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I wrote this post almost exactly 6 months ago on the heels of. Amy Winehouse's death and re-posting it on the heels of Whitney's death.
http://thedazeofwhineandroses.blogspot.com/2011/07/what-if.html
Clearly, I am not privy to the details of either of their deaths but both had problems with substance abuse. I worry daily about the addiction that we, the medical profession, cause patients by not saying 'no' to narcotics. Too many times life-long problems with addiction to pain medications stem from legitimate injury or pain and someone somewhere in the healing process did not say 'enough'. Patients have the expectation that we will take care of their pain. That is a good and proper expectation. What we are not teaching patients is that sprains and fractures, lacerations and surgical incisions, headaches and menstral cramps DO hurt and that it is not appropriate to remove all traces of pain.
We need to recognize that addiction is not a CHOICE of patients but the result an illness all by itself. People with addiction have pain and people with pain have addiction history. We need to be more aware and really help these patients. The TV is on as I'm writing this and there have been several ads for medicines on TV. At the end of each commercial there is a recitation of the possible side effects. Why aren't drug companies required to periodically put ads out there listing the side effects to their most popularly sold drugs?
"Side-effects of hydrocodone/paracetamol are most commonly upset stomach, nausea, and altered mental status (e.g., dizziness, light headedness). Other rarer side-effects include allergic reaction, seizures, clammy skin, paranoia, hallucinations, severe weakness, dizziness, hyperventilation, unconsciousness, jaundice (yellowing of eyes or skin), unusual fatigue, bleeding, bruising, stomach pain,[3] constipation, dry mouth, decreased appetite, muscle twitches, sweating, hot flashes, itching, tinnitus, hearing loss, decreased urination and altered sex drive. Vicodin also has depressant effects on the central nervous system, which may cause irritability. However, some of the less mundane effects can be desirable effects that are sought after by some. Those effects include euphoria and drowsiness,"
Who would take this if they knew? Would an ad like this cause a red flag to imprint in someone's brain and question accepting a prescription? Patients are taught to trust their doctor and surely if a prescription is offered it must be safe. Right?
WRONG! New insurance reimbursement criteria are based in part on a hospital's 'patient satisfaction score' and part of that score is 'how well did we control your pain?' Pain needs to be controlled. Obviously. But is it really beneficial to a patient to have this flaw built into the system???
From day 1 a patient needs to be EDUCATED that 'controlling pain' does not mean to remove all traces.
Arrrgh. I could go on and on. The patient this week that stands out was an 8 year old boy with a 2 day old sprain to his pinky finger. It was bruised and swollen and I bet it did hurt. Of course it took parents 2 days to have it addressed [understandably] and they hadn't given him tylenol or ibuprofen in those 2 days for the pain. He was a cute kid, all smiles when he realized that there would be no shots and he and his sister raced to the fridge for juice and crackers when I told them there would be a bit of a delay for the xray due to a trauma which was requiring the rest of the ER team. The xray did not indicate fracture and we put a splint on the finger and buddy-taped it to the next finger. The shocker came when mom asked for a prescription for vicodin for his pain AND THE DOCTOR WROTE THE SCRIPT! I hope you are as shocked as I was and I pray that you question it should it ever happen to you.
I was up all night again with facial/mouth pain due to the trigeminal neuralgia. I made it clear to my doctors that I will not take narcotics for the pain. Does that make me a better person to live with the pain? Not at all. What it says is that I'm afraid. Very afraid. I've seen the addiction and life long pain this addiction causes and I want no part of it. I would probably be smarter to take something, it was offered, but it is such a slippery slope and I keep saying no. Maybe it's because I'm a nurse and I want to get to the root of the problem rather than mask it. I want it fixed. Maybe it's because I know the steroids will kick in again and today will be better. Maybe it's because I'm a nurse and I know to move taking my med to later in the day so that I might sleep tonight.
We are taught to trust doctors but we need to be taught to take contol of our own healthcare. We need to question medications that we're given. Our pain needs to be contolled by the least invasive method even if that means we are uncomfortable.
RIP Whitney. I hope we finally learn
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