Does any of this sound familiar? Have you been to a new, old, or indifferent Pain Specialist or Primary Care Provider recently and been told to take acetaminophen or something like naproxen instead of your FORMER dosage of an opioid? After all, opioids are HYPER-ADDICTIVE and they just CAN’T justify prescribing such a DANGEROUS drug to someone in unbearable agony or dying?
Yeah, I thought so.
The Hippocratic Oath is simply brushed aside for self-preservation.MR Blare
Unfortunately, this country’s healthcare system is facing a bit of a conundrum. Our providers have forgotten the fact that they do not serve their pocketbook, the one motivation which has driven the profession for over a century.
However, the relative safety which money has always provided no longer exists especially now with the prescribing of opioids. In fact, it proves to be more of a curse. And the Hippocratic Oath is simply brushed aside for self-preservation.
When the Old Meets the New – The Hippocratic Oath
AS A MEMBER OF THE MEDICAL PROFESSION:
I SOLEMNLY PLEDGE to dedicate my life to the service of humanity;
THE HEALTH AND WELL-BEING OF MY PATIENT will be my first consideration;
I WILL RESPECT the autonomy and dignity of my patient;
I WILL MAINTAIN the utmost respect for human life;
I WILL NOT PERMIT considerations of age, disease or disability, creed, ethnic origin, gender, nationality, political affiliation, race, sexual orientation, social standing, or any other factor to intervene between my duty and my patient;
I WILL RESPECT the secrets that are confided in me, even after the patient has died;
I WILL PRACTICE my profession with conscience and dignity and in accordance with good medical practice;
I WILL FOSTER the honour and noble traditions of the medical profession;
I WILL GIVE to my teachers, colleagues, and students the respect and gratitude that is their due;
I WILL SHARE my medical knowledge for the benefit of the patient and the advancement of healthcare;
I WILL ATTEND TO my own health, well-being, and abilities in order to provide care of the highest standard;
I WILL NOT USE my medical knowledge to violate human rights and civil liberties, even under threat;
I MAKE THESE PROMISES solemnly, freely, and upon my honor.
Adopted by the 2nd General Assembly of the World Medical Association, Geneva, Switzerland, September 1948 and amended by the 22nd World Medical Assembly, Sydney, Australia, August 1968 and the 35th World Medical Assembly, Venice, Italy, October 1983 and the 46th WMA General Assembly, Stockholm, Sweden, September 1994 and editorially revised by the 170th WMA Council Session, Divonne-les-Bains, France, May 2005 and the 173rd WMA Council Session, Divonne-les-Bains, France, May 2006 and the WMA General Assembly, Chicago, United States, October 2017
I will never say that being a doctor or provider of medicine is EASY. What I will say is this… never undertake the profession for YOURSELF.
The day you do that, anyone does that, you will unfortunately find yourself in the predicament many doctors, nurses, pharmacists, and other healthcare providers find themselves in this very day— at the mercy of a corrupt, agenda-driven government.
And a country and its citizens will find itself at the mercy of a healthcare system driven by people with no common sense, but only book knowledge and the capacity to make decision based on statistics, regulations, and personally motivated reasons.
And like marionettes, we are at the mercy to the healthcare system we find ourselves with today. One that we never dreamed we would have— controlled by the powers that be in government and President of the United States of America.
- Where doctors do what they are told— or else.
- Patients take what they are given and shut up— or else.
- Pharmacists fill this but not that and report the others— or else.
- Pharmacy and Doctor Boards go along— or else.
- Nursing Boards do what they’re told— or else.
- Statistics are doctored or ignored— or else.
- The media says what they are told— or else.
- The Constitution, Bill of Rights are ignored— or else.
- The First Amendment is suppressed and ignored— or else.
- The ADA and Civil Rights Act is violated— no one cares.
- The Disabled and suffering are dying by the thousands— no one cares,
- Children, cancer, surgical, severe chronic pain, and rare disease patients writhe in agony— no one cares.
- Incarcerated prisoners, seeking and recovering drug addicts, and the micro-percentage of chronic pain patients who develop addiction (approximately 1/2 of a percent) receive therapy including opioids — adequate if not excellent care usually for “criminal behavior” or the admission of such.
- Illegal drug mules, drug dealers, sources which originate in Mexico, Canada, or other countries and access this country over the porous and open borders are ignored — no one cares.
- Law Enforcement meant to stop the delivery, sale, or access of illegal drugs including the LETHAL combination of synthetic FENTANYL AND HEROIN over the border and on the streets of this country are buying, dealing, and using it themselves above and beyond any use within the duties of their jobs. — no one cares.
Rare Disease and Chronic Pain Patients are being accused of being drug addicts, drug seekers, and outright liars on the FIRST VISITS to their primary care providers and pain specialists simply due to the fact that they are taking high-dose opioid therapy to attempt to live quality lives.
As a result of the sheer intolerance of opioids in this nation, their therapy is either abruptly and dangerously halted, tapered down, or changed to ineffective medications. These actions send their disease states if not mental conditions into rapid decline. What does that mean?
For a Chronic Pain or Rare Disease patient, such effects could mean “flares” of severe pain including neuromuscular, joint, bone, or neuro-sympathetic including intolerable pain. The results could also include intolerance to the pain on any level mental, emotional, or physical therefore resulting in a psychological breakdown and suicide.
The Chronic Pain and Rare Disease Community does not seek relief from unconfirmed or questionable sources—usually. Most patients prefer results that are guaranteed.
What About OTC? Do They Work? Good? Bad?
I seem to remember an FDA Warning about them. Do you? Go ahead and find out for yourself if you don’t believe me, but I know I can’t take either one of them— NSAIDs or Tylenol.
Why? Let’s see . . . because of my kidneys, my liver, my GI tract, my intestines, my heart. Yeah, I, like many other CHRONIC PAIN PATIENTS took them too long trying to avoid the heavy duty drugs like opioids because I WORKED IN A PHARMACY!
I was dosed at the maximum of ibuprofen, then naproxen, then celecoxib, then . . . You really don’t have time for this. I could go on and on and on. I was alternating Tylenol the entire time until my doc tried me on Tramadol—OUCH! NO, THANK YOU, HEADACHE CENTRAL.
So, now I have kidneys, a liver, and a GI tract that has decided those meds are the ultimate poison of all things on Earth or my body simply turns into the proverbial dragon and blows fireballs at every pill like it that it sees!
There are several BIG MISCONCEPTIONS that many including providers and friends, and sometimes family, have about the CHRONIC PAIN AND RARE DISEASE COMMUNITY. What could they possibly be? I mean doesn’t everyone know everything there is about us? The answer to that would be no. Not because many don’t care, but because they do— maybe too much.
- THE LAST THERAPY WE WANT FOR OUR PAIN IS OPIOIDS.
- THE LAST THERAPY WE WILL TAKE FOR OUR PAIN IS OPIOIDS.
- WE KNOW MORE ABOUT OUR BODY THAN YOU DO.
- WE KNOW MORE ABOUT OUR DISEASE STATES THAN YOU THINK.
- WE ARE ABREAST OF EVERY THERAPY AND TREATMENT AVAILABLE FOR OUR DISEASE STATES— IN THE WORLD.
- IF WE ARE ON OPIOID THERAPY, WE HAVE TAKEN EVERYTHING ELSE THAT YOU CAN SUGGEST EXCEPT BREAKING NEW THERAPIES.
- WE ARE OPEN TO TRY EVERYTHING EXCEPT THOSE THAT WE HAVE REACTED TO, ARE KNOWN TO FAIL, HARM, OR CREATE MORE INSTEAD OF LESS CHRONIC PAIN.
- THE ONLY TWO WORDS THAT ARE SPOKEN AND MEANT IN OUR VOCABULARY ARE NO AND CAN’T. RESPECT THEM. WE CAN’T COMPROMISE.
- IF WE SAY WE HURT, WE HURT. IF WE SAY WE CAN’T, WE CAN’T. IF WE SAY NO, IT MEANS NO. ACCEPT IT AS THE TRUTH, IT IS.
- ONE THING WE NEVER ABIDE IS LIARS AND LIARS. ONE WHO LIES TO AVOID THE TRUTH AND ONE WHO LIES TO COVER THE TRUTH.
Doesn’t everyone know everything about us? The answer to that would be no.M R Blare
Pain is not always good, not always bad. What is it? Pain.
In my case, it is a dysfunction of the brain. In others, it may alert them to a broken bone or torn tendon. Others? It may actually be an illusion of a burned limb—again, a dysfunction of the brain.
But where in one case it can be treated with surgery or hopefully, extensive mirror therapy, another cannot. So do we brush the agonizing pain away with a hand or callous comment that has no medical merit or do we treat the patient and their CHRONIC PAIN and/or RARE DISEASE so they can actually live a LIFE WORTH LIVING?
According to the DEA and CDC, the answer to that last question would be a resounding and ruthless NO.
But I’ll let you decide.
The CPAW Chronic Pain & Rare Disease Survey
Help me help you! This is an anonymous survey!
M Renee Blare, RPh (disabled)
Chronic Pain Alliance of the West