Health Staff And Relatives Underestimate Chronic Pain Experienced By SNF Residents

@sharpeimom; there are pain management doctors who will work with the previously addicted to control their pain-with opiods. Find yourself a pain management doc out there, tell the doc of your fears, and then work together on a method of getting that pain down from a 9.5. I don't know what state you are in, but there is a doctor in NC who works with recovering addicts to help them with pain control. If there is one in NC, surely there have to be more around the country.
I understand your fear of addiction. I have a friend whose been clean and sober for 20 years and he is terrified of taking pain meds- but he was inured on the job, very badly and has had to cope with the awful pain. He's the reason why I fond out the name of this doc, just incase he ever needs pain help again.

Good luck to you

I'm thankful for alternative methods of pain relief.
I had backpain that was relentless, which, in nursing is very difficult.
I know more nurses in chronic pain than patients.

I went to a chiropractor after 3 physicians and various drugs could not solve the problem.
X-rays showed that I had two vertebrae that had slipped forward anteriorly,
and I was very close to slicing my spinal cord.
As it was, my spinal cord was being pinched.
No wonder I could hardly raise my legs after a 12-13 hr shift!
No idea how it got that way, but everything is adjusted back in place now!
Thanks, to my great chiropractor!

If you reread my post, I never said that I had an addiction problem. In fact, my paternal grandfather was an alcoholic. I want to avoid the use of opioids because of family history as well as because I have a balance problem since my CVA.

Thank you for the information about pain specialists however.

sharpeimom

I understood your fear of addiction, even if that didn't come over very clearly. I thought it'd be nice if you cold find someone lie that in the event that you really absolutely needed pain meds and wanted to work with someone who'd be very understanding of your familial history.
My apologies!

The proper term here is "Pharmacological Calvinism". Unfortunately, it's how we think here in the US. The idea is that if any med makes you feel ANYTHING good, it MUST be bad. The old Calvinsit way of thinking told us that all suffering is for our own good, for a reason, and to treat it is interfering with God's plan.
So, no narcotics for you, Grandma! Tough it out...
I see this attitude all the time...

Unfortunately I think you are right. Many people believe that.
Many doctors are afraid to medicate the elderly properly (and of course many also don't want to perform procedures/operations that might help the pt. due to age or surgery risks or even deal with the criticism of a costly procedure done on a 90 year old when that money could be spent elsewhere).
I hear the excuse often that administering a narcotic to anyone over 65 is risky because the pt. then becomes a fall risk, ect. But surely there are bright minds in the medical field that can figure out the solution to making sure our elderly are relieved from pain adequately AND safely.
Also we need to somehow make it safer/less risky for doctors to prescribe narcotics, if necessary, without fear. Sure there will always be some people (drug seekers) that make it harder for true chronic pain pts. and the elderly to receive the medication they need. I would rather have a few seekers possibly receive unnecessary medicine than many more people who truly need medicine not receive it.

I was diagnosed at 13 with JRA. Since then I've had lumbar spine surgery and 2 ankle surgeries. The most common thing I hear? Your to young to be on daily pain meds. I've been hearing that line from multiple doctors the last 11 years. A lot of doctors are afraid to give meds to younger adults as well as the elderly.

Thankfully I have more or less gotten the majority of my pain issues under control. There are days you'd never know there was something wrong with me...and then I have days that I can't move.

I wish doctors would be more understanding to the needs of patients.

something happened last weekend at work that has been on my mind all week...

pt admitted on friday to SNF. had been in/out of hospital since respiratory failure,ARDS,sepsis in july. still getting over all complications involved. came to us for therapy to strengthen her before she goes back home.

pt also has chronic back pain and had been on MS contin for years. one week before the last hospitalization, she was stepped down to percocet 10/325mg with pain specialist. (she had requested to step down).

one day after the med change, she ended up back in hospital. all last week at the hospital, she received the percocet for pain and was well controled with it. she and husband both were happy with the pain control of the new med.

on discharge to my facility, the hospitalist at the hospital that had followed her case checked the box to not continue the percocet at the SNF.

fast forward to saturday morning.....

she's in a lot of pain. she didnt sleep the night before from the pain. all we had to give her was tylenol.

so i call the doc on call and ask for something. he says to continue the percocet and how he cant believe the doc didnt order it on discharge.

i tell him thanks and say "dont forget to fax me a prescription so i can get the med from the pharmacy".

he says "i dont have time for that. just give her tramadol then".

the tramadol was not effective. the night shift nurse reported to me that she had slept very little and said the pain was not gone even after 2 doses of the tramadol WITH tylenol.

the on call doc on sunday wouldnt fax me a prescription either telling me "have the doc do it on rounds tomorrow". i tell him i dont have a doc in facility until tuesday. he tells me "well they can do it then".


all this because of the new DEA rules about having to have hard copies for narcotics. ok...i understand why this is needed in the home setting. but LTC is getting jumbled in to the "home" category because techincally it is the patient's "home".

this is so wrong. now the DEA is dictation who gets meds. so now we have the insurance companies telling docs how they should treat patients and the DEA telling the docs what meds they can have.

i'm just sick about it. i've thought about it all week. i've decided that not one of my patients EVER AGAIN is going to be without pain control. if i have to, i will drive to the hospital to pick up the prescription myself!

i cant live with myself over it. and never again am i going to look a patient in the eye and tell them i cant help them because of the DEA.

i've also decided that i'm going to write a letter to the DEA about it. they probably wont even read it but i'm going to send it anyway. i might even send it weekly.

this has to be changed!

Good for you-it's a sad time, indeed, when doctors "can't be bothered" by their patient's need for pain medication...with all that this poor woman has endured, the last thing she should have to do is beg for medicationt that is obviously needed...

i know! it's really, really bothered me all week.