Want to know the scoop on a patient? Ask us! Patients will tell you what you want to hear so you’ll give them an Rx. However we see when they are getting their refills, who they go to, and how they act. The patient that complains of a 10/10 low back pain to you may waltz into the pharmacy like nothing is wrong. You may not see how your patients act outside of your office, but we do. We usually see your patients enough to get a good gut feeling if something fishy is going on with them. If we don’t know, then their insurance company computers can tell us if they have been naughty or nice (like Santa!).[emphasis added]
Sure, during the 1 minute and 30 seconds a month we spend together, you can tell more about me than the doctor that's been treating me for years. And he should totally listen to your reporting of my pain over mine, because I'm a junkie whore and you have an Rph after your name, which apparently grants you psychic powers.
If you are dependent on painkillers to live your life, and I don't mean addicted to painkillers, I mean your pain is so intense that you need powerful narcotics to walk across a room (assuming you can still pull off walking), you know why this scares me. (Hi, denelian!) As bad as my days are, they'd be a whole lot worse without vicodin. I know because I wake up that way and it sucks. I sometimes end up crawling to the bathroom to pee first thing. Now imagine that being all day long because some angry, self-absorbed, megalomaniacal asshole decided they know me better than anyone because they saw me walk 30' without screaming in agony.
First of all, showing pain and discussing pain are verboten in American society. It is unseemly to display pain. It is rude to talk about it. Don't make a scene. Stop bothering me, jeez. So, no, I'm not exactly inclined to humiliate myself by displaying my pain for all the world to see, and that includes you, Pharmacy Asshole.
Secondly, I rarely limp, it's true. I rarely limp because a physical therapist once spent some time explaining that any gait change is very bad for your body and that limping to relieve the pain in my hip would lead to pain in other places (and wouldn't really do anything for my hip anyway). The last thing I need is more pain, so I suck it up and walk straight. It's painful, it's pure force of will, I don't know how long I'll be able to keep it up, but it's not waltzing. Fuck off.
Thirdly, the 10 point pain scale is bullshit. It's ridiculous. It makes no sense. Ask any chronic pain patient about the 10 point pain scale and you're likely to be dealing with frothing at the mouth within 3 seconds. It's that fucking stupid. I know 10 is supposed to be "worst pain you can imagine", but I can imagine being on fire and how likely is that to come up? (Plus, just guessing here, I don't think I would be asked to quantify my pain were I to see a doctor while actively on fire.) So when I am asked to quantify my pain, what I say is "my pain is for real. It's affecting my mood, my outlook on life, my ability to do the things I need to do and I need you to do something about it, because that is your job." Then the doctor looks at me funny and I say, "9.5. 8 on a good day."
I really hate this shit. I hate going to the pharmacy to pick up a legally prescribed, valid prescription for a real medical condition and knowing that the people behind the counter are judging me based on that alone- and maybe they'll make a phone call that will leave me unable to live my life. So I try not to sound eager, but not too fakely disinterested, nice, but detached because too nice is a junkie's trick, educated, calm, etc. It's ridiculous. It's a prescription, give it to me and stop fucking judging me.