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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 18 of 18. This is the beginning of the thread.
Posted by cubbybear on March 8, 2005, at 1:05:06
I'm wondering if I'm alone in sensing that pdocs of all kinds hesitate to write prescriptions and give us the analgesics we need--like Codeine--when we're really in pain.. Whereas some years ago, it was relatively easy to get scripts for Tylenol/Codeine or Codeine/Empirin, it seems that now, they suggest taking Ibuprofen, aspirin,etc. even for debilitating pain from toothache, lower back problems, etc.
Is this all a result of the so-called war on drugs? Even the innocent should suffer because the doctors are afraid of turning us into drug addicts? As I see it, denying a patient an analgesic when he or she really needs one amounts to willful neglect, in my opinion. Would anyone like to share experiences?
Posted by alexandra_k on March 8, 2005, at 1:43:14
In reply to Do they like to see us suffer?, posted by cubbybear on March 8, 2005, at 1:05:06
I don't think they like to see people suffer.
Not with pain
And not with the pain of tolerance and withdrawal
But it can be hard to get the balance right.Pain is a hard one.
There is a large psychological componant with respect to how intense and disruptive you perceive pain to be.
People have really been helped out with learning meditation etc to deal with chronic pain.I think they are more cautious
And for that I am glad.
I live in chronic pain.
I do not take medications for that
Except the odd anti-inflamatary.
I have a history of drug abuse
And I am grateful that I have learned to do without.
But that is just my experience.
Posted by cubbybear on March 8, 2005, at 9:18:00
In reply to Re: Do they like to see us suffer? » cubbybear, posted by alexandra_k on March 8, 2005, at 1:43:14
>>
> I think they are more cautious
> And for that I am glad.>> I have a history of drug abuse
> And I am grateful that I have learned to do without.
> But that is just my experience.I've heard that ex-smokers are among the most vocal anti-smoking proponents. Is this the case with people who once had a so-called substance abuse problem (hate that phrase).
I happen to be one of those people who never had a drug abuse problem; if anything, I've been too conservative about taking meds than I should be, and have oftentimes denied myself a sedative when I should have taken one.I want and need an occasional tablet of codeine to make my days more bearable. I've already tried many other treatment modalities for a shoulder injury, including acupuncture, ultrasound and hot pack. I'm not interested in having my comfort levels dictated to by people whose values about pain tolerance create additional difficulties for me, on top of the physical pain.
Posted by Optimist on March 8, 2005, at 9:50:16
In reply to Re: Do they like to see us suffer? » alexandra_k, posted by cubbybear on March 8, 2005, at 9:18:00
> >>
> > I think they are more cautious
> > And for that I am glad.
>
> >> I have a history of drug abuse
> > And I am grateful that I have learned to do without.
> > But that is just my experience.
>
> I've heard that ex-smokers are among the most vocal anti-smoking proponents. Is this the case with people who once had a so-called substance abuse problem (hate that phrase).
> I happen to be one of those people who never had a drug abuse problem; if anything, I've been too conservative about taking meds than I should be, and have oftentimes denied myself a sedative when I should have taken one.
>
> I want and need an occasional tablet of codeine to make my days more bearable. I've already tried many other treatment modalities for a shoulder injury, including acupuncture, ultrasound and hot pack. I'm not interested in having my comfort levels dictated to by people whose values about pain tolerance create additional difficulties for me, on top of the physical pain.
>There's a new therapy out the last 5 years or so called ART(Active Release Technique) which is supposed to be a "miracle" for things like shoulder injuries, carpel tunnel, etc... Basically what it is, a therapist manipulates your joint while they break up the adhesions/scar tissue with their finger. It's very effective and usually requires a couple appointments to relieve the situation in full. Chiropractors, massage therapists, and athletic therapists are the one's most likely to be trained and certified in it. Being in Thailand I'm not so sure if you'd be able to find anyone there with the necessary expertise though. ART was invented in the U.S. so perhaps on your next visit you could look in to options to get it done. Here, a lot of people have used it successfully instead of surgery. I've also had a lot of luck with it, treating my athletic injuries in the past.
Here's a copy of the main website:
The nearest location to you now looks to be in Singapore, on the provider search engine on their site.
Brian
Posted by ed_uk on March 8, 2005, at 10:35:59
In reply to Re: Do they like to see us suffer?, posted by Optimist on March 8, 2005, at 9:50:16
Hi,
My opinion........
Doctors who fail to provide adequate analgesia are not fit to practice. The provision of good pain relief must always be a top priority, something which should be emphasised greatly during medical training. There is nothing more vile that refusing to prescribe opioids to patients in severe acute or chronic pain who really need them. The commonly held opinion that chronic pain should not be treated with opioids unless it is due to cancer is particularly ridiculous. Thankfully, many doctors are now willing to treat non-malignant pain with the necesssary medication. Clearly, opioids are not necessary for everyone but they do need to be available for the times when they are. Like all treatments, opioids need to be prescribed with care, this is not unique to opioids.
One of my friends relatives is currently dying from kidney cancer. I was pleased to hear that she is currently being sucessfully treated with a titrated dose of controlled-release oxycodone (OxyContin) and can take rescue doses of immediate-release oxycodone (OxyNorm) when necessary for breakthrough pain.
If she had been in severe pain due to a chronic non-malignant condition, what would have happened if she failed to respond to acetaminophen, codeine or an NSAID? What often happens is that people have to live with agonising pain on a daily basis, often for many years, partly due to poor resources and a shortage of pain specialists. Opiophobia is common and many people are therfore refused treatment, even when there is no reason to believe that the patient would abuse or sell their medication. Patients must never be denied analgesia because some people abuse their medication, this is something I strongly believe in. More pain specialist are urgently required in the UK, most patients never get to see one. As a result, many people are treated by practitioners who often have very little knowledge of analgesics and have little idea of how to use them. If opioids are appropriately prescribed, respiratory depression is almost unheard of. Physical dependence is inevitable if opioids are used on a long term basis but true 'addiction' is not so common. If I was in severe pain, I would gladly accept physical dependence on any medication that could relieve my pain.
Regards,
Ed.
Posted by ed_uk on March 8, 2005, at 10:53:04
In reply to Re: Do they like to see us suffer?, posted by Optimist on March 8, 2005, at 9:50:16
Posted by Spriggy on March 8, 2005, at 12:03:04
In reply to Oops, above post to cubbybear, not Optimist!!!! (nm), posted by ed_uk on March 8, 2005, at 10:53:04
My doctor literally would offer me pain medicine ANY time I came in. It was a joke me and my husband had.. If I went in with a hangnail, she would say, " what would you like for pain? Vicodin?" To which I would say, " that's okay, I'll just use ibuprofen."There were a few times when I had the flu (and once when I broke my ankle) when I took her up on her offers.
BUT, the funny thing, now that I am suddenly dealing with mental health issues, I notice when I went in with a 102 fever and horrible body aches, she said, " take two ibuprofen for pain." where before she was throwing prescriptions at me.
I suppose she thought I might swallow the whole bottle at an attempt to kill myself.
I wonder if there is signal or code on our charts (that take psych drugs) that says, " DO NOT GIVE ANY PAIN MEDICINE...EVER"
But we have a good doctor at our church that we sometimes call if we are sick and don't want to pay the copay. He will call in cough syrup with codeine and such if he knows we are really sick (he does still check us out at church). So that helps.
Even here lately, I've considered asking him for the prescription for Lamictal (but he's a pediatrician so I don't even know if he can legally do it).
Also, my father who has the following:
1) Degenerative disc disease - he has had FIVE back surgeries in 3 years and has a titanium rod in his back.
2) Diabetes
3) hepatatis C
4) heart disease (pace maker and 3 heart attacks)
5) Nerve damageMy dad can BARELY walk.. I mean, if he can get up on his own to use the bathroom, it's a GOOD day.
And becuase of his past drug abuse problems, doctor's would not give him anything. I understand he has drug abuse issues but they have given him 3-6 months to live- they KNOW he's in pain.. HAVE SOME COMPASSION.
So when they called in Hospice to care for him, Hospice said, " This is so ridiculous. This man has hardly any time left and we will not let him have it in pain."
So they provide him with Oxycontin and my dad can laugh, walk, and actually LIVE the few months he has left thanks to the medicine.
I guess it would be a tough call if I were a doctor. You don't want to encourage a habit or abuse, but you also don't want your patient in pain.
I think they just have to go with their gut and be more attentive to how their patient says they feel.
Posted by alexandra_k on March 8, 2005, at 17:33:29
In reply to Re: Do they like to see us suffer? » alexandra_k, posted by cubbybear on March 8, 2005, at 9:18:00
You asked people to share their experience and thoughts. I shared mine.
Sorry that they weren't what you wanted to hear.>I'm not interested in having my comfort levels dictated to by people whose values about pain tolerance create additional difficulties for me, on top of the physical pain.
I wasn't trying to dictate your comfort level.
I resent your saying I was trying to 'dictate' anything.Clearly you had certain responses in mind.
You have reminded me why I avoid the meds board usually.
Posted by Phillipa on March 8, 2005, at 17:34:11
In reply to Re: Oops, above post to cubbybear, not Optimist!!!!, posted by Spriggy on March 8, 2005, at 12:03:04
When I worked in the hospital as an Rn, if I let a pt suffer in pain I could have been fired. A doctor will not permit it in the hospital. And anyone who is terminal should have all the pain meds they need. They will not abuse them [this shouldn't even a issue] they will find the level that offers them relief. Fondly, Phillipa
Posted by alexandra_k on March 9, 2005, at 2:35:07
In reply to Re: Do they like to see us suffer? » alexandra_k » cubbybear, posted by alexandra_k on March 8, 2005, at 17:33:29
> >I'm not interested in having my comfort levels dictated to by people whose values about pain tolerance create additional difficulties for me, on top of the physical pain.
Ok so maybe after some thought you meant your doctor rather than me.
Not sure what you mean about 'values about pain tolerance'.
Posted by cubbybear on March 9, 2005, at 7:20:27
In reply to Re: Do they like to see us suffer?, posted by alexandra_k on March 9, 2005, at 2:35:07
> > >I'm not interested in having my comfort levels dictated to by people whose values about pain tolerance create additional difficulties for me, on top of the physical pain.
>
> Ok so maybe after some thought you meant your doctor rather than me.
>
> Not sure what you mean about 'values about pain tolerance'.Sorry, but I was referring to anyone, not just doctors, who would legislate, advocate, suggest, or imply ABSTAINING from the use of opioids for severe pain relief.
The last paragraph of your original post clearly implies where you're coming from. It was not a very welcome post for me at a time like this, and, you're right, it was NOT what I wanted nor expected to hear on this board.
When I speak about "values", I mean personal values, ethics, or models of what "should" constitute right and wrong, good or bad. I'm sorry, but I can get be very nasty to people who would impose their personal values upon me, either through legislation or just a polite implication that "what's good for me should be good for you."
Posted by alexandra_k on March 9, 2005, at 17:12:46
In reply to Re: Do they like to see us suffer? » alexandra_k, posted by cubbybear on March 9, 2005, at 7:20:27
> Sorry, but I was referring to anyone, not just doctors, who would legislate, advocate, suggest, or imply ABSTAINING from the use of opioids for severe pain relief.
My mistake. I thought the point of your post was that you cannot get the opiates you need / want. Given that I was trying to suggest something that may help you. I guess the topic of your post wasn't really about alleviating your pain, it was a grumble about your not being able to receive the medication you believe you need. I would think that if your pain was really that unbearable you would be open to suggestions as to what you may be able to do to alleviate that.
If the pain is really that bad, then I would have thought it would have been worth a try. After all, what do you have to lose? Even while you are waiting to find an alternative supply for your medication.
But alleviation of pain wasn't the real issue I guess.
> The last paragraph of your original post clearly implies where you're coming from. It was not a very welcome post for me at a time like this, and, you're right, it was NOT what I wanted nor expected to hear on this board.I said it was my opinion. That means that it is my opinion. You didn't want to hear peoples opinions after all? You just wanted to hear from people who have opinions the same as you? Right. I see...
> When I speak about "values", I mean personal values, ethics, or models of what "should" constitute right and wrong, good or bad. I'm sorry, but I can get be very nasty to people who would impose their personal values upon me, either through legislation or just a polite implication that "what's good for me should be good for you."How is telling you my opinion imposing my personal values on you? Did I say my opinion was right because it is the truth? Did I say you should adopt my opinion as your own?
Good luck to you.
Posted by alexandra_k on March 9, 2005, at 17:17:13
In reply to Re: Do they like to see us suffer? » alexandra_k » cubbybear, posted by alexandra_k on March 9, 2005, at 17:12:46
PS. I have to say that if I was a doctor and was looking at prescribing addictive medications to someone for sleep or alleviation of pain or anxiety I would also look at what the person is doing to try to find alternative ways of dealing with the problem.
Because of the evidence out there that suggests that these things can be managed (to a degree) by alternatives to medications. And because the medications tend to produce a tolerance and lose their affectiveness over time.
If a person was of the mindset that medication would be the only thing that could assist them then I would think that they have an increased risk of depending solely on the medication for the alleviation of their symptoms which places them in a very high risk category for becoming dependent on that medication.
It might be cruel short term, but it will prevent a lot of long term suffering.
Just my opinion. Probably an opinion you don't want to hear. But just in case this means something for someone - that is my opinion for what it is worth.
Posted by Dr. Bob on March 9, 2005, at 21:07:16
In reply to Re: Do they like to see us suffer? » alexandra_k » cubbybear, posted by alexandra_k on March 9, 2005, at 17:12:46
> your original post ... was not a very welcome post for me
>
> I'm sorry, but I can get be very nasty to people who would impose their personal values upon me
>
> cubbybear> I guess ... your post ... was a grumble
>
> You just wanted to hear from people who have opinions the same as you? Right. I see...
>
> alexandra_kPlease don't post anything that could lead others to feel accused or put down or jump to conclusions about them.
If you or others have questions about this or about posting policies in general, or are interested in alternative ways of expressing yourself, please see the FAQ:
http://www.dr-bob.org/babble/faq.html#civil
Follow-ups regarding these issues should be redirected to Psycho-Babble Administration. They, as well as replies to the above posts, should of course themselves be civil.
Thanks,
Bob
Posted by up'n'down on March 11, 2005, at 2:53:41
In reply to Re: Do they like to see us suffer?, posted by Optimist on March 8, 2005, at 9:50:16
Dear ones;I wish I could comfort you both with a great big mamma-hug that would make both of you feel warm and fuzzy.
I think you both are nice people, and that your situation at the time of your posting escalated into a head-to-head disagreement.
I was hoping Phillipa would pour out of her wisdom and compassion as she so often does. I offer my humble attempt make all things better. U'D
Posted by cubbybear on March 11, 2005, at 3:44:40
In reply to Cubbybear and alexandra, posted by up'n'down on March 11, 2005, at 2:53:41
>
> Dear ones;
>
> I wish I could comfort you both with a great big mamma-hug that would make both of you feel warm and fuzzy.
> I think you both are nice people, and that your situation at the time of your posting escalated into a head-to-head disagreement.
> I was hoping Phillipa would pour out of her wisdom and compassion as she so often does. I offer my humble attempt make all things better. U'Dthat's very kind of you, but I'm afraid that our differences went a bit deeper than what could be smoothed over with a "warm and fuzzy" Band-Aid.
I guess it just happens that once in a while, as in real life, someone will come along and post a message that, unintentionally, will push one of my hot buttons. In the end, however, I take it with a grain of salt since my overwhelming experience with Psychobabble has been positive and rewarding beyond any relationship I could have with a doctor or so-called "expert."
I may disagree strongly with Alexandra but I wouldn't consider her my adversary. All of us here constitute a cyberspace "family," and in every family, there's going to be an occasional argument between siblings.
cubbybear
Posted by up'n'down on March 11, 2005, at 23:49:38
In reply to Re: Cubbybear and alexandra » up'n'down, posted by cubbybear on March 11, 2005, at 3:44:40
> >
> > Dear ones;
> >
> > I wish I could comfort you both with a great big mamma-hug that would make both of you feel warm and fuzzy.
> > I think you both are nice people, and that your situation at the time of your posting escalated into a head-to-head disagreement.
> > I was hoping Phillipa would pour out of her wisdom and compassion as she so often does. I offer my humble attempt make all things better. U'D
>
> that's very kind of you, but I'm afraid that our differences went a bit deeper than what could be smoothed over with a "warm and fuzzy" Band-Aid.
>
> I guess it just happens that once in a while, as in real life, someone will come along and post a message that, unintentionally, will push one of my hot buttons. In the end, however, I take it with a grain of salt since my overwhelming experience with Psychobabble has been positive and rewarding beyond any relationship I could have with a doctor or so-called "expert."
>
> I may disagree strongly with Alexandra but I wouldn't consider her my adversary. All of us here constitute a cyberspace "family," and in every family, there's going to be an occasional argument between siblings.
> cubbybearYou found one of my major troubles getting along in this world. I can't handle disagreement or hurt and want to rush in and make things all better. You are so right-that life is going to have times of disagreement and troubles and hurt; I don't know why I think I'm responsible for it all, but I do, so I try to undo it. Sorry. U'D
Posted by Dr. Bob on March 12, 2005, at 6:09:14
In reply to family, posted by up'n'down on March 11, 2005, at 23:49:38
> You found one of my major troubles getting along in this world. I can't handle disagreement or hurt and want to rush in and make things all better.
That's a great topic, but I'd now like to redirect follow-ups about getting along to Psycho-Babble Relationships. Here's a link:
http://www.dr-bob.org/babble/relate/20050212/msgs/469961.html
Thanks,
Bob
This is the end of the thread.
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