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View Full Version : How to ask for a better pain reliever


chukhung
03-30-2003, 07:07 PM
Luckily, I've only ever needed a prescription pain reliever twice in my life.

Both times that I've needed something stronger than your typical aspirin/acetaminophen/OTC NSAID, I've been given prescriptions for pills that were a compound of 5 mg hydrocodone bitartrate and 500 mg acetaminophen. The first was for "Zydone" and the second for "Vicodin".

Neither one did much good. Honestly, I think I got as much or more pain relief from the acetaminophen in the pills as I did from the hydrocodone. One tablet ever four hours was worthless and two tablets every four hours just made a very minor dent in the pain. It certainly didn't allow me to get any sleep.

So here's my question: In the future, what's the best way for me to ask a physician or dentist for some other type of opioid pain reliever? Hydrocodone just isn't cutting it, so the next time I need a root canal, I want something different.

What I don't want is the dentist to think I'm a drug abuser trying to scam her. It seems like any time you talk to a dentist or physician about opioid drugs, their "junkie alert" antennas start twitching. (Understandably, I suppose.) So, doctors and dentists, what's the best way for a patient in my position to approach you on this subject?

Qadgop the Mercotan
03-30-2003, 08:24 PM
Establish a relationship over time with your doc and/or dentist, so they get to know you, and your prescription habits/lack of them. Honestly tell them that in the past, what's considered a potent pain reliever left you in pain and miserable, and ask them for their help in getting you relief when you need it in the future, after surgery or significant trauma.

If the doc isn't receptive, try another doc, but then stop seeing the first doc. Be willing to release all past medical records to your doctor.

Then don't call their office complaining of back pain, and asking for narcotics! :D

QtM, MD

Eva Luna
03-30-2003, 08:35 PM
I had this problem too; after 4 hours of leg surgery, they wanted to release me from the hospital with just a Vicodin prescription. Given that I had metal pins and rods bolted all the way through my leg, with both bones broken into splinters, the Vicodin just wasn't cutting the mustard.

The attending doc said they had to wean me off the IV drugs and injections, because I was going to be released and they couldn't set me up an IV at home. Finally a different doctor took over when the shift changed, and I tried again. She said the first doc was being ridiculous, and that there were plenty of other alternatives. I don't remember now exactly what she gave me - this was a few years ago now - but it sure worked better than the Vicodin, which was doing zilcho. So I second the recommendation to try another doc.

j_kat_251
03-30-2003, 08:43 PM
"Hey, doc. This Panadeine ain't even giving me a buzz. Hit me up with some OxyCs, pre-crushed. *snort* Ahhhhh, prescription my ass".

Qadgop the Mercotan
03-30-2003, 08:46 PM
If you can't be part of the solution, be part of the problem!

chukhung
03-30-2003, 08:47 PM
Originally posted by Qadgop the Mercotan
Establish a relationship over time with your doc and/or dentist, so they get to know you, and your prescription habits/lack of them.Thanks, QtM.

I'm pretty sure my dentist now believes I was in real pain. (Apparently, most of her patients don't ask her to skip the farting around with the topical and just stick the needle full of novacaine in immediately...)

If this ever happens in the future (and I really pray it doesn't), I'm hoping she'll be open to prescribing something different.

Mephisto
03-30-2003, 11:14 PM
Well, what I do is go into Ye Olde Emergency Department screaming in agony. After a couple hours, somebody will usually get around to bringing me a couple Tylenol.

What my wife does is go into Ye Olde Emergency Department with, say, a splinter, and she usually gets some morphine.

Okay, slight exaggerations, I admit. But that's what it seems like at times. If I ask for drugs, they look at me like I'm a junkie. Heck, sometimes I feel like a junkie if I ask for drugs. If my wife, OTOH, asks for drugs, she usually gets far more than what I think is necessary. The last couple years, though, it seems doctors are becoming more liberal with pain medication. For example, I recently tore my toenail half way out of my foot (ouch!) and was given a couple Vicodin and a prescription for more of the same. To tell the truth, the first couple pain pills, while welcome, were probably more than was necessary to alleviate my pain--I certainly didn't need the follow-up prescription.

Lissa
03-31-2003, 01:17 AM
I've been having the exact same problem. I was in a car accident last November, and my back is still giving me a LOT of discomfort. My doctor has given me Ultracet, but it really isn't helping. However, I hesitate to ask for anything stronger out of fear of looking like a junkie. I even feel bad about calling in to ask for a refill.

I guess I feel that way because a lot of people fake back injuries, and I'm afraid of being percieved as one of them.

lesa
03-31-2003, 03:20 AM
Don't ask for a specific type of pain reliever. First of all, that can make the doctor suspicious. Second of all, it limits your options. Maybe you ask for a opioid pain reliever, but a prescription NSAID would serve you better.

It's also important to be firm and clear when discussing this with your doctor. I have a friend who had spinal surgery, and wasn't getting relief from his pain killers. He would mention this to his neurosurgeon during his check-ups, but wasn't getting anywhere.

I pointed out to him that every patient his neurosurgeon saw was in pain. All the doctor heard all day long, was that someone was in pain. So my friend just blended in with all the rest.

I convinced my friend to make a special appointment to see the doctor. I told him to tell the doctor he was in a lot of pain, that the pain was unusual, and that the pain was worse than before the surgery.

Once the doctor really understood, he decided my friend had developed a tolerance to the medication. He switched him to something else and my friend finally felt better.

So you have to be sure to make yourself clear. It's not enough to tell a doctor/dentist that you're in pain. A certain amount of pain is "normal" from their point of view, depending on what procedure you've had done. You have to explain that your pain is abnormal, and serious.

You should also explain to them before the procedure that you've had trouble with certain medications in the past. Tell them the names of the pain killers, and tell them they weren't effective. Say "even taking the maximum amount, I was in severe pain and couldn't sleep."

Being firm and definite will help. Also, if you take medicine a doctor gives you, and it isn't working, call their office the next day. Explain your problem to the receptionist. Many times a doctor will be willing to give you a different prescription without a new office visit, if what you say is reasonable and makes sense. Again, tell the receptionist that your pain is so severe you can't sleep.

Sorry to ramble on so long. I hope next time you get a medication that works.

Lobsang
03-31-2003, 03:28 AM
I was given co-codamol (is that the right name) at hospital. It sent me into a stupor, f****g great! I am notoriously bad sleeper (I find it very difficult to fall asleep) but while I was in hospital I slept like a baby thanks to those tablets.

I was responsible though (mainly for fear of becoming adicted) I only had it when I was in pain.

whiterabbit
03-31-2003, 11:30 AM
I HATE Vicodin but it seems to work on me. It makes my head buzz very unpleasantly. The next time I need serious pain meds I'm going to ask if I can try something else first, because I hated the feeling.

It also works well for my mom; she had foot surgery nearly a year ago but is having problems with a nerve and is still on VERY low-dose Vicodin for it. She is most certainly not hooked and is gradually decreasing how much she takes. Her doc's opinion is as long as she's having pain, and isn't having problems with the drug, there's no reason for her to stop.

Dr_Paprika
03-31-2003, 04:14 PM
Tell the doctor about your previous experiences with medicines. Don't claim to be "allergic" to medicines you have never heard of.
Don't ask for a specific drug by name.
Don't spend a lot of effort "bargaining" with the doctor about the number of pills -- but do state how many you needed to take per day in the past
Don't seek narcotics from more than one doctor.
Do recognize there is a big difference between acute and chronic pain conditions; and the effect of different pills on different people.

Kalhoun
03-31-2003, 05:04 PM
My husband is VERY radical looking. He never gets any good pain relievers. I look much more conservative than he does, and I get whatever I ask for. It drives him nuts.

Manda JO
03-31-2003, 06:10 PM
What is the best way to deal with a doctor when you haven't had time to build up a relationship?

About a year ago, I woke up one morning with a severe ear infection: I went to bed feeling fine, and by ten the next moring, I had lymph and pus flowing out of my ear. The pain was intense. It was Sunday, and there was no way I was going to wait until Monday morning to get me to a doctor: it just hurt way, way too much, and Iwas worried that my ear might explode.

I ened up at the local urgent care clinic. I told the doctor that I was in a lot of pain, but he just prescribed these little ear drops (in addition to the antibiotics), which did nothing. I wasn't thinking very clearly, what with the pain, but I was nervous about pushing him for better pain pills because he wasn't my doctor, I didn't know him, and I was worried about looking like a junkie. Even when my ear started bleeding on the way home, and the pharmacy didn't have the drops he perscribed and I had to call about getting a differnet perscription, I could not bring myself to flat out suggest pain pills: the anti-junkie stigma seems so strong to me (and I know this is stupid, but I was in a lot of pain and not thinking clearly) that even with blood and pus coming out of my ear and every momment a living agony, all I could bring myself to do was hint broadly" I am in a lot of pain you know. Really a lot. It's bad" while the doctor told me there as another version of the ear drops, and he would call it in.

I don't know what the point of this is, really, except to illustrate how strong the junkie stigma is, and how stupid pain makes people. If I had said "No, really, this hurts so bad I'd rip off my own ear if that would stop the ungodly pressure and pain, PLEASE give me something with poppies involved!" would I have gotten them?

Zenster
03-31-2003, 08:24 PM
Whinge and squawk in such a continuous and irritating fashion that they put you on a constant IV drip of pure morphine just to get some peace and quiet.

Qadgop the Mercotan
03-31-2003, 08:54 PM
Manda Jo, don't worry about sounding like a junkie. Raise your concerns. Talk about the severity of the pain and your concerns over it. I've got my radar out constantly for drug-seeking patients, but I also recognize conditions which require narcotics. And said conditions include ear infections! I frequently prescribe oxycodone for otitis externae such as you describe.

Honesty and openness are your best tactics.

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