I was denied sedation/effective pain meds before a procedure pretty recently. Despite the fact that I spent the entire time literally screaming in pain, they dismissed it as “anxiety” and did nothing to help.
I also received very little when I first came into the hospital - as my body was flooding with literal shit and I was fucking dying. They let me writhe and roll around for hours before they mercifully knocked me out for my operation.
I’m traumatized to the point where watching movies where people experiencing pain is upsetting. I was watching fucking Avatar the Last Airbender and wincing every time someone got punched or kicked.
I also go back to getting my IUD put in - again, another extremely painful procedure that is “not supposed to hurt” so there is no option for sedation or effective pain meds.
It feels like asking for pain meds gets you labeled as a drug seeker/addict too. I made the mistake of mentioning that I smoke weed (because I knew the anesthesiologist needs to know that) and it feels like it was instantly assumed that I’d be a pill popper too.
And I have extremely high pain tolerance. I’ve literally had people whip me until they’ve drawn blood. I’ve worked a fast food shift with a second degree (even a bit of third degree) burn going down the majority of my arm. I’m not a wuss, I know how to breathe in ways that help, I know how to go to a mind palace, but Christ, when you start digging around in someone’s guts with sharp objects, that’s not really something you can meditate away!
Is it training? Is it the fact that becoming a doctor in the U.S. requires the kind of upper middle class upbringing that doesn’t tend to help people develop empathy?
My most recent experience in the UK is that they’re fairly generous with painkillers. I was in an orthopedic ward - broken hips, ruptured tendons, that kind of thing. We all got oxycodone and paracetamol (plus laxatives to ward off the consequent constipation). I enjoyed the oxy but didn’t become an addict.
I’m going to mostly focus on the more legitimate answers since you already seem to know some of this was possibly / probably oversight / neglect and that they should have given you more.
a) the big one is pressure from regulatory agencies to prescribe less narcotics. Some of this is legitimate; a lot of the opiate crisis was started by pharma companies lying about how habit forming their medications are and intentionally encouraging dependency through overprescribing to sell more, but a lot of it is also just straight up puritanical and part of efforts to disrupt minority communities that are more affected by illicit drug use. In the end though, even if they don’t share the stigmatizing view of it, there’s little individual prescribers can do about it.
b) there’s huge pressure in institutional environments to do ANYTHING to prevent falls. In addition to getting stingy with sedatives that might make you dizzy there’s also pressure to have 1:1 care where people watch the patient in the bathroom and we used to even restrain old people to keep them from falling (although thank goodness that’s finally falling out of favor). To get rid of that we’d have to accept that sometimes people just fall and crack their head open and die and that’s life but we’re just not there yet as a society. In the US everything needs to be someone’s fault and if the doctor prescribes a sedating med and I give it and you fall, it’s partially considered my and the doctor’s fault. If we do ALL the environmental AND don’t give sedating meds, it’s considered less our fault.
c) There’s legit specific medical reasons sometimes. If you had a bowel obstruction opiates are actually specifically contraindicated since they’re the medications MOST likely to cause constipation. Now if surgical intervention was the best option it might make sense to give them anyway, but there may have been some waffling on what the best option was and they couldn’t un-give you the meds if the final decision was to have you pass it with medication / enemas instead of surgery. And bowel surgeries have a huuuge possibility of sepsis and having to parts of the bowel removed and having to get regular vitamin shots for the entire rest of your life (once had a bypass patient so iron deficient she stated hallucinating) so that’s not a decision to make lightly.
d) insurance in the inpatient environment likely didn’t interfere with the medication prescription directly. they probably DID interfere with the surgical decision which may have interfered with the medication decision (see above). but the bigger issue is that insurance agencies in general do something waaay more insidious than just avoiding paying. they create and fill a psychological need to find someone to blame for things. every time something bad happens in the US we immediately try to figure out who to blame so we know who’s paying for it. this is your health but also to your house and your car. the insurance is there more than just to pay but also to pay court fees if the blame isn’t immediately placeable. if I give you a sedating medication and you fall, the insurance doesn’t pay for it they make the hospital pay for it. So as a result the hospital pressures me to not give you that medication so you don’t fall and leave them with the bill. to truly be rid of insurance companies in general we would have to fundamentally move away from blame culture. we would have to shift to a mindset of, wow that’s horrible but we as other humans are going to take care of you. and like I said, we’re just not there yet (but universal healthcare is definitely a step in the right direction; that kind of change can’t start with individuals struggling to make rent).
Probably just thanks to insurance companies yet again
Doctors don’t get to make their own decisions anymore, they’re paid more like car mechanics and get a “job rate”.
Change a tire? It’s billed at $28 bucks. Doesn’t matter if it takes you 10 minutes or an hour. Air and balancing is included. Anything extra you don’t get paid for.
Gotta put in an IUD? You get $500 for the job, included is one shot of pain meds, the IUD, and one set of sterile equipment. Pain meds not working so great on this patient? Insurance doesn’t pay for extra, outpatient center doesn’t get paid for it or has to fight insurance for it.
Same for novocaine in dental work.
Insurance is terrible.
I actually don’t have insurance so it probably wasn’t a factor.
I am super fucked lol.
The fact that insurance companies are allowed to deny claims on the grounds and on medically necessary against doctor’s orders without being required to pay for second opinion from a doctor is insane. They are literally a core operating part of the medical system and it’s the most dysfunctional part
This is marginally related but in case anyone else doesn’t know: dental procedures are not supposed to hurt.
I grew up terrified of dentists and ended up not going for nearly 10 years because of the fear/pain. I finally gave in when a tooth broke in half. The dentist I went to gave me the regular amount of numbing stuff and about 5 mins in saw in my face how much pain I was in and from then on she always gave me extra. I just have a high tolerance for the stuff and had never been receiving enough.
Word. I teared up out of happiness after a dental hygienist (who I currently see) offered me numbing gel for my gums during a cleaning (even let me choose the flavor) in a totally non-judgmental way. I was in my late thirties and I didn’t know any dentists would be willing to offer that sort of stuff to adults.
We’re in the throes of a few crisis in the US:
- a professional backlash against the over-prescription of opiates that were advertised as “non-addictive” which was actually a lie,
- the monster the above crisis created: a domestic population of drug addicts who are either seeking drugs themselves or looking to non-addicts to acquire them,
- constriction within the health insurance marketplace, demanding more and more justification for care and drug access,
- an entire political system that’s in the pocket of said industry who are incentivized to manufacture a world that maximizes health care spending while minimizing actual health care delivered.
Studies have also shown that female pain is ignored far more than male. I think this shows just how much men don’t trust women.
Doctor here. This is exactly it. The system created a bunch of addicts on a lie and then punishes everyone else for the mistake of lying about how addictive opiates are
If I give them back the leftover oxy from what they sent home with me, would that help in getting any potential “drug seeker” notes removed?
I don’t even get how I’d abuse the stuff. It just makes me sleepy. Like - marijuana is fun because it makes food taste good and helps me think more creatively. Opioids take away intense pain just enough for me to sleep it off. I ended up throwing away most of a bottle of Percocet after I got my top surgery because I’d rather have a little breakthrough pain on Tylenol and be cogent than sleep 18 hours a day.
In case you don’t see it below, you can request the “drug seeking” be removed from your chart. For a long time knowing the names of specific prescriptions meant you were drug seeking.
So if you had ADHD but weren’t diagnosed, like lots of folks but were somehow smart enough to accommodate your disability and then told your doctor you’d be interested in trying Adderall then they would mark you down as drug seeking instead of helping you.
There’s no note, everyone is a “Potential Drug Seeker”, no exceptions.
Except “drug seeking behavior” is a specific kind of note that can be in your chart. You can actually have this removed from your chart if you ask a provider to do so and they are so inclined. I have a drug therapist friend who removes it from everyone’s chart because it’s bullshit.
You’re female. No, doctors don’t care. Ask my wife about how many different doctors she had to see before someone finally took an X-Ray of her back and found out one of her vertebrae is basically crumbling away.
I believe John Oliver covered this exact phenomenon in this video: https://youtu.be/TATSAHJKRd8
tl;dw Doctors assume women exaggerate pain compared to men (the opposite is true), in addition to ethnic (we’re all the same race, so I don’t use that term anymore) biases also discussed in the video.
… a lot of times, women’s […] pain [is] attributed to emotional imbalance or women being hysterical…
I really appreciate you citing a white man for this. No one believes it otherwise.
Which is why women get hysterectomies, to remove the hysterical bits.
My experience, also in the US, has been the opposite: I get prescribed addictive painkillers “just in case”.
Last time I had surgery, they told me to take ibuprofen for pain, and they also gave me a prescription for vicodin if the pain was too great. I live in an area with a significant opioid abuse problem, and they’re handing it out like candy. They didn’t tell me “call back if it’s severe” or anything like that, they just gave me the prescription. I stuck with the ibuprofen, and realistically I could have done without even that.
I suspect your experience is largely due to sexism. I’ve heard so many stories like this, where doctors don’t even think of taking women seriously.
You must be one of the Real People™ if you make above a certain amount of money or you have certain professions or if your family has a certain amount of money then you are considered a real human. Importantly you must also be male and cisgenderrd and heterosexual, though enough money can counteract these effects.
The reason that most humans are not considered Real People™ is because it’s the only way for folks nearer the top of the pyramid of social hierarchy to justify their existence. Poor folks and people who don’t have professional careers must be less than those at the top and the ones at the top must have special criteria that means every judgement they make must be better.
I used to be on disability and when I went in to see healthcare professionals I was basically treated like dirt and was never believed about anything I said. Then I went to law schools and suddenly everything I said mattered. It’s wild how much differently folks treat you when they think you are Real People™
You’re female which is a detriment to appropriate medical care, being non-white is also a detriment to care. As others note there are also various systematic and medical reasons a doctor may not prescribe or use pain-relievers especially prior to understanding the problem.
I will say you need a new ob/gyn as there are recent updates that make pain relief a standard for iud insertion.
My mother literally had a gynaecologist just tell her that they’re putting her under general anesthesia for a surgery where other clinics won’t because “we don’t believe in torturing our patients”.
Thank you to that clinic. We need so many more of those in the world.
NGL as a white guy I just have to ask nicely for the good drugs and they give me opioides, granted it’s for kidney stones and it’s the most pain I’ve ever experienced, but honestly it sounds better than whatever OP was going through.
I do think I present with classic pain symptoms, I litterally can’t form sentences, which might help.
Kidney stones are known as one of the most painful things, and knowing the problem means the pain is no longer important for diagnosis.
True, however the first time they gave me fentanyl before they did a CT scan, they had figured it was stones but only had my pain to go off, so I suspect I got better treatment than if i’d been an equally erratic POC or woman, but hope I’m wrong and they’d give everyone similar treatment.
Completely normal. I had hemorrhoid surgery and got 3 fucking pills. Recovery was supposed to be 1 week. It was more 4 months.
I live with constant back pain and fall all the time. They tell me to take ibuprofen. Which does fuck all.
Wtf? No this is not normal. My wife even gets pain meds for the Dental Hygienist, because she has a fear for the dentist or anything dentist related. I think it is absolutely unnecessary, but maybe she has hyper sensutive teeth or something. I’m not a doctor. Anyways, the pain meds help her, so she gets them, regardless of whether it is just phychological or not.
I think you’re just suffering from the ridiculousness that calls itself the US healthcare system.
I can just tell you that it’s not universal: several doctors I’ve seen and know are very cautious when it comes to pain - both from own experience (“we will go strong with the pain killers for the best two days to prevent stress reaction from the body”) to others (“we need to get the chronic pain under control fast, otherwise there’s the risk of phantom pain developing even after we’ve tackled the issues”) (not verbatim quotes of course but the gists).
It might not even be US generic but a regional or age thing in the doctors you’ve met - remember that usually everyone one of us has only a very limited insight into the whole medical industry.
I’m similar to you in terms of pain tolerance and I’ve walked away from a doctor who talked shit about pain in patients - but I’ve head way better experiences before so that didn’t feel like I’m being stuck with this one medical “professional”.
Wishing you the best of luck though! It’s absolutely terrible when people don’t take you seriously, especially if it’s their job to help you :(
All my life what I’ve heard is that pain is only useful as a warning of a problem. After that the pain is something that must be minified.
Yes and it’s a personal benchmark of mine for a doctor how they talk about pain - because this is by now such well studied that I don’t understand how people like OP described are still allowed to do what they’re doing.
I got surgically sterilized because the pain from that was less than what an IUD would have been.
The only pain I felt was for the initial IV stick. After that it was nothing.
I will refuse any painful procedure that doesn’t have adequate pain relief. I don’t care if I die.
Medicine keeps getting away with this shit because women just accept it. Endometrial biopsy? Only if I’m completely out. If not I guess I’ll enjoy my hospice drugs while I’m dying.
IUD? Lol I just cut my shit out instead. I need hormonal treatment for endometriosis still, but I just take hormone blockers for it. Way better than dealing with sadists.
I’m too fed up to live through this shit anymore. I have no kids IDGAF.
Part of why my condition got so bad to begin with was because I’ve had so many bad experiences with doctors that I didn’t go to the hospital until I started feeling unbearable pain. I spent a full two weeks with an infected abscess just getting worse and worse because I figured that whatever it was would be blown off if I went to the hospital - because that happens any time I’ve ever gone to an ER.
I need to get my IUD replaced (it’s been 10+ years) and I’m terrified. I don’t have insurance, so my best option is Planned Parenthood, who told me that it was “just a little pinch.”
I’ve been fucked with knives and wartenberg wheels (abusive BDSM relationship). That shit was not “a little pinch.” I filled up a diaper with blood afterwords.
It’s to the point where I avoid seeing doctors, unless it’s the nurse practitioner who does my hormones - he’s the only doctor I’ve felt listened to me.
They’re so damn condescending too - I’ve taught biology and chemistry - I can understand a real explanation of what’s happening and want one!
It’s because you’re a woman. It’s double bad if you are also a woc. We are nowhere near close to even beginning to fix this. It’s systemic, and no one in power in the medical field gives a shit. Because only women and POC suffer from this.
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The side effects of medication can interfere with diagnosis and treatment
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Pain can be a useful diagnostic indicator itself
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They see people in pain all the time, so it doesn’t seem like an exceptional state to them
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People with low pain tolerance, and people feigning pain to get opiods, are overrepresented in the population of people seeking medical care, so experience conditions medical providers to overweigh that as a potential factor
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There was a nurse in a fertility clinic who was an addict and replaced the fentanyl drip with saline. Multiple women experienced agony during the procedure for extracting eggs. That procedure was to insert a huge syringe into the vagina, through the vagina wall, into the ovaries to suck up some eggs.
Many women experienced this with no pain medication at all and their complaints, even their screams were dismissed. Needless to say, when the addict nurse was discovered, they felt pretty silly.
Doctors have incredible tolerance for the suffering of women.
