Could denial of pain care for EVERYONE… be a good thing for the chronic pain community ?

Question- I am a 65 year old disabled female.  Have dealt with pain for past 20 years.  My opioid dose was cut in half in 2014 along with so many others.  I have taken the same amount, 70 mg (85meq) for worsening conditions, cervicalgia, dystonia, as well as joint hyper mobility since 2014.  Life is painful every day regardless.  There isn’t much left to my life.  I can’t travel well, my mobility has decreased, most all items are delivered, my life is confined to my home for most part.

Yesterday, I had surgery to (1) re-sect margins on a malignant melanoma on my back and (2) do a nipple biopsy on my breast.  I was told that since I already take pain meds, the surgeon was ‘between a rock & a hard place’ with being able to prescribe any additional meds.  I had received pre-op forms explaining that pain meds would be prescribed for all surgery patients, so I was confused, but tried to be understanding-  Until the drugs from surgery wore off yesterday afternoon. 

The dr explained to my husband right after surgery that my breast would be very painful for several days.  No joke.  I cried most of the night.  I am tolerant, obviously, to the amount that I am accustomed to taking for fibromyalgia & degenerative issues, labral tear in hip, subluxation shoulder causing unbelievable thoracic pain in back left shoulder blade area.  The amount of medication that I have is not enough to cover post surgical pain as well.  I will run out before time for my next fill because of the surgery.

The surgery center called this a.m. to see how I was feeling.  I explained I had been awake most of the night, hurting all night, having to take something every hour and a half, and still burning, stinging pain within my breast.  The nurse said, “well, you have pain meds to take, correct?” I replied that I do, but I am shorting myself later in the month.  If she understood, she was unfazed.

Steve, I need a sanity check- am I being unreasonable?  Should I have to suffer through this after surgery just because I am already in an amount of pain that is being barely managed?  By the way, my family dr manages my pain, conservatively.  He stated before the procedure that he could write more meds offering me a tramadol prescription but I probably wouldn’t be able to have it filled.  He convinced me I definitely need the surgeries, to go forward with them, and if I run out, he will try to figure something out.  Am I missing something?  Is this not what pain meds were designed to do?  My pain during the winters keeps me bed-bound.  My doctor has also said he would have my knees redone but he wouldn’t be able to control my pain?

This is way beyond discouraging.  It’s been hard enough to accept that the medical community can do no more than barely keep me comfortable.  I like my primary care doctor. And have no ill feelings toward surgeon, hospital, or anyone, except those who have laid out unrealistic limits for patients who are suffering already.  I have been disabled for nearly 10 years.    During my working career, I carried a top secret clearance with the same government that has me categorized as opioid tolerant.  I might as well be on the street corner looking for drugs.  I have been misjudged by pharmacists among others in healthcare.  I have never asked for my med early, I have never failed a drug test, and am fully compliant with everything my dr has asked.  This practice is discouraging future health procedures based on past pain experiences and i feel a form of discrimination.  How can this be happening?

Is this average?  I will make it thru this somehow, but God forbid, should I need another preventative procedure, I won’t be able to.  Tell me others are not having to suffer like this. 

Thank you for reading.

Just imagine in days.. months to come… how many “regular people” are going to go under surgery or have a accident that at the very least causes them some substantial pain..  According to this https://www.answers.com/Q/How_many_surgeries_are_done_in_the_us_every_year  there is an estimated 40 million elective surgeries in the USA EVERY YEAR… that is 110,000 surgeries PER DAY.

How many of these surgery pts don’t experience some sort of on going/long term pain before their surgery and they wake up from surgery to be told that they will be given TYENOL/ACETAMINOPHEN to help them deal with their pain.  How many of these pt and their family going to “go ballistic” about how they or their family member has been allowed to suffer post surgery ?

How much is their pain and/or frustration is going to be calmed by being told that the healthcare system “don’t want them to become addicted” and that is why they have to just “suffer thru for a few days or a week” ?

Not all surgeries produce “excellent outcomes” and how many pts end up with worse pain or end up with chronic pain post surgery ? All of these new little/no pain management post surgery pts & family going to be “more active” in filing complaints with various agencies over how they or their family were treated poorly or allowed to suffer in pain.  The existing chronic pain community may be acquiring new and more active & vocal allies.

 

7 Responses

  1. Speaking as a 70 year old RN, I clearly know that there is a difference between a patient with a severe chronic illness and a heroin addict. I am shocked to see them both being pushed into the same basket of ” addict”. While it may, ( or may not ) be true that many addicts began as pain patients, I think that the majority of the people out there are completely missing the point. By stopping the flow of LEGAL opiates, the government will save money. While increasing the pain of these patients, it is likely that some will die from distress, severe pain and or severe depression caused by their situation and that alone will save the government money, as many are on state or federal assistance programs. Third, if you just read the comments, people are now refusing medical procedures and surgeries that they should have, because they don’t want to deal with increased pain. This is an all around win for the government…and you can’t blame this on Trump…it started in 2014 under the waved about wonder called obamacare that left so many people without ANY care. As a human being, as an RN, and as a woman who has had 23 surgeries, I just can’t understand that anyone is actually believing that the opioid crisis is about helping PEOPLE ! This is the government folks. As usual, it is all about MONEY !

  2. There have been systematic overviews done on post-operative prescribing at many hospitals across the country and they have decided to decrease the amount of pain medications given to patients by setting limits based on the surgical procedure and nothing else. They fail to take into account individual characteristics, fail to use pharmacogenetic tests, fail to note the current opiate level of use by patients already in chronic pain. They fail also to take into account the studies that have shown that poorly, uncontrolled post-operative pain is by far the biggest contributing factor towards a patient ending up in chronic pain. Surgeons and other providers are too scared to write for appropriate pain relievers and encourage these patients to use the medications that have already been prescribed for their chronic pain problems, by telling them to exceed the written guidelines, thus putting these patients in jeopardy of losing their current prescribing physician because of their drug agreement violation and thus avoiding taking any responsibility for their actions, especially when they fail to contact the prescriber to discuss such increases and also fail to document it in the records. It’s high time for some lawyers to stand up and defend these nefarious actions that border on malpractice and more.

  3. I have always been told,,,never ever take our pain medicine for anything else other then what our medicine is prescribed for,,,!!!Sooo I don’t,,,,unless that surgeon calls my pain doc,,or that doctor who is telling me to take em for something other then what their prescribed for..calls my pain doc…
    As far as proceeders/surgeries,,,,no-way,,,I have not scheduled any surgery or proceeders that requires MEDICINE from thee opiate plant..Need 2 surgery for my feet,,,not gpong to do it..not in this day and age..Im whining here,,my feet are soo swollen,,bruised etc,,I can’t even get shoes on,,and the surgeries would fix this..
    On a off topic a bit,,,those of us prescribed the medicine methadone for our C.P..I just fund out,,our methadone is the next dea target.Also our doctors prescribe this medicine for it converts into morphine in our bodies,,thus a pain reliever in its own rite,,,I never knew this,,,just a fyi,,,for knowledge is always good,,jmo,,maryw.

    • So sorry Mary but you are right. No surgery. Heck I don’t want to see those guys for anything anymore. They have found a gold mine in medicaid and you will be swallowing every killer med there is before they are done. And mis-diagnosis is almost guaranteed.

    • Methadone is the next DEA target? I´ve taken it for CP for about 17 years now, was force tapered to half that amount last fall very rapidly which is the wrong way to taper methadone. It was really bad. It has been fairly effective for me & I´ve been extremely frustrated. How can I find out more about what you said? Thanks

  4. I would not recommend having any procedures done. I am myself denying the multi level cervical spine fusion redone that failed last year and because of how my post operative pain was ignored I won’t be having it done in this lifetime. It’s horrifying to me that their doing this to surgical patients but they are and I doubt we’ll see it go back to the way it use to be ever again. For me, I’m just waiting for God to call me home. Ive had it with this opioid hysteria and the suffering of not just myself but for millions. It’s heartbreaking. The only way we can affect change is to stop seeking healthcare it’s just not available any more. Doctors, surgeons and everybody else that treats patients for mental or physical health have become immune to our suffering and for them to understand we need to get then where it really hurts, the wallet. Once they start feeling financially insecure will we see action.

    • I can relate to everything you stated. But in my case, not only have I been waiting for God to call me, I’ve been asking Him every night to please not make me wake up in the morning. Your comment also made me think about something….We chronic pain patients are aware of what’s happening to post-op patients; however, those needing surgery who are not CPPs have no clue what they’re in for post-op. Perhaps if they did, they would decline surgery. Although I can understand doctors’ fears, the AMA waited too long to get involved, and only did so after hundreds of their own were raided by the DEA–not because they cared about CPPs (though I am grateful for those doctors who have advocated on our behalf). Maybe the next step is for all patients (not just CPPs) to decline surgeries that can either be avoided or postponed. I think you hit it on the head when you said that doctors need to feel the pain where it will hurt them most–in their wallets.

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