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 Post subject: Fear of medical staff
PostPosted: Mon Aug 16, 2010 6:59 pm 
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I am new to this site and just posted this rant in another area, not realizing that this area existed. I'm having a total knee replacement at the end of the month. I am an RN, and I know only too well how we are treated in the health care system once they find out there is a history of opiate addiction. Some nurses and MDs think that every time you complain of pain you are just looking for drugs. I have put this surgery off so long now that I am at the point where I literally can't walk more than 10 feet. My terror is being helpless in the hospital and being in pain from this surgery, (I know that it is painful.) and being stigmatized, mistreated, or ignored. It happened to me when I was in the hospital for something else in early 2009, and I was in ICU for one month. (This was before Suboxone.) You cannot believe how mean and nasty the nurses there were to me when they realized I had an addiction history. They said mean things to me, ignored my call bell, and were just plain old rude. I worked in a hospital for 20 years and did home health for almost 10, and I never once spoke to a patient the way I was spoken to. One time when I rang the bell and asked for something for pain in the middle of the night, a nurse came in and said "You are a pain in the ass! What's the big idea of ringing your bell! I have other patients to take care of besides you!" I hardly ever rang my bell - only once or twice a day. There I was, sick and completely helpless in the middle of the night, in Intensive Care with no phone, and this guy was my nurse. I will never forget how powerless and terrified I felt. This is only one of many incidents that happened there. My doctor was very rude as well. Honestly I am still so traumatized by this experience that I start crying every time I think of it. I have a different doctor now, who is in family practice with an interest in addiction medicine, and the surgery is at a different hospital. My new doctor is just wonderful but he does not have privileges in the hospital where my surgery will be, and my orders will be written by ortho. My doctor is sending them his recommendations for pain management so hopefully it will go well. I'm just so scared of being ignored, labeled as a drug seeker, or having untreated pain. I'll be so glad when it is over because the pre-anxiety is killing me! I've done so well on the Suboxone that I am just afraid about monkeying around with it, but I know it needs to be done. Thank you all who may read this for letting me vent! ~Rossma


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PostPosted: Mon Aug 16, 2010 8:09 pm 
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rossma, I can totally understand your fears and I know they are totally valid. I would venture to guess that pretty much everyone on this forum has the same fear of being stigmatized and mistreated by medical staff when we are in need of pain meds.

As I was reading your concerns about being alone and powerless after your surgery, I had a thought. Do you think you and your Sub doc could talk to your surgeon and arrange that you'll have a patient-controlled analgesia pump for your post-op pain?

My partner had this after a long and involved surgery to rebuild his shattered ankle. He had had to wait for almost 3 weeks from the time he broke his ankle until the surgery could be done, and during that time the doctors had him on high doses of opiates. When he went in for his surgery, he informed the doctors that he probably would need more than the usual post-op pain meds, as he'd been on a lot of opiates for the last month.

As you can imagine, the doctors were kinda skeptical. But they gave him the PCA pump, and that was good because he could dose himself like every 15 or 30 minutes or whatever. And when they looked at how often he had dosed himself through the night, they could see that his tolerance was higher than typical, and they were able to give him adequate take-home meds to treat his pain. (I guess someone with less opiate-tolerance would have passed out from the morphine long before my partner did.)

Anyway, I know it's not a total solution, but it is one way for you to retain at least a little control of the situation. Another thought I had is whether you have anyone who can be there to advocate for you that first day and night after your surgery? I know that can help sometimes; just having another person there might make the staff think twice about mistreating you.

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You can't stop the waves, but you can learn to surf.

-Jack Kornfield


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 Post subject: Knee Pain
PostPosted: Mon Aug 16, 2010 8:52 pm 
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rossma, your story just brings home my #1 and only fear. I,m down to 1.5mg per day, I,m cutting back .5mg every 60 days and its still sooooo tough.. If feeling good was not important to me I would have never got hooked on pills that made me feel good.. Stay off your knee, that will keep the swelling down and really help with pain, do what you can do, Mike


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 Post subject: total knee
PostPosted: Mon Aug 16, 2010 10:57 pm 
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Wow, thanks for the feedback! I'm very handicapped and am unable to go very far. It's nice to know that there are others out there who have gone through the same thing, and understand my feelings and fears. Being able to put them down here really helps. I live in a very small town and most doctors and nurses here have never even heard of Suboxone. I don't know of anyone who is on it, and was working as an RN until the end of 2008, and I never heard of it while I was working. I kind of had myself convinced that I was the only person in the world to have these issues.


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PostPosted: Tue Aug 17, 2010 5:49 am 
Rossma,

Glad you posted! Welcome to this site! I have found so much info and support on here. It's a good place.

Anyway, I am an RN too. I am on suboxone and working in a hospital. You are totally right about the way some medical staff treat patients who ask for pain medication. If they find out you have an addiction history it becomes 10 times worse. I am so sorry you got treated that way at the hospital in the past. That nurse was an asshole. Plain and simple.

It pisses me off when I hear nurses deciding who is in pain and who is "seeking." How in the hell can they even THINK they know who is in pain and who isn't. And addicts do experience pain. Do they think the addict DESERVES pain? What usually happens is the addict will get less pain medication ordered, because of their history, and be in pure agony because they have a higher tolerence. Then they ask for more pain meds and the nurses will say "see!! I told you they are a drug seeker!!! I have made it my personal mission to educate these idiots on pain management. I also have a talk with these nurses on their control issue. If the doctor orders morphine to be given every 2 hours if needed, don't lie to the patient and tell them they can have it every three hours just because you don't think they "need that much." Oh shit I could go on and on about this....sorry....I just get soooo mad. Anyway.......

In all my time as a nurse I have never seen a patient on suboxone. I have seen many many people on methadone. At work, I asked a doctor if she had heard of suboxone. A trauma doctor. A doctor that would care for one of us if we ever got in a car accident. This woman had never heard of it. That scared me for a minute. What if I got in an accident and ended up in the hospital. They would have no idea what to do with me.

After I "suggested" she look it up, I started thinking about what I would do if I ever had to be in the hospital. I think I would print out some articles that Dr Junig wrote about how suboxone works. I would give these to the pharmacist at the hospital and in your case, my surgon, my nurses, and whoever else has the power to treat you like a piece of crap. Good medical people will apreicate you handing them some written reliable info. I think the main thing is making sure your sub doctor talks to your surgon. That surgon has the power to write the orders. I would also tell them I am an RN. This helps the asshole nurses realize that you know what is going on and that you will expect to be treated with respect. The educated kind nurses will give you some extra TLC.

After that, it is really out of your hands. I guess I would be praying for a safe surgery and kind competent nurses. If you come to my hospital, you have about a 40% chance of getting a good nurse who will not judge you. And thats just on day shift. Who knows what the assholes on evenings or nights are doing.

So thank you for reminding me to keep doing a good job at work and to keep being a patient advocate. (Although I just quit that job and will only be working there on call until I can find something else, but thats a whole different topic) I will be thinking about you and hope you let us all know how it turns out.

Take care, Kire (sorry this got so long...Im so sensitive to this topic in case you didn't notice LOL LOL) Now maybe I can sleep!


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PostPosted: Tue Aug 17, 2010 6:30 am 
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Rossma!
Listen to me.
The key here is outsiders constantly visiting you and talking to your doctors and nurses every time they come!Make sure your family gets in touch with pain management and your regular GM daily if needed.Have your family get these people tired of messing with your visitors so they give up and give you the meds you need!
I do this for my mother all the time.I show up in a full suit at 6am sunday morning demanding to see and talk with her nurses and doctors.I also won't let her pain management doctor rest either.They don't like suits showing up at 6am Sunday morning or any day or hour for that matter making waves trust me.And have every one show up at different times that way they know you are important to people and or you may be a powerful figure yourself.Keep them guessing.They are your helpers and enemies at the same time.You're
paying the service in on way or another so you are to be treated as well as possible.

So you see when "outsiders" are fighting for you constantly,you will be treated better.
Power in numbers baby!

Also one more thing that people might or might not agree with is have someone give you a good dose of some pain meds when no one is looking if you are not being treated properly.You will be in and out as fast as possible with the least pain possible as well.

Good luck with the procedure and be strong with them.Get back to us when you get home ok?

bye Rossma,
Tony


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PostPosted: Tue Aug 17, 2010 2:22 pm 
Rossma,

Dont sleep has a great idea with the outside support. If these nurses and doctors know your family/friends will be there fighting for you the chances are higher your message will be heard.

On the other hand I suggest you do NOT take anything from an "outsider." As an RN you know how dangerous this is. I have seen people code in the bathrooms because of this exact situation. People DiE when they do this. Also, they usually get caught. Then there is NOTHING you can say to make it better. It will go on your medical record for everyone in the future to see that you had an outsider bring you drugs. Bad bad idea. Sorry dont sleep, not to attack you. I have just seen people with GOOD intentions do that and it blows up in their face.

Best wishes Rossma, let us know how you are doing! Kire


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Fond Du Lac Psychiatry
Dr. Jeffrey Junig, M.D., Ph.D.

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