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Feminism: Sex and gender discussions

Asked to provide own painkillers!

163 replies

Insertdeadcatsnamehere · 03/11/2020 15:45

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...

OP posts:
CaraDuneRedux · 03/11/2020 18:46

@Louiselhrau

Paracetamol is actually one of the best drugs for pain relief post surgery, literally the best there is so I don't know why so many people are going on about needing something stronger.
Worked fine for me post CS (after epidural was out) but doesn't even touch some of the more serious pain one can encounter (gallstones, I'm looking at you).

Paracetamol is also cheap as chips so no real saving to the hospital (unless of course you're on "adult Calpol" as I was cos I couldn't keep anything down).

Also, as I mentioned, the downside with paracetamol is the effective dose is uncomfortably close to the dangerous dose, so if your patient is also on opioids and somewhat out of it as a result, you really don't want them with a stash of their own paracetamol in the bedside cabinet in case they lose count.

Insertdeadcatsnamehere · 03/11/2020 18:46

I'm not enraged. Just very surprised and curious whether this is a blanket policy. Yes it's Leeds. I was given all sorts after my EMCS 2 years ago (can't remember what, I was a horrible mess for several days) so this seems to be a huge change. Obviously I'm hoping I only need OTC stuff anyway this time but don't have a comparable experience to go on as I don't remember a huge amount about my first section or aftermath.

OP posts:
skylarkdescending · 03/11/2020 18:49

@Insertdeadcatsnamehere

I'm not enraged. Just very surprised and curious whether this is a blanket policy. Yes it's Leeds. I was given all sorts after my EMCS 2 years ago (can't remember what, I was a horrible mess for several days) so this seems to be a huge change. Obviously I'm hoping I only need OTC stuff anyway this time but don't have a comparable experience to go on as I don't remember a huge amount about my first section or aftermath.
Sounds like we had similar experiences OP. After my second section, I was fine with paracetamol and some codeine that I had left over from a bad back. It was overall a much better recovery.

Postnatal seems to have improved in Leeds since my first one. Ask them about enhanced recovery pathway for c section.

viques · 03/11/2020 19:43

Wow, when I had my fibroids out and ended up with a similar sort of scar I was given a self administered morphine driver (they were doing a trial thing on pain relief post surgery) it was amazing, the best bit being that I hardly used it unless I knew I was going to have to move about, because just knowing I had it helped with reducing anxiety about pain and so reduced the pain. The woman in the next bed (also post fibroid) wasn’t on the trial so had to rely on pain killing injections, she was in a lot of discomfort and very anxious.

I think I would have been very unhappy with paracetamol.

wellthatsunusual · 03/11/2020 20:34

@Louiselhrau

Paracetamol is actually one of the best drugs for pain relief post surgery, literally the best there is so I don't know why so many people are going on about needing something stronger.
Because I have experience of it not working, that's why.

I have had several surgeries, including two csections. Stronger pain relief than paracetamol was offered in every other surgery, even the ones which were much less invasive than a c section. And in most of those cases, I declined them because I didn't need them.

If paracetamol is the best pain relief there is, why are different painkillers offered routinely after other surgeries? I am dubious that they are holding onto the best stuff, the paracetamol, for the post natal ward.

wellthatsunusual · 03/11/2020 20:37

@Louiselhrau

Paracetamol is actually one of the best drugs for pain relief post surgery, literally the best there is so I don't know why so many people are going on about needing something stronger.
Because I have first hand experience of it not working.

I have had a number of surgeries, including 2 c-sections. The post surgery pain with the CSs was unlike any of the other surgeries, it was incredibly severe. The difference with the other surgeries was that I got good pain relief and was up and about afterwards within hours. With the two paracetamol that I got after my spinal block wore off, I was in unbelievable pain (somewhere on a par with gallstones and labour, for context) and being told 'but paracetamol is a great painkiller' didn't make it work any better.

I know it's a great painkiller a lot of the time, but if it was the best painkiller there is for post surgery, why are there alternative painkillers available after other invasive surgery?

Graceviolet1 · 03/11/2020 20:39

As a midwife this is bullshit. They meant for you to stock up on paracetamol and ibuprofen at home so you don't need it as part of your take home meds. No way would you ever not be given adequate pain relief post section..

wellthatsunusual · 03/11/2020 20:39

Sorry, I don't know why that posted twice.

I posted once and the post disappeared so I had to write it again. Then when I wrote it again (and couldn't remember the exact wording the first time!) they suddenly both appeared. Weird.

Heyha · 03/11/2020 20:51

Crikey I got given a box of diclofenac (?) to take home. And that was only after an episiotomy that was beautifully stitched as I'd had an epidural so she took her time! Wasn't allowed to take my own painkillers (I'd read on here to take a stash because you might have to wait longer than you'd like...), I did take a ranitidine while I was waiting for induction and that had to be recorded formally too.

Maybe take the basic stuff in but be pretty firm in requiring something better while you're there. I can't imagine even ibuprofen touching the sides after a section. Fingers crossed for you OP!

skylarkdescending · 03/11/2020 20:56

@Graceviolet1

As a midwife this is bullshit. They meant for you to stock up on paracetamol and ibuprofen at home so you don't need it as part of your take home meds. No way would you ever not be given adequate pain relief post section..
Well you don't work in every hospital in the country do you? There's plenty of women on here telling you their own experiences.
Insertdeadcatsnamehere · 03/11/2020 21:09

Graceviolet1

Well I'm not making it up!

Asked to provide own painkillers!
OP posts:
jessstan1 · 03/11/2020 21:09

Louiselhrau:

Paracetamol is actually one of the best drugs for pain relief post surgery, literally the best there is so I don't know why so many people are going on about needing something stronger.
...................

I don't know where you got that from. It's never even shifted a headache for me so cannot imagine it would be much use post-operatively.

Insertdeadcatsnamehere · 03/11/2020 21:09

Graceviolet1

Well it's what my letter said, I'm not making it up! They may well offer me something else straight after surgery but it's not mentioned.

Asked to provide own painkillers!
OP posts:
Insertdeadcatsnamehere · 03/11/2020 21:11

No idea what happened there. Double / partial posts.

OP posts:
jessstan1 · 03/11/2020 21:11

Louiselhrau:

Paracetamol is actually one of the best drugs for pain relief post surgery, literally the best there is so I don't know why so many people are going on about needing something stronger.
......
I don't know where you got that from. It's never even shifted a headache for me so cannot imagine it would be much use post-surgically.

jessstan1 · 03/11/2020 21:13

Louiselhrau:

Paracetamol is actually one of the best drugs for pain relief post surgery, literally the best there is so I don't know why so many people are going on about needing something stronger.
......
I don't know where you got that from. It's never even shifted a headache for me so cannot imagine it would be much use post-surgically.

FFSFFSFFS · 03/11/2020 21:16

Well of course that's ridiculous and a sign of health system that is not working if you have to bring your own drugs. That is ludicrous.

I'm intrigued by the people who are saying that you should do it because its cheaper to buy it in the supermarket than it is for the NHS. Does this not indicate that the NHS is not terribly good at procuring drugs????? If it was working well it should be able to procure basic pain medication at a much cheaper price that it retails for at the supermarket!

KiriAndLou · 03/11/2020 22:12

@Louiselhrau

Paracetamol is actually one of the best drugs for pain relief post surgery, literally the best there is so I don't know why so many people are going on about needing something stronger.
Umm... because it doesn't work for lots of people? Is it just surgery pain it's magic for? Because I've always found out pretty pants tbh- can't even do away with period cramps without backup from ibuprofen.
Louiselhrau · 03/11/2020 23:06

It's coupled with ibuprofen as the latter is anti inflammatory rather than actually numbing the pain.

Louiselhrau · 03/11/2020 23:09

@jessstan1

Louiselhrau:

Paracetamol is actually one of the best drugs for pain relief post surgery, literally the best there is so I don't know why so many people are going on about needing something stronger.
......
I don't know where you got that from. It's never even shifted a headache for me so cannot imagine it would be much use post-surgically.

What would you suggest is a fitting alternative then?
KiriAndLou · 04/11/2020 00:35

@Louiselhrau

It's coupled with ibuprofen as the latter is anti inflammatory rather than actually numbing the pain.
I tend to go for ibuprofen on its own because it works better (obviously can't in labour). I think it has some painkilling effect (better than paracetamol in a lot of cases).
FannyCann · 04/11/2020 00:46

I'm really shocked by this thread.
A few random thoughts, not necessarily in a logical order:

The NHS has been told not to provide prescriptions for paracetamol to save money. I had thought this applied to TTO's and GP prescriptions which is entirely different to inpatient pain management.

For effective pain relief analgesics should be taken regularly - waiting until you are in pain will mean being in pain whilst waiting for pain relief to kick in. That's why there are specific drug round times for regular administration.

Post LSCS and post vaginal birth the contraction of the uterus can be extremely painful, quite apart from the abdominal surgery and/or perineal damage and haemorrhoids, not to mention engorged breasts. Plenty of pain to go around!

When I was a student midwife, rather a long time ago, we used to give out Aspirin and papaveretum to anyone who wanted it, for the "after pains" (never mind the post surgery pain). This is discontinued now, and would not be considered safe, but I have to say - the women loved it! How times have changed.

In the USA, over prescription of opiates has caused significant problems with addiction. My niece had appendicitis while visiting New York and was given a month's supply of oxycodone to take home, which my sister promptly binned. In the UK, at least in my hospital, post knee replacement (which is extremely painful) standard pain relief is six doses/three days of oxycodone. They rarely prescribe it to take home. We don't have a comparable prescription opioid problem to the USA. (Yes I know lots of people are addicted to a range of prescription drugs, but I'm just pointing out that thanks to the NHS/NICE and prescribing policies we keep a bit more of a handle on it here).

Personally I think it's perfectly reasonable to expect all patients having elective surgery to have a supply of over the counter pain relief at home, however the hospital should be properly managing post operative pain, offering suitable analgesia and managing patient medications safely. It's really not a good idea for patients to be self administering on an ad hoc basis whilst ward staff are coming along offering various other medications. A recipe for disaster I would think.

It's also odd routinely instructing purchase of ibuprofen - not everyone can take ibuprofen and in my hospital anyone prescribed NSAIDS, ie ibuprofen or diclofenac is also routinely prescribed omeprazole or similar for gastric protection. A colleague took ibuprofen for the first time after taking part in a weekend staff endurance event on Dartmoor and promptly had a gastric bleed and had to be hospitalised for several days. A fit young woman with no previous health problems.

NameChange2PostThis · 04/11/2020 00:52

@Insertdeadcatsnamehere

Graceviolet1

Well it's what my letter said, I'm not making it up! They may well offer me something else straight after surgery but it's not mentioned.

@Insertdeadcatsnamehere This recommendation (patients self-managing their pain medication in hospital) has been removed from the NICE guidelines so your hospital should not be suggesting this any more.
SheepandCow · 04/11/2020 01:35

I was told the same, OP, when I was due to have gynaecological surgery. I spoke to my GP and was told she'd prescribe me some codeine to take with. In the end I went private. The casual disregard for potential pain after surgery played a role in my decision. A small part but nevertheless it helped me make the decision.

Something like a C Section is major surgery. Whilst every woman is different, OTC painkillers will not be anything close to sufficient for many.

HairyRrug · 04/11/2020 02:12

Sorry, not rtft but saw you were in Leeds. After appendectomy in Leeds I was sent home with no pain relief. It's not only CS this applies to in Leeds. I naively believed that paracetamol would be ok but soon realised that (or otc cocodamol) wasn't touching the pain and had to get emergency gp appointment for stronger stuff. Right old faff and a totally unpleasant & unnecessary experience. Get a prescription ahead of time if you possibly can.