that I have to be there for. If they want to stop all PK’s from new generations, or people that never took them, it is still wrong to make anyone suffer needlessly, but I can understand just giving them 7 days, but that should be reassessed after 7 days.

    The guidelines are so extreme that NOBODY with chronic pain should be able to have quality of life! It is so reprehensible, I don’t even have the words. Sorry for the rant.
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  8. #28
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    @M77...oh you always have very good rants! I can’t even remember all of the anxiety meds I was prescribed for both my fibromyalgia and even multiple sclerosis. As I recall I never got any pain relief from any of them (that’s why they were prescribing them to me because I guess a drug rep told them it might help and to prescribe off label). In any case I was never on them long enough to feel any dependence yet when I’d tell the doctor I had just stopped taking them he’d just about go into shock and say “you can’t do that! You have to taper! That’s very dangerous.”

    Now the fact that he was very blasé about prescribing them yet freaked out with how I stopped made me wonder what the heck else he wasn’t telling me. Remember this was pre internet. So I would have to go down to the library, get out the Merck Manual, etc and research what I could. When I left that neurologist I requested paper copies of my records and found at the end of each appointment he’d written “discussed medication in great detail”. Ahole! I even asked my husband who’d come sometimes...each time he’d hand over multiple scripts and say “many people have found this very effective”...that’s great detail?

    So I guess after all these years I hope I’ve become smarter or at least more cautious. But I do thank the internet...for all its faults, it’s probably saved me some very unpleasant medical experiences.

    As for kids being given scripts, I have no problem with them being prescribed pain meds when needed but I don’t understand why they aren’t given to the parent? Would anyone hand a 14 year old a bottle of Jack Daniels?

    As the child of an alcoholic I can say first hand that alcohol is just as dangerous and maybe more insidious because it’s accepted. Just saw an article today about another kid (of 3) died after being hit by a drunk driver. And last night, yet another story of a couple of young adults (males in their mid 20’s) dead after demolishing their car when they hit a tree ... haven’t heard but my guess is alcohol was probably involved. I love Cape Cod but they have an incredible alcohol and drug problem. Most of these areas like the Cape, Alaska, W Virginia...areas where there’s not much going on in the winter or little work available.
    Helpful M77 Rated helpful

  9. #29
    @Bawston
    I’m glad my rants aren’t too much. I truly do get agitated from this stuff, as it really is ridiculous. I’m glad you mentioned pre internet days. I used to always have a PDR. I remember reading with every benzo that the weren’t for long term use. Nothing about being stuck on them forever, but that they would be ineffective after 14 days. What a crock! It sounds like they knew, but just covered themselves by “suggesting” only 2 weeks of use. Remember, they do years of trial before approval. I always wondered why my various doctors never mentioned the 14 day thing, when they gave me monthly scripts for years. I wonder if it just might have something to do with the gifts the manufacturers gave to the doctors, like a week convention in Maui, etc. I know nobody followed that rule because I saw an article in a well know paper, that Diaz was the number 1 prescription med in the country. It was millions of prescriptions per year. I also remember when alpraz came out. It was the new safe alternative to diaz! What a racket these companies run.

    I agree completely with alcohol, I have had relatives destroy themselves, and their families. There is so much damage caused to families, children, society, etc., and that is not including the tragic accidents that seem to be in the news every day. Notice no outcry of a crisis? How odd!
    Helpful Bawston Rated helpful
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  10. #30
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    @M77 Yes it was all oral once the surgery was done. I am at home now. I received a script for 40 1mg hydromorp... the instant release. It is going to be a battle as I am extremely sore. The surgeon said it was as severe a hip joint as he has worked on and I am only 50. I will see how it goes but will ask for me if need it as if I am at a pain according to their stupid 1-10 then I am at 7-7.5 and cant do rehab exercises with this level of pain
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  11. #31
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    @north19...when I had mine done they made me do basic activities with the walker before sending me home. As soon as I heard that they had the option of sending me to a rehab instead of home I did whatever it took to get home. They want you up and moving because I’m they warned you about blood clots, pneumonia, etc. but for PT I needed the pain meds. Also the PT should be appropriate...by that I mean only what you are comfortable doing, pushing through a little pain but not overdoing it. My PT came to the house and she was excellent because she’d have me do exercises but was also very good at massage if an area or muscle was bunching up.

    My friend had a knee replacement and he just thought he’d be the gung ho marine pushing himself thinking he’d get back on his feet faster. Instead he laid down scar tissue like nobody’s business (some people just do) but he had to go back for a procedure for them to break up the scar tissue and even now a year later he can’t fully extend his leg.
    @M77...I’m going to go with some doctors like the perks that comes from prescribing certain drugs but I’m going to also go with thinking that most doctors, especially primary who aren’t experts in a particular area, are too busy to keep up with everything coming out there. I’m also going to go with the fact that half the doctors finished in the bottom half of their class and most didn’t go to one of the elite med schools.
    Helpful M77 Rated helpful

  12. #32
    Quote Originally Posted by north19 View Post
    @M77 Yes it was all oral once the surgery was done. I am at home now. I received a script for 40 1mg hydromorp... the instant release. It is going to be a battle as I am extremely sore. The surgeon said it was as severe a hip joint as he has worked on and I am only 50. I will see how it goes but will ask for me if need it as if I am at a pain according to their stupid 1-10 then I am at 7-7.5 and cant do rehab exercises with this level of pain
    @north19
    It sounds like the doctor has to appear conservative with the opiates, but since they increased the amount, when you asked, I think they will certainly do so while you are home. I hope you mend quickly, and with as little pain as possible.
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  13. #33
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    Now here’s another interesting article from the Pain Network...talking about doctors feeling the pressure when they prescribe! I wasn’t sure what my doctor was talking about when she mentioned how high prescribing doctors were getting letters from US Attorneys but now I see it wasn’t just my state. So the word must have gone out at the federal level.

    And they’re patting themselves on the back for reducing the number of prescriptions. Don’t look behind the curtain at the deaths from illicit drugs now though...

    https://www.painnewsnetwork.org/stor...-opioid-crisis
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  14. #34
    @Bawston - or suicide. Don't look behind the curtain at the deaths from suicide, which are on the upswing in the wake of the 2016 guidelines and legislatures limiting prescribing. People get desperate. Some of them come here. A few state legislators in a few state legislatures are starting to push back, but it will be a slow reversal of the draconian policies that have been put into place over the past 5 years.

    It's horrifying to read about how limited pain management has become even for seriously invasive surgical procedures such as joint replacements. It's a big reason why I have (so far) stayed with my very painful arthritic knees and refuse to have knee replacement surgery until I just cannot walk - I am terrified of poorly managed post-op pain. The knee pain I have now is the devil I know. The back pain I have now is the other devil I know (although I am hoping that specialized physical therapy will, eventually, be helpful) - I am just terrified that surgery will leave me in more pain, with no good alternatives and lousy pain management. This is the year 2020 - you'd think we'd be beyond the barbaric idea that somehow pain is edifying, that it's acceptable to allow people to live with pain levels that CAN be managed but for politics and fear.
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  15. #35
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    Quote Originally Posted by M77 View Post
    @north19
    It sounds like the doctor has to appear conservative with the opiates, but since they increased the amount, when you asked, I think they will certainly do so while you are home. I hope you mend quickly, and with as little pain as possible.
    Thanks so much @M77 I just want sufficient pain meds so I can rehab properly. I sure hope they will up the dosage if needed now that I am home. I took 2ng of the hydromo....last night before bed and woke up at 3 am in a lot of pain.
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    @Ellyn...yes, the suicides are mounting but you just don’t see much press on that crisis though do you?

    I may be in need of another hip myself (had one before politicians decided to jump into the medical field) but I’m with you on either holding off or getting verification of pain treatment before having another joint replacement. Not to be gross but think of a hip replacement...

    They cut you open, saw off the top of your leg, screw in a ball joint, take out the hip socket and put in a new one, stitch you up, put you in bed with a drain coming out your hip...and they want to give you Tylenol? Or ibuprofen? Oh I’d like every state legislator to go through that and tell me their feelings on the drugs laws THEY forced down our throats.

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