Six and a half years ago (August of 2006), I was diagnosed with colon cancer. I had surgery, chemotherapy, and radiation, the whole nine yards, and have pretty much felt fit as a fiddle ever since. I remember coming home from the hospital with a prescription for a massive amount of Oxycontin (or perhaps it was Oxycodone). The prescription was for 100 pills. My wife asked the pharmacist if she could get just part of the prescription filled. He said, “Yes, but you can’t get part now and the rest later. Whatever you get cancels the rest of the prescription, so I would advise you to get it all. It’s better to have it and not need it than need it and not have it.”
She got seven pills.
As it turned out, seven pills was sufficient.
Fast forward to last week. On Friday the 22nd, I had my chemo port removed. I have friends whose port came and went within a year. Why mine was still in approaching seven years later is anybody’s guess. But that’s not what this tale is about anyway. It’s about pain and pain killers. This time I was given a prescription for 60 Percoset tabs. Based on that alone, I was expecting some serious pain. Even so, I thought I would wait. I could run to the pharmacy if and when the pain materialized. That never happened. Not even close. Not only did I not need a Percoset, I never came close to even aspirin-level pain. Not even baby aspirin-level pain. Yet I was given a prescription for 60 Percosets.
I realize that everyone has a different tolerance for pain and a different threshold for what they define as an unacceptable level of pain.
In view of that, doctors, why not have a one-minute chat with your patients before a procedure? Ask them about their personal levels of pain tolerance. Based on their answers and the procedure they’re having, let them know you’ll send them home with an appropriate pain reliever, and write a modest supply. Let them know if they need more, just call your office. (Most doctors I call offer “for prescription refills, press X” as one of the choices on their answering system.) It’s a safe bet that many patients will never call for a refill. And for those who do, it’s a better alternative than writing a single scrip for enough drugs to supply the whole family for a month. It’s also a practical means of fighting the growing problem of addiction to prescription meds.
As patients, we need to remember that we are under no obligation to have an entire prescription filled. A therapeutic drug should be taken as prescribed, but addictive pain meds are best doled out in small quantities. Feel free to tell your pharmacist to fill only a portion of your prescription if you feel the quantity is excessive. You can always call your doctor for more if needed.
Remember this: all pain is not bad. Pain can be a very good thing: it tells us to drop something hot we picked up, or to hop off something sharp we stepped on. In a post-operative setting, it’s neither possible nor beneficial to avoid all pain. Pain reminds us to take it slow. It tells us the healing isn’t complete yet. Listen to it. You can’t do that if you can’t feel it. The post-op world is sometimes a place where it’s “know pain, know gain.”