Sent home from hospital after c-section without ANY analgesia

(73 Posts)
TeaJunky Tue 04-Dec-12 13:54:48

The title says it all.

The night before coming home I was up all night in hospital crying with pain after having taken pain relief. This was noted by the midwives.

Yet the next day I was discharged from hospital without as much as a single paracetamol. I asked several times about it, and was eventually told that as its so cheap to buy over the counter, the hospital is cutting costs.

This is St Mary's in Manchester. Otherwise, I had fantastic, round the clock care and support and the teams were excellent.

But sending a woman home, who has just given birth via major abdominal surgery, without any pain relief (at 6pm evening), with a newborn to look after is just criminal.

The community midwife that came to see me today said it has started happening only in the past few weeks, and they initially thought the hospital/staff were forgetting - but it was becoming more apparent now that it's just cost cutting. She suggested I tell the local press, which I will be doing.

I also wanted to raise awareness of this on mumsnet and ask other women to add similar experiences about such incidents.

I spent the night in pain of course - I think I must have overdosed myself with ibuprofen and a bad mixture of other odds and sods of pain killers I had in my kitchen drawer sad

This has to fit into an MN campaign somewhere, surely? It's just not right.

kilmuir Tue 04-Dec-12 13:56:51

Thats awful.
have had a few sections and was given voltarol to go home with as well as paracetamol
has your GP given you something

That is disgusting. You should have prescription meds, for sure. If you have a hysterectormy, which is not much different really as a procedure, you are generally given an epidural for the next 3 days.

ChestnutsRoastingonaWitchesTit Tue 04-Dec-12 14:01:03

That's terrible. I was given a bucket load of voltarol and paracetamol to go home with after my section 2 years ago. Whilst in hospital I was given . morphine on request until I said I thought I could manage without it too.

I hope things haven't changed since then, I agree paracetamol is cheap but then its not cutting much cost if the hospital are trying to economise.

Chigertick Tue 04-Dec-12 14:04:13

Poor you sad
I didn't have a c- section but had an episiotomy and they were practically forcing the codeine on me. They said "welll
It's been dispensed now just have it"!

LargeLatte Tue 04-Dec-12 14:04:18

I had a C section 5 years ago and was sent home without anything. I remember stopping at local shop and hobbling out of car to get paracetamol and ibuprofen. They told me I wasn't allowed to buy more than 2 packets and I just wimpered that I'd just had a c section and they put it through in 2 transactions. That was my second section and am pretty sure I wasn't sent home with anything for the first one either. I just assumed it was normal. I have also just realised that dh sat and waited in the car while I got my own tablets - how thoughtful.

Floralnomad Tue 04-Dec-12 14:09:04

I had a section several years ago and didn't take any analgesia post OP . I'm afraid in these days of austerity I agree with the hospital midwife and you should buy your own analgesics. You're not likely to overdose if you read the instructions ! Hospitals give out far too many medications that don't get used and its a complete waste of money, money that could be spent on patient care. Congratulations on your new arrival and I hope you feel better soon .

FirstTimeForEverything Tue 04-Dec-12 14:09:27

Message withdrawn at poster's request.

Honsandrevels Tue 04-Dec-12 14:16:10

I've had two sections and was sent home with nothing. I can't take ibruprofen or related medicines either so just paracetomol and codine bought over the counter for me. Agony.

I was in so much pain the day after my second c section that I told dh I must have been sewn up wrong. I really thought my bladder was attached to my womb.

It is barbaric compared to pain relief given for similar surgery.

theonewiththenoisychild Tue 04-Dec-12 14:19:13

Thats awful i was given tramadol to take home after my first cs and dyhydracodeine after the second cs
sorry if thats not spelt correctly. You cant buy strong painkillers over the counter. Poor you

noblegiraffe Tue 04-Dec-12 14:51:50

I was given some voltarol to take home, but had to buy my own paracetamol.

OwlLady Tue 04-Dec-12 14:54:36

you need diclofenic and co-codamol ime. Have you rang your gp?

OwlLady Tue 04-Dec-12 14:56:07

I do think c-sections are underestimated too compared to other similar surgery. You are expected to just get on with it. I remember when i had my third I had to do the school run on day 3 confused and I felt frightened someone would bump into me and knock me over

rainrainandmorerain Tue 04-Dec-12 18:37:03

Well, buying them is one thing - arguably all patients could pay for their own analgesia after any op, I fail utterly to see why women who have given birth should be uniquely denied -

but YOU ARE LIKELY TO NEED PAINKILLERS WHICH ARE STRONGER THAN OTC PAINKILLERS AFTER A CS.

You cannot buy the co-codamol and diclofenac I had from any high street chemist. It HAS to be prescribed and dispensed.

op - write a letter of complaint, at the very least.

rainrainandmorerain Tue 04-Dec-12 18:38:44

ps I was going to say, contact the press if you feel up to it - interesting your mw has suggested the same.

We do diclofenac and/or codeine but not paracetamol. It only costs 16p a pack OTC and the NHS is too skint to dish it out.

Nordicmom Tue 04-Dec-12 18:44:43

I had c- section almost 8 y ago on NHS and I got a bag of medicines including codeine which I took for the first week . I was in a lot of pain could hardly move the first week . Had to sleep sitting up first since I had trouble getting out of bed. I did stop the strong painkillers after the week though for the fear of getting used to them. After that copious amounts of ibuprofen an paracetamol. In the hospital I had several morfine shots ... I can't believe they sent you hom with nothing !

diyqueen Tue 04-Dec-12 21:20:16

I had a cs a year and a half ago and also wasn't given any painkillers to take home - we stopped at sainsburys on the way home but that was a bit optimistic, nearly fainted. It would be good to know beforehand so you could at least stock up in advance - next time I certainly will just in case. After my Cs I found the care for the first day great, but after that awful - on day 2 was in more pain as the morphine wore off but was still expected to hobble the length of the ward to pick up my food and get water from the machine.

TeaJunky Wed 05-Dec-12 01:15:34

Sorry to hear about everyones bad experiences.

Please keep adding ladies - and if there are any particular incidences at st Mary's in Manchester, please do say.

PerryCombover Wed 05-Dec-12 01:22:25

I was given codeine with the first and nothing with the other two. I stayed 2 nights post birth so perhaps they felt there was no need.
There was a need

ripsishere Wed 05-Dec-12 01:26:39

I had my DD in a land far away. I had, IIRC two paracetamol after she was born and that was that. I didn't even get the offer of anything else. The ELCS I had was frowned upon.
IMO, it is a bit harsh to go to the press. I would suggest to the unit that they advise people of their non dispensing policy before the surgery. That way you can buy what you need before.

TeaJunky Wed 05-Dec-12 01:28:49

Perry, how did you manage your pain?

Did you go out and buy some pain relief, and was it effective? Do you think it spoilt the entire experience of your labour and birth?
I strongly feel that it has for me. DH went to pharmacy to find codeine phosphate and they said prescription only. Waited all
Day for gp to call about it and rang on twice but received nothing. sad

PerryCombover Wed 05-Dec-12 01:31:44

My first two c/s were fine really tbh. I was very very lucky.

The third was dreadful as I had a huge amount of adhesions to wade through and tubal ligation carried out at the same time.
Analgesia that I was written up for was simply not enough after the epidural wore off. The nurses couldn't do anything without a doctor's sign off. Only one doctor on apparently....
When he arrived he said, "oh yes..it says here a lot of adhesions, you will be tender, did no one tell you that?" Me..."Er, no"
Me "please ensure I am written up for more pain meds that I could possibly need, I'd rather not be placed in this situation again"
Him,"we'll you have just had major surgery"

Me,"grrrrrrrrrrrrr"

PerryCombover Wed 05-Dec-12 01:35:26

I had dihydrocodeine 30 mg at home as I had had an abscessed wisdom tooth previously.
I took those. I have no idea what I would have done otherwise.
I wouldn't have coped ( I'm not that wimpy btw)

bissydissy Wed 05-Dec-12 02:09:24

I got sent home with a huge bag of codeine and diclofenic - more than half ended up being disposed of in the end.

BUT!

Immediately after surgery I was prescribed only paracetamol and was pretty much made to feel like some kind of junkie for crying for better pain relief.

This was a mistake not penny pinching but surely one of the nurses should have said 'this is a mistake - wel'll bleep a dr to change it.'. Surely if you are a nurse in the recovery bit in a maternity ward you'd realise this. But reading this thread maybe not.

abrotherfor Wed 05-Dec-12 02:20:20

I agree that caesareans are not seen in the same way as other surgery, I'm not sure if it's because you're (generally) awake or because it's a birth or what but the surgery seems to be incidental. Women can be guilty of that as well as HCPs.

I was in hospital for a long time with mine because they were premature and I remember at one point being told I could have oramorph OR paracetamol - bearing in mind that oramorph lasts half an hour and paracetamol lasts 4 hours. So I was taking the lower option for hopefully longer relief. My last birth which was a VBAC I had my normally prescribed co-dydramol stopped because the MW told he doctor I didn't need it and wouldn't let me see a doctor to discuss it! I've been on it for three years at that point!

newbielisa Wed 05-Dec-12 02:28:44

2nd c section 4 weeks ago. Pain post op seemed much worse this time. Left hospital with paracetamol and ibuprofen. I did chunter about rubbish meds but in retrospect if I'd had stronger painkillers I'd have done more and overdone it. As it was I could do f.a. for the first week other than wince and feed my baby.

Do think it was a shock for you to get sent home without meds but agree with rips suggestion to speak to the unit rather than the papers.... as your community midwife should do rather than stirring you up. If they are continuing with this practice then the patients need to be forewarned so can have their own stash of "not that effective" paracetamol

Not sure how long ago this all happened but congratulations on new arrival.

nooka Wed 05-Dec-12 02:55:20

I had morphine for the day or so after my sections, and then I think paracetamol the day after that. Nothing to take home first time around, and then second time they wanted to give me iron so I had to wait around for hours before the doctor turned up - in the end dh took me home and came back later for the drugs. They gave me a fair few painkillers too which I don't think I used. But then as I have bad periods there is never a shortage of neurofen in our house.

I took my dd into a Welsh hospital recently when she dropped a cutting board on her toe and was really surprised when they gave us both paracetamol and ibuprofen to take home. I thought that they would have been more cost conscious. We've still not used up either pack.

However the point is that you were in pain, and probably needed something stronger in any case and that should have been assessed and advice provided at the very least (to be honest I think after a c-section you should expect some pain, it's the manageability that's the issue, which is of course an individual thing).

sleeplessinsuburbia Wed 05-Dec-12 03:11:23

I thought this was standard procedure. I have always bought my over the counter pain relief and was only once prescribed proper pain relief as I was discharging myself early. I was pissed off when I got home and counted my tablets to see the pack prescribed only had 1.5 days of medication and the instructions were for 3 days!

To be honest I look back on all of the c sections with a feeling of annoyance wondering why they don't just prescribe a week of pain killers, I doubt too much 'abuse' can occur under the circumstances and I have a mental note for my next one to beg for more!

sleeplessinsuburbia Wed 05-Dec-12 03:13:21

It is a good point that you are meant to feel pain so you don't overdo it.

Want2bSupermum Wed 05-Dec-12 03:14:11

Had a CS here in the US 17 months ago. I didn't feel anything for the first day and was given a tablet to disperse any gas build up with each meal. After day three they switched me to 500mg of ibruprofin during the day and codine based pain relief for the night as it does make you drowsy.

When I was discharged it was a Sunday and I was given enough medication to see me through to the next day along with scripts for everything. CS are painful and during the first week you really need something strong to take the edge off.

FWIW DH was supposed to be relocated to Manchester while I was pregnant with DD. After our interaction with the maternity wards at the various Manchester hospitals we were left underwhelmed by the care provided and it was a factor in our decision to not move to the UK. I was impressed with the Liverpool Womans Hospital. The midwives were professional and talked me through the process rather than talking at me in a patronizing tone.

mmmmsleep Wed 05-Dec-12 03:27:06

Had similar situation although was at least given paracetamol and ibuprofen in ttos. i refused to leave without stronger prescribed meds and pointed out i'd needed oramorph overnight so diclofenac plus co codamol was the minimum i was leaving with. got it after some huffing. Agree people do underplay pain post cs/birth trauma. Discharging a patient without adequate pain relief isn't acceptable nor is telling pt to get it from gp. I am a gp and get so frustrated and upset on my patient's behalf when my patients come to me in pain because hospital denied them meds. It's not fair on the patient, just moves the cost to other parts of the nhs and is sloppy medicine imo. Rant over and lots of hospitals do discharge with good pain relief and after care arrangements in their defence.

mmmmsleep Wed 05-Dec-12 03:33:45

Oh and i agree with above. Speak to PALS department at your hospital who can helpyou resolve your complaint. Speaking to papers really should be a last resort if usual complaints procedures don't work and can hamper a positive resolution of the complaint for you as once papers involved legal team will be involved. It may be misunderstanding of a ruling that wasn't supposed to be applied like this and department should be given chance to change. Your midwife should have guided you to proper nhs complaints procedure and i expect has her own axe to grind if she jumps at suggesting papers.

RedToothbrush Wed 05-Dec-12 08:53:02

You should definitely complain as much as possible.

Why? Because if they are doing it for cost cutting reasons then they need to have it rammed home to them that it costs MORE in time and effort to deal with discharged patients in pain than it does to give you pain killers.

fufulina Wed 05-Dec-12 08:57:29

With my first c section, I was sent home with just paracetamol. I didn't query it at the time, I didn't know any better.

Second c section, I was sent home with codeine, and voltarol, which were amazing for the pain of the surgery, but the codeine really really buggered up my stomach, which at times was almost more painful than the surgery wound.

In hindsight, I was so desperate to get home after dd1, that I think I pissed them off. Hence paracetamol only!
Codeine was a double edged sword, frankly.

fufulina Wed 05-Dec-12 08:59:36

Oh, and oramorph, which I had to have post second c section was just weird. It was horrid actually, itchy face, sooooo drowsy yet couldn't sleep. Horrid. I've come to the conclusion that paracetamol and ibuprofen are the best approach, actually!

KvetnutsRoastingOnAnOpenFire Wed 05-Dec-12 08:59:42

didn't have a c section, but a fairly brutal forceps delivery, and was discharged with no pain relief within 20 hours. they tried to discharge me before they'd removed the catheter and one of the lines in my arm though, so think they were just massively overworked/understaffed.

I ended up crying all night then calling the GP and howling at them the next morning! and was prescribed wonderful, lovely, co-codamol!

topsmart Wed 05-Dec-12 09:02:58

Well, this is odd.
I too was discharged from St. Mary's in manchester after my CS - 10 wks ago -but I was given strong painkillers (diclofen or something?) if I struggled though told if I needed paracetamol or ibuprofen then I should buy them myself. I actually thought this is fair enough, they cost what - 20p? Most people have them in their houses already.

Is this the only aspect of your care that you're unhappy about? Then you need to complain to the hospital first, not run to the papers.

It is rubbish being in pain but it does force you to rest your tummy.

Nordicmom Wed 05-Dec-12 09:32:17

I have to say my experience of the EMCS on NHS 8 y ago was so bad ,other than the pain relief , specially the aftercare that I swore next time I'd go private. The resources are so few and they were so busy that I did feel completely abandoned after my section when DH wasn't there . The care before and the surgery itself were quite good. Never again!!!!

theonewiththenoisychild Wed 05-Dec-12 09:41:12

The pain does make you rest more but i had morphine in hospital and strong painkillers to bring home with me and i was still in a lot of pain. After my second cs the stitches on the outside burst on the one side as i stupidly picked up a washing basket full of wet washing as i got fed up with calling for help while db and dp had a chat about xbox. I overdid things both times but not because i wasnt in pain i was but because if you want a job doing right in my house you just do it yourself

TeaJunky Wed 05-Dec-12 10:19:04

Topsmart - I think if I 'ran to the papers' it would be with good reason. I have been in constant tears of pain since coming out, and without the full time support of DH I would never cope. In my particular situation, I havnt been able to make immediate contact with my gp - I don't know anyone who can to be honest. Where does that leave you in terms of strong pain relief in the short term?

As I said, the midwife did say its being brought in very recently, from around three weeks ago. That might explain why you ha a lucky escape.

topsmart Wed 05-Dec-12 10:22:49

I'm sorry TeaJunky, I didn't mean to downplay the pain you're in. Sounds horrible. Also sounds like you need a better gp! Have you rung your surgery and told them its an emergency?

elizaregina Wed 05-Dec-12 10:37:53

Tea Junky

You have to kick up a fuss to get the pain relief you need, how many peole have said on here - and midwives that keeping on top of pain after a section is absoluty KEY to recovery.

I am sorry but saying the pain helps you to not overdo it is absoluty rubbish.

pain is not good and does not aid recovery.

did you have an emergency section?

i had a planned one and i did alot of asking about pain relief - are they quick to respond if something isnt working to relive pain etc...

at the pre op i was given a prescription of pain relief to get then = to make sure i had paracetomol, senacot and codine at home. we brought our own ibprufen.

i then switched to diflonec as i was getting codine headaches....which the midwife prescibed for me - or got docs too and my Dh picked up. i saw the mw the day after i came home i think and she sorted out the new prescription....

if i cant get hold of my docs on the day i need, i call out of hours and get seen that night.

unfortunaly i did myself an added injury after the op which caused me tremendous pain -however if it wasnt for that i felt no pain in the wound AT ALL, and i managed to take it very very very easy for four weeks!

as for the cost cutting

i think there are MANY MANY other areas where they can cut back on costs....one idea could be on the health tourists who come here to deliberlaty abuse our nhs and those who buy their way into it - see
" panorma health tourists" the NHS in lots of hospitals doesnt have anyone to even check whether someone is entitled to free care which is costing hundred of thousands.

so for a start they could start to check people are entitled to free care.

make drunks pay for thier care in a & e on the weekends? youngsters out fighting and getting drunk....charge THEM.

IF they are cost cutting - fine but shouldnt they TELL patients and make them aware before they go in, and if she had an emergency section shouldnt she have been told this and told what to do if she needed stronger pain relief?

i agree with the other poster that said - they are passing on the problem if they leave a woman in pain like that - passing the buck back to " busy, over strected GPs".

when i was younger i always remebered our docs to be civilsed my mother was never stressed getting us appointments - our local hospitals were normal and not really anything we ever thought about - it was all running fine.

i just dont know how we have descended into this hideous bun fit to get an appointment - terrified of my local hospitals being able to take of me or my family if we need to use thier services....horror stories all the time....

dreadful.

Tea - i dont know why your MW didnt sort you out with meds - keep tyirng docs and please get yourself codeine and ibprufen or use paracetomol and diflonec....kick up a huge stink - write your MP if you have too and demand help.

shocking.

RayanneGraff Wed 05-Dec-12 10:39:33

This happened to me too. I am also thinking about complaining to the hospital (different one). The post cs aftercare was bad overall- no advice on wound care, signs of infection, activity levels etc.

I was in a lot of pain and I think diclofenac should have been prescribed, although I didn't really mind buying my own paracetemol- it just wasn't strong enough.

elizaregina Wed 05-Dec-12 10:40:42

tea - i would go to PALS - and papers - and MP.

AnitaBlake Wed 05-Dec-12 10:41:20

I was discharged at 2 with paracetamol and iburophen,, called GP at 3, and had a filled script by four for paracetamol, dicolphenic and codiene. GP was horrified by the whole thing. .Ws said they couldn't give diclofenic anymore due to costs.

RayanneGraff Wed 05-Dec-12 10:42:41

Sorry you're in so much pain Teajunky- do keep hassling the gp.

elizaregina Wed 05-Dec-12 10:45:31

Rayanne

I thought too aftercare was ridiculous - they are making a rod for thier own backs - if they cant give proper advice on how to move - what to avoid - infection etc then instead of people healing and not coming back they are just going to get repeat visits with problems.

i was told to " get moving, get on your side" by a very rude MW the night after my op - she didnt advise me on how to move - and i did a massive twist and ruptured or pulled something, it caused tremendous pain at the time - i had to have more care assistant help moving than anyone else on the ward who had all had emergency sections - and nasty labours - they were all more mobile than me - i had to have more pain relief, i have been back to the docs with the pain - i have been back to the hospital!

utterly ridiculous. i then was handed a leaflet by the health visitor THREE WEEKS after the op - on how to move etc....with pictures!

she shoudl have at the very least been given a prescription to pay for if neccasry of stronger stuff should she need it.

all the midwives at hospital and commuity said to me = " we always tell section ladies - keep on top of the pain, dont let break through pain happen or it could be very hard to control....and beat back down...keep on top of those meds"

Sweetiesmum Wed 05-Dec-12 10:58:28

Tea junky I agree the hospital has a duty of care that you are discharged home with pain adequately controlled. With a tiny baby needing 3 hourly feeding and a painful incision that is barely beginning to heal you have every right to expect at least 24 hours of pain relief medication to take home. (A period of grace for you to hobble to pharmacy and stock up on meds) Why dont they cut costs with cutting the managers pay that made this nasty decision to disregard the wellbeing of new mothers

Pourquoimoi Wed 05-Dec-12 11:06:24

It's wrong isn't it. I think unfortunately that it is cost cutting throughout. I had major knee surgery on both knees at once earlier this year and they tried to send me home two hours after the op with no painkillers!!

The nurse tried to tell me to get paracetamol from the supermarket as it was cheap!! I was in agony and couldn't walk!! I really had to be strong to insist that they got me the stronger medication that the anaesthetist had prescribed. She reluctantly agreed and said grumpily that it'd take an hour as if I'd tell her that it didn't matter! I waited and got the necessary painkillers. I was really quite shocked by the treatment though.

Thankfully my c sections were years ago and the cost cutting wasn't in place then so I got plenty of painkillers.

I am all for making savings where appropriate but skimping on painkillers is just ridiculous.

reikizen Wed 05-Dec-12 11:28:35

Firstly, some units do not prescribe codeine to breastfeeding mothers full stop, although the evidence for this is very weak, but you can buy co-codamol (at a lower dose) from a pharmacy. Secondly, I do not rate voltarol as a painkiller and I think that your standard 15p ibuprofen will work better. So, a good idea to stock up on both these before you have a baby.
Secondly, although paracetamol & ibuprofen cost 15p from your local shop, for the hospital to buy them from the pharmacy costs at least 10 times this. I'm not sure it makes sense for the NHS to spend this money on an easily bought OTC painkiller (as bissydissy says, she threw most of hers away - probably about 50 quids worth of drugs) when we are losing staff and resources hand over fist but I understand that some will disagree with this. Many women don't require anything over and above paracetamol in my experience after the first 24 hours anyway.
Thirdly, it isn't just maternity as my DH was sent home following a major operation with totally inadequate pain relief, GP was happy to prescribe something stronger.
I'm pretty sure going to the press will be pointless tbh, the NHS is getting squeezed so much ( I know midwives who share one sonicaid and one set of scales between a team of 6 people and I have had to buy my own neonatal resus equipment for homebirths) I think most people will think nothing of it. As long as St Mary's are advising people in advance (as I am doing at my antenatal classes) they can make appropriate provision. Perhaps getting GP to prescribe it if having an elective section.
I am truly sorry that people have had a shit time with their maternity provision but believe me, it is going to get much, much worse. sad

whatsoever Wed 05-Dec-12 11:49:57

Sorry Tea, I haven't read all the posts but I was sent home from St Mary's in October after an episiotomy with no pain relief either. My dad gave me a few strips of his diclofenac or I wouldn't have managed.

When I had cervical cautery at Wythenshawe in 2010 (very minor and I left same day in no pain) they gave me tons of paracetamol and diclofenac to take home.

TeaJunky Wed 05-Dec-12 16:56:47

Topsmart - it's ok, didn't mean to sound snappy - I blame the no/shit analgesics!
I had an emergency section - dd was brow presentation and I pushed for all I was worth but nothing happened sad

I called my surgery again and it turns out the cow receptionist had left my message in the book for a gp that isn't in until tomorrow- after knowing the whole story of why I desperately needed to speak to a gp. (Me: can I please explain..."no , can you explain to the doctor please what the problem is, me: if you just give me a quick minute I can explain why it's so urgent) sad

Anyway the gp was shocked and astounded by this, and has also suggested I complain, at the very least. He said the surgery was about to close but has written out a prescription (with all them glorious pain killers!) and dropped it off at the pharmacy next door, and dh has gone to pick it up < sigh of relief>

Hoping tonight will be a tear-free night. Thank you Nhs for ruining my precious first days with dd

[tears roll]

Nordicmom Wed 05-Dec-12 21:08:05

Happy you got your prescription Tea! To be honest the first few weeks were a blur of pain, tiredness etc after my CS but after a month or so I was feeling much better smile . You'll be ok . In the meantime take all the painkillers you need , rest as much as you can and make other's do everything possible for you if you can . Congrats on your little one smile My littlest one is now 7m . Time goes fast !

rainrainandmorerain Wed 05-Dec-12 22:41:50

reikizen, i hope you have nothing to do with caring for women post cs. And if you do, you never ever come anywhere near me.

'In your opinion' voltarol isn't as good as otc ibuprofen? and many women manage on paracetamol 24 hours after a cs? and btw, the co-codamol you get otc is a LOT weaker than what you get on prescription, where there are different strengths of codeine according to need.

Thank god I had consultant care, where adequate analgesia was discussed with me beforehand. What a shame the only low point of my cs was when 2 bitches of mws told me to 'manage' on paracetamol only, 24 hours after me cs, going against the specificied pain relief protocol in my notes, leaving me in such pain that I needed tramadol. Which is expensive and strong, and which I would most likely NOT have needed had they stuck to the agreed pain relief. Oh, and the humilation and fear of BEGGING them for more pain relief is something that will stay with me for a while.

For a woman crippled with agonising pain after a cs, who needs more pain relief, getting to a GP can be impossible. Or add to the agony. What we need is rest, right? so what good does hauling myself physically to the gp's surgery to physically pick up a prescription do?

WOMEN SHOULD BE GIVEN ADEQUATE PAIN RELIEF WHEN THEY ARE IN HOSPITAL AND WHEN THEY LEAVE. If they find they can manage on less, good for them. If cheap otc painkillers form part of the regime, then fine, warn women in advance of what they need to buy.

But sending women home from hospital without the prescription medicine they are likely to need is barbaric.

TeaJunky Wed 05-Dec-12 23:55:18

Thanks Nordic smile feeling do much better tonight, even managed to have a rummage through my bounty pack grin

And rain - you said it so much better than me. It IS barbaric. Rez mentioned about it not being about c-sections only etc and how her husbands knee(?) operation was a similar experience. Now in hindsight, I had to physically 'chase' (read hobble in excruciating pain) the midwives at night a couple of times to get some painkillers. I was told by a midwife that I could help myself to the infant feeding room (which was miles down the corridor) when I buzzed her to get me a feed in the night, although she said it after she brought it. I said I was in too much pain to walk the length of the corridor and back. Re the painkillers, It's not that they didn't readily give them out while I was there - they just didn't seem to think a c-section as 'major abdominal surgery' that you hear so often. It was the whole attitude, verbal and non verbal around it that just made me feel like it wasn't taken seriously. at all.

And that, I think is scarier for women than nhs cut backs.

I was discharged with about two months worth of diclofenic after my c-section. I only took it for three weeks BUT I certainly did not throw the rest away, the remaining pills got used over a period of two years.
Why would you bin perfectly good painkillers?

TackyChristmastreedelivery Thu 06-Dec-12 00:20:53

Our unit has just moved from diclofenac to ibuprofen as it is considered a bettter option by the anaesthetics department. Less tummy upset for the pain relief gained. People seem to do ok on ibuprofen and paracetamol, with codeine in the first 24 hrs or so. At least, women often turn down the codeine and accept the others on drug rounds.

I think the issue is just how utterly insane it is that a person can buy a box of paracetamol for 22p but a trust has to spend many many times more to buy in, prescribe and supply that drug.

That's the issue here

Obviously anyone who needs anything extra should get it. Although perhaps if greater amounts of analgesia are needed then discharge should be postponed? The thought of climbing stairs or climbing into a shower-over-bath post section makes me cringe! I always try to remind families who are desperate to be home at 24 hrs, these things aren't always obvious until you get home!

I'm a bit nervous of very newly, knackered delivered mums being home at night and taking tramadol etc. That's probably a personal thing though, I know I'd be out of it.

I am sad for postnatal care. It's always been the poor relation in maternity and obstetrics (imo).

nooka Thu 06-Dec-12 06:20:46

You should not use prescription medicines except under medical advice. Neither should you just throw them away, they should be taken to a pharmacy for safe disposal. Many prescription medicines including painkillers have significant side effects, some can be dangerous if taken in the wrong circumstances.

After my first section I remember thinking that the midwives were very mean when they didn't bring me toast (we had a unit with a communal room for breakfast) and kept telling me to get up, and I remember the first trip to the bathroom being very scary. Second time around knowing that if I wasn't up and about they wouldn't let me go home as soon as I possibly could I made myself move early, and it wasn't nearly as scary (even though that labour was physically and emotionally much more traumatic than the first, which was in retrospect very easy).

Sometimes you get healthcare workers that are simply not very caring. Sometimes they are overwhelmed and supportive. But other times they are telling you what you need to know, even if you don't want to hear it.

bissydissy Thu 06-Dec-12 07:48:59

Hi - to clarify - I did not throw away my drugs - I returned them to a pharmacy - who then throw them away. They gave me several weeks worth. The solution to nhs over prescription is not, however, to cease prescribing but to prescribe sensible ammounts.

Sweetiesmum Thu 06-Dec-12 11:01:12

wow.... seems the staff are not working on keeping patients pain under control but some other policy??

rainrainandmorerain Thu 06-Dec-12 14:01:29

I'm sorry, but someone not bringing you toast when you want it is not the same as leaving a woman in serious pain because a carer personally feels she should be managing on paracetamol shortly after a cs.

NICE guidelines say this: "WOMAN WHO HAVE A CS SHOULD BE PRESCRIBED AND ENCOURAGED TO TAKE REGULAR ANALGESIA FOR POST OPERATIVE PAIN, USING - FOR SEVERE PAIN, CO-CODAMOL WITH ADDED IBUPROFEN. FOR MODERATE PAIN, CO-CODAMOL. FOR MILD PAIN, PARACETAMOL."

Here - www.nice.org.uk/nicemedia/live/13620/57163/57163.pdf - page 28.

And that's after recommending patient controlled opioid anaesthetics in the immediate post operative period.

so OP, I would recommend asking your local hospital to justify their reasons for not following nice guidelines for a start.

The idea that you should not be discharged from hospital if you require painkillers stronger than paracetamol is daft. A night in hospital is far more expensive than a packet of pills. Apply that rule to all post operative patients (and why should women post-birth be treated differently) and you've just bumped up your local nhs hospital bill considerably.

by ALL means, ask women to buy a box of paracetamol prior to birth. Why not. But that has nothing to do with discharging women 24 hours after major abdominal surgery with no painkillers and no sensible means of getting hold of them. Expecting them to jump through hoops trying to get hold of prescription medication from their gp when it turns out they need something stronger than a painkiller for 'mild pain' is just cruel. Sod buying paracetamol - you cannot buy the co-codamol I was on over the counter. It just isn't legal.

How long til someone overdoses on otc painkillers because it is the middle of the night, and they are in desperate pain? Or takes a relative's medication, not prescribed for them, with bad consequences?

I am left wondering how much of this is connected to the idea that birth, vaginal or cs, SHOULD be painful, and women should just be putting up with this pain.

I had a nasty episotomy several years ago and was presceibed voltarol...not much, but enough.

This year I had a hip replacement privately. I was in for 6 days, and had my pills brought round. Before discharge I went to the pharmacy and paid for additional medication (that I would need at home). I also knew to stock up on ibrorofen and paracetamol.

It seems totally inappropriate to discharge post CS without some drugs - although usually I would think it apprpriate to let people buy their onw OTC meds. IT seems to me that they were pretty negligent in not explaining what you would need, and enabling you / DH to stock up.

reikizen Thu 06-Dec-12 14:47:39

Message deleted by Mumsnet for breaking our Talk Guidelines. Replies may also be deleted.

nooka Thu 06-Dec-12 15:53:25

Sorry rain, my point was simply that the pain that I thought was totally unbearable, when the idea of getting up and walking was to me unthinkable was actually manageable. The staff who I thought were uncaring were actually giving me the right advice and support to achieve my objective (to get home as soon as possible).

Otherwise I would certainly agree with you that pain should be managed on an individual basis as much as possible. Sadly from my experience (I'm not a healthcare worker but I did manage a NHS complaints service for a few years a while back) post natal care is a bit of a Cinderella and not at all well funded. My personal experience is over ten years ago when funding was generally better, given the pressure the whole service is under now I suspect it is a great deal worse.

rainrainandmorerain Thu 06-Dec-12 18:38:56

rezieken - you don't actually work in a profession where you care for people, do you?

YOU personally have taken diclofenac and ibuprofen and you personally found ibuprofen more effective? Great! You do know that different painkillers work differently on different people? So a mw or nurse dismissing a patient in pain with the argument that 'paracetamol works perfectly well for ME, so what are YOU complaining about?' is just badly informed nonsense.

And I sound like an angry and 'quite a nasty' person, do I. Oh, my heart breaks.... I tell you what does make me angry. Mad as hell, in fact. Poor patient care, vicious woman hating nonsense, and carers who abuse their power. Not to mention new mothers whose first precious days with their newborn are spent in needless pain and distress. So shoot me.

TeaJunky Thu 06-Dec-12 18:51:02

I agree with you rain all the way, especially that last bit.

I would also like to add that I wanted to breastfeed, but the constant pain of sitting up for long periods of time, without pain relief, has not allowed me to do this. sad

VivaLeBeaver Thu 06-Dec-12 18:52:25

You can buy voltarol/disclofenac over the counter now. It comes in a 12.5mg dose rather than the 50mg dose that hospitals dispense. But you can take 4 tablets to get it up to 50mg and take 3x a day.

JaffaSnaffle Thu 06-Dec-12 18:54:23

Had the same experience in a different part of the country, Cambridge. No analgesia to take home. In the hospital, it was oramorph and diclafenac round the clock, and tbh the thought of having to manage on lower painkillers was a factor in when I felt happy to go home.

Once it was clear that there would be no pain relief coming home with me, I was on to the GP,, who prescribed co-codamol. There is no way I could have managed the early days without it.

But I didn't save NHS money, just charged a different budget I guess.

JaffaSnaffle Thu 06-Dec-12 19:00:01

And, yes I was shocked by it. It was abdominal surgery, for heavens sake, not a small procedure. Why should women be expected to endure pain like that, I've no idea. Because it's childbirth? It's hard enough recovering, when you've got a small baby to care for and you are sleep deprived and on a learning curve...

doublecakeplease Thu 06-Dec-12 19:02:04

I was sent home without pain meds too - Sunderland hospital. Ds was in scbu so missed most of the meds the 2 days post birth too as I wasn't on the ward at drug times.

Really struggled the first 2 nights but, having never had an operation before assumed I was being a wimp.

Didn't kill me but I'd def rather have had them! wasn't asked about my pain and just muddled through. Only had my scar checked by a student and an auxiliary too

Message withdrawn at poster's request.

Waswondering Thu 06-Dec-12 20:03:39

I had a cs 6y ago. I was on a morphine PCA for the first 24h, then voltarol etc.

I think I had a great recovery as a week later (ie day 7 exactly) I forgot to take my meds ... and was in good form and out and about.

reikizen - have you had a CS or other abdominal surgery? It's difficult as you are sore and you have to lift and carry a 7lb ish baby - when everything is tender and even standing straight is tricky (not to mention not being allowed to sleep for long thanks to a feeding baby,!!). I am glad that I wasn't told that at 24h I should have been managing on paracetamol alone - I think I might have felt like I was seriously lightweight pain wise if I had.

OP - I hope you can clarify the position of your Trust on post CS pain relief so that others don't have to endure the same pain you have - and I hope you recovery quickly: congratulations on your baby.

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