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...

Huh?

Not RTFT but I was on morphine after both of mine.

I hope I've missed an update later on...

Omg just read all OPs posts.

Why 3 days worth of painkillers? Standard section out in 48 hours.

But the main thing. No decent pain relief after major surgery?

What the fuck?

There have been studies showing pain in women and children is under treated. Lots of them.

A fucking paracetamol?

Jesus. That's appalling. I'm genuinely shocked.

i was told that they could give me pain relief, but i could have my own if i wanted. some women were ringing their bells for medication and waiting up to an hour to be given it so it was easier for me to take my own and then i just told the nurse and she recorded what i took and when.

I'm really taken aback.

I've had loads of surgery in my life including plenty as a child.

Decent pain relief is essential. It really is.

Take a fucking paracetamol? Bloody hell.

My dh had to take in painkillers when he had a brain tumour removed. He was on Oramorph for 3 days though. Then something else they gave him but on day 6 his own painkillers. He came on day 12 so got through a few. I would rather NHS spent it's money on operation than giving people Ibuprofen or good for that matter. I think people should pay for their own meals.

Just gave birth by CS a few days ago. On the ward, was given pain killers and after 24-36 hours I could manage on paracetamol alone or combined with ibuprofen. Not for everyone of course. What annoyed me was I was told I was being sent off home with pain killers only to realise they only gave me dihydrocodeine to use in worse case scenario. I wasn't told to buy my own paracetamol or ibuprofen or what dose to use (just got home and realised, no paracetamol or ibuprofen, no instructions!). My annoyance being: there will be people who arrive home with no pain killers and they don't stock any who will then have to frantically need to make arrangements (some of them single mums with no support). And others who won't know the dosing. Yes, many can easily arrange these but it's just a hassle one can do without when recovering from the big event that is birthing. Granted it was probably just part of the chaotic discharge process (which took over 20 hours and was the least coordinated process I have ever seen!)

Pretty shocked that you've been asked to bring your own medication into hospital, but I very much doubt this will be all that's on offer. They will also prescribe morphine etc as needed, it's just that these are the baseline OTC medications that everyone can obtain (and are much cheaper to buy than for the NHS to provide). I've also worked as a midwife in Canada and there the hospital provided the analgesia but we gave it to women for them to self-medicate while inpatient. I think it works much, much better since there is no waiting around for the patient. Furthermore drug rounds spent doling out OTC medications are such a time suck for midwives and take a lot of time away from clinical hands-on care, when most people are perfectly capable of taking their own paracetamol, just as they do at home. I just can't believe you've been asked to supply it yourself!

WTF. Paracetamol? I am so angry on your behalf. Women I know with csection had oral morphine first couple of days in patient then took home strong prescription only pain relief (tramadol) for over a week and in between doses was in pain. I know not everyone feels the same but BYO paracetamol is fucking ludicrous. Pain isn’t a moral issue, it’s a normal and expected physiological reaction after major abdominal surgery.

Congratulations Ginger

Thanks Chatty. By the way, I had oral morphine first say 24 hours. One midwife withheld it as some point to point that I was moaning with pain. My anaesthetist came in for a chat and was shocked and told them to give me a pump if needed (incidentally, morphine seems to do little for me and quickly runs through my system).
I didn't mind not being given stronger stuff at discharge as I was doing fine with 1g paracetamol every 6 hours. What I minded was not being told in advance to get it. I recall the lack of paracetamol all over the country before first lockdown. And there will be people who won't have it at home so being told in advance would be good.
OP, discuss your pain management options before admission. Am sure Oral morphine will be provided. Good luck and enjoy

My mum is due to have an operation this month (if it goes ahead). She has also been told to bring in painkillers for afterwards.

My dh had to take in painkillers when he had a brain tumour removed. He was on Oramorph for 3 days though. Then something else they gave him but on day 6 his own painkillers.

Hopefully your DH made a quick recovery and with no mental impairment, but as a general rule of thumb I think it's probably best for the hospital to manage drug regimes for people undergoing brain surgery!

I took my own cocodamol on the post natal ward after my c section. I told them I'd already taken paracetamol when they tried to give me it, and I got told off for it - they were only going to give me paracetamol and ibuprofen, screw that. That was 3 years ago.

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.

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!

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

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

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.

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

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.

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.

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

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.

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.

@feelingverylazytoday

Think this happens quite a lot now, presumably as a cost cutting issue. I don't really see what the problem is, or why it's a feminist issue?

It’s a feminist issue because do you think the same would EVER happen if men were the ones undergoing similar abdominal surgery? Of course it wouldn’t.