This happened years ago and didn’t cause my any lasting damage, so I’m not gonna sue or anything like that. I’m just wondering if I was treated properly. Other than the pain issue, I was treated well. I think. :rolleyes:
When I was about 23, I started having severe classic gallbladder pain on my right side radiating around to my back. Oh the pain! It was over the New Year’s Eve weekend and it just didn’t occur to me that it was something surgical, even though it hurt so much. Finally went into the doctor’s office on Monday morning and found out it was most likely cholecystitis and I’d need my gallbladder out. The doc sent me home to wait to be called to come to the hospital for testing and admission. No pain medication was offered.
Got called to the hospital and got an abdominal ultrasound, then finally got wheeled into surgery that evening at around 8 p.m.
All that day I received NO pain medication, nothing at all, until they finally put me under. Was that correct? I was in such pain and not thinking clearly, not used to hospitals and doctors, and it didn’t occur to me to say, “Yo, I’m in the most pain I’ve ever been in my life, think I could get a little something something?”
To this day that was the absolute worst pain I’ve ever been in and they left me to it until they finally took the gallbladder out. Was there some medical reason for this? Would it have made it worse somehow? I don’t remember anyone asking what my pain rating was, but this was back in about 1993 or so and I’m not sure if they were doing pain scales yet at that time.
When I had a kidney stone, from the time they were sure that’s what it is to the time I had Torodol and Morphine in me was about 17 seconds and I never asked for anything. That actually kind of bugged me since the nurse gave me a stupid cutsey answer as to what Torodol was and I would have declined it. As she walked over with it and I asked her what it was she said “It’s like Tylenol, but a thousand times more potent..[pushes it into my arm]”
“So is it an NSAID”
“It’s like Tylenol”
“So it’s not an anti-inflammatory”
“Yeah, it is”
“Oh, I’m gonna end up with really, really bad heartburn”
“Well, we can get you a GI cocktail of Maalox and lidocaine, but this should bypass your stomach since it was IV”
“Doesn’t matter, and that’s not going to work”
Anyways, I know my system, I ended up with heartburn so bad I almost couldn’t talk. Took two days to get rid of it and the GI cocktail didn’t do anything, as I expected.
Woulda been nice if she had asked me first. OTOH, maybe the heartburn is better then the kidney stone pain, besides, I always feel awkward telling nurses and doctors that NSAIDS giving me heartburn. I worry they’ll take that as drug seeking behavior.
Anyways, back to the OP, I don’t know. As I read it, the doctor might think that by the time you picked up the script you might be getting called to the hospital anyways and they don’t want you to have Vicodin/Percocet in your system plus whatever you get at the hospital. OTOH, if you had asked, it wouldn’t surprised me if he had called in one or two Percocets if you told him how much pain you were in.
OTOOH, if it was that bad, you should have just headed for the ER. That’s what I did when I had my kidney stone. I thought I either had a herniated disc or UTI, but it was Saturday. I was going to call my doctor or wait it out but the pain got so bad so fast I just headed for the ER. The next day, I realized that I was in so much pain (officially the most pain I’ve ever been in), I shouldn’t have even been driving.
Many women have told me that they would rather have 50 babies in a row than a kidney stone.
Yeah, nurses have heard “I can’t take anything but narcotics” enough, they’re always skeptical whenever somebody says they can’t take something else. But many people have told me that Toradol is some really good stuff, and doesn’t make them dopey. When I graduated, almost 20 years ago, it was used long-term by lots of people with chronic pain, and then it was discovered to cause severe kidney damage so it was restricted to no more than 5 days at a time.
Demerol (meperidine) is a better drug for kidney and gallstone pain because it also relaxes smooth muscle, whereas morphine can cause it to go into spasm. :eek:
I didn’t ask for anything - I was in a lot of pain and pretty scared and I think I assumed they couldn’t give me anything for some reason. I was obviously in pain, shifting around and hunched over and probably with a pretty bad look on my face. I didn’t necessarily expect anything from my regular doc, but they should have started an IV once I got to the hospital and given me something that way. Probably should have gone to the ER but was following my doc’s instructions and it wasn’t long before they called me to come to the hospital.
My labs were bad and the ultrasound showed the gallstones, they had to know I wasn’t faking. I wasn’t a frequent flyer and had no history of asking for pain meds inappropriately or doctor shopping or anything like that. It’s weird because years later I had a different procedure there and they were pestering me to use my pain pump even when I didn’t particularly want it.
I guess it depends on how many “years ago” it was. There was a time where people were less likely to get pain medication prior to a surgeon seeing the patient, lest you “mask physical exam findings.” That’s out the window, now, and it sounds like you’d already seen the surgeon at that point.
One unfortunate reason could be that they simply forgot. If you’re off in a corner or behind a curtain, and don’t make a fuss (especially if a unit or the ER is busy), it’s easy to fall into the out-of-sight, out-of-mind trap. I’m sorry to hear you suffered like that!
Thanks. It was 1993. I have a feeling you are correct, that they were thinking the physical exam findings would be masked. It was really painful, but it makes me feel a little better to think that they might have been trying to help me at the time, even if it was misguided. Even after I saw the surgeon I didn’t get anything! I notice nowadays they give most people pain medication pretty quickly when they suspect gallbladder attack (I’m a medical transcriptionist), so it made me think back to my own experience and how I was just left to sit with the pain! Made me feel a little stabby!
The Torodol must’ve worked. About 20 minutes after they gave me the Torodol and 2mg of Morphine I felt so much better I had almost wondered if whatever I had was gone and I should just go home. It was probably mostly the Torodol since they told me it was a very low dosage of morphine. I have no idea how many mgs of morphine constitutes what kind of dosage but I didn’t feel anything and I’m no stranger to the effects of those kinds of meds. I certainly would’ve recognized the buzz if it was there.
The other thing I always find myself turning down it Flexeril/cyclobenzaprine. I had a doctor (about 15 years ago) give it to me and I just about slept into next week. Since then, every time a doctor has offered it to me for whatever I needed it for, I’ve politely declined it and given that reason (and then mentioned the heartburn/NSAID thing). Again, my fear is that, in their heads they’re thinking “Oh, he just wants Valium or Vicodin…he get’s nothing”. Luckily, my current GP gives me Soma which does a great job of unpinching the nerve in my back when it acts up and I wake up in the morning just fine.
Same thing happened to me when I got my gallbladder out. I did ask for pain medication; anything, even normal Tylenol, to take the edge off. Got nothing. Not the worst pain I’ve ever experienced, but it was the worst sustained pain. Fortunately, my acute attack subsided after 8 or so hours.
I did initially go to the ER, which might have had something to do with it. Still, I wasn’t demanding opiates or anything, so it shouldn’t have seemed like drug-seeking behavior.
Of course, once I had the surgery, they wouldn’t give me anything less than morphine… which was too much for my preference. I got Vicodin to take home but didn’t take more than one pill.
If that was the “policy” back then, what did they do if somebody came in with appendicitis, kidney stones, or a heart attack?
This really was the worst pain of my life and would not go away. I had it for 3 days straight and that was the only thing that made me seek medical help. If it had been just a little painful, I would have tried to ignore it. It was showing no signs of abating. It did lessen somewhat if I laid perfectly still for several hours, but if I got up it would start all over again. Can’t exactly go through life lying in bed forever…
I can’t even remember what they gave me after the surgery. Probably gave me something but I felt so much better, like night and day, that I never gave it a thought and took only Tylenol after I got home.
2mg of morphine IV is pretty standard for a treatment-naive patient. And I love cyclobenzaprine! I maybe need it twice a year, and take half a tablet, but if I’m having back spasms, they go bye-bye. I did learn the hard way to only take it at bedtime.
Toradol is not like Tylenol. I tell my pts that Toradol is the 151 proof of the Motrin family. It has a well deserved reputation for being amazing on kidney stone pain, it’s likely that 15-20 mg of morphine would have been needed to get you similar relief.
I love toradol for quick light pain relief for something my usual undermedicated self takes [I try to stick it out with ibuprophen or indocin before moving up the chain]
I would have the love child of whoever invented toradol, if I hadn’t had a hysterectomy and was over 50 :smack:
In the sixteen years I’ve been a nurse I’ve seen great strides in pain management in a hospital setting. Back in the 90’s it seems more research was coming to light on how people would not become addicted if they took medicine for pain when needed, and if a person became dose dependent, well, there were methods and meds to deal with that too. Now it’s pretty much standard policy for nurses to regularly ASK a patient if they’re in pain and to let them know medicine is available if needed, and if it is not ordered a doctor should be called to order the medicine.
I’m not surprised that on the early 90’s lack of pain management was an issue. Still, a nurse or doctor should’ve asked or noticed. Thank goodness things are changing.
While nurses won’t give meds without a Dr’s order, part of their job is to assess a patient’s condition including pain, and do whatever is necessary to solve the problems that may arise.
I can’t believe that it would be medically necessary to leave a patient in pain.
So either your nurses were useless, or there was something very strange going on.
However, you should have asked.
I’m amazed at that. I trained in 1985 and we always gave morphine if required. Perhaps it was because in my country few people were drug addicts, but really, we all knew that patients didn’t become addicted if they needed it.
If pain management was so bad in the States in the early 90s, I guess hospital care there wasn’t as good as they liked to claim.
As a nurse, when I walk into a patient’s room in the morning and start my morning introduction spiel, one of the first questions I ask is, “are you in any pain?” Most of my fellow nurses, I think, do the same. But sometimes the conversation goes elsewhere, or the patient is initially asleep and I don’t wake them, or something. Maybe the patient down the hall starts having chest pain. Things get missed.
It is entirely possible that your nurse never realized you were in pain. If it was the worst pain of your life, you should have said something. No harm in asking, after all.
Pain assessment is also one of my early and repeated questions.
OTOH, I had a scalp laceration sutured in the ER in’79 without even a local, OTOH, the whole '90s ‘research’ that opiates won’t addict you if you really need them has been debunked and the pedulum is swinging back from indescriminate use (thank the maker).
Highlights:
The number of overdose deaths from prescription opioids in the United States has more than tripled in the past decade,
The authors concluded that their paper offered “suggestive evidence that opioid medications can be safely and effectively prescribed to selected patients with relatively little risk of producing the maladaptive behaviors which define opioid abuse.”
Reading that paper today, I am amazed at just how poor the science behind it was.
It is now generally accepted, even by former evangelists such as Dr. Portenoy, that the risk of addiction in patients prescribed opiates for chronic pain is substantial.
OP, I would happily have given you morphine for your gallbadder pain.
Yeah, I agree that I probably wouldn’t have gotten addicted from a small dose or two before the surgery. I wouldn’t have expected them to give it to me forever, just to get me over the hump until they could get the gallbladder out. It wasn’t for chronic pain management - the problem was acute and would be gone once the surgery was over. Something funky was going on IMO because it was obvious I was in pain. Even though I didn’t specifically ask for pain medication, pain was the reason I was there. It was my chief complaint.
I suspect Speaker for the Dead has the right idea. Either that or they really thought you could get addicted from a single, small dose. I wish I could remember what they gave me after the surgery, but I can’t. I know I went home with Vicodin but don’t remember if they gave me anything in the hospital after surgery or not.
