Asked to provide own painkillers!

As pp said the idea of people 'managing' their own pain relief with whatever they can get before they go in is problem in terms of tracking.

Seems bonkers.

Also tbh plenty of people in general can get hold of illicit drugs. If you think you're facing a major op with a paracetamol after. Isn't that asking for trouble in terms of people taking in stronger illicit drugs?

I was on an opium drip for ? Time with both my sections. Catheter out next day and up and walk. If no issues discharged that day.

The opium helped. Morphine rather. Different names same difference really.

Same as heroin and methadone essentially in all but when it's used, who by and for how long, and that dosage is controlled.

So that kind of makes me think. This surgery fucking hurts. You've been cut open to get right to your insides. I've had other surgery many times and CS was no more or less painful. Decent pain relief is key to recover. BYOdrugs seems like a strategy that will cause more harm than good in the longer term.

I had my section 30 years ago and didn't get any pain relief afterwards. I had my first child nearly 50 years ago, back then they supplied all sorts, nappies and nightgown for the baby, sanitary towels for mum. I was surprised when I had to take my own with my youngest so I suppose this is just following the trend.

I did catch midwife trying to steal some of my nappies for 15 year old mum on the ward who had nothing, I told her she could have them when I saw what she was doing but thought it was a bit off for midwives to be nicking my stuff. She did apologise.

I had major gynae surgery back in 2011 and refused all painkillers except paracetomal - had 35 stitches . Had to provide my own sanitary pads, pain relief etc . Told it was cost cutting .

Similar experience last year when a doctor proudly told me they’re trying to persuade people to first try some surgeries (he said most gynae procedures, urology stuff, etc) with no anaesthetic where possible - said it usually isn’t needed and that I won’t be in that much pain if I just relax !

I agree boatyardblues
How is someone hazy from lack of sleep,pain and opiates to remember when she last took paracetamol? IV paracetamol is extremely effective but couldn't be given if the woman had dosed up on oral paracetamol. And as I mentioned up thread, ibuprofen isn't a benign drug, it doesn't suit everyone and in my hospital anyone prescribed Ibuprofen or drugs in the same class (NSAID) is also prescribed a proton pump inhibitor drug eg omeprazole for gastric protection.
It seems a recipe for disaster to me.

This surprises me. Surely all medication needs to be charted so no one accidentally overdoses by either taking too many themselves or a combination of drugs administered by the medical team & the woman supplementing. Also, what about drug interactions? Sounds really unsafe to me.

It's a bit worrying to read, but I'm sure nobody is going to turn around and say "well, if you didn't bring your painkillers, there's nothing we can do to help you - you're on your own".

I wonder could it be part of an "enhanced recovery" policy. If you have your own painkillers, then maybe there are fewer delays waiting for midwives to get them for you and less likelihood pain keeps you in hospital for longer? Unless you have complications, getting home sooner has got to be good!

I got that too Betty.

The letter states that the paracetamol will be the pain relief after.

I'm totally amazed by that. Decent pain relief is so important and it's well known that women and children have in the past and probably still are undermedicated for pain.

This is rubbish but it’s much better than having to wait for an overstretched staff member to issue you some. Very easy to go past the 4 hour mark like that which makes it significantly harder to get back on top of it.

It’s been a while since I had a c section but I’m pretty sure I had a morphine pump immediately post surgery (which cause havoc with a breastfeeding baby!) and was then given Diclofenac til discharge.

I've got no probs with taking in paracetamol etc you can get a box for 20p or something, very cheap.

The letter is clear that that'll be the pain relief though which is what has shocked so many.

Sorry but I haven't read the full thread, but obviously make sure whatever medication you take, that it is compatable with breast feeding, if that is your intention.

I've had a lot of surgery of different types in a few different hospitals in recent years and have been asked to provide my own paracetamol and ibuprofen to take home on all occasions - but not as an inpatient, that seems odd.
It is cost related. Not the actual purchase costs of the drugs themselves but the costs around prescribing, dispensing, labelling etc. I can't remember the exact details but I was got a leaflet with my admission papers for a day case procedure last year and it said something like the total cost to the NHS of giving a day patient paracetamol to take home was something like £10 whereas at the time you could get 16 paracetamol for 30p in the supermarket. That might not be the exact figure but it was something in that range. I still got given the prescription only drugs to take home but was asked to get some of the over the counter drugs in preparation for admission. The anaesthetist did ask me if I had got them though and I don't think they would have sent me away with nothing if I had said no, and people on some benefits were mentioned as not needing to get them in the leaflet. The cost savinbs this particular Trust saud they have made from this change was significant.
I don't think there's anything wrong with asking people who can afford OTC drugs to buy them to be honest. I also wouldn't assume that there will be nothing else offered. Pretty much every operation I have ever had has had the same basic post op "recipe". Regular paracetamol, a regular NSAID and opioids as required in between. So the hospital will probably still provide the opioids. It does seem odd to have to actually take your own drugs in as an inpatient though. I've only ever been asked to take my own for home. That said, the amount of time I have waited for pain relief on busy wards at time I would not have minded having my own medication and being autonomous. I have a long term painful condition and am pretty good at managing it at home, but on more than one occasion have found myself prescribed less post op than I was taking pre-op.

That's cutbacks for you. And saving money for NHS. Abominable strategy.

If I were faced with this, I would demand to know if EVERYONE facing surgery have to do this.

But look, CS is a woman thing and they will be fine. Get the drift?

I bet those undergoing Transgender surgery will get everything they want for fear of Equality Act. But women having a baby Nah.

I am so angry for you OP.

What I find most ironic about this is that if you request to have an elective section (on a maternal request basis as opposed to being advised to have one for medical reasons) you’re told “it’s major abdominal surgery” etc etc to try to dissuade you from having one. But apparently despite being major abdominal surgery, after having had this major surgery, the only pain relief you’re routinely offered in hospital is paracetamol and ibuprofen and when you are discharged (less than 24 hours post op in the current climate) you’re given no pain relief to take with you.

It’s fucking depressing.

DD (12) has had multiple surgeries and in recent years the letter calling us in has said they no longer prescribe ibuprofen or paracetamol to take home so please ensure you have supplies in.

I don't think we've ever been asked to take our own but it seems like that would be the next step.

Anything stronger needed has been provided.

The issues with massive death rate due to abuse of prescription opoids doesn't map to this.

I had morphine on a drip for 12 hours or something after both sections. Then paracetamol etc.

Denying adequate post operative pain relief, supplied and controlled by the hosp, as a reaction to a different issue in a different country just doesn't make sense as a reason.

Perhaps one reasoning is to avoid an opoid crisis as in USA but has gone a bit the other way.
ChateauMargaux I remember reading that article with my MIL. Interesting but also sad.
CaraDuneRedux you raise some interesting points on patient-led care. I recall at some point the pain meds trolley came and I was asked what I would want. Daaaaa? What the heck? I might have no idea the difference between dihydrocodeine and paracetamol! Equally, removing staples today I was asked why I had staples and I said, my surgeon's choice: oh, she said. As long as you are happy. And I was thinking, well, I read so many journal articles and still wasn't 100% sure it was the right choice (was 80%sure). Patient-led care has to be accompanied by good and mass-scale understanding of science etc. More time per patient, and a change in culture where patient and medical expert have critical discussion, where doctors have time and a listening culture. And an acceptance that even medical research and therefore findings are politically and culturally informed.
Better stop there before I start a dissertation lol

caringcarer well sure but he had opiates after the op.

I was on morphine after both sections.

To deny women decent pain relief after major surgery is shit.

The "it's cheaper for the NHS" argument makes no sense. The NHS has massive bargaining power which it uses to keep drug prices down (so much so this is going to be one of the major sticking points in any post-Brexit US-UK trade negotiations, because American pharmaceutical companies want to strip the NHS of that power). To imagine that 40p worth of paracetamol is what's driving this (when the cost of an overnight stay in hospital, in terms of facilities and staffing) runs into thousands, is nonsense.

I would be interested to hear from HCPs on this one. Is it part of a move towards getting patients more involved in their own care, to move away from paternalistic medicine and the institutionalising tendency of long stays in hospital? Just implemented in a really stupid and cack-handed way?

For instance, by the end of a week in hospital with a raging gall-bladder infection, I was actually in a position to ask for various things that I knew would work - diclofenac suppositories (a must if you are vomiting frequently), and anti-emetics to take before the worst of the antibiotics. Actually being treated as a grown up who could say "this is working for me, that isn't" helped.

But that has to be balanced against risks like the one I mentioned upthread - that HCPs lose track of what medication's been taken, when, if it's not on a central drug list.

This is totally outrageous to my mind. Doesn't happen where I live. Crazy stuff.

Errr....never had a c-section but I'm not sure if simple ibuprofen or paracetamol is going to be enough - that combo is what I take for period pain! I thought they used a rectal diclofenac after surgery like this? That's only available on prescription, as far as I'm aware, so you should get it from your hospital.

I would also like to see research on all operations to understand whether women and treated equally after surgery.

This would suggest ingrained sexism in the treatment of pain by medical staff. www.independent.co.uk/life-style/health-and-families/health-news/how-sexist-stereotypes-mean-doctors-ignore-women-s-pain-a7157931.html

I am shocked by attempts to pass this off as OK by reference to cost cutting in the NHS. I was also shocked by the suggestion that as it was an elective operation, it was therefore fine to be asked to provide your own pain relief.

These are the NICE guidelines on pain relief, also refer to the 'going home' section which states that you should be sent home with pain relief. Obviously if it is cheaper for you to buy the medicine OTC than pay for the prescription, you can make that choice.

www.nice.org.uk/guidance/cg132/ifp/chapter/Having-the-caesarean-section-operation#after-the-operation

My mum recently had a bone debriding/ rebuilding and large muscle transplant from her shoulder to her leg. It was a 10 hour major surgery. She then got several infections in all 3 operation sites. In for months. She was given paracetamol. Didn't have to provide it herself though!

I think the NHS is just not keen on handing out pain relief tbh. I'm surprised you have to supply your paracetamol yourself though!

Would be good to clarify whether this is expected of patients across the trust or just maternity services.

My experience of being on gynae ward as an emergency was being left for hours without pain relief, even after using my buzzer to remind them. The poor woman next to me was sobbing all night. It was horrendous and I wish I had taken my own pain relief.