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

  1. 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....
    Last edit by Joe V on Apr 4, '12 : Reason: spacing
  2. Visit sharpeimom profile page

    About sharpeimom, MSN Guide

    Joined: Oct '08; Posts: 10,008; Likes: 11,569


  3. by   CapeCodMermaid
    I think I remember reading an article a while ago how keeping one's pain under conterol speeds rhe healing process....okay so I made that up, but here's my theory: we each have a finite amount of energy. If we use our energy fighting pain, we will have no energy left to heal. Might be a bit too mystical but....I truly dislike nurses who label people addicts or drug seekers because they asknfor pain medication their doctor ordered for them.Tell your husband to take the meds.
  4. by   sharpeimom
    thank you for yet another way i can explain it to my resident mule. men!
  5. by   CompleteUnknown
    My mother thinks that taking anything more than ONE paracetamol (tylenol) is overdoing it a bit so yep, it can be very difficult when people have this mindset. She'd rather struggle on in pain, it's how she is. I think it's a stoicism that is just part of her make-up and perhaps can't really be changed a great deal so maybe it's the same with your husband.

    My father is exactly the same way or rather he was until he broke a couple of ribs. He told the doctor he would not need a prescription for painkillers as 'I can put up with it'. The doctor told him he WOULD be getting a prescription and he WOULD be taking them as directed as otherwise he wouldn't be breathing deeply (in an unconscious attempt to reduce the pain) and he would be back with pneumonia on top of the broken ribs. So that's sort of along the lines of what CapeCodMermaid said.

    I'm sure he's fed up with the whole thing, worried about the long term effects of all the medication he's taken over the past 15 months, trying to reduce that and wanting the ulcers to just heal already but if you've tried logic, persuasion, truth, and threats of dismemberment without success I'm not sure what to suggest!

    Any chance he thinks the medication he's taking is actually making the ulcers worse? (Are they going to heal any time soon??)
  6. by   bradleau
    I redirected this to my husband. His reply was that the husband is being an ass. Taking his physical pain out on those closest.
    Toradol is great. too bad you can not sneak it into his food like you would a pet. Maybe he thinks he is not hurting. Diabetic issues can cause you to feel less pain, not always more. Perhaps he needs to be informed that what he is taking decreases inflamation which when controlled will increase the healing. Not so much as it works on pain. Good luck. Get your self some odor supressing trash bags while you are in town.
  7. by   sharpeimom
    thank you everyone for your varying ideas. sometimes it can be difficult to overcome one's childhood
    teachings and i think that accounts for quite a bit of his attitude toward his pain meds and this illness
    in general.

    he isn't usually a jack xxx as a rule, nor is he an uneducated rube. he's just tired of being like this and
    feeling like this, i think. he was always so active before.

    jack xxx? absolutely not. foolish behavior? maybe. scared to death? most certainly.

    i'd much rather have on toradol than oxy, or most of the other pain meds he's been on. he's in the midst
    of finishing up three books that have looming publisher's deadlines and i know he hates to feel snowed.
  8. by   needshaldol
    I may sound "uninterested" but if this was my husband and after repeatedly going on and on about taking pain meds with him not doing so, I would just let it go. He is a grown man. I would concentrate more on his wounds healing.
  9. by   sharpeimom
    thanks needshaldol! i'd dearly love to step back and just concentrate on letting his final almost-healed
    wound heal, but there are other factors that keep rearing their ugly little heads. his parents were like
    something out of a children's services case file.

    his mom was a passive agressive mentally ill woman who controlled her family through tantrums and tears.
    she was institutionalized from the time he was just a few months old and was discharged when he was in
    the second grade.

    his alcoholic abusive dad was feared and drank up and/or gambled away most of his paycheck. he unmercifully
    beat and raged against life in general and everyone in it who dared contradict or cross him in any way. my sister-in-law
    was in college when my husband made his appearance. fortunately, a neighbor took an interest and steered him
    toward college.

    since he was beaten if he caught cold, got a virus, or a usual kid's disease, being ill really creates inner angst and
    turmoil for him. his mom believed in christian science and that was an issue. sometimes your inner child runs amok
    and must be slowly reined in again.

    i am severely physically disabled from a cva caused by an earlier ruptured anurysm that occurred in 2003 and, while
    i try to be as independent as i can be, he still provides much of my care. pre-stroke, i was a psych nurse and maintained
    our 4500+ sq. ft. house, so this has been quite a change!!

    as i said in a prior post, my sweet wonderful husband is not a jack xxx, immature, or anything like it. he's just frustrated
    because he was initially misdiagnosed, mistreated, and that made his condition much worse and very nearly killed him. the
    great news is that his osteomyelitis has gone, he still has his lower leg, and feels enough better to be a pain in the neck
    sometimes. i can live with that.

    sorry this grew so long!
  10. by   needshaldol
    Oh My! He sounds like he did pretty darn well with such a difficult childhood. He may be good at caring for you because no one really cared well for him as a kid. You sound like a good match. On the other hand, my hubby, who is a real nice guy, would probably not do as well caring for me. He doesn't even like going into a hospital. He had a decent childhood but as a very young adult he had to identify his father who had jumped off the GG Bridge. About three months before we got married (13 yrs ago) his very young adult son was into heroin and did the same thing bridge-wise. Now last month his other son lost his 10 yr old.
    We all need to be grateful for the goodness we get and it sounds like you are doing as well as possible. Now about that 4500 sqft house! I wouldn't know where to start in such a big place! But it would be fun furnishing it!
  11. by   bonquilt
    Good for you for not killing him yet! I've been lucky in that my husband's health issues have all been short-term. About 3 days after an ankle surgery, he complained I wasn't being sympathetic enough--"I hope you don't treat your patients this way." I told him "I get PAID to be nice to them!"

    It truly sounds like his background is what's creating the problem. Shame on the nurses who told him taking pain meds equals addiction!! It's great that Toradol is controlling his pain. Maybe reinforcing the fact that it's an anti-inflammatory rather than a narcotic-type drug (and therefore the 'addiction' factor is out) will help him to take it regularly.

    And I've got an idea for you--you don't have to wait for garbage day, just chop him up into 4-6" pieces, put them in a cooler on wheels and take some kids to the zoo. When no one is looking, toss pieces into the big cat cages!
  12. by   bonquilt
    "... cat cages!" okay, so I like watching Dexter and similar shows/movies/books. Hmmm, maybe that's why I love working in the OR......
  13. by   silverbat
    toradaol is a non-narcotic.. maybe explain it that way?

    My hubby is kinda the same way. He cut the end of his finger off many years ago, on the way to the bathroom that night, he hit the end of the finger on the dresser in the dark. he screamed bloody murder, of course, and when I tried to just LOOK at it too see if he had made it bleed, he grabbed his hnad turned away and screamed no, no, your NOT touching it!! LOL.. I kept explaining he could show it to me from across the room if he wanted to, but I needed to see if it was bleeding. He is usally great, but NOT when ill.

    Gotta love hubbys... unfortunately it is still illegal to kill them...unless you are not caught, of course....Could try the pirranha tank at the aquarium for disposal??
  14. by   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.