I am not guilty because I am in pain. I am not a criminal because I want to be pain free.
I was released from a central Ohio hospital Thursday after major surgery to my abdomen. The incision is 8 inches long. The morning of the day I left, I still needed intravenous Dilaudid to relieve my pain. By that afternoon, my pain was held in check by 3 Percocets every 5 hours. My body’s tolerance for Percocet is high, since I’ve been on it dozens of times in the past decade.
I had had a horrible week with pain. Monday night about 8 hours after my surgery I was in the most excruciating pain I’ve ever been in. And I’ve had Pancreatitis and Whipples Resection surgery, both extremely painful physical experiences. The surgeon had ordered a very conservative dose of Dilaudid. He increased it only after I was subjected to extreme pain.
As I lay yelling for relief I was told the nurse was busy and would come as soon as she could. When she did arrive, she chuckled at me lying there moaning in pain. I couldn’t believe it. I told her she wouldn’t be laughing if she had my pain. She later apologized, but it highlighted a common problem.
Nurses are trained to care for patients, including treating their pain. They are also trained not to be too attached to the patient’s emotions. It’s difficult to draw the line. This nurse’s lack of compassion for me was her failing, but not the cause of my suffering. The surgeon’s lack of foresight limited her ability to help me.
When I was released, I had to lobby for more than a very frugal dose of pain meds to take home, 20 Percocets total. A few months ago I had another small surgery and was sent home with 40, more than I needed, but plenty to make me comfortable until healed.
But this surgeon apparently believes in “tough loveâ€. Perhaps he also believes that boys who cry are sissies and pain strengthens the spirit. We come from a puritanical culture where pain is something you should endure, that it’s good for character. Even those who supposedly embody the spirit of compassion are not necessarily aligning themselves with the patient’s comfort.
Mother Teresa’s hospitals for the sick and dying were stingy with pain treatment, believing that pain brings you closer to god. I wonder how many died there in agony, wondering if the next life would be so cold to their comfort.
Even my father, while visiting me in the hospital, encouraged me to keep a stiff upper lip and grow from the pain. He said it lightheartedly, but the message was clear. Stop whining. Deal with it!
Perhaps pain can strengthen the spirit, but only if one chooses to be in pain. Athletes who push themselves to painful levels of training are doing so by their own volition. Meditators who endure fire or needles have volunteered. Those suffering from wounds inflicted by a surgeon’s scalpel may have needed the surgery, but they didn’t chose to be in pain.
After loud lobbying for more than “god’s anointed†amount of painkillers, I was sent home with double that amount, 40. The dose was to take 3 every 5 hours as needed for pain.
That was Thursday afternoon at 5 PM. Through out that evening and night, I was in constant pain. It’s not that I can’t endure some pain. But when pain is so debilitating that I can’t eat, move or breath properly, then it’s interfering with my health and healing, something doctors are supposed to be interested in.
Symptoms got worse that night, which is not unusual. I took the prescribed amount of meds. By Friday afternoon, I realized I may not get through the weekend without running out.
I called the surgeon’s office to let them know. They told me they would not prescribe more and that I should just make them last. “Don’t take so manyâ€, I was told. I was found guilty of being in pain and had dared to ask for compassion. Stiff upper lip! Build character! Seek god in the pain!
Many people abuse pain meds. They are highly addictive and are rightly highly controlled. But as I described in my earlier post on this subject, “Not So Rare Airâ€, there are a few souls among the “catholic pain purists†who believe compassionate treatment pain is more important than the risk of some addiction.
Those in pain are not criminals who are automatically guilty of addiction until proven innocent. That’s like saying all black men are criminals and all gays are child molesters. I suggest those to stereotypes because many in our society do think that way. It is socially acceptable that this hospital continues to treat every patient as suspect until satisfactory medical “validation†has been provided.
When I arrived in the ER of this same hospital a few weeks ago with what was thought to be gall bladder attack, (another story) I languished in the waiting room for two hours, screaming in pain, until a doctor could treat me. Why doesn’t the hospital have a trained pain technician to make the patient comfortable until the proper doctor can attend? Why didn’t a doctor treat my pain and then return later to diagnose? Why weren‘t more doctors available in the ER?
Perhaps I wasn’t bleeding or retching or showing any sufficient “external†symptoms to validate my illness and my pain. I just “acted†like I was in pain. The nurses who checked on me smirked or acted impatient with my moaning. In this case the patient was guilty until proven innocent.
Here it is Saturday afternoon and I am quickly running out of pain meds. Luckily I didn’t need quite as many last night and today things are going better. But I am already in enough pain to lose my appetite and have difficulty taking a therapeutic walk to heal further. Yet I dare not “overdo†treating my pain. Remember, I am already guilty. I need to “grow†from this pain.
Better meds are needed for treating pain. Science will surely come up with non-narcotic replacements for these troublesome culprits. Toward that goal, my surgeon instructed me to take up to 800 mg of ibuprofen every 6 hours, a huge amount which has apparently been found safe. It has helped take off the edge. Each day my condition improves. I’m not in agony. I also admit that I may not be objective about all this. Pain is a powerful persuader, and so is the built in allure of addictive narcotics.
The point is that I believe I experienced unnecessary suffering because of a cultural and legal system fearful of leniency. If narcotics do the trick, palliate the pain, then treat any problem of addiction, not the other way around.
What do you think?
In truth, I have no business commenting because I have never experienced that kind of pain. Not exactly. I did give birth without any pain medication, and it turned out to be a very difficult birth which almost required surgical intervention. Yes, that was unbearable, but it was over in 48 hours. I’m sure that at the time, I thought I was going to die. I have no clear memory of it. I do remember begging the midwife for painkillers, but I had signed off my rights to such medication 2 months earlier, when I was “clear-headed”.
I’ve also had cavities filled without novocaine. Many people wouldn’t dream of doing that, but a couple years ago I had a bad toothache following a botched dental procedure. That pain lasted weeks, and it was pretty bad. From that I learned that I can tolerate more than I thought I could. Since I am a medical minimalist, I am happy to do without novocaine. My medicine cabinet is empty except for echinachia.
I have no idea what I’d do if I were in your shoes, but I think I’d be pretty darned upset. Your healing requires a certain degree of pain relief.
Hugs,
Betty
Betty, you must have endured a lot of pain to go through a long childbirth without narcotics. And tooth aches are never pleasant. But you chose to go through the agony of pain in both those cases. You endured it for a pre-determined reason. Many do not. I certainly do not.
Thanks for stopping by and commenting. You are always compassionate and honest. hugs, D
I have total empathy for what you experienced and have learned to discuss palliative care as a priority with a surgeon BEFORE agreeing to hire that person. Some of these doctors have little compassion for pain and suffering and won’t even discuss it with you. Many are so concerned about lawsuits and being socially correct that they focus TOO MUCH on the addictive effects of certain pain meds. I think that doctors of this ilk are barbaric and inhumane. Don’t you think that the fear of unbearable suffering is why most people are fearful about death?
– Nancy
Nancy- Your comment helps me a great deal. I think we begin to believe we really are guilty because so few support the radical idea of full, compassionate palliative care. Thank you so much.
You make a very good point about pain being the real reason people fear death. I agree.
-David
Dear David – How awful to hear what you have had to endure. As a pharmacist…and one who works for a pharmaceutical company who makes a lot of pain medications, there are many in the health care field who believe that the treatment of pain is one of the more important factors in the healing and recovery of patients. I would like to believe that your experience is in the minority. However, some surgeons can be some of the most obstinate and arrogant individuals. Regardless, you should NOT let that dissuade you in your attempt to get relief from your pain. You must NOT feel guilty or ashamed…but rather, you should demand that your pain is real and that you have a right to be pain-free to the fullest extent possible. A good start for research in the area (and something perhaps you can share with your surgeon is the American Pain Society: http://www.ampainsoc.org/advocacy/statements.htm
It sounds like you are on your way back and may have gotten past the worst…so at least know this. You have a right to have your pain treated to the fullest extent possible…never feel ashamed for asking for relief. There are many caring and compassionate health care professionals out there…it just looks like you got about the worst treatment possible from all of yours. Take care and get better soon.
Your friend and colleague…
Bob P.
Bob- Wow. Thank you for the informed and empathetic comment. I read some of the articles on the American Pain Society site. Doctors have a difficult balance to achieve. Unfortunately, mine prefers to err on the side of conservative. Patients don’t have much recourse other than to scream more.
Thank you for your support. Nice to see you. I hope you are well.
best wishes,
David
Sorry to hear that you’ve had such a tough time with your Gall Bladder, David. Hope you recover quickly. I’ll send you some positive energy. Yes, it’s OK to scream. It’s reassuring to remember that you will move on and come out of it. Best wishes, Noel
Noel- Thanks for the good vibes. It’s funny that no one has commented on my mention of Mother Teresa’s belief that pain brings you closer to god. What do you think? Does pain serve a function?
David – Hello again – hope that your recovery after surgery is rapidly progressing. I would like to comment about the Mother Theresa belief thing (about pain) ….. I think that is just another fairy tale/fantasy created in the mind of a human who requires a comprehension/explanation of biological pain/suffering/death. As sentient beings, many humans are desperately afraid of these natural experiences because they want to avoid them or elevate themselves above them. All that blather about pain bringing you “closer to god” is simply fear speaking and the inability to accept what IS in the natural world — and we humans are definitely a part of Nature.
– Nancy
Nancy- Interesting answer, very humanistic and scientific. Pain is like thirst or hunger or need for shelter. It’s obvious it should be treated, without questions or philosophizing.
I am well recovered now, almost back to a normal schedule. I have to say, one nice thing about pain meds is they allow you to overcome the lingering stress of pain and get back to regular healthy habits faster.
take care,
David
I totally agree with you! I developed an injury to my knee in January of 2006. I had to ask for pain killers…I was only perscribed tylenol 3 the first time..and vicodine the second time. I underwent 3 months of physical therapy…and then surgery and then 3 months more of therapy..and in that time I only had 4 perscriptions filled. I was not allowed anymore. I have Grade 4 Chondromalacia of my right knee..I am only 35 yrs old. I work a full time job standing on concrete for 10 hrs a day..and at this point I can only take tylenol and ibuprofen. I am starting my third round of physical therapy..and I am still being put off about pain killers. I go to bed…I get up..and walk the floor and cry at night because my pain is unbearable..until I am exhausted…and I finally go to bed…get a 2-3 hours sleep and start all over again. I feel like I am being treated like a criminal for wanting pain killers. I don’t want to take them…in a perfect world my knee would be better and I could play soccer with my kids and walk a city block without wincing! My injury is only going to get worse unless I have reconstruction surgery..but now days you have to wait until you are 70-80 what the hell will I need a new knee then for..with only 10-20 yrs left to live!…I’ve asked them all…what will it take…for me to be completely imobile for you to ease my pain?? Frustrating!!!
P.S. I am glad you are feeling better…sounds like quite the ordeal. I am all for breathing through pain..but suffering..thats where the line should be drawn!
Sprugal- I’m sorry you have to suffer so. Perhaps you should talk to another doctor about your pain. Be frank. Ask why the other doctors won’t give you proper relief.
You should know that taking large amounts (800mg) of Advil (ibuprofen) helps the pain, but can be hard on your kidneys over a period of time.
take care,
David
Sometimes I get surprised by the tolerances and values our culture imposes upon people. Your experiences with medication and support for pain remind me of similar responses generated by the treatment of clinical depression. Overmedication and overtreatment present their own dangers, but ignoring real problems such as pain and depression when reasonable treatment exists often manifests itself as battle lines that decide which things should and should not be treated.
Good luck with your recovery, and I hope you find others in the medical community who are more supportive.
P.S. I discovered your blog a few weeks ago through Spiritual Blog Reviews, and I’ve enjoyed reading your thoughts. Keep it up!
Jacob- Thanks for stopping by and for your comment. You make a good point about the parallels between treatments for pain and depression. It is a never ending balancing game.
take care, and see you around,
David
Having just been through surgery myself, I empathize. Fortunately,
my nurses and doctors dispensed as much medication as I needed–which is as it should be.
Patry- Hi! Nice to see you. I’m glad your pain was well treated. I hope you are recovering and on your way back to good health.
best wishes,
David
Prescription pain medications in the U.S. are pretty much the equivalent of what you could get over-the-counter in Canada and Mexico. But people in Canada and Mexico don’t have an addition to these pain meds. I think a lot of this has to do with the culture of the U.S. and its dependence on drugs to solve all their woes.
This is an excellent entry! I loved the images that accompanied it. I think a lot of people fail to realize that they don’t NEED to go to the doctor for their prescription every time they feel pain. There’s a ton of alternatives to prescription drugs that help alleviate pretty much the same symptoms!
I suffered an injury about 5 years ago. I went sledding with my friends and unfortunately fell into a hole in the side of the hill. I fractured my spine and it was the most painful experience I have ever felt. I didn’t talk about getting hurt to my parents… because I didn’t want them to worry about me. Plus the fact that men aren’t supposed to cry (that’s seriously how I felt). It was only after my back was swollen the next morning when I got x-rays. That next week I was on a prescription of vicodin, told to stay in my bed for two weeks straight. The Dr. advised me that I could either have my spine fused, or let it heal. I asked him if I had the fusion if it would stop the pain, he told me it might, but there was no guarantee, so with that answer I elected to try and heal naturally.
After about a year of physical therapy, I felt better. Then I got into a biking accident, and everything went back to square one. It’s been a number of years and the pain has not diminished. I hurt everyday, especially in the mornings and evening where either it hurts so much when I wake up I just want to be unconscious again so I don’t hurt anymore, or I can’t sleep for hours. I found your article by googling “guilty pain relief”. The pain hasn’t gone away, though yes, I have been able to deal with it these numbers of years, I realize I shouldn’t have to, but I still feel guilty asking for help because of exactly how you put it, feeling like you’ve been tried guilty before you even describe your life situation. Now that I have health insurance, and at the prodding of my girlfriend who has had spinal surgery, I’m looking into seeing a Dr. Thanks for helping me know I’m not guilty for wanting the pain to stop, or at least be brought to more bearable levels to increase my quality of life.
Thanks for sharing your story. I can relate to a lot of it. I’m glad you finally decided to get the medical help you deserve. I can also recommend that you consider studying the Alexander Technique a bit to understand how your spine works, and how to keep it healthy with fine tuned awareness. The simplest idea of being present in your body at all times (after you have properly managed the pain) and help you be aware of habits which may be aggravating the situation.
Best Wishes for a long and healthy life,
David
Nice entry, I live in Canada and as for what Tim A. said, that’s not quite true. Many many Canadians have addictions to narcotic pain meds, and I am one of them. I found this site by accident when doing some research on hydromorphone. I figured it was time to know a little more about the drug I had been buying black market in canada for the last 6 months.
It all started when my girlfriend was prescribed oxycontin for her peripheral neuropathy (nerve pain from diabetes). I started sneaking a few here and there, and I found that with a little gravol to settle my stomach, i quite enjoyed the pills. She was being prescribed 60 20mg oxycontin slow release and 75 oxycodone a month so I was able to take them without notice…..for a while. But when I was found out I had to turn to the black market and found all sorts of different narcotic opiates like hydromorphone, morphine, oxys, kadians, etc. I have been taking them pretty much steady for 6-8 months now, and it is very difficult to quit. Even though I have been able to keep my dose amounts to a minimum, (i have heard of people taking 800-1200mg oxycontin daily, at the very most i take 50-60mg) I dose regularly and go through terrible withdrawl when i don’t have any for a day or two. This has caused problems in my relationship with my girlfriend, but one of my most pressing fears is the prospect of what would happen if I was seriously injured or needed painful surgery like David’s. I know my tolerance for the meds is high, and although no official action has been taken against me, my family doctor is aware of my addiction as well.
It frightens me to think that doctors would treat somebody without a known previous history of addiction to narcotics as if they were a guilty addict, and opt to let them suffer instead of over-medicating. Hopefully someday the technology will be in place to use brainwave activity as a failsafe method for weeding out drug seeking behavior and make sure that those who need these drugs are able to use them safely. Even if I can get and stay clean I’m not sure if I will ever be able to safely use narcotic painkillers again in my life. But that’s not to say a time won’t come when I absolutely need them to be prescribed.
For instance if my girlfriend’s doctor ever suspected her of lying about her pain, or abusing her meds and she was taken off of them, her life would essentially be ruined, as they are the only thing that allows her to eat/sleep/function at any capacity.
Just thought i would leave my 2 cents as an addict who has never legally been prescribed any narcotic, but who has used them all.
Nice entry, I live in Canada and as for what Tim A. said, that’s not quite true. Many many Canadians have addictions to narcotic pain meds, and I am one of them. I found this site by accident when doing some research on hydromorphone. I figured it was time to know a little more about the drug I had been buying black market in canada for the last 6 months.
It all started when my girlfriend was prescribed oxycontin for her peripheral neuropathy (nerve pain from diabetes). I started sneaking a few here and there, and I found that with a little gravol to settle my stomach, i quite enjoyed the pills. She was being prescribed 60 20mg oxycontin slow release and 75 oxycodone a month so I was able to take them without notice…..for a while. But when I was found out I had to turn to the black market and found all sorts of different narcotic opiates like hydromorphone, morphine, oxys, kadians, etc. I have been taking them pretty much steady for 6-8 months now, and it is very difficult to quit. Even though I have been able to keep my dose amounts to a minimum, (i have heard of people taking 800-1200mg oxycontin daily, at the very most i take 50-60mg) I dose regularly and go through terrible withdrawl when i don’t have any for a day or two. This has caused problems in my relationship with my girlfriend, but one of my most pressing fears is the prospect of what would happen if I was seriously injured or needed painful surgery like David’s. I know my tolerance for the meds is high, and although no official action has been taken against me, my family doctor is aware of my addiction as well.
It frightens me to think that doctors would treat somebody without a known previous history of addiction to narcotics as if they were a guilty addict, and opt to let them suffer instead of over-medicating. Hopefully someday the technology will be in place to use brainwave activity as a failsafe method for weeding out drug seeking behavior and make sure that those who need these drugs are able to use them safely. Even if I can get and stay clean I’m not sure if I will ever be able to safely use narcotic painkillers again in my life. But that’s not to say a time won’t come when I absolutely need them to be prescribed.
For instance if my girlfriend’s doctor ever suspected her of lying about her pain, or abusing her meds and she was taken off of them, her life would essentially be ruined, as they are the only thing that allows her to eat/sleep/function at any capacity.
Just thought i would leave my 2 cents as an addict who has never legally been prescribed any narcotic, but who has used them all.
@Jesse: Very good comment. It’s true that addiction to those drugs is a permanent change. Unfortunately, I’ve had some issues with that, since I’ve been on and off them for medical reasons for over a decade. But it doesn’t change the issue of responsible pain management from the medical side. You don’t know until you’ve been there.
@Jesse: Excellent comment! I think the technology to monitor brain wave activity to measure pain will be available soon. It will clear up the issue for all parties.
Keep telling yourself, that you are better than those “happy pills”. They are an empty, self-fulfilling vicious cycle. You probably already know that. But logic gets fuzzy with them available. Compulsive behavior, like an anima salivating at a bell ringing, kicks in. Aren’t you better than that? Tell your girlfriend to lock them up around you. It can’t be that hard. I guarantee, you will feel much more “high” on being empowered by self-control.