Permanently Deleted

  • happybadger [he/him]
    ·
    3 years ago

    Chronic pain patients are such a pandora's box of nothing good. Realistically you can't cure most of its causes, especially spinal pain of some kind which might be a degenerative process. I've had countless pillseekers try to bullshit the emergency room and my veterinarian went off on them for intentionally injuring their pets so they could get veterinary narcotics. At best it'd be an endless succession of those calls where the receiving doc immediately discharges them with a pain clinic consult and then the pain clinic wouldn't give them more opioids because they signed a pain management contract.

    Good job murdering two doctors. Now there are fewer doctors for the next patient. Hope it's real fucking hot down there and a lot more painful.

    • aaaaaaadjsf [he/him, comrade/them]
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      edit-2
      3 years ago

      But this isn't a chronic pain patient or drug seeking behaviour. This is a medical facility not providing appropriate pain management for a guy that had back surgery on May 24. How can you cut into someone's spine, and ignore their pain literal days afterwards?

      This is not to excuse the shooter, you can't kill someone because your doctor is ignoring you. That should go without saying

      • happybadger [he/him]
        ·
        3 years ago

        Depending on the surgery that can still be drug seeking. I'm not saying he feigned his injury or anything, but if it's a low-grade surgery that only calls for anti-inflammatories afterward I've seen that enrage patients who expect narcotics. Their history with that condition means previous times where they've been prescribed and built the addiction back when the goal of pain management was the Sackler-sponsored absolution of pain rather than getting it to a tolerable level without risky interventions. If it was a serious spinal surgery warranting the good shit, I doubt he'd be mobile enough to do the shooting so soon after. When I worked in an SNF downgrading surgical patients we'd have a lot of spinal ones from procedures like vertebral fusions. They could barely ambulate to the toilet with help usually. Something more minor with the unrealistic expectation of the pain ceasing entirely on drugs he can't get and that's a motive.

          • happybadger [he/him]
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            edit-2
            3 years ago

            Sure, I'd also want the same. Pain sucks. Do you go to a hospital to feel good or to receive the most scientifically valid care under the most strictly developed protocols? A chiropractor will make you feel good and is much cheaper, but there's a reason you hopefully go to a doctor instead of a spine warlock.

            Medicine's goals necessitate the bigger picture both for your health and public health. If the protocol says you get opioids because you want them and they'll mask the pain with significant side effects/addiction risk, sure that Russian roulette might work well for you but every other patient is treated under the same protocol. That's dozens or hundreds per day. Each a personal and public health risk, every day until enough of you die to change the protocol in the obviously sensible direction.

            edit: The counter-example to that is when I went in for a vasectomy. Typical recovery time is like three days with the dull sensation of being kicked in the testicles. The urologist gave me ten hydrocodones without me even asking for narcotics, which I strictly avoid as someone with an addictive personality. Taking that many under the vague assumption that it's the sound medical advice of a doctor is probably enough to get me hooked. I controlled that pain just fine with ice, ibuprofen, and a CBD vape. That's a bad protocol that could get me killed if I didn't come from stricter ones.

              • happybadger [he/him]
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                edit-2
                3 years ago

                That's a more convoluted way of treating COVID with antiparasitics for horses. We don't put medicine in the hands of the public because no matter how competent and informed and ontologically sound you are the idiots driving next to you would have access to the same drugs under the same logic. The authority of the medical system isn't arbitrarily established in this case. That's a decade of schooling and teams of experts and treatment standards informed by external research that's continuously updated. Even if you manage to correctly identify all the elements of your easily visually identified condition and treat it totally appropriately to the standard you'd receive in a hospital, what's that crystal mom in the next car over going to do? She goes into Walgreens, walks to the OTC medications aisle, and everything that used to be behind a glass panel and a PhD is now on the shelf. What's she going to buy and is it going to be the right thing when she's treating abdominal pain?

                  • happybadger [he/him]
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                    3 years ago

                    Both really but I do mean ontology in this case. If your knowledge framework is up to that same standard of an informed scientific worldview, if there isn't some small gap for woo to enter through or some oversight in where your information came from and how it was processed, maybe it will work out just fine and you'll have the same experience you would from a doctor doing their job. Taking in those individual pieces of information is important but how you synthesise them into understanding something as wildly complex as the human body is where you can really fuck up.

            • mazdak
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              edit-2
              1 year ago

              deleted by creator

              • happybadger [he/him]
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                3 years ago

                I had three after a dental procedure when I was a teen. That was enough to make me think "I like this feeling" and reach for the bottle to continue it in the same way that I'm never quite stoned enough. While I wouldn't jump to heroin after ten, if I still wanted that feeling or still felt the pain and had a cultural expectation/personal desire to not feel that pain I could probably score a different pill. If not physically addicted or mentally dependent, I'd have a positive association with the drug and its effects while knowing it's no big deal.

                • mazdak
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                  edit-2
                  1 year ago

                  deleted by creator

                  • happybadger [he/him]
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                    3 years ago

                    Alcohol can be just as addictive as opiates, in fact there are far more alcoholics than opiate addicts, but you probably don’t advocate for the prohibition of alcohol

                    Nor am I advocating for the prohibition of opioids, only their usage held to the same clinical standard any one of you criticising me would readily acknowledge with antibiotics. Alcohol was once prescribed widely and even now I've used medicinal vodka in the emergency room. Is that alcohol appropriate for infant sleeping tonics? Fuck no. Is it appropriate for a patient with a dislocated or broken arm? Nope. Patient seizing because they're a severe alcoholic and there are clinical indications their body needs it? That's a responsible and informed decision which takes their situation into account beyond their feelings on it. It's based on protocols based on current science. Serious painkillers have their uses and they also have a long list of times when they shouldn't be used. Could be used, patient would be thrilled if they were used, but it's not blood on the patient's hands when the next appointment also wants the same drug and has a negative outcome.

        • aaaaaaadjsf [he/him, comrade/them]
          ·
          edit-2
          3 years ago

          I'm sorry what kind of spinal surgery only requires anti inflammatory medication afterwards? Did I hear that right? Is the US medical system so afraid of opioid addiction that you can only get anti inflammatories after "minor" spine surgeries?

          Also of course people with spinal problems were on opioids before surgery in certain cases, taking most anti inflammatories long term will destroy your kidneys. Or mess up your digestive system. It was also easier to get opioid prescriptions a few years ago. And they've probably been waiting to get operated on for years because of financial problems. Even if they were addicted before, is it right to let them suffer in pain because of a previous or ongoing addiction?

          I am never, never, never, ever, going to get any medical care in the USA. Not like I would ever get the opportunity to anyways, but just reading that entire paragraph, it has me scared.

          • happybadger [he/him]
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            3 years ago

            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.

            • Frank [he/him, he/him]
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              3 years ago

              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.

              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.

              • aaaaaaadjsf [he/him, comrade/them]
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                3 years ago

                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.

              • happybadger [he/him]
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                3 years ago

                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?

                  • happybadger [he/him]
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                    3 years ago

                    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.

                • mazdak
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                  edit-2
                  1 year ago

                  deleted by creator

            • aaaaaaadjsf [he/him, comrade/them]
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              edit-2
              3 years ago

              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.

              • happybadger [he/him]
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                3 years ago

                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.

    • supergremlin [they/them]
      ·
      3 years ago

      You really took this opportunity to punch down on people with chronic pain. Honestly, fuck yourself. Your kind of attitude is the reason I can't get treatment for the pain I've suffered for the past 10 years after an accident. Your kind of attitude is why people with chronic pain kill themselves because they are treated like scum for daring to ask for some fucking relief. Fuck you .

      • sappho [she/her]
        ·
        3 years ago

        Thank you for bringing the appropriate amount of anger to this discussion. God that comment pissed me off.

        • aaaaaaadjsf [he/him, comrade/them]
          ·
          3 years ago

          I don't get angry anymore, just sad.

          Still can't believe the USA is trying opioid free spinal surgery, including fusions apparently.

          https://pubmed.ncbi.nlm.nih.gov/32320863/

          Conclusion: Opioid-free elective spine surgery, including lumbar fusions, is feasible and effective. We suggest that opioid-free spine surgery be offered to patients who are opioid-naïve or who can be weaned off before the operation.

        • VILenin [he/him]
          ·
          3 years ago

          One more scratch away from advocating for the T4 program

      • happybadger [he/him]
        ·
        3 years ago

        I'm not punching anywhere. He shot up a hospital because he has unresolved pain. That's an issue worth examining and a demographic that needs to be critically understood because there are obvious consequences to the "satisfy the patient's every desire" approach that has been used until very recently. His pain complaint might have been just as valid as yours and the fuckup might have been on what now seems like a larger group than his target. It might have also been the same thing I saw half a dozen times a day either deliberately or out of ignorance, patients overstating their pain or having unrealistic expectations of it ending despite undergoing something more traumatic than we naturally survive. There isn't a solution which makes you happy and doesn't make a physician discharge patients who then become victims of something worse because the only drugs that make them happy are really bad. If your problem was chronic anxiety and you said "fuck you" because I don't think we should overprescribe drugs as effective and toxic as benzos, the solution isn't to prescribe more benzos. Fuck me but you'll still be alive to say that so I don't care.

        • supergremlin [they/them]
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          3 years ago

          Chronic pain patients are such a pandora’s box of nothing good

          This is fucking dehumanizing. We're not Pandora's box of problems we're fucking people with lives.

          "Pillseekers" is fucking derogatory. Yeah there's people that lie to try to get drugs. Because they're addicts. They need help and compassion not your smug judgement.

          Fuck me but you’ll still be alive to say that so I don’t care.

          Laugh in my face more asshole. Honestly I wish you could live a couple years in my position and then maybe you'd have some fucking empathy.

          • usa_suxxx
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            edit-2
            1 month ago

            deleted by creator

          • happybadger [he/him]
            ·
            3 years ago

            Work a couple years in an ER and try to resuscitate the patients you've previously discharged.

            • supergremlin [they/them]
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              edit-2
              3 years ago

              Live a couple years with debilitating pain that makes you unable to walk more than a few hundred feet at a time. Live a couple years getting ridiculed and harassed by doctors and nurses and pharmacists when you mention you are in debilitating fucking pain. Live a couple years in so much pain that you can't maintain a social life. Live a couple years knowing that the only thing that could end your pain is by blowing your own head off, or having to go to some sus dealer and buying shit that could be laced which would kill you anyway.

        • MaeBorowski [she/her]
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          3 years ago

          “satisfy the patient’s every desire” approach that has been used until very recently

          As someone who has had pain issues for almost 2 decades and known others who have had it for even much longer, fuck you even more for saying this shit. I can't believe that first comment got any upvotes it's such priviliged fucking bullshit. You are part of the problem.

          • happybadger [he/him]
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            3 years ago

            Medical god complex is when you say medicine isn't capable of curing pain and the tools we have to try are really bad for the patient and society so we should generally use the alternatives that kind of work over time and aren't surgical because we don't know how to do that in a way that doesn't cause more pain.

            • KollontaiWasRight [she/her,they/them]
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              3 years ago

              Medical god complex is when you declare that the only valid judge of pain and the utility of its treatment is the medical establishment and disregard the humanity of the patient altogether. Physicians are not moral arbiters. They have an obligation to informed consent, not dictatorial control. If a patient's pain is such that they cannot live with it and they have been given a reasonable and measured explanation of the danger of pain medication and how to use it in the least harmful way possible, it is then their choice what should be done. Not yours.

              • happybadger [he/him]
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                3 years ago

                That patient went to that hospital for their staff's judgement. They can just as easily walk out at any time and go anywhere else under any other standards. I had a special AMA form just for it and gave them out routinely without any affront to my god complex. If multiple hospitals under multiple sets of protocols are denying the treatment that the patient wants, there's a reason for that which puts a wrench in using it the least harmful way possible. Using it might do more harm because of some set of factors not clear to me, you, or the patient themselves unless they're reading journals. Informed consent is so basically critical to routine medicine that I got it for everything I did. A dozen times repairing a wound. If they want to walk out at any point for any reason they can just do so and the only time they're stopped is when they aren't capable of forming informed consent. There is absolutely no disregard for their humanity, only the attempt to find the best path of restoring their functionality without risking extra damage unnecessarily. They have to fully consent to what's done and face no penalties for challenging what's declined and getting other opinions.

                • KollontaiWasRight [she/her,they/them]
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                  edit-2
                  3 years ago

                  This did not, in fact, address my statement in any way. Your line is still 'if daddy medicine says no, then that's that', but with more steps. You should be honest with yourself about that fact. It will improve your ability to engage in self-criticism.

                  I learned a long time ago that trusting doctors is a terrible idea, after doing so nearly killed me because the infection that was increasingly risking my life was less important to the doctors seeing me (and giving me useless treatments repeatedly with zero effective communication at multiple hospitals ) than it was to me. The idea that the medical establishment can be trusted to make the right decision for an individual is, frankly, laughable. Instead, it is incumbent on the patient to go read those very journals and try to parse them for themself in order to reasonably be able to challenge physicians in order to ensure that they actually get the help they need. Hell, I need to have a discussion with my own neurologist about why I'm being prescribed a medicine that no studies I can find show effectiveness for in treating chronic sciatica (which, at least in my case, is effectively not treatable by fucking anything, it seems) next week.

                  Look, I have no idea what was going on with this guy's back. If this was nervous pain, odds are opiates would have done jack shit anyway. But if it was, he also wouldn't be likely to be very mobile. But medical privacy being what it is, we're never going to know that (and that's okay). Maybe this guy was a victim of legitimate malpractice. Maybe he was just unable to cope with pain and decided to take it out of his doctor. What we do know is that despite the incredibly toxic social stigma on opiate use, people are going to find and use opiates if they think they need them. If the hospital thinks that its procedure is safer than the patient going out and finding opiates where they can be found, I'd suggest that they are dangerously wrong about that. The hydrocodone that the Hospital prescribes is a hell of a lot safer than the shit you can get on the streets, which is almost universally cut with Fentanyl these days. But if I'm in unbearable pain and I can't get other relief, I'm sure as fuck not going to be concerned with a Doctor who thinks they know better than me what I can bear. I'm gonna buy that street shit and take the risk. Because that Doctor literally cannot know what I am able or unable to bear.

                  Have you ever been in so much pain that you seriously considered suicide to escape it? I have. Luckily, my current Doctor is a good one who actually understood my pain was unbearable for me, and she worked with me to get me short-term relief while we tried to find a long-term solution. If she hadn't, I'd have probably done it. The short-term relief was a higher-end anti-inflammatory injection on an annoyingly regular cadence, instead of opiates, because opiates would have done absolutely nothing for me (pain without Dilaudid? 10/10. Pain with Dilaudid? 10/10, but now with wooziness), but if I'd needed opiates to control the pain and she'd refused me, I'd be dead today, because I was well past what I could bear. Your argument leaves alternate universe me just as dead as if I'd overdosed.

            • mazdak
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              edit-2
              1 year ago

              deleted by creator

    • VILenin [he/him]
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      3 years ago

      :yikes-1::yikes-2::yikes-2::yikes-2::yikes-2::yikes-2::yikes-2::yikes-2::yikes-2::yikes-2::yikes-2::yikes-2::yikes-2::yikes-2::yikes-2::yikes-2::yikes-2::yikes-2::yikes-2::yikes-3: