A good friend of mine's hubby is waiting for a hip replacement surgery. He's the farthest thing from a drug seeker I can think of. He's in a lot of pain, bone on bone. He's a karate instructor as a sideline, probably that repetitive motion contributed to this problem, he's in his mid 60s.
He didn't like the oxycodones which made him itch, but Tramadol helped. The doctor wouldn't let him have 1-2 every 6 hrs like he had before. They wrote the script for 1 every 6 hrs. They told him he needed to wean down before surgery, that it would make pain control afterwards easier.
If they checked the controlled drug database, they'd see that this fellow hasn't needed pain medication until now. Are the doctors under so much pressure to meet goals to satisfy the overseers that they are under medicating?
Previously I always thought that the policies on opiates were too liberal and contributing to addiction. But now I sense an almost puritanical attitude on the part of some.
I think the pendulum has swung to the ridiculous. I have a friend who went to the ER in severe pain from a diner stone. They gave him IV Tylenol. Needless to say it didnt touch the pain. They made him suffer until the tests proved that he had a kidney stone. THEN they gave him IV Dilaudid.
To be fair, IV Tylenol is usually pretty amazing stuff and works better than narcotics for certain kinds of pain. I usually ask for it for ER patients who can't take narcotics for one reason or another, or to have in conjunction with lower doses of narcotics.
Oh I am in such agreement with everyone on here. I see all sides of this...I live in West Virginia...I had to fight tooth and nail for my own Mothers comfort..My Mom is 93, she has dementia and was living in a personal care home..I wont discuss her incident but she fell and ended up with a commuted hip fracture..I have never ever seen my mom take a pain pill in my life. The hardest drug she has ever taken was tylenol arthritis..In June they put a rod and pins in during surgery..Now remember she has dementia..she was being discharged to a SNF for rehab..You got to picture this, we are in her hospital room. The discharging physician has been her PCP since 1990. we are in the room..My mom was holding the leg shaking and yelling "God please take me I can't stand this hurting, please", at that time she was only on oxy 5mg BID..He said he was only going to prescribe her to take tylenol and motrin on discharge because she can not possible be having the pain that I think she is. I was livid, it was not like she was going home where she could OD, where she could have a helper that could steal them..she was in crazy pain..I yelled at him, how could a dementia patient fake her pain? I also told him that he should be ashamed of himself and one day when he dies he can explain his thoughts to my dad, who was also his patient but died many years ago.. I also threatened him that I would go to the hospital ethics committee..My mom was DNR/ comfort care, and I was not at all worried about her taking these meds but to keep her in this much pain was a pure animalistic act..After we had her moved, we did switch PCPs on her, she has been weaned down, due to her being too groggy for PT, then back up for pain..she is back in a personal care home. Now she is on ultram, she is having PT again ,she will never walk again, I realize that but she needs to transfer from wheelchair and back.She is not as groggy but definitely nowhere the pain she was having. her meds will be tapered again after she finishes PT, The personal care home she is in at this time the owner was her Home Health nurse years ago and the Nurse Sup was my own boss back in the 90s when I was a baby nurse straight out of school. We live in a small semi rural area, everybody knows everybody. I have complete faith in both of them. I remember finding one Website online, I wish I could remember the name of it, it named physicians in our area and what narcotics they had been prescribing in 2015..Her initial physician was one of the main contributers to the fentanyl problem in our area, but he wanted to brush off my mothers pain due to her dementia..My own husband is a cancer survivor from NHL stage 4, he still has bone pain, he is now mets with prostate cancer, he had a radical prostatectomy and radiation and refuses to take the hormone shots due to the side effect of bone pain, the oncologist refuses him any pain meds due to this being called "not active cancer treatment". He said he refuses to pay a $500 copay for a medicine that will give him added pain, and I do not blame him..so if all this narcotic abuse and the physicians refusing to treat pain has hardened me, I have good reason..I am a retired RN and am glad I am out of this mess that I would be involved in had I still been working..Thank you for listening to my vent. I am so sorry for the situation that your friend is in. There has to be a middle for this pendulum for pain medications, it is too far swung and is one sided. Keep fighting for him, unless more family and friends and Nurses start sticking up for the non addicted pain patients this will never end..Remember only the squeaky wheel gets oiled. Your friend deserves pain relief and they can deal with the tapering later on after he heals from his surgery.
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
I think the pendulum has swung to the ridiculous. I have a friend who went to the ER in severe pain from a diner stone. They gave him IV Tylenol. Needless to say it didnt touch the pain. They made him suffer until the tests proved that he had a kidney stone. THEN they gave him IV Dilaudid.
Pardon my ignorance, but what is a "diner stone"?
IV Tylenol is amazing stuff . . . I got it when I had my knees replaced, and I looked forward more to the Tylenol than to the dilaudid!
I think the pendulum has swung to the ridiculous. I have a friend who went to the ER in severe pain from a diner stone. They gave him IV Tylenol. Needless to say it didnt touch the pain. They made him suffer until the tests proved that he had a kidney stone. THEN they gave him IV Dilaudid.
I thought toradol is the first drug of choice for kidney stones.
Lunah, MSN, RN
14 Articles; 13,773 Posts
To be fair, IV Tylenol is usually pretty amazing stuff and works better than narcotics for certain kinds of pain. I usually ask for it for ER patients who can't take narcotics for one reason or another, or to have in conjunction with lower doses of narcotics.