Sunday, July 12, 2020

The Nanny State (AKA while I am in hospital may I PLEASE have some painkillers?)


The Nanny State

by Deirdre Bradley

I recently benefited from our wonderful health care system when I received a long needed knee replacement on June 18, 2020. After six years of excruciating pain and my efforts to reduce it (weight loss, massage therapy, acupuncture, cortisone), I was referred to the Joint Assessment and Rehabilitation Clinic at the Queensway Carleton Hospital. I was able to pick my surgery time frame (delayed, briefly by COVID-9) and my surgeon.

The pre-operation assessment is four hours long and thorough so the patient knows what to expect at every step. I was quizzed on lifestyle habits with an emphasis on making sure I was not an alcoholic or an illegal drug user.

With surgery comes pain. I am not afraid of pain – after having two babies, shutting my hand in the garage door was a “huh” moment. What I was not prepared for after my surgery was the difficulty in getting the pain medication I needed.

I had an epidural, a nerve block and a general anaesthetic. After two hours, I was awake with my new knee. I was admitted for a night because I could not stand when the physiotherapists arrived two hours after I woke up from surgery. You aren't allowed to leave until you can prove you can manage stairs with crutches or a walker.

I had to buzz for pain medication. I was not allowed to open my own blister pack. When all my freezing started coming off the day after my surgery I had to beg for pain medication – there was no way I was going to be able to do the crutch and stair routine without more. Thankfully, I received a pain injection and was able to “trot” off, do my physiotherapy then go home.

I had stashed chocolate in my bedroom drawer as an incentive for getting up the stairs. It worked. But the best part of coming home was having my medication at my finger tips.

My husband had the same experience after open heart surgery (aka CABG – Coronary arterial bypass graft). He had to beg his family doctor for more Tramadol a synthetic opiod that isn’t supposed to be addictive. Hospitals seems to think Tylenol is an adequate pain killer. After my babies were born I was told Tylenol with codeine would “constipate a horse” so I only got a little. Thankfully, baby number two was easier and ice and rest did the trick.

I have a medication I take for anxiety and panic attacks (neither of which have been bothering me lately) yet I can't renew that prescription ONE DAY early. It's exasperating.

I assume the reluctance to provide pain medication is a fear of creating addicts. I, like many others have read about the threat of oxycontin and fentanyl yet I don't know how an addict can be created in the hospital/post surgical environment when getting medication is like pulling teeth.

The problem is that post surgical patients are being caught up in new prescribing guidelines from the CDC and Health Canada intended to deal with incidents of addiction in those patients with chronic, as compared to short-term post-surgery or post-traumatic injury. The innocent suffer greatly because the CDC did not differentiate between chronic pain and acute pain management. It has since changed its tune.

“The authors of the 2016 guidelines — Dr. Deborah Dowell and Tamara Haegerich of the CDC, and Dr. Roger Chou of Oregon Health and Science University — said in their new essay the recommendations were not meant to be used to withhold drugs from people who need them, and outlined instances of their misapplication. “ (https://www.statnews.com/2019/04/24/cdc-opioid-prescribing-guidelines-misapplied/)

It has been two weeks since my surgery and I rarely need the “good” drug (my hydromorphone). I am grateful I can put weight on a leg that for the longest time felt like it was stuffed with razor blades and fire. Like most people I just want to get on with my life, not spend it stoned out of my mind.

- 30 -

No comments:

Post a Comment