For Cereal, Time?

I was perusing the internets doing some research for work when I came across this lovely list from Time.

Seems some orthopedic surgeon is now the ultimate authority on all things medical…in every iteration thereof. Doesn’t matter what specialty or what your history. Dr. Scott Haig is now the expert, so stop what you are doing, right now. Do not pass Go, do not collect $200, and certainly do not trust whatever you have worked out in your personal health care, and just do what Our Dear Dr. Scott says.

Of particular interest to me is that the Great Dr. Scott says that narcotic pain medication “never” works for chronic pain. Ever. You should never use it unless your pain is acute, and if you are using it for such, you should stop, now. Forget your medical history, or whatever other methods you have tried or that have failed you:

The drugs are relatively easy to get and tempting to take, but you should never use them for chronic pain. Narcotics addiction is insidious. The drugs change who you are, and over time they make any and every pain worse.

This tidbit makes me want to say something to Our Dr. Scott…something that starts with an “F” and rhymes with “uck You”. Because Dr. Scott does not know my pain, or what I have been through trying to manage it, or how for the first time since all of this started I am living a semblance of a life that doesn’t leave me feeling worthless.*

I have some other very interesting and loud thoughts on Our Dr. Scott’s advice on “Exercising an Injury”, “Overplayed Allergies”, and “Google Abuse”, but I will let you all have at it now. I am going to go chronically abuse some narcotics.

/sarcasm.

*As in, each person has to decide what they can live with, want to live with, are willing to live with in terms of their medical care, and base their decisions on that personal choice insofar as it is in their control to be a part of that choice. It is part of my privilege to be able to do so and to say “I want to be able to do these things, and these side effects are worth it”. It is not that way for everyone, and I want to acknowledge that.

21 Comments

  1. I imagine the Great Dr Scott would change his tune rather quickly if he ever had to live with any type of chronic pain, but he would probably use the excuse that he could handle narcotics for chronic pain because he’s a doctor and knows what to watch for, etc blah blah blah. Isn’t it just wonderful how someone who has never had to deal with your experiences thinks h’ knows just exactly how you should cope?

  2. wow. this guy is incredibly ignorant, and that is sad. for one thing, if i had avoided using my wrists until the tenderness went away, i would literally have no use of my hands today. for another thing, how do decreased fees make it easier to get into medical school? that just makes it easier to PAY. duh. i hope everyone just laughs in his face.

  3. And what about those of us who can’t use anything else, hmm? Crohn’s Disease = any other pain medications for my severe psoriatic arthritis are right out the window. I literally have no other choice.

    I *love* (meaning hate) people who insists that a one size treatment ideal fits everyone.

  4. “Too many specialists?” where are all of these specialists working that it’s so easy to see one for a first line of treatment?

  5. A couple of things stood out to me: “You’re easily spending hundreds of dollars a year to buy into a health plan you rely on daily”

    Ah hah ha ha ha!!! Ooh, that was a good one, Dr. Knows Everything! I don’t spend hundreds, you silly goose! I spend *thousands*. Many thousands, because I’m “lucky” enough that I got private coverage before I was diagnosed with MS.

    And this, too: “your internist…is the single most important bulwark against disease in your life.” O rly? Not in MY life, he ain’t. That would be my physiatrist., who is the only doc I’ve found who will treat my pain without condescending to me about narcotic abuse. AHEM.

    Massive fail all around. Ugh.

  6. I hate the attitude that says that everyone with chronic pain is abusing narcotics based medications. My friend has a whole bunch of inter-relating stuff which means she is in constant pain, but her choice is to live with it as much as possible, take paracetamol if it gets too much to deal with, and if it’s worse she’ll go for ibuprofen or co-codamol. As you said, “…each person has to decide what they can live with, want to live with, are willing to live with in terms of their medical care, and base their decisions on that personal choice insofar as it is in their control to be a part of that choice.”

  7. A few weeks ago I tried having a debate with a know-all ME blogger who couldn’t understand why a particular long-term very severe ME sufferer relied on morphine, when it’s addictive and builds tolerance, etc. The fact was that she hated using it for that very reason, but it was the only thing that worked. Funny how some blogger can know what’s best for someone she read about in the papers without meeting them or anyone who knew them.

  8. Too many specialists? Scuse me?

    Clearly the man has never had anything the PCP a) had never heard of (central adrenal failure) b) had never seen (ehler’s danlos–bonus points in his list for the random aches from that. Where’s my full body brace?) c) wasn’t gunna touch (difficult epilepsy).

    Woe. Maybe I should go taper off my chronic medication and see if I have spontaneous remission, like he suggested. Google certainly lied to me that it doesn’t work that way!

    /snark

  9. “Narcotics addiction is insidious.”

    You know what else is insidious? Chronic pain. While I’m not totally thrilled about the narcotics I take — because even with them, I can’t do everything I want to do — they do alleviate my pain so it’s not at fear- and panic-inducing levels. Thus, on the narcotics, I am not tempted to combine large amounts of multiple other drugs while simultaneously removing my uterus with a grapefruit spoon in order to have hope of relief.

    With the unelevated heart rate, lowered blood pressure, decreased vomiting from pain, and increased ability to sleep at night, narcotics have had a measurable positive effect on my physical health. The opinion of the esteemed (the kind of esteem that can only be coupled with acute sarcasm) Dr. Scott aside, I suspect my physical health is much better with narcotics than with non-narcotic-alleviated pain.

    That’s the thing I think some people who don’t have chronic pain forget: It’s not just a choice between less pain with narcotics and less pain without narcotics. It may be a choice between less pain with narcotics and more pain, maybe even not-live-with-able pain, without.

    I’m already wary enough about my narcotic use because of the large amount of writing and information that describes the risk of addiction, not to mention that Almost. Every. Person who knows about my use of them — GP, gynecologist, each doctor’s respective support staff, pharmacists, pharmacy techs, partner, mother, sister, friends, a couple of coworkers, and some folks on the internet — has mentioned it to me. Some people have only said it once and let it drop; others talk about it as part of their job. I get this, and I don’t mean to suggest that everyone who talks about the potential for addiction is out of line in discussing it with me.

    But — I can hardly be unaware of the risk. It’s not like I haven’t heard about it enough, and it’s not like it doesn’t run through my mind every time I cut a Percocet in half and swallow.

    And I love (there’s that sarcasm again) that the “narcotics trap” is Number One on the list. Clearly of all the missteps that are plaguing medical care, this is the worst. It is much more prevalent than, say, health care providers dismissing patient concerns without prescribing narcotics or insurance companies (where applicable) refusing to cover treatments and so denying care that way.

  10. I once decided I’d cross the “addiction” bridge when I came to it.

    But for the time being, it hurts. I’ll never be like I was when I had my first kidney stone, because I had no idea what was going on. I’m not scared of the pain like I was then, but sometimes its ability to wallop me still surprises me.

    After four years, it still surprises me. Oh, you enjoy stretching out and laying on your back to ease your pain? Nope. Oh, you’re yawning? Ha ha, like those knives?

    But nobody here can write an article on how narcotics have helped us live something near a so-called normal life. We’re biased, we’re (most likely) not rich, and who’s going to listen to a bunch of stoners anyway? But if we’re biased, why isn’t he? Yes, a nurse or doctor can provide inside information (so can getting to know the nurses – who really run the place – at your local clinic – PCM, GYN, whatever), but it doesn’t have to be so damn shaming.

    Of course, docs are nervous about prescribing “too much” pain medication because what if that one is an addict?!

  11. Wow. Well, I’m not surprised at so much fail from an orthopedic surgeon, since it was an ortho who told me I should stop complaining about the pain from my broken bone since broken bones hurt (as if I didn’t know that already) in the same breath that he told me since it had been almost 2 months since the break I should be walking on it already – completely missing the fact that I had all the classic symptoms of Complex Regional Pain Syndrome. The same ortho who told me it was way too early to begin physiotherapy, and then two days later a physiotherapist not only correctly diagnosed the CRPS, but also initiated the intensive physiotherapy and exercise that got me back the use of my foot. But exercising an injury is wrong, isn’t it? As for too many specialists, gee, I should have stuck with the just ortho and not gone to the physiotherapist so that today I’d be… not walking. Ever again. Because that’s what happens when you don’t treat CRPS.

    That ortho must have gone to the same ortho school as the one who wrote this ridiculous list.

    (I only WISH narcotics worked on CRPS – I would take them every day with glee and a clear conscience. Alas, no such luck. They make it worse.)

  12. “When you show up complaining that something hurts, the easiest way for a doctor to get you out of the office is to send you off with a prescription for a pain medication that contains a narcotic (like Vicodin or OxyContin)”

    Actually, the easiest way for a doctor to get me out of the office is to either explicitly or implicitly blame everything on my mental health problems. It’s amazing how quickly I leave when that happens–and it does, far more often than a doctor deciding to give me narcotic pain medication (which has actually NEVER happened to me). Given how difficult it seems to be for people to obtain adequate pain medication, I imagine that’s because these generous doctors who will dispense narcotics at the drop of a hat, just to get rid of you, DON’T REALLY EXIST.

    And for crying out loud, dependency and addiction are not the same damn thing.

  13. The too many specialist thing cracked me up, because no one is more likely to refer me to a specialist than another specialist. My old endocrinologist sent me to a rheumetologist who suggested, when I mentioned my recent digestive symptoms, that I go to a gastroenterologist. I couldn’t even get either the endocrinologist, the rheumetologist, or my gynocologist to treat my simple sinus infection, no, they all told me I needed to make an appointment with my GP for that.

    The delaying treatment one is a big one too, because when I go in before I’m seriously ill, they write me off, and then when I wait until I’m really bad, they yell at me for waiting so long. The doctor who diagnosed my PCOS lectured me for not coming in with my symptoms earlier, despite the fact that, years before, I had complained to several other doctors about similar but more minor problems only to be told to stop making a big deal out of nothing (or that I was just whiner or a fattie). You know why patients don’t go to their doctor first thing? Because most doctors don’t deal with patients who do with respect.

    The ‘too much choice’ thing reads to me as ‘shut up and obey’.

    Maybe we should make a list for doctors, I’m thinking informed consent and actually reading all of the damned paperwork they make you fill out as a good starting place (one doc actually suggested I might have appendicitis, even though I had written on at least a half a dozen forms that my appendix was removed when I was four years old).

  14. What worries me is how much other medical professionals listen to these kinds of appalling mis-advice. I have doctors quoting “evidence” to me that I know is based in opinion rather than research, but I don’t have the knowledge to defend myself against this crap. I’m going to have to start reading medical research…!

  15. This reminds me of a list, actually, now that I think about how angry this one made me, from Reader’s Digest, a few years ago. The article was something along the lines of “Things Your Doctor Won’t Tell You”, and I thought it would be some insights on how to make the most of your office time or something. Instead it was a long list of shaming and snark from several doctors, a few who wouldn’t give their names so that they could say horribly rude and nasty things about patients they used to have. It made me cry, and is one of the reasons I am afraid to go to a doctor when I first start to notice a new symptom.

  16. Ouyang Dan – most of those “What your X won’t tell you” “stories” come down to a few things – I don’t care about you, I am a business person, and I don’t care. Also, I’m busy.

  17. There was actually a column in the Guardian, a (mostly) quality British daily, by some doctor calling himself Dr Crippen (a surname borrowed from an early C20 doctor who murdered his wife and was hanged) which was a lot like those you (Ouyang Dan) just described. He caricatured his patients, particularly the women, as a bunch of hypochondriacs and malingerers, especially those with ME or suspected ME (he even had a side-swipe at the lady I referred to in my last comment). The columnist known under the pseudonym Theodore Dalrymple is also notorious for sneers about his patients (he is a psychiatrist and has worked in British prisons). It’s kind of worrying; I’m pretty sure my GP is not “Dr Crippen”, but he’s not the first person I’d like to have to go to with a niggling health problem.

  18. Dear Percocet,
    Thank you for keeping me out of the hospital this week. (Where, they probably would have just given me another type of narcotic, but in higher doses and in an IV.)
    Sincerely,
    Assiya

  19. …people like this just make my brain break.

    Yeah, I have a whole gaggle of specialists. I have the herd of them because when you have a collagen disorder, nothing works normally. When nothing works normally, you need to see a specialist for each part that is a bit odd. Your gastrointestinalist can’t really help you with your joints. Your physiatrist can’t do much about your bladder. Your urologist can’t deal with your migraines. Your migraine specialist doesn’t do sleep disorders. Your sleep disorder specialist doesn’t know much about seizure-like activity. Your neurologist doesn’t know shit about Ehlers-Danlos Syndrome. And none of them deal with skin, and as I have a mole behaving abnormally, I need to see a dermatologist. When you get down to it, most of what my GP does is triage and direct traffic. He takes care of the more routine trouble – allergies, sensitive skin, minor infections, so on – but the big troubles in my health tend to end up at specialists because they’re bigger troubles than a GP is really equipped to deal with.

    And my life without opioid pain relievers is one that brought me to the brink of suicide before they started treating me appropriately. In my case, it’s a combination of opioid and non-opioid pain relievers. I’m dependant, sure, but I’m not an addict. I don’t want more, I don’t get high, and really all it gives me is the ability to shape a life that has richness and a reason for being.

    Should your average, healthy AB be seeing a herd of specialists like I do? Hell no. Should they be taking the same prescription pain relievers I am? Again, hell no. But it’d be nice if in their recommendations, doctors in the media could maybe just de-center their talk from the AB experience a tiny bit. I’m not asking for much. Just, you know, not telling me that the things that are necessary for me to live are bad bad wrong bad.

  20. My mother is a chronic pain sufferer, and she’s gotten the point where someone has to go in with her so the doctor doesn’t treat her like a child. You see all these ads about how doctors want you to ask questions and educate yourself, but then they are hostile to you being a part of the process. Thanks for exposing this guys jackassery – I’m going to send this my mother, sort of let her know “Hey, you aren’t the only one.”

  21. Garland – on Friday, because I wanted to do something new and ask for different pain medication (an older one), I made sure my mom was in there with me.

    Sometimes she gets mad at me (you’re a grown-up!) and won’t go in, but with every new doctor and new step on our part, she’s in there.

    Like Thursday – “I’m not waiting 2 to 4 hours! I’m going to Target!” “It’s a new doctor, please, and you know I don’t remember anything!” So she stayed and harassed me and a student via cell phone.

    With everything I’m on and the natural problems with memory, it helps to have 2 people there. Especially with Dr Ego (who prescribes my pain meds) because he’s triple booked each time we see him, and we don’t want him messing up.

    (Why doesn’t he carry the entire brick of my records with him? WHY do they always have just one sheet? I ask what something was last time, “I’ll go check” and they never do. And he prescribed something I was already on a couple months ago, because he just had my word about the dosage. My other docs either carry the brick or have it all on computer cause they’re cool.)

    So word on the other person. I always thought it meant I wasn’t getting taken seriously, because I “still need my mommy” but I’m like eff that, I need a 3rd party to say “she’s complained about pain X times, she’s done this X times” because I’m like, um yeah, er, it hurts.

    And word on questioning! There’s a reason he’s Dr Ego. Though he’s mellowed a bit.