Asked to provide own painkillers!

[Insertdeadcatsnamehere]

I've got an elective ceasarean booked in a couple of weeks. Have just had the consent form and info through and I've been asked to provide my own painkillers (for on the recovery ward afterwards, I'm still, possibly naively, assuming they'll provide the actual anaesthetic). Absolutely speechless! Just wondering whether anyone has had any comparable (but not female- specific) surgery and has been asked this? Apparently if I forget to bring my paracetamol and ibruprofen I can toddle down to the onsite pharmacy a couple of hours after my major abdominal surgery and purchase some. So that's helpful. No word on whether they'd sell me anything stronger...

Interesting to hear examples of non maternity care where similar has happened. I think to get an idea of the real picture you'd need to see each trust's policies around pain relief if they have them? (although I know these aren't necessarily an accurate picture of what actually goes on). Just that, anecdotally, maternity care in particular seems absolutely dire, especially in hospitals (personally can't fault my community midwife and have had the same one throughout 2 pregnancies although I hear this is quite rare).

I was given morphine post crash section and sent home with prescription strength co codomol. I'm very surprised at this.

I did find paracetomol and ibuprofen was absolutely fine after my planned section. I think the stuff they give you during the op lasts a few hours and after that it wasn't too bad at all.

I thought if I did it again I would bring my own and hide them (was told not to bring any) as the drug rounds were very irregular and taking them on a regular schedule is key to avoiding pain.

On the same lines I'd recommend bringing your own food and bottled water that you can keep within reach, because getting anyone to bring you any is a non-starter. Especially water, it's essential to drink as they need to check you have pee'd a certain amount before you can be allowed to go home. If you are lucky someone will bring you a tiny jug of water but you have to wait for ages each time. No good if you are dehydrated after no water all day or all the previous night before an afternoon surgery.

My dh had proper pain relief for surgery, but he was given some paracetamol to go home with from the pharmacy as we forgot to bring it as suggested and then we got a £15.50 private prescription charge letter about a week later. It was an nhs hospital and nhs surgery. We paid because on all liklihood the nurse explained that would happen and my dh didnt listen!
I truly hope you are given proper pain relief whilst in hospital.

I had this advice in relation to a private hospital, as the charges for standard painkillers were apparently much higher than OTC, so I was told not to let them discharge me with painkillers but to say I had my own at home.

But an NHS hospital? No idea.

Maybe it is a cost cutting exercise (over the counter paracetamol is about 16p.. hospitals will have to pay a lot more)

I'd have thought hospitals would be paying less for paracetamol and otc pain killers than ordinary people buying a packet in a shop.

ArabellaScott Getting up is a good thing post operatively, helps with easing the wind which can be equally if not more problematic as post-op pain.

Liquid morphine, together with paracetamol ime, is the best combination for most post-section women, stepping down to paracetamol only after 18-24 hours.

I'm an anaesthetist and prescribe paracetamol, Ibuprofen, dihydrocodeine and morphine for all my post op Caesarean patients (or alternatives if allergic). Whether they actually get them in a timely manner on the ward after is another question...

I had my gallbladder out in Feb this year and was told to stock up on paracetamol/Ibuprofen at home as they wouldn't give me any on discharge. Didn't have to bring my own to hospital, but I was only in for a few hours post op.

I didnt have to provide my own but that was the only pain relief I was offered last May! I told them over and over I was in agony after 24hours in labour, induction and emcs but didn't get any pain meds apart from ibuprofen and paracetamol!

I took my own paracetemol and ibuprofen with me simply because I didn't want to wait for them to come round on the medication round ( which takes forever). They were enough for me but on a wider point I agree with you about the shit standard of care for maternity services and the difference in treatment between childbirth and other services. I was always outraged that women had such difficulty demanding elective c-sections. If that was any other type of medical process where there were 2 options available but only 1 was ever offered then there would be outrage.

I'm wondering if this is a regional NHS thing now rather than a just a departmental thing.

DH surgery was in midlands where he was sent home with pain relief and DS they insisted he take pain meds pre and post op while another poster had to provide their own for similar sounding surgery.

Dh had a hernia op at the same hospital I had 2 emergency sections in. He was discharged with considerably more pain relief. Although I was lucky and didn't need anything with either section. Found that out because I was in Nicu with dc1 and wasn't offered any drugs for 2 and a half days. Turns out that like food which I also didn't get, you were meant to instinctly know when the drugs rounds were.

After my 2nd section, I left hospital as possible.

In-patients self-administering painkillers after major surgery sounds like an overdosing (or lethal interaction) accident waiting to happen...

This is just another case of the Americanisation (aka. privatisation) of healthcare here in the UK. Probably standard practice in the States (either that or they charge you through the roof for painkillers). Absolutely abhorrent that they should ask you to use OTC painkillers for major surgery but just another step in the plan to privatise and monetise healthcare. Make no mistake, this will become much more commonplace once the trade deals and no-deal Brexit have gone through.

Are you sure it's for immediately afterwards? Our trust tells us to have paracetamol at home/with us for when in labour and for when discharged.

They gave me paracetamol after my vaginal birth last year (which was fine). From my experience they want you on as few painkillers as possible, especially if you breastfeed. I've also taken paracetamol + codeine in the past after another operation and it made me incredibly spaced out. I certainly wouldn't want to be looking after a newborn on them.

I'd see how you get on with paracetamol immediately after the birth before you ask for anything stronger, but by all means ask if you're struggling.

I had orthopaedic surgery with paracetamol and ibuprofen afterwards for the recovery. They told me they wouldn’t prescribe it after I left hospital because it was something ridiculous like £7 for them to buy a packet but 30p for me to buy it.

@SockQueen pretty much summed up what I was going to say.
I had an emergency c-section recently. I was given Paracetamol, Ibuprofen and Morphine on the post-natal ward. On discharge, I was given 7 x Dihydrocodeine tablets and asked to buy my own Paracetamol and Ibuprofen which was fine by me. I am quite surprised you need to provide it as an inpatient.

Incidentally, Dihydrocodeine is prescribed over Codeine if the patient is breastfeeding as Codeine is contra-indicated in lactation.
I did unfortunately have an issue with a 111 GP when I needed some more Dihydrocodeine. She proceeded to tell me that I shouldn't be using it even though I had been discharged on it by the obstetrics team and the anaesthetist. I am a clinical pharmacist so offered to email her links to specialist resources we use for drugs in lactation which backed up its use. She was not willing to accept the evidence I offered but then prescribed me 6 tablets. I can't fathom why she felt 6 tablets were ok considering her very strong 'feelings' towards them!
Thankfully I didn't need the full 6 tablets but pain from wind and constipation on top of the pain from the wound had been quite severe!

@Insertdeadcatsnamehere according to NICE guidance you should be offered pain relief in hospital. See attached. Definitely challenge this nonsense.

That’s ridiculous. I recently had c section and was offered paracetamol and ibuprofen. I had to ask a number of times for the stronger stuff, declofen and morphine.

They don’t tend to encourage stronger due to the potential to breastfeed so I imagine being your owns cost saving more than anything. I was provided pain relief on site (including dyhydracodine while ebf) but was told to pick up paracetamol on my way home as they wouldn’t be able to prescribe any, totally fine I got DP to pick up a few boxes.

@jessstan1

Ask your GP to prescribe you just a few strong painkillers in case you need more than a couple of paracetamol.

I would think if you were in severe pain, the hospital would give you necessary analgesia. However you have elected to have a Caesarian.

so the pain will be less...? So she should suck it up because she chose it? sorry, I don't follow.

I had a scheduled C section because my baby was breech. I could have opted to deliver her naturally but it would have been dangerous for us. Should I have put up with crap pain relief for that?

(actually that last bit is a rhetorical q as I was given only ibuprofen and paracetamol too, and was frequently in pain - got a bit of oromorph while in the hospital but I had to actually as for it and then it was hit and miss whether anybody ever brought it to me. Maybe I should have supplied my own, it would have been more efficient.)

Both my DH and I have had operations recently. We were told to get our own paracetamol or ibuprofen on discharge. We didn’t have any, apart from the general anaesthetic, in hospital. But we were both in as day patients. Maybe that was the difference.

@jessstan1
I had an elective c-section but had no choice as whether or not to have one. It just meant it was planned in advance unlike my first one which was an emergency section (turned out ending up needing to come out early, on the day I had an appointment when they were going to book it in as an elective 🙄) . I could not give birth naturally without risking both mine and the babies health.

As I take a lot of medication including pain relief everyday I was told to bring my usual meds in with me. My prescription was also on my file but I was told to ask for additional pain relief on top of this if I needed it. I did with my emergency section but not with the elective one which frankly was a breeze in comparison.
I have had the same request re meds and pain relief when I had a procedure on my hip.

I can’t believe this is happening in nhs hospitals. We don’t send women home with paracetamol but we give it out with ibuprofen and morphine on the ward. Diclofenac is give after the c/s and one more the next day. I think it’s appalling to open up somebody’s abdomen and expect paracetamol to be enough! Plus they’re expected to look after a newborn! There’s no other operation where you’d be given a baby to look after immediately afterwards. I think you need to write to the chief executive and your MP about this.

I had another surgery just a few months after having a c section. It was a much smaller surgery and I was constantly offered pain relief, which I declined, as I really didn't need it. And I was discharged from hospital with a few heavy duty painkillers 'just in case'. After my cs I had to plead for pain relief, and was told I didn't need it and paracetamol should be sufficient. Couldn't even get ibuprofen.

If paracetamol is all you need, why do they offer stronger pain relief after other surgeries?