Alternate title: Penalized for doing the right thing.
TMEW had complete knee replacement surgery last week given that all of the cartilage was completely gone. Bone on bone on the kneecap (femur and tibia); it’s a wonder that she waited this long to have it. Oh wait! I already know why – she hates to see doctors and hates hospitals even more. That said, after years of pain and frustration, she finally gave in. Dr. Hogan of Lakes Region General Hospital did the surgery.
Sidenote: we hear from everyone from the intake nurses, the anesthetist, recovery and floor nurses, and the Physical Therapist all said he was the best. Thus far, it seems like his work has lived up to the hype.
So far, so good and she is making steady progress in becoming more and more ambulatory. More importantly, she took the tact that she would be really good about pain management in that she has been taking just barely enough of the opiates given to her to take the edge off. And that’s where the problem started.
One was Tramadol. IF she had taken it as quickly as prescribed, she would have run out earlier this week. Instead, the pills from the initial script ran out on Friday – she really stretched it out. Long story short, she only got two pills when I picked up the refill late yesterday as as most of the script was filled right after discharge – and it was too late to get ahold of her doc for a refill. Called the “on call” doc – he refused to do a refill. Even though LRGH has been on EMR (Electronic Medical Records) for years, he claimed he couldn’t review her chart so he wouldn’t do a opiate refill. Huh???
So, she loses out on her pain management. His response was “meh – go to the ER and get them to write a script”. Translation: go pay the $90 ER co-pay to get a script that, with the Humana Part D insurance I pay for her, might cost a tenth of that. Knee replacement? Go pay much more to be able to pay a bit. More important, was the attitude – and it didn’t help TMEW’s attitude towards them. I understand the legal issues – while I blame him a bit, it really now has made her a statistic in the opiate wars.
Because a number of people are abusing this class of drugs, every one else is automatically guilty. I’ve written about this topic a few times in the past and have said the same thing. Those that really need the pain management that only opiates can give are getting screwed over by politicians and a regulatory system that penalizes those that require it.
By doing the right thing of trying to stay off those meds, TMEW is now getting screwed over. If she had used them as prescribed, rather than trying to limit their usage, she would have run out earlier in the week and most likely would have been able to get a refill done by Dr. Hogan. You can say, well, she should have done just that but she is aware of how addictive these can be and is trying hard to mitigate that possibility.
For full disclosure, she was also prescribed a much more powerful pain med that I will not mention by name. She is trying, like the plague, to NOT use them. Now she’s forced to. And she’s upset that what she is trying to avoid might happen (addiction).
So what am I saying? Once again, politicians waded into an area in which, IMHO, they were unprepared to make decisions that should have been made. Again, IMHO, they made decisions, in part, on the idea of being seen to “be doing something” about a problem the media was flogging all day and night long for months. One about a very small number of people who deliberately are ABUSING medications they shouldn’t have in the first place. Sure, some started like TMEW and decided to go down that path – I feel sorry for them. Others just made the decision to get started down this path WITHOUT injury or illness. I have much less sympathy for them (and yes, I have addict for a son).
And in those political decisions, IMHO once again, those that have long term chronic pain and those with short term surgical pain from major surgery are the ones really paying the price. A HARD price, as it turns.
Instead of using a political scalpel and aiming legislation at just abusers, they used a sledgehammer against everyone. In her case, with a known problem and a short term and temporary need, she’s collateral damage of a political process in which politicians should have known better. Better? Yes – leave well enough alone. It’s Sudafed all over again – just because a few abused, everyone pays the price.
It’s what Big Government does. It’s too bit and too enthralled by special interest groups or put upon by “anti” activists, it continuously creates On-Size-WILL-fit-all policies. It lacks reason and the ability to correctly see right versus wrong needs, slicing the problem down into the granularity sometimes needed for this kind of problem.
Or, refusing to acknowledge that there are those, due to the very issue of human nature, it CAN’T solve all problem or “fix” all people – and we all end up in this mess. Sometimes Govt needs to just say “sometimes the best thing to do is to do nothing at all for certain cases”.
