My week on narcotics

THE DREAMS YOU HAVE when you’re withdrawing from narcotics make David Lynch look like an After School Special hack. How I got on narcotics was outpatient, noninvasive surgery on a double hernia. I got the double hernia from a mistake I made in the gym, or maybe I slipped in the bath and caught myself funny and ripped open my abdominal wall in two places without knowing it.

Doctors dump all this useless data on you and tell you nothing you need to know. Before the surgery I was given a 40 page disclaimer about my privacy rights and how hospitals use and share my medical information. I reckon I was given this because someone sued someone else once. Flash to the medical community: I want you to share my info. That’s what databases and XML and the internet are for. If I fall down a staircase in Katmandu, I want the emergency medical team that rescues me to know I’m allergic to penicillin, and I want the doctor who attends me to know what medicines I take. Thank you for the lovely 40 page disclaimer.

And no thank you for what I left the hospital with: a prescription and nothing else. After all that upfront paperwork, the hospital didn’t even bother giving me my surgeon’s name and phone number. (I had to look them up on the web when my painkiller prescription ran out.)

Here’s some information the hospital could have given me: your peas and carrots are going to swell up and look more like eggplants and cauliflower. That’s normal and you don’t need to call in. For at least five days, you’ll feel like someone just cut you open with a street knife. That’s normal and you don’t need to call in. Your sleep will be fitful, with wild dreams. You’ll wake up at 2:00 AM and 5:00 AM, unable to sleep. If you take the prescription pain killers, your sleep will be even more disrupted. The pain killers don’t so much take away the pain as move it slightly off-camera. You’ll want to take more than we give you and your digestive system will resemble that of a hardcore junkie within two days. All of this is normal. After five days, we cut off the pain killers and provide no way for you to get more. But you’ll still be in terrible pain. This is normal.

If they had told me that in the hospital and written it down somewhere, I wouldn’t have worried so much when parts of my body started resembling clubbed baby seals and seemed to be undergoing racial transmutation. While they were at it, they could have left me a card with my surgeon’s phone number and asked me to call in after four days for an evaluation.

They wanted to evaluate me next week, but I’m taking my daughter to Disney World next week, so instead they’ll see me when the surgeon returns from vacation on August 15. Meantime, I guess I muddle through.

I’m not on narcotics today and the pain is bad but manageable with Advil. I haven’t had that shit or any shit in my system for nearly 20 years, and I don’t like how close it brings me to the old days. I can get my prescription refilled by begging the surgeon’s answering service until eventually he calls the pharmacy, but I think maybe I’ll stick with Advil.

34 thoughts on “My week on narcotics

  1. From having had similar surgery – I found the first week would have been best with pretty much no movement – bed rest. The second week – half a day. (Of course I went back to work full time in 5 days.)

    I wouldn’t count on a comfortable trip to Disney for 5 weeks.

    But after a week, you should not have so much pain. Aug 15 sounds like a terribly long time to wait. And lots of pain if you are not moving or contracting your abdominal muscles just shouldn’t be there after a week. No one can guess what is wrong. But lots of pain can mean that something else may be wrong – even a post-operative infection.

    Someone should be covering for your surgeon. (Who hopefully was the same one you visited before the surgery in their office (outside the hospital?)) It would probably be a good idea to ask for the covering surgeon and get over their for a visit. If you feel warm or the skin is red, swollen tender, you can let them know that also. They may be in more of a hurry to see you with that.

    But, knife like pain with movement. Or if you watch a comedy and laugh can happen. Tragedies only this week. But have those docs check you out before the weekend, if you can!

    The 40 pages – probably a requirement of hospital lawyers but also in large part is a result of the “patient protection and affordable care act” which has a patient’s bill of rights. Of course in newspeak it means you have some rights and a lot less privacy and your information which theoretically you now control…can go almost anywhere it is requested….

    Feel better, soon!

  2. I’ve found rapid release Tylenol works really well for most things. I’ve used it on toothaches when prescription painkillers didn’t work and it was great (plus, I could actually think straight while taking it). Feel better soon and have fun at Disney World!

  3. Ouch, Jeffrey. (Reminds me of the time I had all 4 wisdom teeth out at once, but worse…after the ineffective painkillers wore off it was like I had been chewing razorblades.) Get better soon.

  4. Oh no bad grammar and misspellings! “Their” of course should have been “there”. Back to the grammar doc for me!

  5. Sorry to hear it was so tough. Especially the part that was needlessly tough.

    I remember (on TV – but that is how I learn things!) when the recovering Andy Sipowicz had surgery and his total terror of narcotics.

    Hope next week is better.

  6. I hear your pain, I had a very similar experience with pain management, Western medicine did nadda for me. Thank god for chinese acupuncture, sunshine and 12 keys to ultimate health by Dr Briffa, http://www.drbriffa.com/. More recently I have removed refined wheat from my diet and start the day with my own version of “Holy Crap” http://holycrap.ca/ Chia seeds rock, dropped over 20llbs in weight over 3-4 months so much more energy and no diet. peace peace nB

  7. As someone that has been struggling with a chronic illness for the past 8 years and having had to go through surgery (with no anesthesia whatsoever), I can understand a little bit. My thoughts and prayers are with you and your daughter.

    I hope it gets better soon!

    Gedy

  8. I’m coming up on surgery #8 in two years. Whenever possible, I refuse all narcotics. Seems like medical staff give you the important things to know when you’re doped to hell and gone. My favorite is when the ER billing team wants you to pay up when you can’t make important decisions for yourself. You just blindly hand them the credit card and say yeah sure, “here’s $50,000 for your new boat,” hoping you’re really paying your ER bill. LOL

    I’ve seen paperwork now that says, “yeah your privacy is protected but we’ll be sharing with insurance and your care team,” so rest assured the medical team will know your history and insurance will eventually hold it against you.

    Sorry your experience was so lousy. It honestly doesn’t have to be. There are medical institutions that really do put the patient first, I promise.

  9. NYU is a good hospital. They do put the patient first. And I have excellent insurance. You’d throw up if I told you how much I pay for that insurance each month, but it’s worth it for my family’s protection. And by family I mean daughter and ex.

    The nurses do tell you everything you’re supposed to know the moment your narcotized gauze-wrapped frame begins to show the least sign of consciousness after surgery. They’d probably prefer to tell you the next day, when you’re actually somewhat conscious, but it’s outpatient surgery, which means they need the bed for the next victim. That’s why I think a written leave-behind would be a good thing. Then you’d at least have printed notes telling you what kinds of horrible things to expect, and which (if any) you need to worry about.

  10. One issue on information sharing: Some years back, a friend of mine had a minor stroke..Believing that openly discussing medical info with his doctor was a good idea, he told the doctor that he occasionally smokes pot. Later, his information was “shared” with an outfit in Waco hired by his health insurance company to sift thru his medical records.

    The people in Waco found the pot reference in the doctor’s notes, and that became an excuse for the health insurance scumbags to rescind my friend’s insurance. It took him many years to dig out of the financial hole that created.

    I could go off on a rant about evil health insurance companies and how I long for the day when we get a Canadian or European system that puts these ghouls out of business, but…

    Funny how we all come our of our medical adventures with horror stories of one sort or another.

  11. I’m surprised you didn’t get a mound of written instructions.

    I had a super minor outpatient surgery a few months back in Ohio (had a mole removed from my face). The anesthesia I had was local, so I was conscious the entire time. I still got a folder full of things to know like: try not to show much emotion for the next week; don’t get the area wet, leave my bandage undisturbed for a week, stack extra pillows under my head when I sleep, take Tylenol for pain, yadda yadda yadda. I’m not exaggerating about it being a folder. It had numbers for who I should call should the area cause more pain than “expected”, started to look swollen and inflamed, etc.

    It sounds to me like whoever was in charge of you when you were preparing to leave just dropped the ball. I thought that kind of stuff was standard.

  12. Not only that, but my surgeon hasn’t returned my calls or the pharmacy’s calls, in two days. I’ve made several pointless trips to the pharmacy across the broiling tarmac that is NYC in the summer, to no avail. The pharmacy calls my doctor; my doctor’s service says he’ll call back; he doesn’t call back; the pharmacy doesn’t call me; I take the pain and lump it.

  13. My wife’s a doctoral student in Nursing.
    Plus, as a patient, she’s had more major surgeries than I can count due to a car accident years ago. She’s on major chronic pain meds and, dammit, she’s got more energy than me.
    I’m completely unsurprised by your surgeon’s behavior. Surgeons don’t do follow-up. In fact, the system doesn’t take follow-up into account.
    SEE SOMEBODY IN NEW YORK BEFORE YOU COME TO FLORIDA.
    Urgent care, an emergency room, somebody.
    Trust me, I know.
    Just because it’s an outpatient procedure doesn’t mean they can’t kill ya just the same. There’s no such thing as minor surgery.

    Best wishes.

  14. Jeffrey, I just sent you a message through your contact form. It may be helpful info. Best wishes and good luck getting better.

  15. I hope things get better for you soon, Jeffrey. I also hope the heat isn’t making it any worse on you — assuming you’re staying near AC as much as possible!

  16. And you pay for these services? that’s horrible! I never hear anything good about the American healthcare system.

    I hope things get better soon for you.

  17. Jeffrey, sorry to hear of your experience. You have a bad doctor (I’m sure you’ve figured that out by now). Get another doctor. Doctors provide services, if you don’t like them, change doctors. Your “family doctor” can prescribe narcotics if you need them.

    Double hernia is painful but if you can get by on ibuprofen do it. All that other stuff is poisons (I know I do anesthesia).

    The hospital you were in is negligent if you did not receive follow up info.
    They sound like a myspace web page.

    Hope you recover quickly.

    Richard

    ps. Gedy, surgery without any anesthesia at all? please do share.

  18. Hey Jeffrey,

    I was in the hospital a couple of months ago for exactly the same operation and unfortunately, had the same post operative experience. For days I drove my wife absolutely insane because I was not sure what to expect and the pain was insane.

    Hang in there, rest as much as possible, take the pain meds as needed and if the area of the operation is warm and red, I would suggest a stop by even your GP just to rule out any infection and to ensure that the wound is healing well.

    All of the best and I hope you get better very soon, but, this thing does take time and it is best to make peace with that aspect and allow others to take care of you.

    Kind Regards,
    Schalk

  19. That’s a rough deal. As the commenter above me said, make sure to see a doctor before going to Disney World. You can walk over five miles a day in the parks, so if you need it, get a wheelchair. Be careful, and get better!

  20. My epigastric hernia in the 90s was from that first kickoff on a leg press machine when I’d overloaded it… my legs were strong enough but that first bit just separated the muscle wall somehow. It’s easy to do. Inner muscle layer is vertical, outer is horizontal (six p ackish)… so just as I started to push and the weight freed up — it was on the end of a long extension — then i felt a hot sick feeling that I quickly ignored. Not long after I noticed the little bubble of guts poking through that i could squelch in and out.

    Luckily in our day and age it’s a minor issue. But even back 10 yrs before mine they used to cut people horizontally from one side to the other… was a big thing. My mother, an ex-nurse, still worries.

    Get well soon, Jeffrey. We’re not 20 anymore ;-P

  21. I will say that this is something that my HMO does very well: every visit comes with a follow-up sheet, which I can also get on the web if I lose the paper, and which can be reviewed at the next visit. It’s been especially helpful for visits to the urgent care clinic: do I call my regular doctor if the swelling/coughing/pain doesn’t get better in one day, two days, a week? Should I be using a heat pad or a ice pack? All those things that are way too easy to get backwards!

    I hope you’re feeling better soon!

    (BTW, my great-uncle was the first chair of UCLA’s dept of anesthesiology, and a pioneer of out-patient surgery. I didn’t know that until after he died, or I would’ve sent him a thank-you note after my partner’s lymph node removal.)

  22. Whatever you do, don’t sneeze!

    Learned the hard way while recovering from a hernia operation.

    I hope you mend quickly.

  23. You’d throw up if I told you how much I pay for that insurance each month, but it’s worth it for my family’s protection. And by family I mean daughter and ex.

    I admire your design chops. I respect this. You the man, feel better.

  24. The painkillers you are on, sorry you were on from your consultant, did they take into account your reaction to penicillin?

  25. I feel with you, brother. We all go through hell periodically. Why not lay low and lie down while considering having been doing too much. Seriously.

    In a recent re-design of a site I’m working on I did something that would have been considered plagiarism, if I’d know of what you did to your site with the red background. It was not that, it is the spirit of practical design that lead me to chose a red background, our site actually has a CSS3 blue degraded background. Very strong. Thanks for the inspiration.

    This is not meant as a joke, but you have to take our work playfully. I do follow your comments on CSS and related efforts and well, I am devoted. So, please, get a break.

    –einar

  26. I will say that this is something that my HMO does very well: every visit comes with a follow-up sheet, which I can also get on the web if I lose the paper, and which can be reviewed at the next visit. It’s been especially helpful for visits to the urgent care clinic: do I call my regular doctor if the swelling/coughing/pain doesn’t get better in one day, two days, a week? Should I be using a heat pad or a ice pack? All those things that are way too easy to get backwards!

    I hope you’re feeling better soon!

  27. It would probably be a good idea to ask for the covering surgeon and get over their for a visit. If you feel warm or the skin is red, swollen tender, you can let them know that also.

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