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11 March, 2009

Treating Pain

The book I'm reading right now, Having Faith: An Ecologist's Journey To Motherhood, quotes an obstetrical anesthesiologist as saying, "There is no other condition in medicine where we allow patients to have severe pain and not treat them."

It says something about me that my response to this was to bark out a laugh. Or something about my knowledge of the world. Or ... something.

I read this a few days after spreading the word to some fellow bloggers about the research fraud on Celebrex/Lyrica combinations.

I read this in a state of awareness that the "War on Drugs" has led to doctors being unwilling to prescribe narcotic painkillers - because if they do so too often, they will be investigated, because they don't want to "feed the addiction" of people suffering from chronic pain.

Out in the real world, people with a wide varieties of "conditions in medicine" are actively denied pain treatment, or denied adequate pain treatment. I know more people with chronic pain conditions who are unable to get competent treatment than people who can - many of the ones lacking competent treatment know fully well what medications will ease their condition, but if they go and ask for them they're labelled "drug-seeking" and turned away to suffer.

There is an illusion that pain is treated, that pain is taken seriously, that pain is recognised and respected and dealt with in an appropriate fashion. It is the mythology.

It is a lie.

6 comments:

Zeborah said...

I worked with someone once who had really bad... I forget the word but it was to period pain(*) as influenza is to a sniffle. She told of once being out of town and in desperate need of painkillers - but when she went to the doctor and said "This is what my condition is, this is what I need," the doctor promptly wrote her off as a druggie.

Pain... you can't see pain. If there's a hole, you can see it and you can fix it. But to believe in pain you have to have some empathy, and too much of the modern medical business is devoted to surgically removing the empathy from its practitioners.

(*) Speaking of common conditions where patients are allowed to suffer pain untreated.

MP said...

This is so true - I have a gf who suffers from migraines. She is afraid of asking for help, when she is without really good oversight from a neurologist, because, whether they'll admit it or not, doctors will label her as "drug seeking", and that notation will get passed on when she gets referrals. And it will get passed on when the doctor's office check, through her insurance coverage, who ELSE has treated her (HIPAA be damned).

Another friend of mine, with migraines, AND just diagnosed with epilepsy, was dealing with ovarian cysts this weekend - they gave her a two day supply of serious pain meds, and were SHOCKED, SHOCKED I tell you, when, over two days later, she didn't have any more.

They labeled her as drug seeking.

DaisyDeadhead said...

Yes.

(Another great post!)

Sungold said...

One difference between obstetrics and the rest of medicine is that there's still a certain glory attached to suffering in childbirth. There's an ideology that says you're a better mother if you refuse pain relief. This area is a total rat's nest, though, because some women feel that doctors push them to get epidurals, while others feel culturally pressured to *refuse* an epidural.

I too have seen people in severe pain being routinely denied treatment - you're absolutely right about this. Medical attitudes in Germany (where I lived for a decade and had my first baby) are even more cavalier when it comes to pain relief. By comparison, the U.S. is relatively humane.

But it's not just medical attitudes that spawn callous treatment, it's also the legal system. My sister has had terrible trouble getting decent post-surgical relief. She can't tolerate Vicodin but she's OK with Percocet - yet doctors are reluctant to prescribe it because Percocet is a more highly controlled substance. So they give her Vicodin and she throws it up. I get the feeling that the law is willing to let a million people suffer rather than feeding one addict's habit.

whatsername said...

In addition to the laughable bit of the assertion already pointed out, let me also say how much it irks me to see pregnancy/labor referred to as a "condition". Ugh.

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