There's inappropriate pain management and there's pain management with realistic goals and protocols written in blood. If someome needs narcotics they're still widely used but the epidemic means the consequences of two decades of wanton prescription are forcing nuance. Patients don't see the clinical picture of their pain and living with it isn't a preferable option to drugging it at the risk of addiction.
Maybe this was a shitty surgeon oblivious to treatable pain out of stupidity or malice, but I'd expect he called the ward about the issue at least a time or two. If it were the appropiate decision to give him more pain management, there probably would have been at least one other opportunity for it even if he didn't have followups in that week.
I'm sorry I'm hearing about opioid free spine surgery in your first comment and I've noped out. No amount of writing is going to convince me that it's appropriate.
Also this guy had a 5 day impatient stay at the hospital according to the video, to me that sounds very serious. My hospital stay for back surgery was only a few days longer.
If he's in there for five days they've got a really good clinical picture of his pain and how it should be addressed. That's 12 hour rounds with the attending physician, hourly nursing checks, probably followups with the surgeon and/or multiple specialists. I'm really curious to see what surgery he had, what he was discharged with, what he wanted, and what his medical history/comorbidities are. When there's an inpatient stay there are so many people involved in the care that it's not just the incompetence of a single provider. That decision has a lot of data behind it.
Getting flashbacks to every doctors appointment I've had. At least my surgeon was good with pain management and post operative care. But other doctors, Christ.
Scientists play god with the laws and limits of the universe. Eventually they're even proven wrong as better scientists use the same process to form better conclusions. Do you reinvent physics to prove them wrong or do you see the basic value of expertise in their understanding of a field you don't work in? Feel free to be your own doctor but we've just seen that play out with the pandemic. None of those citizen-doctors seemed to outsmart the actual ones. They mistreated the disease they didn't understand and couldn't reliably digest information about. If they didn't die as a result, was their outcome better than what they would have received from those highfalutin doctors with their god complexes? Did they come to understand the virus more, treat it more effectively, or die less than they would have if they weren't libertarians about it?
I'm not stopping you. Please by all means be your own doctor or better yet reinvent the field they've spent a decade studying. That institution probably just arbitrarily exists and everyone in it is probably just some schmuck.
Do you understand that the way Doctor's treat pain is based on politics and vibes rather than patient outcomes? They spent decades handing out pain pills like candy because they were bribed by pharma companies, not because of science or really any justifiable reason.
What I'm saying is that we learned from that. It illustrates my point which is why it's my point. Recall how Oxycontin was originally marketed by the pharmaceutical company. As non-addictive. It was a magic pill that could cure pain without consequence. The patient's needs were fully met and they left happy. There's plenty of corruption with the marketing like kickbacks and sponsored events, but at the time pain management could transcend the word management and become an actual solution to pain. Pain mind you is your body screaming that you probably won't naturally survive what's happening to you, and it's only fixing that thing which makes pain go away.
We learned from opioids that they don't make pain go away, they only mask your perception of it. There are massive consequences to even prescribed versions like Oxycontin that go well beyond the individual patient with their individual goals. Using a pharmaceutical crutch meant discouraging things which might help restore the injury site or compensate for it, but slowly and with mild pain. There are health impacts beyond addiction and you not experiencing them doesn't mean the next person won't as well. If we open the faucet and then cut it back, they turn to street alternatives because a wholly different element of the healthcare system fails them.
So patient outcomes. I like that shit too. What's the actual outcome of prescribing those narcotic painkillers? Does it fix the pain, heal the injury or cure the illness, or restore function in some meaningful way? Those are all patient outcomes that any person in medicine seeks unless you're a full conspiracy uncle. It will dull or completely mask the pain sure, but it will do less for the injury than other classes of drugs while potentially aggravating what the pain is warning you away from using. That will mean the pain is still there when you use your full agency to choose to quit the painkiller. It has a role to play certainly. In plenty of contexts and patients. Where it's contraindicated though, patient outcomes are what develop those contraindications. If someone is turned away from those medications, there's reasoning behind that decision beyond that patient's immediate goal to stop hurting. That pain isn't a meaningless switch that can be turned off and on without consequence. Trying to do so demonstrably has consequences that are worse.
The only thing I've deciphered from it is that you're very sure that you're correct about whatever position you hold. If you think you're more correct than medicine, replace medicine. Surely someone with as much brain mileage as you can decide better. Go do it.
There's inappropriate pain management and there's pain management with realistic goals and protocols written in blood. If someome needs narcotics they're still widely used but the epidemic means the consequences of two decades of wanton prescription are forcing nuance. Patients don't see the clinical picture of their pain and living with it isn't a preferable option to drugging it at the risk of addiction.
Maybe this was a shitty surgeon oblivious to treatable pain out of stupidity or malice, but I'd expect he called the ward about the issue at least a time or two. If it were the appropiate decision to give him more pain management, there probably would have been at least one other opportunity for it even if he didn't have followups in that week.
I'm sorry I'm hearing about opioid free spine surgery in your first comment and I've noped out. No amount of writing is going to convince me that it's appropriate.
Also this guy had a 5 day impatient stay at the hospital according to the video, to me that sounds very serious. My hospital stay for back surgery was only a few days longer.
If he's in there for five days they've got a really good clinical picture of his pain and how it should be addressed. That's 12 hour rounds with the attending physician, hourly nursing checks, probably followups with the surgeon and/or multiple specialists. I'm really curious to see what surgery he had, what he was discharged with, what he wanted, and what his medical history/comorbidities are. When there's an inpatient stay there are so many people involved in the care that it's not just the incompetence of a single provider. That decision has a lot of data behind it.
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I love when doctors play god with other people's lives. It makes me feel really good about the standard of care I'm receiving.
Welcome to chronic illness 101.
Getting flashbacks to every doctors appointment I've had. At least my surgeon was good with pain management and post operative care. But other doctors, Christ.
Scientists play god with the laws and limits of the universe. Eventually they're even proven wrong as better scientists use the same process to form better conclusions. Do you reinvent physics to prove them wrong or do you see the basic value of expertise in their understanding of a field you don't work in? Feel free to be your own doctor but we've just seen that play out with the pandemic. None of those citizen-doctors seemed to outsmart the actual ones. They mistreated the disease they didn't understand and couldn't reliably digest information about. If they didn't die as a result, was their outcome better than what they would have received from those highfalutin doctors with their god complexes? Did they come to understand the virus more, treat it more effectively, or die less than they would have if they weren't libertarians about it?
:PIGPOOPBALLS:
I'm not stopping you. Please by all means be your own doctor or better yet reinvent the field they've spent a decade studying. That institution probably just arbitrarily exists and everyone in it is probably just some schmuck.
Do you understand that the way Doctor's treat pain is based on politics and vibes rather than patient outcomes? They spent decades handing out pain pills like candy because they were bribed by pharma companies, not because of science or really any justifiable reason.
What I'm saying is that we learned from that. It illustrates my point which is why it's my point. Recall how Oxycontin was originally marketed by the pharmaceutical company. As non-addictive. It was a magic pill that could cure pain without consequence. The patient's needs were fully met and they left happy. There's plenty of corruption with the marketing like kickbacks and sponsored events, but at the time pain management could transcend the word management and become an actual solution to pain. Pain mind you is your body screaming that you probably won't naturally survive what's happening to you, and it's only fixing that thing which makes pain go away.
We learned from opioids that they don't make pain go away, they only mask your perception of it. There are massive consequences to even prescribed versions like Oxycontin that go well beyond the individual patient with their individual goals. Using a pharmaceutical crutch meant discouraging things which might help restore the injury site or compensate for it, but slowly and with mild pain. There are health impacts beyond addiction and you not experiencing them doesn't mean the next person won't as well. If we open the faucet and then cut it back, they turn to street alternatives because a wholly different element of the healthcare system fails them.
So patient outcomes. I like that shit too. What's the actual outcome of prescribing those narcotic painkillers? Does it fix the pain, heal the injury or cure the illness, or restore function in some meaningful way? Those are all patient outcomes that any person in medicine seeks unless you're a full conspiracy uncle. It will dull or completely mask the pain sure, but it will do less for the injury than other classes of drugs while potentially aggravating what the pain is warning you away from using. That will mean the pain is still there when you use your full agency to choose to quit the painkiller. It has a role to play certainly. In plenty of contexts and patients. Where it's contraindicated though, patient outcomes are what develop those contraindications. If someone is turned away from those medications, there's reasoning behind that decision beyond that patient's immediate goal to stop hurting. That pain isn't a meaningless switch that can be turned off and on without consequence. Trying to do so demonstrably has consequences that are worse.
props to you for attempting to help people understand, happybadger. You're a better man than I
Quit being a power tripping :reddit-logo: nerd
What the fuck does that even mean? What's wrong with you and why is it my problem?
Damn dude if you can't decipher it maybe you shouldn't be deciding who gets to not writhe in agony
The only thing I've deciphered from it is that you're very sure that you're correct about whatever position you hold. If you think you're more correct than medicine, replace medicine. Surely someone with as much brain mileage as you can decide better. Go do it.
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