Doctors and poor pain management

[Tortoise]

My friend recently had his appendix removed and it was done the old fashioned way, ie one big cut as opposed to keyhole surgery. You know what the doctors prescribed for him? Fucking panadeine forte! That's right, a dude has some pretty serious surgery and all he gets are tablets with 500mg paracetamol and 30mg of codeine. WTF!? Is this normal?

Swim had surgery for appendicitis when he was in America and at least he got Vicodin, which seem much stronger than panadeine forte.

Honestly, what is wrong with doctors who underprescribe pain meds? If you ask me they should have at least prescribed endone (paracetamol + oxycodone 5mg) considering we don't have hydro in Australia. It just seems that they're scared to prescribe anything stronger than absolutely necessary, even if it means less effective pain relief for the patient. Sad.

Reputation Comments on this post:

	good thread
	His posts are overall informative

[Mint boi]

Some doctors are ridiculous. A friend of mine had an accident in spain last summer, slipped on a pool edge, broke his nose, split open his lip and forehead, needed 6 stitches, guess what he was prescribed for pain? 400mg ibuprofen pills, Helped with swelling i guess, but crap for pain management.

[stoneinfocus]

Around here it´s just 2 -x days of piritramid (Dipidolor tm) it works, but they´re afraid to prescribe/give it to their patients for more than 2 days.

This is ridiculous, as you need a year to develop a serious opiat dependence, not to mention that pain seems to be an antagonist to any form of opiate dependency and they´re afraid of dependency even when giving a few days opiates.

-"One shot and you´re on!" *lol* Sad but true, how this prejudice made it to academics, who should know better.

[Jatelka]

"You need a year to develop serous opiate dependence"?

Source? Science behind your statement?

Opiate tolerance develops much quicker than that

Reputation Comments on this post:

I agree w you jat.

[Psych0naut]

Never in my life did I get opioids for serious pain, not even after surgery for post-operative pain, nor when I had an inguinal hernia which was the most painfull experience in my life(in most cases it doesn't hurt much, in mine it did!)
The only country where opioids are prescribed in abundance seems to be the US, but in Europe prescriptions for opioids are rare, unless you're dying. Ofcourse there is the odd exception, but this is certainly a general rule, a lot of people who need opioids don't get them, because doctors are afraid to prescribed them.

Reputation Comments on this post:

it would seem in the Neth. rx should be ez to aquire. guess not

[stoneinfocus]

Originally Posted by Jatelka

"You need a year to develop serous opiate dependence"?

Source? Science behind your statement?

Opiate tolerance develops much quicker than that

W.S.Borroughs "Junkie" .. when he speaks of a full blown -so to say- addiction, with tolerance sky-rocketing after abstinence afer one year, which is what he´s talking/writing about, I trust him, although there might be huge interpersonal differences.

I read in an enceklopedia that it would take at least 1 months, with multiple morphine injections a day to develop an addiction, with withdrawl and all the fun-stuff.

[bloodred1889]

as swim said in a previous reply, we need to stand against doctors in the uk and europe and make them see that not all ppl are drug seekers and not all back pain can be cured with anti imflamatories, paracetamol and exurcise.

swim has had chronic back pain for 7 years now, and the pain is getting worse, its in swims legs, arms, lower and upper back and in most cases it states that if the pain in your back moves to your legs then somthing more serious then back pain is there, but still swim is refused pain relief, becuase... its too addictive.
all swim is given time after time is, a refural to a rumatologist, paracetamol and an anti imflamatory.

WTF.

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how's things doing now.

[yaba]

Originally Posted by bloodred1889

as swim said in a previous reply, we need to stand against doctors in the uk and europe and make them see that not all ppl are drug seekers and not all back pain can be cured with anti imflamatories, paracetamol and exurcise.

swim has had chronic back pain for 7 years now, and the pain is getting worse, its in swims legs, arms, lower and upper back and in most cases it states that if the pain in your back moves to your legs then somthing more serious then back pain is there, but still swim is refused pain relief, becuase... its too addictive.
all swim is given time after time is, a refural to a rumatologist, paracetamol and an anti imflamatory.

WTF.

Swim has a similar problem he has genuine lower back pain and recently he has a problem with his neck and shoulder. He works in health care his doctor is the best one he probbally can get in his region.

He first got: Diclofenac sodium 25/50 mg dual release he didn,t like them and got Co codamol 30/500 mg and they wern't strong enough now he is on Tramadol. Can he push for something better ? And what will be the best thing to say ? He doesn't want to piss them of either.

It appears to swim that the bigger pain someone is the more he will be helped.

[beentheredonethatagain]

oxycodone is only prescribe for chronic pain, not accute.

[bloodred1889]

Originally Posted by beentheredonethatagain

oxycodone is only prescribe for chronic pain, not accute.

yeah swim has chronic pain but swim doubts she will EVER get oxycodone, as that is for cancer patiants, at least around here.

[Olivier]

When SWIM was about 14, he had appendacitis and had to have surgury. He was in the local ER for a few hours, didn't give him any meds til his parents were telling them he needed them, finally got some morphine. Then he was transported to another hospital with an adolescant surgeon and had surgury that day. He got morphine in the hospital, got out the next day and then didn't get ANYTHING. He was crying all day because it hurt so bad, he got tylenol from his mom, who was a former nurse. She should have fucking known better, because she's also been in the same situation.

That's fucked up. Even though age was only part of it, he didn't even get some ibuprofen, maybe his parents never picked up the meds for a reason, but still. It was the most fucked up thing he's ever been through.

[stoneinfocus]

Originally Posted by bloodred1889

as swim said in a previous reply, we need to stand against doctors in the uk and europe and make them see that not all ppl are drug seekers and not all back pain can be cured with anti imflamatories, paracetamol and exurcise.

swim has had chronic back pain for 7 years now, and the pain is getting worse, its in swims legs, arms, lower and upper back and in most cases it states that if the pain in your back moves to your legs then somthing more serious then back pain is there, but still swim is refused pain relief, becuase... its too addictive.
all swim is given time after time is, a refural to a rumatologist, paracetamol and an anti imflamatory.

WTF.

Sure, it´s a joke, they get things teached all ´wrong, like corticosteroids are demanded by the patients in ever increasing doses, to get high, which is not true: corticosteroids do make you high, but only for a week, then it´s just an awful receptor and HPTA-downregulation and it´s needed in high doses to do what it should do, and doesn´t make you high anymore.

For back-pain e.g. dexamethasone is prescribed, I liked testosterone and dianabol along with some diclofenac or, which worked along with the anabolics without any dose increase, 0.5mg dexamethasone every other day.

Withaout anabolics (AAS) I had to take 8mg dexamethasone/day and it didn´t do much, except for sides. With AAS, no sides, no pain, no dose-increase, as estrogen is needed for the upregulation of the glucocorticosteroid-receptor anmd AAS for the estrogen and to even out the HPTA negative feedback.

[yaba]

Originally Posted by Psych0naut

Never in my life did I get opioids for serious pain, not even after surgery for post-operative pain, nor when I had an inguinal hernia which was the most painfull experience in my life(in most cases it doesn't hurt much, in mine it did!)
The only country where opioids are prescribed in abundance seems to be the US, but in Europe prescriptions for opioids are rare, unless you're dying. Ofcourse there is the odd exception, but this is certainly a general rule, a lot of people who need opioids don't get them, because doctors are afraid to prescribed them.

Swim is Dutch and his old family doctor was old school! When swim was 14 he went true a hard time and his doctor give him 3x 10mg diazepam daily and thermazepam at night. Also when swim had tooth pain he went to a emergancy dentist in Amsterdam. The dentist asked receept swim told him no thanks, he said ok I do it a bit cheeper. When swim asked him for pain killers he wrote down paracetamol+codeine swim told him they aren't working. He asked swim what do you have in mined ? Swim sad morphine and he replyed I can do that for you. Not sure what it was bit it knocked swim out!

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good post

[samuraigecko]

Originally Posted by stoneinfocus

W.S.Borroughs "Junkie" .. when he speaks of a full blown -so to say- addiction, with tolerance sky-rocketing after abstinence afer one year, which is what he´s talking/writing about, I trust him, although there might be huge interpersonal differences.

I read in an enceklopedia that it would take at least 1 months, with multiple morphine injections a day to develop an addiction, with withdrawl and all the fun-stuff.

Throw some Hammer or Morphine (or any other opiate for that matter) up SWIY's arm for 2 weeks strait and then tell us that it would take at least a month. LOL. That is just totally ridiculous information and dangerous to post as such in a forum such as this which can influence other people.

Opiate dependence and tolerance begins very quickly. After the 10 to 14 day mark ones own body will discontinue the production of endomorphins (a type of endorphin which is most similar to Morphine) and the brain will become Dependant on the introduced opiate because the brain is no longer producing its own endorphin which the opiate mimics. As use continues the endorphin pumps will no longer even work until full withdrawal and reconditioning of the brain has occurred. In some instances people have permanently damaged these endorphin pump systems which has resulted in a full blown depression which cannot be recovered from. For more information and links to help provide the proof for this one may look at "what makes an opiate" thread or other threads one has posted in to substantiate these facts.

Hope this has been of help or insight.

[stoneinfocus]

Swim was hammered 10-20mg´s of morphine equivalent into his arm at a hospital for 8 days and there was nothing... absolutely nothing even hinting to any kind of addiction, pain-increase after discontinuation or depression whatsoever.

[Tortoise]

Apparently opiates used therapeutically (ie, to relieve physical pain) do not cause nearly the same dependance as the same dosages used purely recreationally. Plus, we're all different; some people just react differently to different drugs.

[JJx23]

I have a serious wrist injury and am prescribed Percocet. It is chronic pain, but Percocet is a strong drug. I have had Vicodin and it touched it lightly, the Perks work wonders though. I am shocked at how other countries handle patient's pain, that's ridiculous.

[samuraigecko]

Originally Posted by stoneinfocus

Swim was hammered 10-20mg´s of morphine equivalent into his arm at a hospital for 8 days and there was nothing... absolutely nothing even hinting to any kind of addiction, pain-increase after discontinuation or depression whatsoever.

10 to 20mg Morphine a day for 8 days is hardly a recreational dosage or comparable to an opiate users normal dosages. It takes a fair bit more than that to produce the result one was actually talking about. In this range one will not experience almost any of the effects one mentioned, depression etc. Most Heroin users can put a 30mg MScontin up their arm and not even feel the effects. Much higher dosages are needed for the brain to stop producing endomorphin.

Hope this has been of insight

[Lisa J]

SWIM has had chronic neurological pain for years and appears to have been lucky as she lives in the UK and gets good pain relief. SWIM has fentanyl, codeine/paracetamol, gabapentin & baclofen.
SWIM had a little "blip" a few months ago and started using heroin, she thought the GP would stop the pain meds but he didn't and she now gets methadone as well.
SWIM'S current problem is that she started reducing the methadone and found her pain was getting bad, GP upped the fentanyl and SWIM was able to reduce the methadone further. She has now reached a point again when she can't go any lower on the methadone and the GP says he can't increase the fentanyl (now on 125mcg) so she's waiting for an appointment with the pain clinic to see if they can find an alternative to methadone for the pain.

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hope all is well

[Laudaphun]

Originally Posted by beentheredonethatagain

oxycodone is only prescribe for chronic pain, not accute.

Not sure what California's regulations and such are but oxycodone is commonly given to high school kids who get their wisdom teeth out. SWIM's first ever prescription for narcotics was in the emergency room for oxycodone/acetominophen 10/650. This was only a prescription for a few days to alleviate the soreness of the next few days due to an automobile accident.

Oxycodone in it's time-release form should and is typically used in chronic pain rather than accute, but the oxycodone/acetominophen(paracetamol) preparations most certainly are used for accute pain and not just for chronic pain... at least in my state. On the other hand, who knows what regional differences there are as the U.S. is a fairly large country.

Reputation Comments on this post:

somewhat agree, except oxy for teeth?

[myfavoriteaccident88]

swim has never ever received oxycodone or oxycontin (time release oxycodone) from a doctor.

Thank god for swim he has other ways of getting the pills, they are amazing.

and 10-20mg is nothing.. for swiim it takes at least 60-90mg per shot to give a nice rush and a good nod.

[JJx23]

Oxycodone is used for Chronic pain, at least for me since I have a wrist injury that deals with tendons, etc. Anyhow, each state would probably be different I'd imagine.

[samuraigecko]

The type of opiate prescribed is dictated by a number of factors

1] the doctor prescribing it.
2] the type of person he see's you as.
3] the type of pain it is
4] how intense the pain
5] how prolonged the pain is likely to be.

it is a combination of these determining factors which dictate which drug the doctor will prescribe. Any number of these combinations can steer his decision in different ways.

A big factor is also "promo's" and "Bonuses" .
Example: Doctors receive cash bonuses in some instances depending on what brands etc they prescribe. This can also help to dictate what they are likely to prescribe you. Oxycodone can be prescribed for both acute and chronic pain, but it depends on the above factors weather or not that is what you will get.

Hope this has helped.

[HighCountryHero]

If swiy is unhappy with what the doctor is prescribing him than he should go to other doctors and pain clinics. At least in the US, one can usually find a doctor willing to give him stronger/better/more appropriate meds. It just takes some searching and a lil bit of luck.
Swim has ACL sugery recently and was given morphine by IV for the 2 days in the hospital, then 60 5mg percs, 40 vics, and 40 lorcets. Swim was in so much pain he had little recreational effect from the pills but they did keep him from going crazy from pain. Swim can't imagine being given anything less as he was in lots of pain. Swim thinks its wrong to give useless meds to those that are in real pain and in need of real relief.
So if swiy thinks he needs something more effective than he should go find a doc or clinic willing to give him those meds that will work more effectively. If one does have real, legitimate reasons, than it shouldn't be too hard. Just look around. Swiy will find something better.
Peace

[samuraigecko]

Originally Posted by HighCountryHero

If swiy is unhappy with what the doctor is prescribing him than he should go to other doctors and pain clinics. At least in the US, one can usually find a doctor willing to give him stronger/better/more appropriate meds. It just takes some searching and a lil bit of luck.

In some countries they call this "doctor shopping" and can quickly get a person black listed from being able to obtain a certain class or type of drug. The doctors in some countries have a computer database network which will show up when one such person is blacklisted from being able to obtain these types of drugs. After this event the only chance of one of these people being able to get that type of drug is if there is an emergency situation that calls for its use and/or continued prescription.

Hope this has been of some help