8 ms·

Of course while YMMV, I've found the same thing - I've been prescribed opioids for pain, and I found that Advil worked just as well, without the side effects. I

Of course while YMMV, I've found the same thing - I've been prescribed opioids for pain, and I found that Advil worked just as well, without the side effects. I do understand that opioids have their place - for example I was told that Advil was not safe to take before surgery so I was stuck with the prescription meds. On example that made an impression on me: a couple of years ago, I had arthroscopic surgery on a knee. When the surgery was done and I was being discharged, a nurse came to me with a percocet script and told me to take one every xx hours. Having taken percocet in the past and being familiar with the aforementioned side-effects, I asked her if she wanted me to take it for pain management, or if there was another reason to take it (blocking the formation of blood clots for example). I'm fairly pain-tolerant, so if it was a pain management thing, I wasn't going to take it. Her response was "just take the pills." That was not helpful. If doctors and nurses are just shoving these things down patients' throats it's not surprising there is a problem out there.

astura 9y ago
I agree the nurse absolutely should have answered your questions about the medication or gotten a doctor to answer them. It's just inexcusable behavior on her part. Did the script say "P.R.N?" PRN means "as needed" in medical terms. It's an abbreviation for "pro re nata." Just for future reference. I've also found that, for me, naproxen (Aleve) works much better than opioids. Opioids just make me feel very, very sick (from nausea). If they do help with the pain relief I can't tell over the nausea and vomiting. But, yeah, YMMV.
ythn 9y ago
> Her response was "just take the pills." There's a fairly big camp of people both online and in real life that is strongly against questioning medical authority. I've encountered it before. For example (and I know this is purely anecdotal), after doing a few hours of extensive research and photography comparisons online I came to the conclusion that my sister had shingles. I mentioned this to the doctor when I took her and he dismissed it and said that it is unlikely since she is so old. I mentioned this on a subreddit that I frequent and a bunch of people jumped on me and told me to stop doing my own research and to let medical authorities do their job without me pestering them. However, after taking her to a different doctor, he immediately recognized it as shingles and prescribed her the appropriate medicine. On the one hand, I get why doctors don't want the "ignorant masses" doing their own research and coming op with cockamamie theories, but on the other hand, doctors can only hold so much information in their heads whereas the internet has vastly more information available and I can become an expert in one tiny little niche fairly quickly.
- DanBC 9y ago
  A useful approach is to ask "could this be shingles?", and then "why not?", and then "if i isn't shingles what else could it be, and why is it that and not shingles?" the UK has had a campaign recently around sepsis where people are being trained to ask these questions.
- pasbesoin 9y ago
  After a number of years with a different diagnosis, I convinced an ultrasound technician to go beyond their exam script -- enough to discover that, in fact, I did indeed have a minor hernia. If the doctor hadn't been so sure of his diagnosis, this would have been caught years earlier. I'd specifically asked, more than once, about the possibility. A lot of scrambling on their part, that day, to get me a same-day appointment for consult with a well-regarded surgeon.
- ramses0 9y ago
  I always like to come to a Dr's appointment with a "sealed envelope" ... what I think the problem is, but not to mention it until they get through with their diagnosis. Yes doctor, no doctor, I don't think so doctor, yes doctor also my left foot. => He thinks I have a sprained ankle, I think I'm not sleeping well (or whatever) and I'll mention what my guess is at the end (not before) and ask him why my guess is (presumably) wrong. Of course if you think there's something unusual or your symptoms are severe then of course go to the doctor without delay, but it's also helpful to get a bit of a personal education when you've got time with a specialist.
- bayesian_horse 9y ago
  It's a fine line. Most of the time, the patient is actually wrong, and that can make it pretty annoying, especially if the medical professional in question is having a stressful day (and aren't they all...). I have a lot of medical knowledge and I try not to be a wise ass with my doctors. Sometimes though, it pays to pay attention.
PaulHoule 9y ago
NSAIDS are not benign. Digestive problems are so common with long-term use that some doctors think that they should co-prescribed with omeprazole and other agents to head them off. (Long-term omepraloze will give you B-12 deficiency if you don't supplement; it is an unusual side effect, but I can't sleep if I take omeprazole. Cardiovascular risk from Vioxx was enough to pull the drug from the market; risk is also seen with Celebrex and other COX-2 selective NSAIDS. The risk with non-selective NSAIDS is less understood but still present. My doc does not want me taking acetaminophen because she thinks it causes me to get elevated liver enzymes. Like opioids there are problems when people don't "use as directed". My grandmother used to take Bufferin by the handful and one day at the dinner table we saw her throwing up blood like something out of a horror movie and she was subsequently hospitalized.. Acetaminophen overdoses can easily destroy your liver and are one of the most common forms of fatal poisonings. The verdict is that we don't have truly 'safe and effective' medicines for pain in 2017.
- testvox 9y ago
  Cannabis works pretty well and has minimal side effects, at least compared to those you describe.
  - ams6110 9y ago
    It's almost certainly not as well studied over long term large populations though.
    - Jill_the_Pill 9y ago
      So many innovations in medicine, food, exercise, pesticides, whatever, only look better than the old stuff because they haven't been around long enough for all their flaws to be discovered.
  - darpa_escapee 9y ago
    Perception changes with cannabis are a significant negative side-effect.
kbutler 9y ago
I was going to post a similar opinion specifically of percocet: it was prescribed for me after a surgery, it gave me a weird sense of detachment, but didn't seem to do anything particularly significant for pain. I stopped after the first one. I have enough addictive behaviors, I don't need to add a chemical one.
shams93 9y ago
This is not the case when you suffer major 3rd degree burns. When you need morphine in the case of say regrowing nerve endings in a damanged limb advil will not cut it, not even medical cannabis will cut it, there are still cases where giving a patient morphine is appropriate.
- SheepSlapper 9y ago
  The discussion around opiate abuse isn't about the extreme cases. Yes, if I get 3rd degree burns then I want to be as out of it as possible until the pain goes away. The problem isn't the extreme cases, it's the every day ones. Opiates are being massively over-prescribed in cases where OTC medicine or a shot of whiskey would suffice, and this over-prescription is a driving force behind the addiction epidemic.
  - randlet 9y ago
    > or a shot of whiskey would suffice Not sure if you said it in jest or not but alcohol is also highly addictive, prone to abuse, and harmful to your health and IMO would really not be a step in the right direction. edit: I almost added to my comment "It's almost taboo in our society to mention this fact" but didn't. I was almost immediately down voted so I guess maybe I'm not wrong...
    - sliverstorm 9y ago
      Yeah, but what is it, 1/8 Americans are already alcoholics, so 12% of the time you're not making things any worse!
      - walshemj 9y ago
        As on expat UK-> USA said if you have a pint for lunch people start leaving AA leaflets on your desk. A while back I was talking to a course tutor who in the UK gave the "dealing with staff with serious addiction problems" course - he commented its when you find 3 or 4 stashes of vodka hidden in the office that you know you have a problem
SheepSlapper 9y ago
Agreed, I've been lucky and only required a few surgeries in my life. Every time I get handed a jug full of opiates, and end up taking ibuprofen instead. Personally the pain management I get from ibuprofen is similar (definitely less, but sufficient) to the opiates but without the side effects.
mjcl 9y ago
I had a slightly different experience, luckily, I guess. When I was in recovery after having a brain tumor removed, I was first being given fentanyl once every hour or two. I found that for the few minutes I was lucid (before the next dose), I really didn't have much pain and asked for something less strong. They moved me to norco, which still seemed too strong. After another request for something less, they moved me to plain tylenol. I did get a big script for norco when I was discharged, but their instructions were to take it if the pain became distracting. The nursing and medical staff at the hospital (CPMC Davies) overall seemed great, so it may just be the difference between staff that listens/tries and staff that doesn't.
pasbesoin 9y ago
Same here. After a LONGGG phone call cradling the receiver while trying to type, etc., I had my neck spasm severely -- so much so that the following day someone else had to drive me to urgent care (1). They prescribed a strong muscle relaxant in combination with either Percocet or Vicadin -- I forget which. I switched over to the default over the counter dose of ibuprofen, and it worked better than the combination of those two "heavy duty" prescription drugs. I will say, though, that doctors in the U.S. have been damned cavalier about ibuprofen. One doctor with a popular radio show would cite the nickname, "Vitamin I", and routinely tell people to use it non-stop for a month or two. I've found that now, a few days on it will make me rather lethargic. My cardio strength and sometimes rhythm feels impaired. And lo, there are studies now coming out that indicate it may carry as much risk as Vioxx and the like. (Incidentally, a doctor prescribed me Vioxx a month or two before it was yanked from the market. I questioned this, remarking on recent news I'd read indicating it had problems. He had no clue and told me it was perfectly safe. Sure, it was still on the market, then, but he appeared to have no clue about the looming controversy.) With any medicine, it really seems TANSTAAFL. You have to carefully weigh the benefit against known as well as suspected risks. And the U.S. medical system completely falls down in not fully informing not just patients but also doctors to the existence and nature of these. 1) Well, that urgent care experience -- a new facility opened by the premier area hospital -- was itself a horrible experience. Deserted facility, by all appearances, yet it took about 2.5 hours to see a doctor. Who gave me no neck brace; family took me to their chiropractor, the next day, who DID give me a neck brace -- which provided the first real relief and stopped me from constantly retriggering the injury with every movement. To be clear, I refuse to have my neck cracked. And the chiropractor wouldn't have, at that point, anyway, given my severe spasming. But at least he had the sense to immobilize my neck. (Then he provided some ongoing care to encourage the release and healing of the spasming. To whatever extent this may have helped, that initial immobilization was key. WTF was wrong with that fully credentialed MD serving the urgent care's rather extensive ER facility?)
- mholmes680 9y ago
  I've found through my experience that the choice of urgent care vs a non-urgent care doctor is more important than I have always thought: An urgent care center wants to focus on the shortest path to getting you relief (your story aside). They'll err towards slightly over-prescribing. The non-urgent care doc will take a more comprehensive treatment path. A slight distinction that might not matter sometimes, but i often wonder how many antibiotics/pain killers I've taken prescribed from urgent cares that were possibly overkill.
ryanmarsh 9y ago
Took morphine for a back injury, I just got sleepy but still had the pain. Took Percocet after a shoulder surgery, I just slept through the pain. I also understand now why people get addicted. I get raging migraines, Excedrine is the only thing that works for that. True story, when my daughter was in the hospital (cancer) we overheard a nurse and doctor discussing what to give a child (also with cancer) for tooth pain... "morphine". The nurse was like "for a tooth? can't we tell the mother to give him Tylenol?" Also, true story Tylenol is not "formulaic" (I may be saying that wrong) at many hospitals. Meaning THEY DON'T KEEP IT IN THE PHARMACY (the one that fills orders for internal use). I was very surprised to learn this.
empath75 9y ago
had a similar interaction after an appendectomy, except the nurse asked me if I was an addict after i said I didn't want opiates.
phofangor 9y ago
I find it very odd that a nurse would be so cavalier about that. There are a lot of people who can't/won't take prescription pain meds for a myriad of reasons. Some are concerned about addiction, but other reasons are religious/philosophical. I've always been asked if I want those kinds of pain meds, even when they are highly recommended, it was always a question.
temporallobe 9y ago
> just take the pills God do I hate medical professionals like that. It's as if they don't want you to steal any of their elite knowledge or that you as a patient are beneath them. How dare one of us ask a semi-intelligent question!
arcbyte 9y ago
That is straight up malpractice.

astura 9y ago

I agree the nurse absolutely should have answered your questions about the medication or gotten a doctor to answer them. It's just inexcusable behavior on her part. Did the script say "P.R.N?" PRN means "as needed" in medical terms. It's an abbreviation for "pro re nata." Just for future reference. I've also found that, for me, naproxen (Aleve) works much better than opioids. Opioids just make me feel very, very sick (from nausea). If they do help with the pain relief I can't tell over the nausea and vomiting. But, yeah, YMMV.

ythn 9y ago

> Her response was "just take the pills." There's a fairly big camp of people both online and in real life that is strongly against questioning medical authority. I've encountered it before. For example (and I know this is purely anecdotal), after doing a few hours of extensive research and photography comparisons online I came to the conclusion that my sister had shingles. I mentioned this to the doctor when I took her and he dismissed it and said that it is unlikely since she is so old. I mentioned this on a subreddit that I frequent and a bunch of people jumped on me and told me to stop doing my own research and to let medical authorities do their job without me pestering them. However, after taking her to a different doctor, he immediately recognized it as shingles and prescribed her the appropriate medicine. On the one hand, I get why doctors don't want the "ignorant masses" doing their own research and coming op with cockamamie theories, but on the other hand, doctors can only hold so much information in their heads whereas the internet has vastly more information available and I can become an expert in one tiny little niche fairly quickly.

DanBC 9y ago
A useful approach is to ask "could this be shingles?", and then "why not?", and then "if i isn't shingles what else could it be, and why is it that and not shingles?" the UK has had a campaign recently around sepsis where people are being trained to ask these questions.
pasbesoin 9y ago
After a number of years with a different diagnosis, I convinced an ultrasound technician to go beyond their exam script -- enough to discover that, in fact, I did indeed have a minor hernia. If the doctor hadn't been so sure of his diagnosis, this would have been caught years earlier. I'd specifically asked, more than once, about the possibility. A lot of scrambling on their part, that day, to get me a same-day appointment for consult with a well-regarded surgeon.
ramses0 9y ago
I always like to come to a Dr's appointment with a "sealed envelope" ... what I think the problem is, but not to mention it until they get through with their diagnosis. Yes doctor, no doctor, I don't think so doctor, yes doctor also my left foot. => He thinks I have a sprained ankle, I think I'm not sleeping well (or whatever) and I'll mention what my guess is at the end (not before) and ask him why my guess is (presumably) wrong. Of course if you think there's something unusual or your symptoms are severe then of course go to the doctor without delay, but it's also helpful to get a bit of a personal education when you've got time with a specialist.
bayesian_horse 9y ago
It's a fine line. Most of the time, the patient is actually wrong, and that can make it pretty annoying, especially if the medical professional in question is having a stressful day (and aren't they all...). I have a lot of medical knowledge and I try not to be a wise ass with my doctors. Sometimes though, it pays to pay attention.

PaulHoule 9y ago

NSAIDS are not benign. Digestive problems are so common with long-term use that some doctors think that they should co-prescribed with omeprazole and other agents to head them off. (Long-term omepraloze will give you B-12 deficiency if you don't supplement; it is an unusual side effect, but I can't sleep if I take omeprazole. Cardiovascular risk from Vioxx was enough to pull the drug from the market; risk is also seen with Celebrex and other COX-2 selective NSAIDS. The risk with non-selective NSAIDS is less understood but still present. My doc does not want me taking acetaminophen because she thinks it causes me to get elevated liver enzymes. Like opioids there are problems when people don't "use as directed". My grandmother used to take Bufferin by the handful and one day at the dinner table we saw her throwing up blood like something out of a horror movie and she was subsequently hospitalized.. Acetaminophen overdoses can easily destroy your liver and are one of the most common forms of fatal poisonings. The verdict is that we don't have truly 'safe and effective' medicines for pain in 2017.

testvox 9y ago
Cannabis works pretty well and has minimal side effects, at least compared to those you describe.
- ams6110 9y ago
  It's almost certainly not as well studied over long term large populations though.
  - Jill_the_Pill 9y ago
    So many innovations in medicine, food, exercise, pesticides, whatever, only look better than the old stuff because they haven't been around long enough for all their flaws to be discovered.
- darpa_escapee 9y ago
  Perception changes with cannabis are a significant negative side-effect.

kbutler 9y ago

I was going to post a similar opinion specifically of percocet: it was prescribed for me after a surgery, it gave me a weird sense of detachment, but didn't seem to do anything particularly significant for pain. I stopped after the first one. I have enough addictive behaviors, I don't need to add a chemical one.

shams93 9y ago

This is not the case when you suffer major 3rd degree burns. When you need morphine in the case of say regrowing nerve endings in a damanged limb advil will not cut it, not even medical cannabis will cut it, there are still cases where giving a patient morphine is appropriate.

SheepSlapper 9y ago
The discussion around opiate abuse isn't about the extreme cases. Yes, if I get 3rd degree burns then I want to be as out of it as possible until the pain goes away. The problem isn't the extreme cases, it's the every day ones. Opiates are being massively over-prescribed in cases where OTC medicine or a shot of whiskey would suffice, and this over-prescription is a driving force behind the addiction epidemic.
- randlet 9y ago
  > or a shot of whiskey would suffice Not sure if you said it in jest or not but alcohol is also highly addictive, prone to abuse, and harmful to your health and IMO would really not be a step in the right direction. edit: I almost added to my comment "It's almost taboo in our society to mention this fact" but didn't. I was almost immediately down voted so I guess maybe I'm not wrong...
  - sliverstorm 9y ago
    Yeah, but what is it, 1/8 Americans are already alcoholics, so 12% of the time you're not making things any worse!
    - walshemj 9y ago
      As on expat UK-> USA said if you have a pint for lunch people start leaving AA leaflets on your desk. A while back I was talking to a course tutor who in the UK gave the "dealing with staff with serious addiction problems" course - he commented its when you find 3 or 4 stashes of vodka hidden in the office that you know you have a problem

SheepSlapper 9y ago

Agreed, I've been lucky and only required a few surgeries in my life. Every time I get handed a jug full of opiates, and end up taking ibuprofen instead. Personally the pain management I get from ibuprofen is similar (definitely less, but sufficient) to the opiates but without the side effects.

mjcl 9y ago

I had a slightly different experience, luckily, I guess. When I was in recovery after having a brain tumor removed, I was first being given fentanyl once every hour or two. I found that for the few minutes I was lucid (before the next dose), I really didn't have much pain and asked for something less strong. They moved me to norco, which still seemed too strong. After another request for something less, they moved me to plain tylenol. I did get a big script for norco when I was discharged, but their instructions were to take it if the pain became distracting. The nursing and medical staff at the hospital (CPMC Davies) overall seemed great, so it may just be the difference between staff that listens/tries and staff that doesn't.

pasbesoin 9y ago

Same here. After a LONGGG phone call cradling the receiver while trying to type, etc., I had my neck spasm severely -- so much so that the following day someone else had to drive me to urgent care (1). They prescribed a strong muscle relaxant in combination with either Percocet or Vicadin -- I forget which. I switched over to the default over the counter dose of ibuprofen, and it worked better than the combination of those two "heavy duty" prescription drugs. I will say, though, that doctors in the U.S. have been damned cavalier about ibuprofen. One doctor with a popular radio show would cite the nickname, "Vitamin I", and routinely tell people to use it non-stop for a month or two. I've found that now, a few days on it will make me rather lethargic. My cardio strength and sometimes rhythm feels impaired. And lo, there are studies now coming out that indicate it may carry as much risk as Vioxx and the like. (Incidentally, a doctor prescribed me Vioxx a month or two before it was yanked from the market. I questioned this, remarking on recent news I'd read indicating it had problems. He had no clue and told me it was perfectly safe. Sure, it was still on the market, then, but he appeared to have no clue about the looming controversy.) With any medicine, it really seems TANSTAAFL. You have to carefully weigh the benefit against known as well as suspected risks. And the U.S. medical system completely falls down in not fully informing not just patients but also doctors to the existence and nature of these. 1) Well, that urgent care experience -- a new facility opened by the premier area hospital -- was itself a horrible experience. Deserted facility, by all appearances, yet it took about 2.5 hours to see a doctor. Who gave me no neck brace; family took me to their chiropractor, the next day, who DID give me a neck brace -- which provided the first real relief and stopped me from constantly retriggering the injury with every movement. To be clear, I refuse to have my neck cracked. And the chiropractor wouldn't have, at that point, anyway, given my severe spasming. But at least he had the sense to immobilize my neck. (Then he provided some ongoing care to encourage the release and healing of the spasming. To whatever extent this may have helped, that initial immobilization was key. WTF was wrong with that fully credentialed MD serving the urgent care's rather extensive ER facility?)

mholmes680 9y ago
I've found through my experience that the choice of urgent care vs a non-urgent care doctor is more important than I have always thought: An urgent care center wants to focus on the shortest path to getting you relief (your story aside). They'll err towards slightly over-prescribing. The non-urgent care doc will take a more comprehensive treatment path. A slight distinction that might not matter sometimes, but i often wonder how many antibiotics/pain killers I've taken prescribed from urgent cares that were possibly overkill.

ryanmarsh 9y ago

Took morphine for a back injury, I just got sleepy but still had the pain. Took Percocet after a shoulder surgery, I just slept through the pain. I also understand now why people get addicted. I get raging migraines, Excedrine is the only thing that works for that. True story, when my daughter was in the hospital (cancer) we overheard a nurse and doctor discussing what to give a child (also with cancer) for tooth pain... "morphine". The nurse was like "for a tooth? can't we tell the mother to give him Tylenol?" Also, true story Tylenol is not "formulaic" (I may be saying that wrong) at many hospitals. Meaning THEY DON'T KEEP IT IN THE PHARMACY (the one that fills orders for internal use). I was very surprised to learn this.

empath75 9y ago

had a similar interaction after an appendectomy, except the nurse asked me if I was an addict after i said I didn't want opiates.

phofangor 9y ago

I find it very odd that a nurse would be so cavalier about that. There are a lot of people who can't/won't take prescription pain meds for a myriad of reasons. Some are concerned about addiction, but other reasons are religious/philosophical. I've always been asked if I want those kinds of pain meds, even when they are highly recommended, it was always a question.

temporallobe 9y ago

> just take the pills God do I hate medical professionals like that. It's as if they don't want you to steal any of their elite knowledge or that you as a patient are beneath them. How dare one of us ask a semi-intelligent question!

arcbyte 9y ago

That is straight up malpractice.