Sucky Doctor

[Akasa]

So my best friend has breast cancer, and has just had surgery for it. She's still healing from surgery, can barely move her arms, and is having a lot of pain in her back.
She goes to see a doctor locally, and this doctor not only tells her she shoud never have had hydrocodone in her 32 years, but treats her like she's a drug addict. Tells my best friend she's testing for a possible infection that could be the cause of her pain.
So my best friend gives the nurse the blood and urine samples asked for and starts reading the lab order form. The doctor was testing her for substance abuse! She was so pissed she demanded her blood and urine back.
I'm trying to convince her to go to the state board about that woman. That was beyond unprofessional.

(A side note, she was seeing his doctor to try and find ways to get relief from the pain WITHOUT drugs. The next doctor she saw told her that what a doctor should be saying is to not worry about beig an addict when she's in so much pain the drugs barely touch it.)

[Seshat]

1. Tramadol (at least) is a synthetic opiate that has a VERY low addiction rate. So low that some pain specialists doubt it has an addiction rate at all.

2. The Dewey Decimal System code for pain & pain management is 616, most of the books she wants cluster around 616.075. (Library science being partially an art, look in the whole 615-617 range, and/or talk to her local librarian as well.)
A good local library should have a range of pain-management books: and librarians are likely to be more helpful than certain doctors. (Sad, isn't it?)

3. The books - and my experience - suggest that of the 'complementary medicines', she should try the ones that 'sound right' first. Her body and subconscious mind know what they're after.

4. That doctor is stupid. Too concerned with the possibility of addiction to be bothered with patient care. Unfortunately, there are a lot of doctors like that.

5. Pain relief methods, the 2c tour.
(IANADoctor, I just have a pain disorder & knowing this stuff helps me.)

Distraction: The nervous system gets too busy to notice the pain.
Ideas for this: engrossing books and movies, burying herself in work, doing whatever she enjoys most.

Signal Override: there's a part of the brainstem which directs signals.
Touch - like massage, rubbing the skin, hugging people - is a higher priority signal than sharp, burning or stinging pain. Sharp, burning, or stinging pain is a higher priority signal than dull pain.
This is the principle behind rubbing your elbow when you bump it, rubbing your temples for a headache, or using oil of wintergreen or capsicain based oils on dully aching muscles.

Stress reduction.
Stress makes pain worse. Pain makes stress worse. It becomes a hideous cycle. Thus, meditation, tai chi, yoga, etc.
However, for some people, a walk on the beach, a cuddle with the kids/grandkids, or throwing a frisbee to the dog are better stress reducers than anything else. For such people, that's the 'prescription' that works for them!

Mild exercise, especially stretching and loosening exercises.
Muscles tense up when under pain. But they can stay tensed, and that becomes a pain of its own. Fortunately, meditation, tai chi, yoga, etc, help prevent this problem as well as being stress reducers for most people.

Nutrition.
Poor nutrition can mean the body doesn't have enough of the right stuff to make pain-soothing chemicals. Also, some foods can apparently help reduce pain, and others apparently can exacerbate pain.

I dunno why it works but it works things:
Acupuncture, acupressure, reflexology, a bunch of other things apparently work. See any good pain management book for a list.

I dunno why it works because I haven't looked it up things:
Biofeedback can help some people manage their own bodies.
Chiropractic or osteopathic manipulation presumably helps by sorting out misaligned joints or whatever.
Feldenkrais, Alexander technique, and other posture-control practices help sort out misalignments as well.
Again, see any good pain management book for a list.


6. Why the doctor didn't give you a sheet of paper explaining all the stuff in point 5 -- well, the doctor sucked, that's all.

[Misanthropical]

I am getting sick of doctors who when their patients have pain, they treat them like they are drug seeking, even if the patients is in horrible pain and has no history of drug seeking behavior.

I have a history of horrific back pain, since I was 13 years old that comes at random, but no history of drug seeking. I'm still treated like I only say I'm having back pain because I'm drug seeking.

I wish these doctors would have to experience our pain for one day, then tell us why they think we are drug seeking.

[Catwoman2965]

And at the other end of the spectrum, are docs who give pain meds when they AREN'T needed and question those who do. Twice in my life I've had some injury that needed something slightly more than advil, and BOTH times, I've been given a prescription for WAY more pain medicine than I needed!

I sprained my ankle last year, and while it hurt, I wasn't dying from it. The doc gave me heavy duty motrin, which was ALL i needed, as well as a prescription for tramadol, which I shredded.

[iradney]

That doctor was a bitch of note! State board - NOW. It's not like your friend fractured her pinky finger and was taking bottles of painkillers. SHE HAD SURGERY FOR CANCER. OMG
*seething*
Sorry, this is a VERY sensitive topic for me, and I am of the opinion this "doctor" should be strung up by her toes!

[Akasa]

State board - NOW. It's not like your friend fractured her pinky finger and was taking bottles of painkillers. SHE HAD SURGERY FOR CANCER. OMG
*seething*
Sorry, this is a VERY sensitive topic for me, and I am of the opinion this "doctor" should be strung up by her toes!

I completely agree.
A problem w/ accupunture, chiropractic care, massage, tai chi, etc. She can't lay on her stomach because she had a bilatteral masectomy. Beause of the surgery she can't lift her arms but a 45 degree angle.
Her specialists are great, but her search for a PCP is, as you can see, not going so well.
We've recently moved to another state and well, getting a PCP close is proving to be not a easy thing. I think I will be suggesting my PCP and see if she has better luck there. True its a 20 minute bus ride, but damn. If she gets a decent doctor out of it, it should be worth it right? Of course my needs from a doctor and hers are different. She has chronic health problems to deal with on top of the cancer.

[Nyoibo]

I don't know how it is where you are Akasa, but in Australia a doctor has to tell you what they're testing for, not telling someone or testing for something else is a breach of ethics, at least I'm pretty sure it is.

Also, if your friend can find someone who does it I'd suggest Myofascial Release, it's gentle and extremely effective, and can be done very soon after surgery, it'll increase range of motion, loosen muscles and tendons and will healp break up existing scar tissue and help prevent new scar tissue forming.

[Yfandes]

Her specialists are great, but her search for a PCP is, as you can see, not going so well.

When I went through the same thing, I went to my oncologist or surgeon for pain. Since they were knowledgeable about what I had gone through, they were a great help.

Can she not stick with the breast doctors for this pain? If she can't, can she get a recommendation from her breast doctors for a good PCP?

[JustADude]

I dunno why it works but it works things:
Acupuncture, acupressure, reflexology, a bunch of other things apparently work. See any good pain management book for a list.

I dunno why it works because I haven't looked it up things:
Biofeedback can help some people manage their own bodies.
Chiropractic or osteopathic manipulation presumably helps by sorting out misaligned joints or whatever.
Feldenkrais, Alexander technique, and other posture-control practices help sort out misalignments as well.

Just my here on the subjects:


Acupuncture = Good stuff, and I'm sure an Acupuncturist should be able to apply the treatment while she's sitting up on a stool.

Acupressure = Also really good, but the same benefits (for her situation at least) can be gained for less money with conventional massage, though application without stomach-laying could be an issue for either.

Reflexology = Bullshit. Totally snake-oil. It has no actual relation to the neurological structure of the human body, unlike Acupuncture/pressure. Placebo results only.

Biofeedback = Good, and highly effective once mastered, but may require a bit too much practice and discipline to be useful for something as short-termish as surgery recovery.

Chiropractic Adjustment = It has its uses, but not for this kind of situation. The issues are caused by muscular trauma from the surgery, not joint misalignment.

Feldenkrais = Haven't studied it enough to say one way or the other. Seems like it might be about as effective as Yoga, Tai Chi, etc.

[wagegoth]

Frankly, I've noticed a disturbing trend among doctors, especially female doctors, to downplay a patient's pain when the patient is a woman. I believe studies have been done on this to back up my personal experiences.

The doctors who know me tend to give me way too much in the way of pain meds, so I just take them as I need them. Also, the doctors know that I'm not filling my prescriptions often, so I think they're not worried.

When I go to a new doctor and they try to downplay my pain I play my hole card: I was in labor for two days with my oldest son without pain relievers; I know what pain is. Actually, that isn't the worst pain I've experienced, but it seems to make them snap to.