Let's talk about opiods and c-sections...

[Anonymous]

Anonymous wrote:

Anonymous wrote:They gave me percocet after my first vaginal birth. I was surprised and didn't use them. When I asked the pharmacy if they would take them back they told me to just flush it down the toilet. It's shocking.

+1. They prescribed it for me with both vaginal births, 7 and 4 years ago. I only used ibuprofen.

Same here.

[Anonymous]

Anonymous wrote:I started this thread and REALLY didn’t mean to shame anyone about your choices. Clearly different people have different experiences and people should do what’s right for them. My question was more about whether women felt pressured by the medical community to take meds that they might not need and which might have some serious side effects. Maybe the pendulum has swung too far in the other direction now, but isn’t it a conversation that’s worth having, either way?
I’m happy if people are just thinking about it and making the right choice for them. As with any medical issue, I think that information is empowering and I personally found that gyn care was often “one size fits all” without providing women the information they would need to make an informed choice.

Really, no shame if you’re making your choice and it’s right for you! I think all these stories are great for women to hear so they know that there’s a wide range of experiences out there.

There is a really unfortunate type of mommy shaming that sows mistrust of medical advice and leads to women declining needed c-sections, going to bizarre lengths to avoid formula, doing uncomfortable elimination diets while breastfeeding, delaying vaccination, etc; your "just educate yourself" tone is very much in line with that brand.

I find it's helpful to ask whether a man having the same procedure would expect prescription pain meds -- let's say, instead of a c-section, a man who had bowel surgery. Usually the answer is yes, everyone would think a week of Percocet was appropriate in that situation and nobody would say "Hey, maybe see if you're tough enough to do Ibuprofen instead." We have a lot of cultural hangups surrounding women's pain and whether women deserve pain relief.

[Anonymous]

Anonymous wrote:

Anonymous wrote:I’m not sure I’d say docs pressure people into taking opioids, but until relatively recentl, the addictive nature of opioids had been downplayed by drug makers. I’d think that most docs would offer the NSAID as a fist option now, but different meds work better or worse for different people so some people will know that an opioid is the better option for them.

I think opioids and the ethics around them are especially difficult now. They have a place and serve a good purpose for some, but for others they’re destructive. And few people think they’ll be the ones to get addicted (and Id guess even fewer see when they’re crossing the line into addiction), so saying that it should just be a personal choice and up to the patient isn’t realistic.

Opioids used responsibly, as in short term pain relief after surgery, have a low risk of addiction. When used to treat chronic sustained pain they are dangerous.

People don't get addicted after a c section, they get addicted after back surgery where the pain is sustained over months.

As the poster who was given 20 pills (to be taken every 4-6 hours) and treated like a drug seeker for asking for two more days of medication I do not feel like I was addicted. But maybe if, denied a prescription from a responsible doctor involved in my care and desperate for relief i sought some less savory means of pain relief I could have become one. Treat patients compassionately and understand who actually becomes addicts. There's a lot of research on this it's not that much of a mystery.

Certainly, use for chronic pain is most likely to less to addiction, but According to Mayo, research shows use longer than 5 days increases addiction risk, so I don’t think it’s quite so simple. I agree that people should be treated compassionately, but part of that means taking care not to ignore the risk of addiction. I don’t think docs have it all figured out yet. I think, unfortunately, the practices will change from those that tend to promote addiction to those that make it hard for people who need opioids to get them. Neither are great for patients, but hopefully in this area most docs will be ahead of the curve and get it right.

[Anonymous]

Anonymous wrote:

Anonymous wrote:I started this thread and REALLY didn’t mean to shame anyone about your choices. Clearly different people have different experiences and people should do what’s right for them. My question was more about whether women felt pressured by the medical community to take meds that they might not need and which might have some serious side effects. Maybe the pendulum has swung too far in the other direction now, but isn’t it a conversation that’s worth having, either way?
I’m happy if people are just thinking about it and making the right choice for them. As with any medical issue, I think that information is empowering and I personally found that gyn care was often “one size fits all” without providing women the information they would need to make an informed choice.

Really, no shame if you’re making your choice and it’s right for you! I think all these stories are great for women to hear so they know that there’s a wide range of experiences out there.

There is a really unfortunate type of mommy shaming that sows mistrust of medical advice and leads to women declining needed c-sections, going to bizarre lengths to avoid formula, doing uncomfortable elimination diets while breastfeeding, delaying vaccination, etc; your "just educate yourself" tone is very much in line with that brand.

I find it's helpful to ask whether a man having the same procedure would expect prescription pain meds -- let's say, instead of a c-section, a man who had bowel surgery. Usually the answer is yes, everyone would think a week of Percocet was appropriate in that situation and nobody would say "Hey, maybe see if you're tough enough to do Ibuprofen instead." We have a lot of cultural hangups surrounding women's pain and whether women deserve pain relief.

+1 OP doesn't get it.

[Anonymous]

OP again and I think I’m just not expressing myself well.
As someone who has two c-sections (including one elective) and happily took the epidural with my vaginal birth, I’m not used to being lumped in with the anti-medical advice folk.
I’m extremely pro-modern medicine and pretty extremely anti-pain. My experience was that the opioids caused a lot more pain than the alternatives, which was surprising to me but then I saw the online study saying essentially the same. I don’t know enough about medicine to know if bowel surgery is the right analysis but if I had any other type of surgery, I would explore options before opioids. And if my son or husband had surgery, I’d feel the same, so I don’t think I’m falling prey to some dumb idea that women should just “tough it out” through pain.
I guess the internet isn’t really the place for discussion, since things tend to get misconstrued and used to support arguments other than that for which they were intended.
Im really sorry if I made anyone feel bad about their choice. I won’t start any more threads outside of the travel forum.

[Anonymous]

Anonymous wrote:OP again and I think I’m just not expressing myself well.
As someone who has two c-sections (including one elective) and happily took the epidural with my vaginal birth, I’m not used to being lumped in with the anti-medical advice folk.
I’m extremely pro-modern medicine and pretty extremely anti-pain. My experience was that the opioids caused a lot more pain than the alternatives, which was surprising to me but then I saw the online study saying essentially the same. I don’t know enough about medicine to know if bowel surgery is the right analysis but if I had any other type of surgery, I would explore options before opioids. And if my son or husband had surgery, I’d feel the same, so I don’t think I’m falling prey to some dumb idea that women should just “tough it out” through pain.
I guess the internet isn’t really the place for discussion, since things tend to get misconstrued and used to support arguments other than that for which they were intended.
Im really sorry if I made anyone feel bad about their choice. I won’t start any more threads outside of the travel forum.

You've chosen opioids as your personal line in the sand; that's fine.

I'm sure you wouldn't appreciate others poking and shaming and questioning you for the very standard, with-medical-advice choice of getting an epidural. It's not like an epidural was some kind of whackadoodle, untested, against-medical-advice drug that you took for shyts and giggles. It's there as a tested, doctor-approved, very common resource that some people turn down for many reasons, but you took it. Great.

Opioids after a C-section? SAME THING.

You don't need to pick apart the different choices and experiences of other women. You are not a doctor/researcher/pharmacologist. Move the eff along.

[Anonymous]

Anonymous wrote:I'm not sure you're telling the whole story here. What particular opioid do you think wasn't as effective as ibuprofen? Taking opioids for a few days, or a few weeks for that matter, will not result in the average person becoming an addict.

Yeah, that's the line the Sackler mafia family has been pushing. Do you work for them?

[Anonymous]

Anonymous wrote:

Anonymous wrote:I actually 100% agree with you. I had never taken opioids before my C section so just assumed I was supposed to and was not told of any of the side effects (like constipation so bad you want to cry and die). I honestly wished my nurse would have said look, opioids will help an additional 25% but you’ll pay for it with 60% more butthole pain on your first poop. Honestly. I didn’t poop for 1 week post birth and stopped Day 3 post surgery with opioids when I realized why. It should be communicated as a choice and explained with side effects, not prescribed as a directive.

Constipation is a side effect of CS, not pain meds. Your medical providers are supposed to tell you to take extra fiber and colace in the last week of pregnancy.

That is not true. Constipation is a side effect of CS AND pain meds. "Opioid drugs are known to inhibit gastric emptying and peristalsis in the GI tract which results in delayed absorption of medications and increased absorption of fluid. The lack of fluid in the intestine leads to hardening of stool and constipation. " Source: https://www.ncbi.nlm.nih.gov/books/NBK493184/.

[Anonymous]

You guys, how can we not have a conversation about this? No one is shaming anyone.

If we can't ask questions like this, we're screwed.

OP wasn't shaming anyone as in how dare you take meds. She asked about experiences and clearly the results here show that some women feel like they were given opioids after their c section without explanation on side effects. That proves this is a worthwhile conversation. This is not a cut and dry issue and that's what OP is trying to highlight.

Honestly I can't handle how sensitive some of you are. It prevents rational discussion of complex issues.

[Anonymous]

Anonymous wrote:You guys, how can we not have a conversation about this? No one is shaming anyone.

If we can't ask questions like this, we're screwed.

OP wasn't shaming anyone as in how dare you take meds. She asked about experiences and clearly the results here show that some women feel like they were given opioids after their c section without explanation on side effects. That proves this is a worthwhile conversation. This is not a cut and dry issue and that's what OP is trying to highlight.

Honestly I can't handle how sensitive some of you are. It prevents rational discussion of complex issues.

Here's a question: What role does the patient and/or patient's spouse and family play in asking questions about prescribed medications and recommended care? Especially for a known likely event like either a delivery (which may/may not involve epidurals and other drugs) and C-sections (which may/may not involve a range of medications during and after the surgery)?

[Anonymous]

Anonymous wrote:You guys, how can we not have a conversation about this? No one is shaming anyone.

If we can't ask questions like this, we're screwed.

OP wasn't shaming anyone as in how dare you take meds. She asked about experiences and clearly the results here show that some women feel like they were given opioids after their c section without explanation on side effects. That proves this is a worthwhile conversation. This is not a cut and dry issue and that's what OP is trying to highlight.

Honestly I can't handle how sensitive some of you are. It prevents rational discussion of complex issues.

Oh, the irony of the bolded. Classic DCUM.

[Anonymous]

Anonymous wrote:You guys, how can we not have a conversation about this? No one is shaming anyone.

If we can't ask questions like this, we're screwed.

OP wasn't shaming anyone as in how dare you take meds. She asked about experiences and clearly the results here show that some women feel like they were given opioids after their c section without explanation on side effects. That proves this is a worthwhile conversation. This is not a cut and dry issue and that's what OP is trying to highlight.

Honestly I can't handle how sensitive some of you are. It prevents rational discussion of complex issues.

There are absolutely ways to discuss how to manage pain after c-sections without shaming women.

In the OP there were many lines that, to me, clearly were not in line with a non-judgemental conversation

- I gave my off-handed advice that the OP shouldn't off-handedly accept the opiods they gave women after c-sections, because, in my experience with 2 c-sections, they don't do much for pain relief but have some nasty side effects

- I remember that what I had my babies, they automatically wrote scripts for oral opiods and told me that it was important to take them to "stay ahead of the pain." I thought it was weird to take medicine if I didn't think really needed it

- I ignored the advice about staying ahead of the pain and instead just tried to deal with or treat the pain I had.

- I saw an HBO documentary about opiod addiction and one of the families profiled lost the mother to addiction that began after she was given opioids after a c-section.

- Anyway, it all had me wondering if they are still telling women to "stay ahead of the pain" with oral opioids. If so, I find that troubling.

OP could have said, "I was wondering what women found effective as a pain relief source for recovering from c-sections. I have been troubled by the recent epidemic of opiod addiction and found myself that IB profen was enough but wondered if we could talk about whether there were effective ways to treat pain that don't rely on treatment with narcotics". I think she could have even said something like, "For those of you who have recovered for a c-section, did you fine opioids more effective at pain relief or were the side effects, particularly related to constipation, uncomfortable enough to have you decide to stick it out with IB profen?"

Instead she tells an 'innocent' anecdote about how she didn't need opiods and was able to deal with the pain with IB profen (toughen up ladies!). Then she tries to delegitimzie the VERY good advice of staying ahead of the pain by putting it in quotations left and right. That advice is actually not hinged upon your drug of choice. Even if you are taking advil, it is good to stay ahead of the pain by taking it every 6-8 hours and keeping it in your system rather than take it when you are in extreme pain as that limits your mobility and slows your recovery.

Then she drops in a story about a mother who died from an opioid addiction. Fear mongering. From something she apparently saw two years ago, so why is she posting today? What brought this up?

Then she again tries to sow doubt in the concept of staying ahead of the pain. This post is a case study of 'innocent' mommy shaming. She's just been thinking about these things, why are these evil doctors trying to create addicts out of us moms by convincing us we need pain medicine to recover from major abdominal surgery, shame on them!

Her follow up was better but seemed to show no insight into how she had offended everyone. And then she adopted a 'woe is me I am so misunderstood' posture and says she will never post another thread again. Come on. Understand what you said and take some responsiblity, don't go run away and act like the victim yourself.

As another poster said, in almost any other context no one would be sowing doubt about pain management advice for a patient recovering from major abdominal surgery, but it abounds for women recovering from c-sections. There is a large conversation generally about whether or not we should continue to use opioids, how to use them, what the alternatives are etc. We don't need to center that conversation about whether they are appropriate for c section moms. We don't need to say that women recovering from c sections who need pain management want to get high. We should talk about pain management after surgery for all people and how to go about that in a way that is compassionate and safe. Don't anchor it in the one surgery that happens to be all about moms and act like you have no idea why people feel like you're singling out moms for shaming.

[Anonymous]

I had an emergency c section and a baby in the NICU for 5 weeks. I took my prescribed opioids around the clock for 4 days and then slowly tapered off in days 5-7. The meds were neither pushed nor denied. It was totally up to me. My mom (a career nurse) did say that staying ahead of the pain is important and helps with recovery but she didn’t care whether I took the opioid or ibuprofen. I didn’t experience constipation but did take regular colace to stay ahead of that side effect. I recovered well considering once I was discharged from the hospital I took an Uber back every day and spent 6-10 hours sitting by my baby’s bedside. I’m glad I had the meds since I didn’t have the opportunity to truly rest and heal physically.

[Anonymous]

Anonymous wrote:

Anonymous wrote:You guys, how can we not have a conversation about this? No one is shaming anyone.

If we can't ask questions like this, we're screwed.

OP wasn't shaming anyone as in how dare you take meds. She asked about experiences and clearly the results here show that some women feel like they were given opioids after their c section without explanation on side effects. That proves this is a worthwhile conversation. This is not a cut and dry issue and that's what OP is trying to highlight.

Honestly I can't handle how sensitive some of you are. It prevents rational discussion of complex issues.

Here's a question: What role does the patient and/or patient's spouse and family play in asking questions about prescribed medications and recommended care? Especially for a known likely event like either a delivery (which may/may not involve epidurals and other drugs) and C-sections (which may/may not involve a range of medications during and after the surgery)?

Good question....

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:You guys, how can we not have a conversation about this? No one is shaming anyone.

If we can't ask questions like this, we're screwed.

OP wasn't shaming anyone as in how dare you take meds. She asked about experiences and clearly the results here show that some women feel like they were given opioids after their c section without explanation on side effects. That proves this is a worthwhile conversation. This is not a cut and dry issue and that's what OP is trying to highlight.

Honestly I can't handle how sensitive some of you are. It prevents rational discussion of complex issues.

Here's a question: What role does the patient and/or patient's spouse and family play in asking questions about prescribed medications and recommended care? Especially for a known likely event like either a delivery (which may/may not involve epidurals and other drugs) and C-sections (which may/may not involve a range of medications during and after the surgery)?

Good question....

I actually don't understand the question. Do you mean something like you should trust your mom and husband more than your doctor about medical care? Because I would disagree with that.

Doctors mostly do and should lay out your options and risks and allow you to make an informed decision. But if you think you have a better understanding than your doctor of the effects of a medicine because you read an article in the post about a woman getting addicted to opioids then you are mistaken. Go to medical school if you would like that same depth of understanding.

Patients should be informed and empowered to make their own decisions. Doctors opinions should inform that decision more than Aunt Sally's opinion.