Editor’s note—It’s great to have Liza back writing with us, she’s so honest.
December 2oth, 2019 I was scheduled for removal of my fallopian tube for hydrosalpinx and an oophorectomy (ovary removal), due to ovarian cysts. I’d had my right fallopian tube removed in roughly, 2000, as well as my uterus. The birth of my youngest, who was born prematurely, as was her two older sisters, had put a lot of strain on by body. It still kind of felt like things were being removed piece-meal, but I was glad to have the surgery as I’d spent the last three months in a great deal of pain. Had I been able to I would have done it sooner, but being close to the end of the year, I wasn’t the only one with this idea. But this shouldn’t be a problem. Your surgery shouldn’t end up being like a booked-up flight and you shouldn’t be treated like you’re just another passenger. Because you’re not; you’re important and unique and this is your body.
I must begin by saying I’ve saying I’ve had many surgeries in my life. Enough where I can distinguish the good, the bad and the ugly. This surgery went off without a hitch. It was everything that came afterwards that left us scratching our heads. It began with pain management. Not surprising, but not in the way you might be thinking. There was a valid reason (as far as I know). The meds they were giving me were opiates which are central nervous system depressants that can lower blood pressure. This can also make the person drowsy, while irritating the opioid receptors which block pain and suppress the cardiovascular system. Causes of Low Blood Pressure with Opiates But, and it’s a very big but, the medicine they chose to send me home with (which I only found out after picking it up at the pharmacy), was the same medication I have been taking for almost five years now. This understandably left me extremely upset and as soon as I was able to, I was on the phone calling my doctor- the one who performed the surgery, to find out if there’d been an error. Mind you, this was already Saturday morning, so I had to speak to the answering service which put me in touch with the on-call doctor. By-the-way, this taught me an important lesson: on call doctors cannot call in opioids because those must be written on triplicate. I don’t know if this is just a Texas thing because I’m not well versed in opioid laws from state-to-state, but I was told my appointment would have to wait until Monday and I would have to show up to the office and wait to be seen. I did this and it was the following part which ended up being the convoluted part, as I will explain.
My ob-gyn sees me, checks my incisions and asks me about the pain- which she explains to me that she can’t do anything about it. I must call my pain management doctor and speak to him to change the medication because she can’t prescribe anything stronger than the hydrocodone that she already prescribed. It seems strange to me, but she is the surgeon, and if she said that is how it is why would I argue? I leave the doctor’s office and while I am in the car driving home, I am calling the pain management doctor. This is all feeling very repetitious by now. Same old story told repeatedly. There aren’t any appointments, so I am on stand-by in case there is a cancellation and that evening I called. There is a cancellation for 9:45 on Christmas Eve and I am there, hoping to be heard, hoping that my pain will end.
Confusion abounds over responsibility of my medicinal needs. It feels that much of it could have been cleared up without me as the mediator, calling and going to see one doctor and then the other, being able to feel the frustration grow. I feel I am in the middle of a game of “Not it” where my doctors are running around trying not to get tagged, with me hopelessly hobbling around with my cane chasing them. It feels like the chronic patient has been forgotten in this vortex of opioid hysteria, where the legalities have become more important than treating a patient’s pain. I could have gone home with stronger medicine for a few days that would have solved everything, instead of medication that I have been taking steady for 4 ½ years 3x a day, and that my body is accustomed to. Taking them after surgery was very nearly like swallowing some M&M four days straight. Think about that for a moment. Is that fair? Is that moral? Is that right? Is causing the suffering of a patient right? I don’t think so. Yet, I never got angry. I never raised my voice. Never blamed anyone. All I wanted was someone to help me. Like most pain patients. To be heard.
This is something I think we are going to have to reconcile as a country and as a profession, very soon. That line, which was never crossed before, which I now see being used as a jumping rope: the good of the patient. What does that inherently mean? How keep true to it without crossing that line? Has anyone said explicitly what that line is? Is it just creating a drug addict in a person who would not otherwise be one if it weren’t for pain medication? Is there a way to predict that without hurting the millions of pain patients out there who don’t abuse their medicine? We’ve been staring at this crossroads for a long time now, but I do believe we’re at the brink of a dangerous tipping point. Patients who do not receive the medicine they need to quell their pain will begin to seek alternatives- and those could be dangerous alternative- and then what have you truly prevented?
-  Wood-Moen, R. (2017). Healthfully. [online] Healthfully. Available at: https://healthfully.com/135531-causes-low-blood-pressure-with-opiates.html [Accessed 3 Jan. 2020].