I was denied sedation/effective pain meds before a procedure pretty recently. Despite the fact that I spent the entire time literally screaming in pain, they dismissed it as “anxiety” and did nothing to help.
I also received very little when I first came into the hospital - as my body was flooding with literal shit and I was fucking dying. They let me writhe and roll around for hours before they mercifully knocked me out for my operation.
I’m traumatized to the point where watching movies where people experiencing pain is upsetting. I was watching fucking Avatar the Last Airbender and wincing every time someone got punched or kicked.
I also go back to getting my IUD put in - again, another extremely painful procedure that is “not supposed to hurt” so there is no option for sedation or effective pain meds.
It feels like asking for pain meds gets you labeled as a drug seeker/addict too. I made the mistake of mentioning that I smoke weed (because I knew the anesthesiologist needs to know that) and it feels like it was instantly assumed that I’d be a pill popper too.
And I have extremely high pain tolerance. I’ve literally had people whip me until they’ve drawn blood. I’ve worked a fast food shift with a second degree (even a bit of third degree) burn going down the majority of my arm. I’m not a wuss, I know how to breathe in ways that help, I know how to go to a mind palace, but Christ, when you start digging around in someone’s guts with sharp objects, that’s not really something you can meditate away!
Is it training? Is it the fact that becoming a doctor in the U.S. requires the kind of upper middle class upbringing that doesn’t tend to help people develop empathy?
Calm down junkie you’ll get your fix.
They just expect you to choke on some ibuprofen or paracetamol, same for most of the western Europe tbf, even if care is way more affordable
Too many doctors getting in trouble for the general over-prescription of opiates
I can just tell you that it’s not universal: several doctors I’ve seen and know are very cautious when it comes to pain - both from own experience (“we will go strong with the pain killers for the best two days to prevent stress reaction from the body”) to others (“we need to get the chronic pain under control fast, otherwise there’s the risk of phantom pain developing even after we’ve tackled the issues”) (not verbatim quotes of course but the gists).
It might not even be US generic but a regional or age thing in the doctors you’ve met - remember that usually everyone one of us has only a very limited insight into the whole medical industry.
I’m similar to you in terms of pain tolerance and I’ve walked away from a doctor who talked shit about pain in patients - but I’ve head way better experiences before so that didn’t feel like I’m being stuck with this one medical “professional”.
Wishing you the best of luck though! It’s absolutely terrible when people don’t take you seriously, especially if it’s their job to help you :(
All my life what I’ve heard is that pain is only useful as a warning of a problem. After that the pain is something that must be minified.
Yes and it’s a personal benchmark of mine for a doctor how they talk about pain - because this is by now such well studied that I don’t understand how people like OP described are still allowed to do what they’re doing.
We’re in the throes of a few crisis in the US:
- a professional backlash against the over-prescription of opiates that were advertised as “non-addictive” which was actually a lie,
- the monster the above crisis created: a domestic population of drug addicts who are either seeking drugs themselves or looking to non-addicts to acquire them,
- constriction within the health insurance marketplace, demanding more and more justification for care and drug access,
- an entire political system that’s in the pocket of said industry who are incentivized to manufacture a world that maximizes health care spending while minimizing actual health care delivered.
Doctor here. This is exactly it. The system created a bunch of addicts on a lie and then punishes everyone else for the mistake of lying about how addictive opiates are
but if you’re in a hospital getting a procedure surely the probability of addiction is much lower than a prescription that will be taken at home…
If I give them back the leftover oxy from what they sent home with me, would that help in getting any potential “drug seeker” notes removed?
I don’t even get how I’d abuse the stuff. It just makes me sleepy. Like - marijuana is fun because it makes food taste good and helps me think more creatively. Opioids take away intense pain just enough for me to sleep it off. I ended up throwing away most of a bottle of Percocet after I got my top surgery because I’d rather have a little breakthrough pain on Tylenol and be cogent than sleep 18 hours a day.
In case you don’t see it below, you can request the “drug seeking” be removed from your chart. For a long time knowing the names of specific prescriptions meant you were drug seeking.
So if you had ADHD but weren’t diagnosed, like lots of folks but were somehow smart enough to accommodate your disability and then told your doctor you’d be interested in trying Adderall then they would mark you down as drug seeking instead of helping you.
There’s no note, everyone is a “Potential Drug Seeker”, no exceptions.
Except “drug seeking behavior” is a specific kind of note that can be in your chart. You can actually have this removed from your chart if you ask a provider to do so and they are so inclined. I have a drug therapist friend who removes it from everyone’s chart because it’s bullshit.
Studies have also shown that female pain is ignored far more than male. I think this shows just how much men don’t trust women.
Also, some doctors look for signs of low pain tolerance rather than just pain. So the ability to maintain composure despite pain can be taken as a sign that there isn’t any pain.
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The side effects of medication can interfere with diagnosis and treatment
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Pain can be a useful diagnostic indicator itself
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They see people in pain all the time, so it doesn’t seem like an exceptional state to them
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People with low pain tolerance are overrepresented in the population of people seeking medical care, so experience biases medical providers to assume that as a factor
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Junkies know everything about getting meds.
A doctor would rather have someone in discomfort than deal with being investigated for over prescribing.
I heard a talk by a doctor who specialized in end of life hospice care.
New interns at the facility are averse to giving out pain meds to people who are literally dying because that’s what they were taught.
Junkies know everything about getting meds.
Seems like an easy to fix problem: safe consumption sites
Not all junkies are homeless.
Plenty of high earners get addicted to pills of one sort or another.
Michael Jackson died after being shot up by his private MD.
That only works if you have a plan in place for these people’s futures like mental/physical healthcare, affordable housing, and stable careers.
Nah even without that, it’s a massive improvement for people: it helps gets people off drugs & stops them ODing.
Yes we should do all of those things, but we have to stop pretending we need to boil the ocean in order to make progress.
- mental/physical healthcare
- affordable housing
- safe consumptiom sites
- stable careers
All independently have a huge impact and while they amplify eachother’s impact we shouldn’t wait on all 4 before making progress on each one individually.
Snidenote: YIMBYs (who ironically enough oppose building affordable housing) often use lack of safe consumption or jobs as an excuse to oppose affordable housing built near them.
I live close to a few safe consumption sites so without seeing a study on this, this is just my observations.
There’s an increase of homeless people around (or perhaps they are more visible?) but since they have nowhere to go they get shifted around town by the police force every now and again. There seems to be a fair amount of violence amongst themselves as well, occasionally bleeding out into the general populace when we have big events nearby. I’ve also got friends from back in HS that went to these sites to “try” a variety of drugs they were curious about and now they’re full blown addicts that I don’t hear from anymore. Maybe they would have tried this stuff anyways but the whole draw for them was that it was “easy” and nobody would stop them.
Definitely aware of the YIMBY’s, I remember seeing their signs posted around before the sites went up, hence why the site got placed in my area despite not having the better infrastructure of the higher income neighbourhood nearby.
Not against safe consumption sites by any means it just feels like a bandaid on a festering wound situation. My neighbourhood safe consumption site hasn’t seemed to improve in the many years it’s been here- worsening conditions I’m chalking up to an increase in the general homeless population. The only time familiar faces seem to disappear is if they pass away.
I think its a liability thing, people get hooked on painkillers, they don’t want to be held responsible for prescribing it. Not sure how regulated certain drugs are, but probably a mix. Not sure why they would hold for certain ops they deem not bad enough. No great answer for this one, could be the system just sucks or there is no really great fix for it.
Is it training?
Yes. As you may or may not remember, the Sackler family spent billions on and made hundreds of billions off of getting the American south addicted to opiates over the 1990s and early 2000s. Every single doctor and hospital involved was sued by their former patients. There are still billboards up in some southern states advertising law firms that specialize in suing doctors over developed addictions.
So any doctor that graduated in the last 16 years has had one specific thing drilled into their head: Do. Not. Treat. Pain.
Because you will be sued if your patient is an addict or becomes an addict.
Is it the fact that becoming a doctor in the U.S. requires the kind of upper middle class upbringing that doesn’t tend to help people develop empathy?
This has always affected doctors in the US, but the medical profession is a calling regardless. If you want money there are so many better pathways, leaving exactly three reasons people become doctors:
- They want control over life and death
- They want the prestige of the title for themselves or their family
3: They have an uncontrollable natural urge to try to help others.
So 2/3rds of doctors are not going to fight their training and just try to prescribe pain meds as little as possible.
Of the remain 1/3rd of doctors or so, the ones that genuinely love helping others and want to deliver the best possible care, one bad experience with addicts can permanently change their attitude, and they may get hundreds of experiences per shift if they happen to do their residency in an ER inside any American city.
On top of all of this is the inherent gender and racial biases in medicine, and American medicine in general. Women’s pain is taken less seriously. It was in medical textbooks world wide until the 2020s that black people felt less pain and were genetically more prone to addiction. There was a literal course in every MA, RN, LVN, MD, etc course about “how different races feel and express pain.”
So if you want pain relief, you better have both the vital stats showing you are experiencing pain (which is awful for chronic pain sufferers who no longer have high BP/High pulse from their pain), and you better be a white man with a conservative lifestyle/look (because we know the gays are more likely to pop pills[This is literally in medical textbooks]), you better get lucky that you have a doctor willing to prescribe pain management, and even if you qualify at that point you better not ever ask for pain meds, period, regardless of your situation. As it only takes one single nurse or doctor to put drug seeking behavior on your chart to ruin your chances at ever receiving pain management ever again.
So 2/3rds of doctors are not going to fight their training and just try to prescribe pain meds as little as possible.
Ah, yes, truly how math works. “I will break all doctors down into three arbitrary, mutually exclusive categories and then decide that they’re evenly distributed.”
How you wrote this and thought “Yup, sounds right” is beyond me.
I see you’re still stalking me and you still haven’t learned anything about hyperbole for argumentative purposes. No, for my ASD friends I do not literally mean, “2/3rds here’s quantifiable evidence of something no one has ever quantified because doctors are allegedly heroes (if you’re a straight white male) and here are my mathematical sources and proofs for this very minor and entirely immaterial point of this particular argument.”
see you’re still stalking me
Yeah, sure pal. I think the last time I interacted with you was a few days ago when you were being a little pissbaby in the thread about Zohran Mamdani, and then god only knows before that. I found this thread naturally and only stopped at your comment for how insufferably stupid your anti-doctor spiel is. “It’s just hyperbole, bro. Baselessly claiming 2/3 of medical doctors are egotists who don’t care about helping others and trying to assign paper-thin logic to it is hyperbole.”
The fact you’re calling this “stalking” shows you’re deeply unwell with abysmal judgment, but then so does most of what you put on Lemmy.
As a trans guy, I got about 50/50 “she” versus “he” despite being a fat balding bearded guy. I’m guessing that factored into it too.
(because we know the gays are more likely to pop pills[This is literally in medical textbooks])
What medical textbook is this in?
Every one broaching the topic in any possible way.
Here’s Johns Hopkins, one of the leading voices in American Medicine, saying gay men tend to use crystal meth. Here’s a meta study referenced in at least 30 textbooks(I stopped counting the books in the cited by section) saying all ‘sexual minorities’ are much more likely to have substance abuse issues, but bixsexual women are the most likely to be long term addicts. Here’s a more up to date article saying Trans people are by far the most likely to be long term addicts. That last one is only in one textbook but is directly cited in two organization’s drug policies.
You’re female which is a detriment to appropriate medical care, being non-white is also a detriment to care. As others note there are also various systematic and medical reasons a doctor may not prescribe or use pain-relievers especially prior to understanding the problem.
I will say you need a new ob/gyn as there are recent updates that make pain relief a standard for iud insertion.
NGL as a white guy I just have to ask nicely for the good drugs and they give me opioides, granted it’s for kidney stones and it’s the most pain I’ve ever experienced, but honestly it sounds better than whatever OP was going through.
I do think I present with classic pain symptoms, I litterally can’t form sentences, which might help.
Kidney stones are known as one of the most painful things, and knowing the problem means the pain is no longer important for diagnosis.
True, however the first time they gave me fentanyl before they did a CT scan, they had figured it was stones but only had my pain to go off, so I suspect I got better treatment than if i’d been an equally erratic POC or woman, but hope I’m wrong and they’d give everyone similar treatment.
My mother literally had a gynaecologist just tell her that they’re putting her under general anesthesia for a surgery where other clinics won’t because “we don’t believe in torturing our patients”.
Thank you to that clinic. We need so many more of those in the world.
Pain is a feeling. Feelings are for priests.
As others have said, it’s a backlash against the pill mills, we have overcorrected.
I get migraines occasionally, and have Imitrex shots for them. I love that drug because it is not at all druggy - it leaves me clear headed with no migraine, there is a nauseating unpleasant rush when administered, then it’s just like walking back in time, headache fades to nothing.
But a handful of times (like literally 6 times in 30 years) I get status migraine. Imitrex does not avail me, 4 days no food no water I will puke even a spoonful of water.
I used to be able to go to the doctor and get some shots with some opiate and fenergan. They would do one, I would still be puking and crying, they would come back every 20 minutes or so and do another until I was so far away from the pain it wasn’t bothering me. Then I could sleep and it worked every time, even though it did not work by killing the pain immediately (painkillers don’t work for migraine) the high plus sleep always worked. Maybe $50 -$100 total cost.
But the last two times I got this, the doctor couldn’t do that, it was outlawed. They sent me to the emergency room. Cold IV in a cold room, some advil stuff that doesn’t work, then send me home still hurting, can’t sleep, headache 2 more days but I don’t die from dehydration. $1,600 for a worse result.
I understand why they say the opiates don’t work for migraine, they don’t directly kill the pain. But the previous protocol worked, and with electronic health records, can they not tell this is a very infrequent event for me? I don’t even like downers. I just want the headache to break and that was the only protocol that ever worked.
To add to the backlash portion: doctors are monitored for what rxs and how many they write for controlled substances. Pharmacies are monitored for how many controlled substances they dole out. Some rural pharmacies will refuse to take on new patients with pain meds (ex: you have a recently-diagnosed cancer patient who lived in the middle of nowhere all their life, and they can’t get morphine because their local pharmacy refuses to take on another scheduled rx). Pain management typically dictates you get a few days at a time and have to be reassessed before you can get another rx, so that means throwing another one on to the pile for the doctor and pharmacy, which means more liability.
Source: spouse worked ambulatory trying to coordinate with bumfuck nowhere pharmacies to get cancer patients their meds.
There was a nurse in a fertility clinic who was an addict and replaced the fentanyl drip with saline. Multiple women experienced agony during the procedure for extracting eggs. That procedure was to insert a huge syringe into the vagina, through the vagina wall, into the ovaries to suck up some eggs.
Many women experienced this with no pain medication at all and their complaints, even their screams were dismissed. Needless to say, when the addict nurse was discovered, they felt pretty silly.
Doctors have incredible tolerance for the suffering of women.
The doctors care. The shareholders dont
Don’t know man but the doctors here be like “just take a paracetamol”.
