Guest viewing is limited

HELP - Pain Med Dispute

Status
Not open for further replies.

Grandma

junior member
Joined
Jan 23, 2009
Messages
81
Location
Canada
This past Monday hubby and I drove (4.5 hrs) to the hospital for my Pre-Op stuff, and was hoping for and actual class situation where many of us would ask questions and go away feeling more optimistic about surgery and recovery.

What in fact happened was a one hour interview type appointment with the admitting clerk. She was very nice, however, was not able to say exactly what my particular Dr. would do or handle things such as catheters, pain meds, as she does all pre-op interviews not just orthopaedic ones. Off I went to get the normal pre-op blood work, x-rays etc.

My final interview was with the anaesthesiologist. She might as well have dumped a bucket of ice water over my head!

She is not sure she agrees with my cardiologist's diagnosis but will follow his instructions anyway (how good of her).

According to her, the Polar Care 300 was a waste of money as you should only ice for 10 minutes at a time and an ice pack would do that no problem. I am definately not to bring it to the hospital with me!

She absolutely freaked out over my current usage of Endocet (5mg/325mg) of 10 per day. She informed me I had no reason for such strong pain medications and certainly not that many per day and I should immediately stop taking the Endocet and start taking Tylenol Extra Strengh and that should do it. When I tried to explain that without taking 2 Endocet every 4 hours I could hardly function I was in so much pain and that even then I still had some pain but at least it was bearable. Her answer was that since Endocet was not taking the pain away I would be just as far ahead taking Tylenol X. She did relent to the point that if I wanted to I could take one (1) Endocet before bed to help me sleep through the night.

She made me feel like a total faker! Like I was making all this up just to get my hand on a narcotic drug! For Heavens sake, I am a 61 year old grandmother!!

I have been torn between anger at her and guilt on me needing such strong pain meds BEFORE surgery. Is this extra pain what happens when you put something off for 5 years after you’ve been told you are bone on bone just so I would be over 60 when I had it done?

I tried to do what she told me and go with just X-strength Tylenol, I honestly did – but after 48 hours of shear agony and barely being able to walk even with my walker I gave up. I have gone back to the Endocet. I have cut back to only 1 every 4 hrs. which is still a lot less then I like. I know it helps with the pain but sure not enough as I see it. I still have a lot to do around home before surgery.

Now I am terrified about what will happen AFTER my TLKR which is Wed 18th Feb.

I only met the surgeon once for his assessment of my need for surgery and apparently won't see him again until after surgery.

I was very nervous before this pre-op visit but now I'm a total wreck and don't know where to turn, other than to you guys.

How do you fight such a negative Dr. that might just refuse to give me sufficient pain medication to keep me comfortable enough to do all the exercises I need and want to do during my recovery.

Any suggestions would be so very appreciated. I’m sure I can’t be the only person to have this problem – it’s hard to argue with someone that is so much more educated and knowledgeable than me.
 
Grandma,
I see you are located in Canada. I am located in the US in NH and am a Grammy too. Here for me, my Primary Care Physician took over my pain management post-op. I would check with the current Dr. who is prescribing your medication to be sure you will receive adequate pain medication management through them following your surgery during your recovery. I was on prescription pain medication for just shy of 4 months.
This woman obviously knows nothing about the surgery. I would leave your own icing equipment home. Some people make out fine with ice packs, but they need someone to bring them to them as well as remember to get them back to the freezer. I used an aircast cryo/cuff cooler on each of my legs. The hospital made sure I came home with 2 of them. I actually used only one at home. It works on gravity with ice and water in the cooler. I was fortunate to have the pump that goes with it.
I see you are having your left knee replaced? Does your right one hurt as much as the left?
I had both of mine replaced on 6/18/08 at the age of 58.
You will do fine...
Be sure to have a high rise toilet seat at home, a shower seat with adjustable legs, and the ability to have your knee higher than your heart. I slept downstairs in our living room, in our recliner lined with a feather bed for months.
I wish you well!
Best,
Crystal
 
I am sorry you had such a miserable experience. I had to attend a mandatory knee joint replacement class for 2 hours and it was fabulous. Had the doctor there, PT, OT and the nurses. Then we had 1 on 1 time with whomever we needed to spend more time with. Information decreases anxiety so much!

I want to share my experience with the Polar Ice machine. I LIVED in mine! I am 3 months out and still get it out on occasion. I am a RN and work 2 days a week. When I get home from work. I put my knee up and ice for a couple hours. For me, that ice machine was the most important post op equipment I had. Mine is 4 years old from a previous knee surgery. I can not tell you how many people have benefited from that ice machine. We have lent it out to many friends and family. I just replace the sleeve every once and a while. I disagree with the advice you got. Increase swelling means more pain and less movement. If you can control that, life will be easier. Not to mention how great it feels on a hot and swollen knee!!
 
Wow,
And I felt I got the run around!!! Gram-ma I too am a Gran-ma. ( I am Gram-ma DUDE)
I to waited till 60 was told that was the best. And I thought I knew my Doctor but I can say now I don't. Crystal has it right you need to talk to your MD. They are the Doctor who takes care of your needs 12 months out of a year. I am very luck to have a wondeful MD. I never did Doctors untill my MV 4 years ago I had Meet my MD and his wife but, I only went to a Doctor about once every 2 years for a cold. But I can now say he is a wonderful Doctor. Crystal and I are in the States so I do not know how it works in Canada.
You do what you need to do Gramma. What did your Hubby think of all this???
^i^
 
Grandma
I am so frustrated for you reading this. I am 51 and had my hip replaced last June. I also had a knee scope recently and back fusion surgery.

I started taking narcotic pain relief a few months before my hip replacement, kept it up for a few months after. Then I immediately started needing it for my back. So I have been on percocet since June, vicodin before that. I just experienced the worst pain ever after this back surgery. My surgeon really tried everything possible aside from killing me in the hospital, nothing worked.
so post op at 3 weeks, he told me to cut back on percocet!!!! I was and still am in so much pain. I really can barely make it to the bathroom and back without pain meds. With them cut back to his level, I am just pretty miserable all the time.
My primary care doc , who I saw a few days after I got out of the hospital, prescribed twice as much as my surgeon. Much better for me and sleeping and moving.
I am going to see him this week and discuss pain management.

Do you have a primary care doc? Is it easy to get in and see him? Can you see your surgeon before the actual surgery day?
The anesthesiologist obviously knew nothing about the pain involved . And the value of ice. I had a knee scope and lived with ice on my knee. People here can tell you what is the proper way to do it . These are the experts, they have been there and recovered. Keeping the swelling down and the pain down are so important in recovery.
Try to keep your blood pressure down dealing with these people.
Let us know what is going on with you. You are now part of the bonesmart family.

Judy
 
Good grief! Where is that doctor from and why is he or she in practice? I don't know what is more outrageous--the ideas about pain control or the idea that icing isn't that important.

Others have said it well for pain control...and please don't stop until you get the relief you need. Thinking that all patients are potential drug addicts and wimps is ridiculous and outdated. Less pain means better recovery.

Regarding the icing: I got an aircast this time (like your Polar) and it has made a HUGE difference! I use it for hours a day, and my swelling is much less this time than for my other knee when I only iced for a few minutes at a time a couple times a day. Keeping the swelling down helps so much for pain and for ROM and recovery.

Hang in there! and let us know how you're doing!

Weezy
 
My final interview was with the anaesthesiologist. She might as well have dumped a bucket of ice water over my head!

She is not sure she agrees with my cardiologist's diagnosis but will follow his instructions anyway (how good of her).

According to her, the Polar Care 300 was a waste of money as you should only ice for 10 minutes at a time and an ice pack would do that no problem. I am definately not to bring it to the hospital with me!

She absolutely freaked out over my current usage of Endocet (5mg/325mg) of 10 per day. She informed me I had no reason for such strong pain medications and certainly not that many per day and I should immediately stop taking the Endocet and start taking Tylenol Extra Strengh and that should do it. When I tried to explain that without taking 2 Endocet every 4 hours I could hardly function I was in so much pain and that even then I still had some pain but at least it was bearable. Her answer was that since Endocet was not taking the pain away I would be just as far ahead taking Tylenol X. She did relent to the point that if I wanted to I could take one (1) Endocet before bed to help me sleep through the night.

My blood pressure went up at least 5 points reading this! I was so angry for you! This is exactly the kind of person you don't want to have to do business with at such a time.

Is this the anaesthetist who is going to deal with you when you go to theatre? Because in the UK, once the patient is back on the ward, they don't have anything further to do with the patients. It's all up to the surgeons so I really hope this will be the case for you. Plus her opinion of using ice and etc., is just that - her opinion! No-one I know would dream of restricting a patient to 10 mins at a time! She clearly has no idea what she is talking about!


She made me feel like a total faker! Like I was making all this up just to get my hand on a narcotic drug! For Heavens sake, I am a 61 year old grandmother!!

I have been torn between anger at her and guilt on me needing such strong pain meds BEFORE surgery. Is this extra pain what happens when you put something off for 5 years after you’ve been told you are bone on bone just so I would be over 60 when I had it done?

Do not feel like you're a fake! Just because she hasn't the nounce to be informed for pity's sake don't let that give you feelings like that. YOU know it's not true, WE know it's not true, your GP knows it and and so does your surgeon.


I tried to do what she told me and go with just X-strength Tylenol, I honestly did – but after 48 hours of shear agony and barely being able to walk even with my walker I gave up. I have gone back to the Endocet. I have cut back to only 1 every 4 hrs. which is still a lot less then I like. I know it helps with the pain but sure not enough as I see it. I still have a lot to do around home before surgery.

Now I am terrified about what will happen AFTER my TLKR which is Wed 18th Feb.

Then you proved how wrong she is but I can understand your fears. I just hope and pray that, as I said before, she doesn't have anything to do with your post-op care.


I only met the surgeon once for his assessment of my need for surgery and apparently won't see him again until after surgery.

I was very nervous before this pre-op visit but now I'm a total wreck and don't know where to turn, other than to you guys.

How do you fight such a negative Dr. that might just refuse to give me sufficient pain medication to keep me comfortable enough to do all the exercises I need and want to do during my recovery.

Ask for an appointment to see your surgeon to discuss this experience and tell him you want a different anaesthetist. Also that you don't want this person anywhere near you when you have your op. I would! Especially to the degree she has freaked you out!

Any suggestions would be so very appreciated. I’m sure I can’t be the only person to have this problem – it’s hard to argue with someone that is so much more educated and knowledgeable than me.

Just because she's educated doesn't mean your opinion is any more or less important than hers. And she has shown her ignorance on several levels. So get those ideas right out of your head. This is your operation on your knee/body and you have every right to expect to be involved in the decision-making and not to be dictated to like this.

The more I think about it, the more I feel you should go straight to the surgeon and explain all this to him. You should not be going into surgery with this total lack of confidence in the person who is going to administer the anaesthetic. Tell him you must have a different doctor.
 
Way to go Jo-Jo!!!!!!!!!!!!!!!!!!!!!!!!!!!
I wish you were in the States!!!! You would be in great demand!!!! Everyone would want to hire you to go to the Doctor with them!!!!
It would be a slam dunk!!!
^i^
 
Yes JO!!!! Calling is right--if you were here in the states, lots of us would be hiring you to come with us to doc appointments and help us advocate for ourselves!

Re the anesthesiologist further involvement--its was the same for my two TKRs--I only saw the anesthesiologist right before the surgery and then never again. They had no say or participation in my care.

I wonder who and why this person thought they had so much input? Particularly since it was so damaging and ridiculous.

Weezy
 
Same here, only saw the anesthetist just before the op.

I actually asked to use the ice machine in hospital as when I had my hip done the previous year, the lady in the room with me had used it on her knee. When they brought it to me I had to show the PT how to use it, but it was invaluable. I had ice/gel packs at home but would have loved the machine. I still ice 12 weeks on if I have had a particularly busy day and get a bit of swelling.

I'm sorry you have had such a negative experience so close to your op, but as Jo said, you have a right to be included in decision making, it's your body you know what you need, hopefully your GP will take over pain management after.

Every good wish to you Grandma, I'll be thinking of you.

Chris :)
 
Had a thought - if the ice machines are such a 'bad idea' why do the hospitals not only use them but send patients home with them as well! I just heard that this is happening even here in the UK though we only have the gravity feed ones yet. I shall be taking mine in with me - so there!
 
Thankfully Crystal, my right knee is not half as bad as my left and hopefully it will feel even better once my left knee can fend for itself. As I had back surgery last year I already have the raised toilet, safety bars and a bath seat.

I’m glad mwolf and others have been more encouraging about the Polar Care than the doctor, I thought I’d read about people using it for a lot longer than 10 minutes at a time.

Angels I don’t think there’s much difference here in Canada. Your MD refers you to a surgeon, you get an appointment with the surgeon and he/she assesses your problem and accepts or declines your surgery. You are free to ask your MD for another referral but you sometimes must wait a year or longer for your initial visit. I was lucky; my surgeon scheduled me in very quickly once he saw me. I only had three weeks notice and there is not time to meet with him again before surgery.

My husband is a wonderful man, however, he is one of those macho guys that would rather die than admit he was in any pain! He has never had major surgery or any of the ‘age related afflictions’ that many of us have. He has worried about me taking all the meds I do for my blood pressure, etc., and certainly for the past five years that I have taken Oxycodone for one thing or another. He (wisely) hasn’t said a word about this, although I must admit I would be happier if he was able to understand my side a little better. I have frozen two weeks worth of suppers and still have to finish cleaning the house. Our youngest daughter and her family are coming for a weeks visit during March break (14th through 21st) as he expects “I’ll be just fine by then”. His idea of support while I’m barfing my inners out is to tell the kids that supper will probably be late because mum’s not feeling well. 

Monday is a holiday here Judy so all business’ are closed for ‘Family Day’. Because we live in a remote town, doctors come here for approx. three years rotation. They get extra money from the government for this plus free housing and two months paid vacation leave. My current doctor just arrived in November and was on vacation for the month of January. I have seen him once and have another appointment for March 23rd which was the next available one. He seems very nice and I’m hopeful about his compassion in pain management.

I have been thinking a lot about the attitude of the anaesthetist Weezy & Jo and I wonder if she has perhaps had some personal experience with someone addicted to pain meds. She was so adamant about it, almost pounding her fist on the desk. I have never experienced this kind of reaction from any other doctor. In fact last year when I had the obligatory meeting with the anaesthetist before my back surgery he checked my breathing and asked the standard questions but offered absolutely no opinion on anything. I wasn’t sure who prescribed the pain regime but you’re right Jo, I don’t recall ever seeing the anaesthetist after surgery, in fact, although I’m sure they were there, I don’t even recall the anaesthetist at all. This one did say that she didn’t know whether it would be her or one of her colleagues at my surgery.

Even if it’s not until after surgery I do plan on telling my surgeon about my extremely negative encounter with this woman. Even if she is an amazing anaesthesiologist she sure shouldn’t be allowed interaction with the patients.

This forum is an amazing thing! God bless whoever started it.

I'm sure you have all helped save my sanity!

I hope I can repay you in some small way for the assurances and peace of mind you have given me.

I luvs ya'll
Diane
 
Hi Grandma,
As a fellow Canuck I can tell you this has not been my experience nor that of anyone I know. I agree with other comments about the anesthesiologist, you won't see this person after the surgery. The only medical people who understand what you go through with a knee replacement are the ones directly involved in your recovery and rehab. Even my GP didn't really get that I still needed a perocet before physio. He said "But your knee is great now. Look how you just hopped up onto the table." I explained that without the perocet I had taken 30 minutes before, this would not have looked the same. My RTKR was on Jan. 6 btw.

I had the opposite experience with meds. I have been given percocet by the 100's by my OS and was afraid of becoming addicted so I have cut way down, but your pain is obviously much worse than mine. Once you have your new knee and have done some rehab, then you can think about cutting down on the meds. One thing at a time.

One thing that comes to mind is that the amount of oxycodone that is being prescribed has been a big focus of the media in Toronto in the last month. Front page in the newspaper. Apparently people get prescriptions for it and sell it on the streets for $45 a pill, which users take by the dozens and crush to snort etc. and it's become a huge addiction problem. Perhaps this doctor is being influenced by this as I'm sure that MD's being asked to tighten up in this area. However, this doctor seems quite over the top!

My daughter is currently doing her masters in physiotherapy and assures me that the latest research is to ice for 20 minutes at a time. (20 on, 20 off). I've just been using gel packs but I haven't really had a problem with swelling and have never seen a Polar Care unit. They certainly do sound wonderful though.

It's too bad that you didn't get to have a proper pre-op class but all the info you would have gotten is readily available here on Bonesmart! Not to worry.

Let's hope that when your daughter comes she'll be looking after you! The grandkids can also pitch in. This is a time to let things be ALL ABOUT YOU... and no feeling guilty about it. When you're overwhelmed, just disappear into the bedroom and close the door. They'll get the message.

I made sure that I had nutritious lunches for myself frozen (soups etc.) so that I could concentrate on my exercises, icing and rest during the day. I also kept simple foods in the fridge (boiled eggs, yogurt, hummus etc.) If I had enough energy to make dinner my husband was pleasantly surprised. If not, he made something simple for us or picked something up. When I did cook, I made a big batch and we'd eat it for two or three dinners.

I know that living in a remote town comes with its challenges and the medical area is certainly a big one.

Tell your husband that the more you can focus on your recovery and rehab after surgery, the faster and more effectively you'll be back in action.

I don't mean to sound militant, but we women do have times when we need to meet our own needs first or we won't be able to do the caring and nurturing for our families when it's needed.

Have a great family day!

Mag
 
GREAT post, Maggy! Are you after my job?
[Bonesmart.org] HELP - Pain Med Dispute

 
Now there's a compliment coming from "the master"!

When it's 3 am and one is in pain and can't sleep, the "straight talk" seems to come easily! And it's often what we really need to hear to get our bearings when we're in pain and unrealistic demands are being made of us by both others and ourselves.

Mag
 
Diane
I am so glad we have helped you calm down. I love having new friends. I fantasize about taking a trip and visiting bonesmarties!!! Family day sounds like it could be the best holiday ever. I think I will try to make my own here on a weekend. Thanks for explaining the medical system in y;our remote area.
I did live in the mountains of southern california for just under 3 years when my 4 kids were little. It was great fun. Not as remote as you. If it was not winter a trip to town was an hour down the mountain to the grocery store, etc. I did that about evey 10 days or longer.

I don't see my back becoming pain free anytime soon as it has been 5 weeks since surgery adn I still need to take 20 mg of percocet every 6 hours. I am going to see my primary care doc about this on thursday .

Please tell me about your back surgery. What I just had was an 8 level thoracic fusion. Of course more was done, opening for the nerves, things permanently removed. I still have to look those up. I have a lot of disc issues in my thoracic spine, they can not be addressed from the posterior . My doc is hoping this will take care of it, otherwise the big anterior or side surgery will be needed. This one has been miserably painful. My doc doesn't think it should be although my physical therapist, primary doc and hip/knee surgeon do think it is very painful to recover from. As I think of 16 screws being put in and bony pieces being cut out and all my back muscles being cut. Could be legitimate pain.

Mly morning rambling.
Oh , I have this posted somewhere as I have been the strong caretaker type, but I read after having my first baby that women should stay in pajamas after surgery, illness etc. As soon as the men see you dressed, they think you are back to normal. It may have some effect on women too. I had a uterine infection after my first and had to stay in the hospital for a week. The first morning home I took a shower and got dressed. I heard my husband on the phone to his boss saying, oh i'm coming in Judy is dressed. I now own a few pair of pajama pants and have been wearing them every day. If I have gone out for a doc's apt, I come home and put them back on very quickly.
You need to be taken care of. It has taken a lot for me to get my husband in that mode of helping. It worked this time, even in the hospital as I told him patients really need someone there to advocate for them.

Maggie what a great post!!!

Judy
 
So sorry to hear about your pain dilemma, Grandma,,,,,,Wow! Talk about a lack of compassion! I hope you get the relief you need and you keep icing and doing your thing! Shame on them! Rant all you like! You definitely need to blow off steam! :)
 
Grandma,
I am a new grandma too as of just 7 months!
Also am an RN in a surgical unit and do the pre-op teaching for all joint replacements which our anesthesiologists take part in too. They would never say anything like that to you. It's none of their business! It's between you and your doctor. Besides the amount you are taking is close to the maximum daily dose but not at it.
I've worked as an RN for 38 years and there are always docs who are pointing the finger about addiction. They really don't get it. Pain is pain. And if your usual doctor prescribes this for you, NO ONE should be telling you otherwise. I can't believe this anesthesiologist would tell you this! If anyone suddenly stops taking opiates for pain, they would get very very sick. And I concur with everyone else's comments. It's your OS who does the prescribing for pain post-op.
I just did a rant yesterday on a different thread about the first OS I interviewed. But he actually did give me some good info about taking Vicoden for my pain, and it's made me want to wean myself off of it before surgery, and find other ways of living with the pain. But mine is nothing like yours.
Hope you can let go of that nasty lady's remarks. It was BS.
Best to you! Nancy
 
Status
Not open for further replies.

Staff online

Members online

Back
Top Bottom