How To Get A Patient To Take Pain Meds When Needed...

[sharpeimom]

how do you get a normally reasonable, mature, male to take his pain meds when he really does need to take them? i'm certainly not asking for medical advice, but my husband is acting like a pigheaded 14 year old and i don't want to have to end up killing him and then putting parts of him out on garbage night until he's finally gone, but...

my usually fantastic husband grew up in a christian science believing household. i don't think he had taken a total of 12 tylenols (or similar pain pills) in his entire life, until about two years ago. he's a type-1 diabetic who was diagnosed through his school nurse, in the fourth grade. he's eaten well and properly for the thirty years we've known each other and taken good care of himself and his feet.

while hiking in the woods with the boys he mentored, he was scratched by branch limbs. despite washing thoroughly and applying an antibiotic cream, it became infected and he developed many venous stasis ulcers on his rt. foot, ankle, and leg. he had surgery 15 months ago, has seen many specialists, done many many hours of pt, spent two extended stints in wound care rehab, and has been on almost every narcotic pain killer that's legal.

while in wound care rehab, the attitudes of his nurses varied widely -- from those who believed in current pain control theory to a couple who felt that anyone (including terminal ca pts.) who took a regularly scheduled control drug (which was ordered for him) or a prn control drug (also ordered) was most certainly an addict and only taking them for the buzz.

ok, he's been discharged and has been home for eight days. at first, he took his pain meds as they were ordered with an occasional prn. for the past three or four days, he hasn't been taking them as ordered and has hurt more and more. he keeps saying things like "___ said i'm probably am a drug addict and i'll be fired when the university finds out." or "___ said that anyone who asks for ___(oxy., percs., morphine, etc. etc.) or who has it as a regularly ordered drug is an addict." or "we don't get many pts. who take that every 4-6 hours."

he's now taking toradol q 6 and lo and behold! it's actually working!! when he takes it, that is. i've tried and tried but what do i know? i've presented absolutely every argument i can think up. i've tried logic, "here, read this article...," treated him like a naughty eight year old, used sweet persuasion, been firm, i give up!

does anyone have any bright ideas? it's unseasonably warm and garbage day is several days away....

[hidesert]

toradol is great stuff, sort of a compromise betw tylenol and narcotics, in my mind, anyway.

i worked in oncology and critical care for seven years and now at the va, and veterans for the most part hate to take pain meds. they are tough guys and at heart do not want to ever admit weakness, exp to women of any age, and i do a lot of pain education. here is what i know to be true:

research tells us that less than 1% of people who need pain meds for acute pain become addicted to them, and those 1% generally tend to be people who have had addictions already. that said it is unethical to withold pain meds from a pt who needs them, addict or not. (try telling this to a resident sometime ...)

anyway, my little pain talk includes the information that if pain is under control, they will sleep better, breathe better, move better, use the is better and use their healing energy to get well - rather than dealing with the stress of the pain, which is their body's first concern. i know somebody already touched on this and it is true. i also remind them it is easier to control pain at a constant 3-4/10 rather than letting it get to a crisis of 11/10 and trying to bring it down. severe pain is scary and i have been there. good luck.