Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I met with a surgeon today for a consult for significant and urgent surgery. There were a number of things I was unimpressed with but one was that they only give Tylenol. I feel like they would probably give more if a patient was in REALLY bad shape but her take was “some discomfort is normal after major surgery but it should be manageable with Tylenol.” That’s jacked up. We invented medication so that you don’t have to feel pain. Give a patient 3-5 days of pain meds. I’m meeting with other surgeons because this one seems heartless.

Apparently your surgery isn't that urgent.

Quit doctor shopping for drugs. Tylenol and ibuprofen will mitigate most pain. Neither has significant side effects, withdrawal symptoms, addiction potential or other complications. You don't need 3-5 days of narcotics, and if you do, you can be prescribed them when you need them. Demanding drugs you probably won't need in advance is drug-seeking behavior. No, you should not have an expectation of 'zero pain' post-surgery. You should anticipate and prepare for discomfort at a level commensurate with whatever procedure you're having done, and be with it for the brief time it's present because that's life in a body. I would strongly suggest you avoid opioids like the plague they are, as the withdrawals kick in after even short-term use, and 3-5 days is more than enough to trigger addiction.

-long-term chronic pain patient who has BTDT with pretty much all of the painkiller options

Asking for pain medication after major surgery is not “drug seeking behavior.” People have lost their minds!

One thing I have always noted on DCUM is the purist mentality; it is so toxic. Pain meds work! There is no prize at the end for enduring crippling pain after a c-section, hysterectomy, bunion removal, or thyroidectomy.

And I am sick of doctors telling me THEY know my body better than I DO. I see no reason to suffer because someone somewhere is addicted to something. Change surgeons and don't look back OP. If you get home from surgery with only Tylenol and have crippiling pain at 2 am, it will be unnecessarily effing miserable getting relief, trust me, I know.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Wanting narcotics before the surgery even happens and there is pain, and shopping around to find someone who freely gives them out is a pretty big red flag. A lot of docs now only use them in a very controlled way for people whose pain isn’t managed in other ways. They don’t just send people home with bottles of narcotics anymore for just in case reasons.

No this is not a red flag at all. Not wanting to endure pain because one doctor thinks it’s fine for you to suffer when there is a different doctor that will make recovery bearable is not drug shopping.

History has taught us it is crueler and does more harm to patients to give narcotics out without an individualized need than it is to ask patient to try and manage their pain initially with OTC and request stronger meds if needed.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I met with a surgeon today for a consult for significant and urgent surgery. There were a number of things I was unimpressed with but one was that they only give Tylenol. I feel like they would probably give more if a patient was in REALLY bad shape but her take was “some discomfort is normal after major surgery but it should be manageable with Tylenol.” That’s jacked up. We invented medication so that you don’t have to feel pain. Give a patient 3-5 days of pain meds. I’m meeting with other surgeons because this one seems heartless.

Apparently your surgery isn't that urgent.

Quit doctor shopping for drugs. Tylenol and ibuprofen will mitigate most pain. Neither has significant side effects, withdrawal symptoms, addiction potential or other complications. You don't need 3-5 days of narcotics, and if you do, you can be prescribed them when you need them. Demanding drugs you probably won't need in advance is drug-seeking behavior. No, you should not have an expectation of 'zero pain' post-surgery. You should anticipate and prepare for discomfort at a level commensurate with whatever procedure you're having done, and be with it for the brief time it's present because that's life in a body. I would strongly suggest you avoid opioids like the plague they are, as the withdrawals kick in after even short-term use, and 3-5 days is more than enough to trigger addiction.

-long-term chronic pain patient who has BTDT with pretty much all of the painkiller options

Asking for pain medication after major surgery is not “drug seeking behavior.” People have lost their minds!

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I met with a surgeon today for a consult for significant and urgent surgery. There were a number of things I was unimpressed with but one was that they only give Tylenol. I feel like they would probably give more if a patient was in REALLY bad shape but her take was “some discomfort is normal after major surgery but it should be manageable with Tylenol.” That’s jacked up. We invented medication so that you don’t have to feel pain. Give a patient 3-5 days of pain meds. I’m meeting with other surgeons because this one seems heartless.

Apparently your surgery isn't that urgent.

Quit doctor shopping for drugs. Tylenol and ibuprofen will mitigate most pain. Neither has significant side effects, withdrawal symptoms, addiction potential or other complications. You don't need 3-5 days of narcotics, and if you do, you can be prescribed them when you need them. Demanding drugs you probably won't need in advance is drug-seeking behavior. No, you should not have an expectation of 'zero pain' post-surgery. You should anticipate and prepare for discomfort at a level commensurate with whatever procedure you're having done, and be with it for the brief time it's present because that's life in a body. I would strongly suggest you avoid opioids like the plague they are, as the withdrawals kick in after even short-term use, and 3-5 days is more than enough to trigger addiction.

-long-term chronic pain patient who has BTDT with pretty much all of the painkiller options

Trash. You’re just trash, my god.

And you're an idiot and an ass, so good luck with being that weak in the world.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Wanting narcotics before the surgery even happens and there is pain, and shopping around to find someone who freely gives them out is a pretty big red flag. A lot of docs now only use them in a very controlled way for people whose pain isn’t managed in other ways. They don’t just send people home with bottles of narcotics anymore for just in case reasons.

No this is not a red flag at all. Not wanting to endure pain because one doctor thinks it’s fine for you to suffer when there is a different doctor that will make recovery bearable is not drug shopping.

You didn’t read the post. More doctors will prescribe additional pain medications. If some continues to experience pain beyond what otc meds can handle. But they don’t just send every patient home with bottles of narcotics benzos just in case they have pain or anxiety. It is shopping around as OP doesn’t even have any pain yet and that pain may be well managed with otc. Just because the current culture is to pop pills for everything and feel nothing mentally or physically doesn’t mean that approach is supported by the medical field. It has led to massive amounts of lives ruined in the past and just isn’t modern medicine. The approach now is to treat the patient and their individual needs, not to hand out bottles of narcotics and benzos to anyone who wants them just in case they have pain that isn’t managed with otc.

DP. Pain is better managed when you get ahead of it, and a pain Rx (for a short duration) often will be called in during the time of major surgery, before the patient heads home, for that reason. Refills are not automatic, but often will be filled after a detailed discussion with the health practice.

The current view is not opposed to offering these meds; in fact the pendulum is very carefully swinging back due to doctors’ concerns about how poorly pain has been managed for their patients over the past decade as a result of the severe limits on opioids.

Again, pain is very individual and procedures affect people differently.

Some of you are actually posting out-of-date and incorrect info, with a dollop of proselytizing on top.

Not out of date or incorrect care. I guess it is different approaches. Where I am we provide individualized, patient centered care which means that having surgery isnt' an automatic narcotics and benzo script for everyone. I am surpised your doctors still hand it out like candy and don't take a more controlled or individualized approach and that surgery = whatever you want for pain before the pain even happens. Pain management is important but where I work, there is no longer the view that narcotics are the only option for pain management. We have a chronic pain clinic that doesn't even prescribe narcotics. There are many ways to manage pain and using narcotics as your solution for every patient who has surgery without any assessment of the individual or their need led to major addiction, overuse and dependency issues. I would say that your approach is more old school - to not recognize the harms of opioids and the dangers of overprescribing and using them broadly for all patients who are surgical patients.

No one is suggesting narcotics are or should be “handed out like candy,” or prescribed to every surgery patient. To imply that major health organizations are unaware of the risk of harms from opioid narcotics is nonsensical.

I was responding to a poster who said all patients getting surgery should get narcotics to get ahead of the pain. That person was saying that is how her faclity approaches pain management - so yes, for that poster, she seems unaware of why other practices are using alternatives to opiods and using opiods sparingly and in an individualized way versus the practice at her center of giving a Rx ahead of surgery to anyone who might have some pain.

I am that poster, who you’re also responding to here. That’s not what I suggested (or intended to suggest), and again, to say anyone is unaware of the risks of those narcotics today - including major medical organizations - is just not logical.

They don’t just hand them out, but do still prescribe them carefully and in very small doses (and without refills) after certain major surgeries. I’m unaware of their numbers, but it sounds like you’ve decided it’s not sparingly enough.

Pain can be very individual (for example, the experience of women having endometrial biopsies), and it’s concerning to hear some trying to equate everyone’s experience of pain as the same, when that’s not the case.

Effective pain management with minimal deleterious side effects is obviously the ideal.

Pain is very individual which is why most surgeons won't agree to give out narcotics and opioids at the time of the consultation. OP wants to know now that she will get narcotics - and it is not out of date as you said it was to wait and take an indivualized course of action versus the surgeon saying yes of course OP, whatever you want, I will agree to it now. You did not speak of sparing use - you said it is out of date to use it sparingly and that in your facility they get ahead of the pain by giving it to people having surgery - which means before they even know if there is pain or not. OP wants to know now, during a consultation that she will get pain meds and it isn't out of date or poor practice for a surgeon to say, no promises, we wait and see what happens for you individually with the surgery

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Wanting narcotics before the surgery even happens and there is pain, and shopping around to find someone who freely gives them out is a pretty big red flag. A lot of docs now only use them in a very controlled way for people whose pain isn’t managed in other ways. They don’t just send people home with bottles of narcotics anymore for just in case reasons.

No this is not a red flag at all. Not wanting to endure pain because one doctor thinks it’s fine for you to suffer when there is a different doctor that will make recovery bearable is not drug shopping.

You didn’t read the post. More doctors will prescribe additional pain medications. If some continues to experience pain beyond what otc meds can handle. But they don’t just send every patient home with bottles of narcotics benzos just in case they have pain or anxiety. It is shopping around as OP doesn’t even have any pain yet and that pain may be well managed with otc. Just because the current culture is to pop pills for everything and feel nothing mentally or physically doesn’t mean that approach is supported by the medical field. It has led to massive amounts of lives ruined in the past and just isn’t modern medicine. The approach now is to treat the patient and their individual needs, not to hand out bottles of narcotics and benzos to anyone who wants them just in case they have pain that isn’t managed with otc.

DP. Pain is better managed when you get ahead of it, and a pain Rx (for a short duration) often will be called in during the time of major surgery, before the patient heads home, for that reason. Refills are not automatic, but often will be filled after a detailed discussion with the health practice.

The current view is not opposed to offering these meds; in fact the pendulum is very carefully swinging back due to doctors’ concerns about how poorly pain has been managed for their patients over the past decade as a result of the severe limits on opioids.

Again, pain is very individual and procedures affect people differently.

Some of you are actually posting out-of-date and incorrect info, with a dollop of proselytizing on top.

Alternating ibuprofen and acetaminophen, setting a timer to wake up in the night as needed to maintain the schedule, has been clinically shown to be as effective as opioids.

https://www.aafp.org/pubs/afp/issues/2018/0301/p348.html
https://www.nsc.org/getmedia/8ecdc0e5-ae58-43e8-b98b-46c205e1c2b2/evidence-efficacy-pain-medications.pdf
https://pmc.ncbi.nlm.nih.gov/articles/PMC8851821/

There's even a podcast for those who don't want to read: https://healthcare.utah.edu/the-scope/health-library/all/2019/03/health-hack-ibuprofen-instead-of-opioids

Be smarter, stay healthier.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Don’t be a baby. Pain is temporary. Tylenol is sufficient.

Are you the maternity ward nurse that has been telling this to all the c-section moms?

Can only speak for myself, but I was appalled at how hard they pushed Oxy after my c-section, even after I told them Tylenol was all I wanted.

1. Because as PP said, pain meds don't just reduce your pain - they also reduce inflammation, etc. Not just steroids, but all non-steroids as well. If you don't want steroids, you should still take something.

2. Because different people have different body compositions, different surgical experiences, and different pain sensations!!!

3. It's horrific to shame some patients for feeling more pain than others. If a woman has endometriosis or ovarian cysts, for example, the lower abdominal area might be EXTREMELY SENSITIVE. I have both, and I need to be very careful about invasive exams or interventions in that area. But when I had thyroid surgery (neck), I didn't need steroid pain meds afterward.

Anonymous wrote:I have trouble believing this is real, OP, it's so contrary to the precepts of modern medicine.

Pain medications are not just to relieve a patient's perception of pain!
They have an important role in decreasing inflammation around the incision site, reducing swelling and generally accelerating healing.

If the goal is for this doctor to avoid an opioid-related lawsuit, they're missing the forest for the trees.

Mind-boggling.

And I am someone who had major surgery and did not take opioids afterward! I was prescribed them. I did not need them. But the fact I had them did wonders for my peace of mind.

Anonymous wrote:Look OP the doctor isn’t a good match for you so move on. You are also giving a lot of red flags as a patient with this “urgent” surgery that clearly can’t be too urgent. It isn’t a travel experience. It’s surgery and you should expect some discomfort and uncomfortableness.
Your doctor is correct IMO to not release pathology in a portal. My mom learned of her cancer this way and it was traumatic as she sat and waited for answers.
100% team doctor.

Anonymous wrote:I had open heart surgery and honestly was pleasantly surprised at how well Tylenol managed the pain and I don’t have a high pain tolerance. Tylenol doesn’t touch my headaches. Try it. Good luck, OP.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Wanting narcotics before the surgery even happens and there is pain, and shopping around to find someone who freely gives them out is a pretty big red flag. A lot of docs now only use them in a very controlled way for people whose pain isn’t managed in other ways. They don’t just send people home with bottles of narcotics anymore for just in case reasons.

No this is not a red flag at all. Not wanting to endure pain because one doctor thinks it’s fine for you to suffer when there is a different doctor that will make recovery bearable is not drug shopping.

You didn’t read the post. More doctors will prescribe additional pain medications. If some continues to experience pain beyond what otc meds can handle. But they don’t just send every patient home with bottles of narcotics benzos just in case they have pain or anxiety. It is shopping around as OP doesn’t even have any pain yet and that pain may be well managed with otc. Just because the current culture is to pop pills for everything and feel nothing mentally or physically doesn’t mean that approach is supported by the medical field. It has led to massive amounts of lives ruined in the past and just isn’t modern medicine. The approach now is to treat the patient and their individual needs, not to hand out bottles of narcotics and benzos to anyone who wants them just in case they have pain that isn’t managed with otc.

DP. Pain is better managed when you get ahead of it, and a pain Rx (for a short duration) often will be called in during the time of major surgery, before the patient heads home, for that reason. Refills are not automatic, but often will be filled after a detailed discussion with the health practice.

The current view is not opposed to offering these meds; in fact the pendulum is very carefully swinging back due to doctors’ concerns about how poorly pain has been managed for their patients over the past decade as a result of the severe limits on opioids.

Again, pain is very individual and procedures affect people differently.

Some of you are actually posting out-of-date and incorrect info, with a dollop of proselytizing on top.

Not out of date or incorrect care. I guess it is different approaches. Where I am we provide individualized, patient centered care which means that having surgery isnt' an automatic narcotics and benzo script for everyone. I am surpised your doctors still hand it out like candy and don't take a more controlled or individualized approach and that surgery = whatever you want for pain before the pain even happens. Pain management is important but where I work, there is no longer the view that narcotics are the only option for pain management. We have a chronic pain clinic that doesn't even prescribe narcotics. There are many ways to manage pain and using narcotics as your solution for every patient who has surgery without any assessment of the individual or their need led to major addiction, overuse and dependency issues. I would say that your approach is more old school - to not recognize the harms of opioids and the dangers of overprescribing and using them broadly for all patients who are surgical patients.

No one is suggesting narcotics are or should be “handed out like candy,” or prescribed to every surgery patient. To imply that major health organizations are unaware of the risk of harms from opioid narcotics is nonsensical.

I was responding to a poster who said all patients getting surgery should get narcotics to get ahead of the pain. That person was saying that is how her faclity approaches pain management - so yes, for that poster, she seems unaware of why other practices are using alternatives to opiods and using opiods sparingly and in an individualized way versus the practice at her center of giving a Rx ahead of surgery to anyone who might have some pain.

I am that poster, who you’re also responding to here. That’s not what I suggested (or intended to suggest), and again, to say anyone is unaware of the risks of those narcotics today - including major medical organizations - is just not logical.

They don’t just hand them out, but do still prescribe them carefully and in very small doses (and without refills) after certain major surgeries. I’m unaware of their numbers, but it sounds like you’ve decided it’s not sparingly enough.

Pain can be very individual (for example, the experience of women having endometrial biopsies), and it’s concerning to hear some trying to equate everyone’s experience of pain as the same, when that’s not the case.

Effective pain management with minimal deleterious side effects is obviously the ideal.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Wanting narcotics before the surgery even happens and there is pain, and shopping around to find someone who freely gives them out is a pretty big red flag. A lot of docs now only use them in a very controlled way for people whose pain isn’t managed in other ways. They don’t just send people home with bottles of narcotics anymore for just in case reasons.

No this is not a red flag at all. Not wanting to endure pain because one doctor thinks it’s fine for you to suffer when there is a different doctor that will make recovery bearable is not drug shopping.

You didn’t read the post. More doctors will prescribe additional pain medications. If some continues to experience pain beyond what otc meds can handle. But they don’t just send every patient home with bottles of narcotics benzos just in case they have pain or anxiety. It is shopping around as OP doesn’t even have any pain yet and that pain may be well managed with otc. Just because the current culture is to pop pills for everything and feel nothing mentally or physically doesn’t mean that approach is supported by the medical field. It has led to massive amounts of lives ruined in the past and just isn’t modern medicine. The approach now is to treat the patient and their individual needs, not to hand out bottles of narcotics and benzos to anyone who wants them just in case they have pain that isn’t managed with otc.

DP. Pain is better managed when you get ahead of it, and a pain Rx (for a short duration) often will be called in during the time of major surgery, before the patient heads home, for that reason. Refills are not automatic, but often will be filled after a detailed discussion with the health practice.

The current view is not opposed to offering these meds; in fact the pendulum is very carefully swinging back due to doctors’ concerns about how poorly pain has been managed for their patients over the past decade as a result of the severe limits on opioids.

Again, pain is very individual and procedures affect people differently.

Some of you are actually posting out-of-date and incorrect info, with a dollop of proselytizing on top.

Not out of date or incorrect care. I guess it is different approaches. Where I am we provide individualized, patient centered care which means that having surgery isnt' an automatic narcotics and benzo script for everyone. I am surpised your doctors still hand it out like candy and don't take a more controlled or individualized approach and that surgery = whatever you want for pain before the pain even happens. Pain management is important but where I work, there is no longer the view that narcotics are the only option for pain management. We have a chronic pain clinic that doesn't even prescribe narcotics. There are many ways to manage pain and using narcotics as your solution for every patient who has surgery without any assessment of the individual or their need led to major addiction, overuse and dependency issues. I would say that your approach is more old school - to not recognize the harms of opioids and the dangers of overprescribing and using them broadly for all patients who are surgical patients.

No one is suggesting narcotics are or should be “handed out like candy,” or prescribed to every surgery patient. To imply that major health organizations are unaware of the risk of harms from opioid narcotics is nonsensical.

I was responding to a poster who said all patients getting surgery should get narcotics to get ahead of the pain. That person was saying that is how her faclity approaches pain management - so yes, for that poster, she seems unaware of why other practices are using alternatives to opiods and using opiods sparingly and in an individualized way versus the practice at her center of giving a Rx ahead of surgery to anyone who might have some pain.

Anonymous wrote:I met with a surgeon today for a consult for significant and urgent surgery. There were a number of things I was unimpressed with but one was that they only give Tylenol. I feel like they would probably give more if a patient was in REALLY bad shape but her take was “some discomfort is normal after major surgery but it should be manageable with Tylenol.” That’s jacked up. We invented medication so that you don’t have to feel pain. Give a patient 3-5 days of pain meds. I’m meeting with other surgeons because this one seems heartless.