Author: donh
Posted: Mon Nov 07, 2011 2:44 pm
It is interesting to see some of the changes going on. I was with someone this past weekend who is awaiting surgery for a shoulder injury. He is diagnosed, the surgery is scheduled for about 10 days from now and he is clearly in pain. The "problem" is, he is not having his pain treated appropriately and is suffering. It is such a double edge sword. While I don’t know for certain, it does not sound like he abused any of his meds. Yet his doc told him he would only give him Tramadol for his pain because they have to "save the Vicodin for after surgery". He had been getting 5 mg Vicodin for a month or two prior to this. From my medical training and experience, typically this patient would be given Vicodin right now, including 7.5 mg or even 10 mg if needed, and then Percocet after surgery. Five years ago he may have been put on Oxycontin either right now or after the surgery. I have no way of known the reasons for his doctor withholding narcotics but clearly it is happening more and more – as these videos state.
Having been in healthcare for over 20 years clearly we went through this huge shift of treating pain. It was preached to us how the pain scale should be used just as often as the blood pressure cuff. Treating pain was at the top of our priority list. Now, I was in emergency medicine so that is somewhat different than chronic pain. Still, I have friends with back problems, etc. who were given huge amounts of opiods to treat their pain.
Did we go down the wrong path? Clearly for those of us who became addicts because of it, we most certainly did. However, what about my friend from this weekend? Is his suffering necessary? Are we better off making him suffer – both now with less than adequate treatment and potentially after surgery by giving him "only" 5 mg of hydrocodone when something stronger may likely be indicated and needed? The answer may well be as difficult as finding the meaning of life. It’s almost like suffer now or suffer later. By that I mean, suffer now with your pain or suffer later with your addiction.
It is truly a very, very difficult choice for doctors and patients to make.
