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.
Hopefully that pharmacist's attitude isn't representative of the profession. I don't know about you, but with my wife -- who is in severe chronic pain -- she has good days and bad days. On good days she's capable of more activity, and on bad days she's in bed 90% of the time, just trying to endure. Obviously she goes to the pharmacy on good days, not bad. And, as you point out, people usually act differently and try to keep it together when they are out in public. Just because someone is able to appear relatively normal for the short-time it takes to pick up pre-ordered prescriptions, doesn't mean she won't be in obvious pain after she gets home.
ReplyDeleteGreat Biscuit-- I am so done with pharmacists playing god. The pharmacists with conscience clauses, the pharmacists like this person, who are bitter that they don't have carte blanch to get all up in their customers business more thoroughly...I'm just, done. Seriously. This guy reminds me of the people who call for restrictive drug test requirements for public aid because a few people some of the time defraud the state. Do a few people some of the time abuse prescription pain killers? Sure. Does that make it ok to punish the rest? Seriously, what kind of a horses ass do you have to be to want to ruin other peoples day to day lives just so you can...what? Play narco cop? Priorities.
ReplyDeleteLike, can we make pharm students read a disclaimer everyday that says: "If you are the kind of person who cares more about punishing a handful of bad people at the expense of the majority of good people, a career as a corrections officer would be a better fit."
HI! PF :)
ReplyDeletehere's some irony for you.
i got vicodin for years. it sat mostly untouched - if my pain's below an 8, i don't take anything [BTW, you know what the "standard" is for pain med? a FOUR. that's right - if your pain is a 4, it's a "good" use of pain meds. A FOUR!!!!!!!!! jesus fucking christ on a pogo stick, i don't even KNOW what a FOUR would BE!!!!! i pray for days when my meds can get me to a SIX! and they're rarer than hen's teeth!]
but still. i was drowning in vicodin. i flushed more than i ever took - it's NOT ethical to give someone else your meds [although i HAVE made exceptions, when it's a person who has Rx for the EXACT SAME THING - like a friend of mine who was mugged as he left the pharmacy, the pharmacist SAW IT, called an ambulance for the guy - and refused to do ANYTHING to help him replace the vicodin that he'd just been mugged for. asshole pharmacists - they're everywhere]
yet, every time - EVERY FUCKING TIME - i went to fill a vicodin script, i was run thru the ringer. why did i need this med? was my pain really that bad? how often did i take it? was i drinking with it to increase the "buzz"? would i submit to a drug test.
that last one KILLED me, as pharmacists have NO RIGHT, no legal way at all, plus no PRACTICAL way, to have me take a drug test. EVEN IF I SAID "Sure, i'll do it right now" NOTHING COULD THEN HAPPEN, because they cannot legally do them and have no WAY to do them [i'd say - call my doctor. i take a drug test everytime she asks. if you can convince her to give me another one, of COURSE i'll take it]
but then i was switched to methadone, and then oxycodone.
NOT ONCE [knock on wood] has ANY pharmacist done anything worse than say "we don't have this in stock; i can order it or i can find a store that has it"
vicodin < oxycodone. by like a factor of TEN.
i just don't get it.
and i would stop going to a pharmacy, these days, if the pharmacist gave me that sort of shit. but i actually live in a place that has more PHARMACIES than CHURCHES, it seems, so i can. people who in a place with only ONE pharmacy are screwed.
and it's complete and total bullshit.
i KNOW i'm not the only person who recieved training in how to "hide" the extent of my pain - and most people learn informally, because we have too. if a doc does something that hurts so bad you scream, you get a fucking LECTURE about how that's not "polite" to all the other people who might hear you [of course, if you DON'T scream, good luck getting said doctor to BELIEVE the extent and severity]
damned either way.