I received quite an education this week. I have been a nurse for many years but for the first time I am on the patient end of pain management for MS. I find myself still slowly shaking my head over my experience. I guess I just want to share what happened and I don't know a better place to get some thoughts other than here.
I arrive at my 8AM appt about 10 minutes early to find about 10 people waiting. We all had 8AM appts. More people kept showing up to the point that there were no chairs left and people were standing outside. I gave up my chair to an elderly lady that clearly could not tolerate standing. I went outside and waited with a group of people.
They all knew one another, they knew one another's diagnosis, med list, history, the works. One lady mentioned she hadn't seen me before and I must be new. I said I was. She asked my diagnosis.... Really? Okay, I guess I don't mind and I explained that I have MS. A few asked some questions about MS and I responded.
The receptionist came out with a mound of paperwork for me to complete, some of it was... quite frankly, stupid. One was a page where I was supposed to draw a picture of how I perceive my pain. Not a silhouette where you put an "X" where you experience pain (that was another page) but an actual drawing of HOW you perceive pain. I just wrote no, this is stupid.
Then a consent for opioids with an explanation that they can be addictive, etc. I drew a line through the page and wrote "refused" with a note at the bottom "No narcotics please." That little note turned into a ****-storm later.
I turned the completed paperwork in and the receptionist came outside handing me a new consent for opioids and I explained I don't want any narcotics she asked if I was refusing treatment and I told her no, I was refusing narcotics. She said I *had* to sign it, I explained I do not have to sign anything. She rolled her eyes at me and walked back in the office.
The other patients hearing all this started quizzing me, what did I want if I don't want narcotics. I explained there are many options for pain management, not just narcotics. One lady explained to me that people like me make it harder for people who do need narcotics, two others agreed. Seriously??
I stood there for an hour listening to these people. I couldn't believe what I was hearing and seeing. One patient with his arm in a cast was sooo drunk he could hardly stand and he had a beer in his hand. Another guy was walking from person to person offering to sell "weed" and those that didn't have money he would deliver locally for a $5.00 fee. Let me tell you, he was quite the salesman and amazingly pushy.
Then they all started comparing withdrawal stories and laughing about how funny it is. One lady couldn't pay her rent one month so she sold her percocet and went into immediate withdrawal. I asked her what she did, she said she went to ER and they gave her 3 day supply. One man complained that he was being given too many meds and he just stopped cold turkey and spent three weeks vomiting and shaking. However, most complained that they were not getting enough meds.
Then they started talking about EMGs and epidurals. Everyone has had both. I asked, is this common with this doctor? They said yes, he requires everyone get them. I asked why, they said he won't give you narcotics unless you line his wallet and extra diagnostics are just part of the deal. SERIOUSLY?
Finally the medical asst called me back to an exam room and chastised me for not signing the opioid consent form. Again I was asked if I was refusing treatment and again I explained I am merely declining narcotics. Again, she told me I *had* to sign it and again I explained I do not have to sign anything. In comes a 2nd lady and it was a repeat of the above. Then a 3rd lady comes in and she's the office manager and another repeat of the above.
One of the reasons I got out of ER nursing was the constant influx of narcotic seekers, especially on weekends. When the very rare patient declined morphine and requested Toradol I wanted to HUG them and say THANK YOU! I was really surprised at all this.
The office manager went out and told the doctor that I refused to sign the opioid consent form and he asked what my problem was. She said I was refusing narcotics. HE asked,
"So she's refusing treatment?" He asked what was wrong with me, she said she didn't know. He blew up and said he was the doctor, he would decide my treatment options.
Finally the doc comes in the room and I just stopped him dead in his tracks. I was sincerely annoyed at everything I had experienced and I explained, "I heard the comments you made out there along with the rest of the building and I want to make something clear. I can't take NSAIDs anymore due to GI problems, I prefer to not take muscle relaxers anymore, and I flat out refuse narcotics." I went on to explain that with his education and specialty surely he knows of non narcotic options? He said he has a few tricks up his sleeve so yes, there are other options.
Then he said he was going to do an EMG, I asked why. He said he wanted to see if there was nerve damage. I asked if the results would change the treatment plan, he said no. I asked how it would benefit me, he said I would know if I have nerve damage. Again, I asked what value there is to ME? Longer story short, I'm not doing the EMG. Then he said he was going to do an epidural, I asked for what? Where? He looked at my file and said, "Oh yeah, you have MS. Nevermind."
I don't even have words to explain how this whole thing made me feel. If I wasn't anti-narcotic (for me) before, I would have been after seeing all these people and listening to them compare withdrawal stories and their behaviors and laughing about things that just aren't funny.
I just have no words, I am shocked and floored at this MD office. But, I did leave with what I wanted, Pamelor for nerve pain. I work full time, I enjoy my job, I do not want to have to quit so I can sit home and become an addict, you know?
Sorry, I know this is long but I just had to vent a bit. No responses are even necessary, just the vent.
I appreciated that it went on for as long as it did with what seemed to me like mostly, constructive, helpful replies. Hang in there.
OCNRN63, RN
5,979 Posts
This comment sounds judgemental, despite your protestations to the contrary. No one is saying you should go to a pill mill. We're saying that there are legitimate reasons to need opioids, and that there are good docs out there who can prescribe them appropriately. Just because you choose not to take them doesn't make you morally superior to those who do take them, and do so responsibly.