I was denied sedation/effective pain meds before a procedure pretty recently. Despite the fact that I spent the entire time literally screaming in pain, they dismissed it as “anxiety” and did nothing to help.
I also received very little when I first came into the hospital - as my body was flooding with literal shit and I was fucking dying. They let me writhe and roll around for hours before they mercifully knocked me out for my operation.
I’m traumatized to the point where watching movies where people experiencing pain is upsetting. I was watching fucking Avatar the Last Airbender and wincing every time someone got punched or kicked.
I also go back to getting my IUD put in - again, another extremely painful procedure that is “not supposed to hurt” so there is no option for sedation or effective pain meds.
It feels like asking for pain meds gets you labeled as a drug seeker/addict too. I made the mistake of mentioning that I smoke weed (because I knew the anesthesiologist needs to know that) and it feels like it was instantly assumed that I’d be a pill popper too.
And I have extremely high pain tolerance. I’ve literally had people whip me until they’ve drawn blood. I’ve worked a fast food shift with a second degree (even a bit of third degree) burn going down the majority of my arm. I’m not a wuss, I know how to breathe in ways that help, I know how to go to a mind palace, but Christ, when you start digging around in someone’s guts with sharp objects, that’s not really something you can meditate away!
Is it training? Is it the fact that becoming a doctor in the U.S. requires the kind of upper middle class upbringing that doesn’t tend to help people develop empathy?
We’re in the throes of a few crisis in the US:
- a professional backlash against the over-prescription of opiates that were advertised as “non-addictive” which was actually a lie,
- the monster the above crisis created: a domestic population of drug addicts who are either seeking drugs themselves or looking to non-addicts to acquire them,
- constriction within the health insurance marketplace, demanding more and more justification for care and drug access,
- an entire political system that’s in the pocket of said industry who are incentivized to manufacture a world that maximizes health care spending while minimizing actual health care delivered.
Studies have also shown that female pain is ignored far more than male. I think this shows just how much men don’t trust women.
Also, some doctors look for signs of low pain tolerance rather than just pain. So the ability to maintain composure despite pain can be taken as a sign that there isn’t any pain.
You’re female which is a detriment to appropriate medical care, being non-white is also a detriment to care. As others note there are also various systematic and medical reasons a doctor may not prescribe or use pain-relievers especially prior to understanding the problem.
I will say you need a new ob/gyn as there are recent updates that make pain relief a standard for iud insertion.
My mother literally had a gynaecologist just tell her that they’re putting her under general anesthesia for a surgery where other clinics won’t because “we don’t believe in torturing our patients”.
Thank you to that clinic. We need so many more of those in the world.
NGL as a white guy I just have to ask nicely for the good drugs and they give me opioides, granted it’s for kidney stones and it’s the most pain I’ve ever experienced, but honestly it sounds better than whatever OP was going through.
I do think I present with classic pain symptoms, I litterally can’t form sentences, which might help.
Kidney stones are known as one of the most painful things, and knowing the problem means the pain is no longer important for diagnosis.
True, however the first time they gave me fentanyl before they did a CT scan, they had figured it was stones but only had my pain to go off, so I suspect I got better treatment than if i’d been an equally erratic POC or woman, but hope I’m wrong and they’d give everyone similar treatment.
I’m going to mostly focus on the more legitimate answers since you already seem to know some of this was possibly / probably oversight / neglect and that they should have given you more.
a) the big one is pressure from regulatory agencies to prescribe less narcotics. Some of this is legitimate; a lot of the opiate crisis was started by pharma companies lying about how habit forming their medications are and intentionally encouraging dependency through overprescribing to sell more, but a lot of it is also just straight up puritanical and part of efforts to disrupt minority communities that are more affected by illicit drug use. In the end though, even if they don’t share the stigmatizing view of it, there’s little individual prescribers can do about it.
b) there’s huge pressure in institutional environments to do ANYTHING to prevent falls. In addition to getting stingy with sedatives that might make you dizzy there’s also pressure to have 1:1 care where people watch the patient in the bathroom and we used to even restrain old people to keep them from falling (although thank goodness that’s finally falling out of favor). To get rid of that we’d have to accept that sometimes people just fall and crack their head open and die and that’s life but we’re just not there yet as a society. In the US everything needs to be someone’s fault and if the doctor prescribes a sedating med and I give it and you fall, it’s partially considered my and the doctor’s fault. If we do ALL the environmental AND don’t give sedating meds, it’s considered less our fault.
c) There’s legit specific medical reasons sometimes. If you had a bowel obstruction opiates are actually specifically contraindicated since they’re the medications MOST likely to cause constipation. Now if surgical intervention was the best option it might make sense to give them anyway, but there may have been some waffling on what the best option was and they couldn’t un-give you the meds if the final decision was to have you pass it with medication / enemas instead of surgery. And bowel surgeries have a huuuge possibility of sepsis and having to parts of the bowel removed and having to get regular vitamin shots for the entire rest of your life (once had a bypass patient so iron deficient she stated hallucinating) so that’s not a decision to make lightly.
d) insurance in the inpatient environment likely didn’t interfere with the medication prescription directly. they probably DID interfere with the surgical decision which may have interfered with the medication decision (see above). but the bigger issue is that insurance agencies in general do something waaay more insidious than just avoiding paying. they create and fill a psychological need to find someone to blame for things. every time something bad happens in the US we immediately try to figure out who to blame so we know who’s paying for it. this is your health but also to your house and your car. the insurance is there more than just to pay but also to pay court fees if the blame isn’t immediately placeable. if I give you a sedating medication and you fall, the insurance doesn’t pay for it they make the hospital pay for it. So as a result the hospital pressures me to not give you that medication so you don’t fall and leave them with the bill. to truly be rid of insurance companies in general we would have to fundamentally move away from blame culture. we would have to shift to a mindset of, wow that’s horrible but we as other humans are going to take care of you. and like I said, we’re just not there yet (but universal healthcare is definitely a step in the right direction; that kind of change can’t start with individuals struggling to make rent).
I can just tell you that it’s not universal: several doctors I’ve seen and know are very cautious when it comes to pain - both from own experience (“we will go strong with the pain killers for the best two days to prevent stress reaction from the body”) to others (“we need to get the chronic pain under control fast, otherwise there’s the risk of phantom pain developing even after we’ve tackled the issues”) (not verbatim quotes of course but the gists).
It might not even be US generic but a regional or age thing in the doctors you’ve met - remember that usually everyone one of us has only a very limited insight into the whole medical industry.
I’m similar to you in terms of pain tolerance and I’ve walked away from a doctor who talked shit about pain in patients - but I’ve head way better experiences before so that didn’t feel like I’m being stuck with this one medical “professional”.
Wishing you the best of luck though! It’s absolutely terrible when people don’t take you seriously, especially if it’s their job to help you :(
I can see from you talking about IUDs that you are a woman.
Which I believe answers your question, especially if you happen to be a non-white woman.
Doctors, Even female doctors, even female doctors of color, are incredibly dismissive of pain in women in general, and frequently hand wave it away as the woman being hysterical, over reacting, anxiety, etc etc.
I’m a guy, but I know this statistically, and I also know it from witnessing how doctors treated female family members who were in pain. . and from my personal witnessed experience, I’d say female doctors are even worse about it than male doctors.
also, on an unrelated note, does anyone else cringe when seeing/using the word female? even if its in a grammatically correct place to do so, thanks to fucking incels and their weird ass filling it with derision and attempting to turn the word into an insult?
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The side effects of medication can interfere with diagnosis and treatment
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Pain can be a useful diagnostic indicator itself
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They see people in pain all the time, so it doesn’t seem like an exceptional state to them
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People with low pain tolerance, and people feigning pain to get opiods, are overrepresented in the population of people seeking medical care, so experience conditions medical providers to overweigh that as a potential factor
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Its because of crackdowns after the opioid epidemic years ago. Doctors were handing out oxycontin because the manufacturers marketed it as being non addictive. Apparently medical professionals actually believed this.
If you want something dont mention illicit drug use. But it probably won’t make any difference
Probably just thanks to insurance companies yet again
Doctors don’t get to make their own decisions anymore, they’re paid more like car mechanics and get a “job rate”.
Change a tire? It’s billed at $28 bucks. Doesn’t matter if it takes you 10 minutes or an hour. Air and balancing is included. Anything extra you don’t get paid for.
Gotta put in an IUD? You get $500 for the job, included is one shot of pain meds, the IUD, and one set of sterile equipment. Pain meds not working so great on this patient? Insurance doesn’t pay for extra, outpatient center doesn’t get paid for it or has to fight insurance for it.
Same for novocaine in dental work.
Insurance is terrible.
The fact that insurance companies are allowed to deny claims on the grounds and on medically necessary against doctor’s orders without being required to pay for second opinion from a doctor is insane. They are literally a core operating part of the medical system and it’s the most dysfunctional part
I actually don’t have insurance so it probably wasn’t a factor.
I am super fucked lol.
There was a nurse in a fertility clinic who was an addict and replaced the fentanyl drip with saline. Multiple women experienced agony during the procedure for extracting eggs. That procedure was to insert a huge syringe into the vagina, through the vagina wall, into the ovaries to suck up some eggs.
Many women experienced this with no pain medication at all and their complaints, even their screams were dismissed. Needless to say, when the addict nurse was discovered, they felt pretty silly.
Doctors have incredible tolerance for the suffering of women.
This is marginally related but in case anyone else doesn’t know: dental procedures are not supposed to hurt.
I grew up terrified of dentists and ended up not going for nearly 10 years because of the fear/pain. I finally gave in when a tooth broke in half. The dentist I went to gave me the regular amount of numbing stuff and about 5 mins in saw in my face how much pain I was in and from then on she always gave me extra. I just have a high tolerance for the stuff and had never been receiving enough.
About half my teeth are now hollow stumps, i finally decided I’d look into getting treatment in spite of being scared off by stories of $50,000 replacement operations without anaesthetic. (Australia btw).
Thanks for the reassurance.
Wtf? No this is not normal. My wife even gets pain meds for the Dental Hygienist, because she has a fear for the dentist or anything dentist related. I think it is absolutely unnecessary, but maybe she has hyper sensutive teeth or something. I’m not a doctor. Anyways, the pain meds help her, so she gets them, regardless of whether it is just phychological or not.
I think you’re just suffering from the ridiculousness that calls itself the US healthcare system.
I got surgically sterilized because the pain from that was less than what an IUD would have been.
The only pain I felt was for the initial IV stick. After that it was nothing.
I will refuse any painful procedure that doesn’t have adequate pain relief. I don’t care if I die.
Medicine keeps getting away with this shit because women just accept it. Endometrial biopsy? Only if I’m completely out. If not I guess I’ll enjoy my hospice drugs while I’m dying.
IUD? Lol I just cut my shit out instead. I need hormonal treatment for endometriosis still, but I just take hormone blockers for it. Way better than dealing with sadists.
I’m too fed up to live through this shit anymore. I have no kids IDGAF.
Part of why my condition got so bad to begin with was because I’ve had so many bad experiences with doctors that I didn’t go to the hospital until I started feeling unbearable pain. I spent a full two weeks with an infected abscess just getting worse and worse because I figured that whatever it was would be blown off if I went to the hospital - because that happens any time I’ve ever gone to an ER.
I need to get my IUD replaced (it’s been 10+ years) and I’m terrified. I don’t have insurance, so my best option is Planned Parenthood, who told me that it was “just a little pinch.”
I’ve been fucked with knives and wartenberg wheels (abusive BDSM relationship). That shit was not “a little pinch.” I filled up a diaper with blood afterwords.
It’s to the point where I avoid seeing doctors, unless it’s the nurse practitioner who does my hormones - he’s the only doctor I’ve felt listened to me.
They’re so damn condescending too - I’ve taught biology and chemistry - I can understand a real explanation of what’s happening and want one!
I’ve stopped seeing doctors in person for the same reason. I only do virtual appointments.
Can you do any alternative to the IUD after it’s removed? I’ve never considered one and did any other alternative I could. I have endometriosis so did birth control then hormone blockers when those stopped working. I had my tubes removed for birth control. At some point I’ll have my ovaries removed if the hormone blockers stop working. I’d rather just throw everything out than have to do an IUD. Medicaid had covered the sterilization entirely.
I’m sorry you’re dealing with this.
As others have said, it’s a backlash against the pill mills, we have overcorrected.
I get migraines occasionally, and have Imitrex shots for them. I love that drug because it is not at all druggy - it leaves me clear headed with no migraine, there is a nauseating unpleasant rush when administered, then it’s just like walking back in time, headache fades to nothing.
But a handful of times (like literally 6 times in 30 years) I get status migraine. Imitrex does not avail me, 4 days no food no water I will puke even a spoonful of water.
I used to be able to go to the doctor and get some shots with some opiate and fenergan. They would do one, I would still be puking and crying, they would come back every 20 minutes or so and do another until I was so far away from the pain it wasn’t bothering me. Then I could sleep and it worked every time, even though it did not work by killing the pain immediately (painkillers don’t work for migraine) the high plus sleep always worked. Maybe $50 -$100 total cost.
But the last two times I got this, the doctor couldn’t do that, it was outlawed. They sent me to the emergency room. Cold IV in a cold room, some advil stuff that doesn’t work, then send me home still hurting, can’t sleep, headache 2 more days but I don’t die from dehydration. $1,600 for a worse result.
I understand why they say the opiates don’t work for migraine, they don’t directly kill the pain. But the previous protocol worked, and with electronic health records, can they not tell this is a very infrequent event for me? I don’t even like downers. I just want the headache to break and that was the only protocol that ever worked.
ETA: and it is spotty - when I had surgery to repair my finger, the doctor gave me 50 pills of oxy, he said hands can hurt bad. But mine didn’t (and yeah I also have a tolerance for pain) and that many pills seem like enough to cause dependence, WTF? I kept a few for rescue med and tossed the rest.
To add to the backlash portion: doctors are monitored for what rxs and how many they write for controlled substances. Pharmacies are monitored for how many controlled substances they dole out. Some rural pharmacies will refuse to take on new patients with pain meds (ex: you have a recently-diagnosed cancer patient who lived in the middle of nowhere all their life, and they can’t get morphine because their local pharmacy refuses to take on another scheduled rx). Pain management typically dictates you get a few days at a time and have to be reassessed before you can get another rx, so that means throwing another one on to the pile for the doctor and pharmacy, which means more liability.
Source: spouse worked ambulatory trying to coordinate with bumfuck nowhere pharmacies to get cancer patients their meds.
I am sorry to inform you good sir or madam that you have taken part in what is known as malpractice. You should contact a lawyer immediately and change your health care provider if you are able to do so in whatever region you are located.
The classic case of:
We just discovered a new thing with a specific use, let’s sell it to EVERYBODY!
Turns out that the new thing is bad for people who don’t fit a specific use case, so in order to prevent the wrong people from getting it, we must stop offering it to the people that DO need it.
