Doctors who poorly treat pain

[ninja2000]

I've been looking on this site for awhile and I've noticed a lot of people are here for PKs...  I was on tramadol for years and it just recently stopped being effective. He would prescribe something stronger for the occasional breakthrough pain, but mostly stayed away from the "harder" meds.  For me, this was a good way to treat my pain from depression, along with amitryptaline and valium. He now prescribes T4, which works better along with the other 2 for my depression and anxiety.

I work at a hospital and was recently asked to produce an application for people who have pk/opi@te addiction,  and going through the history, I noticed that MOST of them were treated with HEAVY doses and quantities to start and hardly pressed or given the option for rehab services (body rehab, not addiction rehab) or alternative therapies. Just handed out prescriptions by the fistfull - then all of a sudden STOPPED without weaning them off first, pretty much pushing them into the street to get what their bodies were used to. That should be illegal. 

I feel fortunate because my pain pales in comparison to a lot of people - people who have broken backs, been in violent accidents, shot or stabbed.  My pain is from depression, tension and anxiety and I have a bigger spectrum of medications to use. 

What changes do you think should be made about the way pain is managed by doctors? Looking at the data, a few people were given several different types of narcotic pain medications for months on end then completely cut off. Or they had patients who had legit pain that wasn't treated effectively and they started buying street meds.  I have a very close relationship with my doctor, but it took a couple months to convince him that the tramadol wasn't helping anymore. 

 

[painsuck]

The pain management system in this country is so broken.  The doctors are worried about losing their licenses and put insane restrictions, including really under managing pain.  I've had a bleed in my spine (caused by a doctor botching a surgery) and now have slipped discs, cysts, and basically big hematomas all-around the spinal cord in that area....it causes insane neuropathy in my legs...to the point that sometimes I can't even handle a pant leg on my legs without it shocking and stabbing and feeling like hot knives stabbing me.  I've had them just cut me before or be on vacation and let me withdraw from fentanyl and opana cold turkey at the same time.  It's horrific.  I know I have a lot of medical challenges...I have a genetic blood disorder and will be on blood thinners for life....but just this year, I started out by flipping my car 4 times after hitting a patch of black ice on my way to visit family in Detroit...I should not have walked out of that.  Then had another pulmonary embolism a week later.  Then in early july, I had to have emergency surgery because a hole formed from an ulcer right where my stomach meets my intestines....I was initially misdiagnosed at the ER and sent home until I was back a few days later because i was almost dead.  They had to cut me gullet to undies and basically eviscerated me.  Because It was emergency surgery, I got a kinda crappy surgeon, and things got infected..the incision had to be opened back up twice (to the size i could stick my fist in and touch my own abdominal muscles)....I then had an open wound for almost 5 months...it just finally closed up at the beginning of this month.  And I've basically had to fight with my pain management doctor to up my doses to deal with this...because of the PM contract, they are the only ones I can get my meds from..so I came out of the hospital and they didn't see me for 5 days...it was horrific.  I am treated like an addict, I think that being sliced open and disemboweled makes it pretty necessary to up someone's dose to deal with it.  I have a high pain tolerance, but there were moments there that I just wanted to fall asleep and not wake up because the pain was so constant and strong and pervasive.  There seems to be little compassion for a patient, and someone who is in real pain.  I know that a lot of people abuse the system, but a lot of people also don't and legitimately need to be treated properly.  It's a fact that most pain patients are undertreated

 

[ninja2000]

The pain management system in this country is so broken.  The doctors are worried about losing their licenses and put insane restrictions, including really under managing pain.  I've had a bleed in my spine (caused by a doctor botching a surgery) and now have slipped discs, cysts, and basically big hematomas all-around the spinal cord in that area....it causes insane neuropathy in my legs...to the point that sometimes I can't even handle a pant leg on my legs without it shocking and stabbing and feeling like hot knives stabbing me.  I've had them just cut me before or be on vacation and let me withdraw from fentanyl and opana cold turkey at the same time.  It's horrific.  I know I have a lot of medical challenges...I have a genetic blood disorder and will be on blood thinners for life....but just this year, I started out by flipping my car 4 times after hitting a patch of black ice on my way to visit family in Detroit...I should not have walked out of that.  Then had another pulmonary embolism a week later.  Then in early july, I had to have emergency surgery because a hole formed from an ulcer right where my stomach meets my intestines....I was initially misdiagnosed at the ER and sent home until I was back a few days later because i was almost dead.  They had to cut me gullet to undies and basically eviscerated me.  Because It was emergency surgery, I got a kinda crappy surgeon, and things got infected..the incision had to be opened back up twice (to the size i could stick my fist in and touch my own abdominal muscles)....I then had an open wound for almost 5 months...it just finally closed up at the beginning of this month.  And I've basically had to fight with my pain management doctor to up my doses to deal with this...because of the PM contract, they are the only ones I can get my meds from..so I came out of the hospital and they didn't see me for 5 days...it was horrific.  I am treated like an addict, I think that being sliced open and disemboweled makes it pretty necessary to up someone's dose to deal with it.  I have a high pain tolerance, but there were moments there that I just wanted to fall asleep and not wake up because the pain was so constant and strong and pervasive.  There seems to be little compassion for a patient, and someone who is in real pain.  I know that a lot of people abuse the system, but a lot of people also don't and legitimately need to be treated properly.  It's a fact that most pain patients are undertreated

Sweet Jesus, you are a strong person! Makes what I'm going through sound minuscule! You have my respect! 

 

[Slegna Owt]

As far as this topic goes I have to agree with @ninja2000, the under-treatment of pain is absolutely horrible. I cannot take nsaids due to stomach surgery and the only thing that I can take for my severe migraines are vics and I haven't had a regular doc prescribe me them in over 3 years even just 5mgs.. the drs are too scared to even help people in legitimate pain now. I am now seeking a pain management facility for help (my apt is in 3 weeks) so we will see how that goes..

 

[Chubette]

Just yesterday I had an appointment with my pain management doctor and she told me that approximately 10-15 years ago the government was telling doctors that they were under treating pain and now the government is telling doctors that pain is being over treated.  What bothers me the most is how in the hell can the government decide when pain is being over or under treated!!  Shouldn't that be up to the doctor not the government?  Maybe 10 years from now they will flip and go back to saying that pain is being under treated but, who can wait 10 years for that to happen!!!  So very irritating!  

 

[Biteme]

The CDC released new guidelines for opioid prescription last year. You can find them here

https://www.cdc.gov/mmwr/volumes/65/rr/rr6501e1.htm

Basically they're recommending people get the weakest thing possible and only a few days worth for acute pain. The problem is that Purdue lied to doctors saying Oxycontin was a less addictive opioid that lead to an increase in unnecessary prescriptions and a lot of heroin addicts today. The drug companies were also behind the push to increase pain treatment, using doctors as fronts. So because the feds weren't doing their job then in overseeing the drug companies (although they did sue them for something like 1/2 billion) they're over-reacting now by clamping down on everything. The legislators don't notice or care about anything until it gets out of hand then they come down hard to show they're doing something. It's why there response to methamphetamine abuse was to make it a serious pain in the ass to buy decongestants even though less than 1% of the meth in this country was made in the US. Just like the current push to stop drug at the boarder when the vast majority of drugs are coming in through port cities. They don't care if they have the best solution they just want to look like they're doing something, and they put pressure on agencies like the CDC to release more stringent guidelines (not laws).

 

[mrreapr]

My mom has cancer n her pain doc took away 2 of her meds and cut another plus now we can't find anywhere to fill the 80s

 

[aarons]

The VA in Seattle won't give out pain meds at all now, you can go in the ER with a broken bone and they won't give pain meds. My VA doc won't even prescribe Tram because he says it is exactly the same as an oxy. I think our healthcare system sucks, lol.

 

[javaman]

I think our healthcare system sucks, lol.

I think that's an understatement! "Cruel" would be my description. The government needs to stop treating addiction as a criminal issue and start treating it as the health issue that it is. Treatment at all stages should be between the doctor and patient. I also don't like the insurance system we have that creates unequal access to health care. But that's a different rant

 

[aarons]

As far as this topic goes I have to agree with @ninja2000, the under-treatment of pain is absolutely horrible. I cannot take nsaids due to stomach surgery and the only thing that I can take for my severe migraines are vics and I haven't had a regular doc prescribe me them in over 3 years even just 5mgs.. the drs are too scared to even help people in legitimate pain now. I am now seeking a pain management facility for help (my apt is in 3 weeks) so we will see how that goes..

It seems like they just want to rotate people through every NSAID and low dose muscle relaxer out there. But those don't seem to do much unless you want to sleep from taking a whole bunch of crappy muscle relaxers, lol. There are only a few pain Dr's left in my area and they only accept a few types of insurance, or cash only patients but if you call they always say they are not taking cash paitients. What  a nightmare, I think we should all contact congress.