OtherGround Forums Doc wouldn't give opioids, and I didnt even ask.

6/12/18 1:15 PM
6/13/09
Posts: 10124

I've been dealing with kidney stones the last few weeks. I've had some moderate pain, but was taking advil and tylenol for it and barely getting by.

I finally got an ultrasound which showed definite stones in the kidney...some as large as 8mm. 

I went to the urologist who had studied the ultrasound. Almost before we started talking, and without me even mentioning it, he said "I'm not giving you any pain meds for this".

I know there is a general crackdown on opioids, but shit, kidney stones can get painful as hell.

I had the impression that he had dealt with some patients faking kidney stones so they could get oxy or norco.

Also, since the stones are up in the kidney, and don't appear to be passing, I may be looking at a procedure where they put a roto rooter up your dick with a camera and a laser to blast the stones. Sounds like great fun!

FWIW, I'm not a big pot smoker, but I have found that pot plus CBD oil gets rid of the pain better than anything else.

 

6/12/18 1:18 PM
8/14/02
Posts: 50975

How could you fake a kidney stone if you've had an ultrasound already?

Edited: 6/12/18 1:24 PM
12/10/09
Posts: 8610

If you've provided an accurate account, shitty doctor, IMHO. 

Sounds like a guy who makes his mind up about treatment plans before ever meeting/discussing with his patients. That is not someone I'd want caring for me.

You treat the patient, not the disease. You interview the patient about symptoms, history and expectations and build a relationship of both trust and monitoring of treatment and results. If competent, a doctor does not need to blindly refuse to give pain meds because he can know you're having issues without that incompetently drastic stance.

There is certainly an epidemic, but it's not from prescribing the apropriate pain meds for the pain and closely monitoring your patients usage. It is from massive abuse by several types of MD's, mostly pain clinics and the refusal of our government to target those places and/or pharmacies/pharmD's who do not question ridiculous scripts. The apropriate amount of medication will leave you level, with greatly reduced pain, not high. 

Kidney stones can be anywhere from unnoticable to incredibly painful. I would find another doctor before i had the latter and an asshole refusing to help.

6/12/18 1:25 PM
6/13/09
Posts: 10126
Mencken - 

How could you fake a kidney stone if you've had an ultrasound already?


People might have just been going into his office without an ultrasound and claiming pain from kidney stones. In the old days drs would just write out a script. 

Also, a lot of people do carry kidney stones but are not having pain from them. They could still easily get a script from most docs. But not this guy.

btw, I'm not an opioid user. I like the relief from pain and I don't mind the high you get, but I would never seek them out.

6/12/18 1:28 PM
6/13/09
Posts: 10127
scrapdo - 

If you've provided an accurate account, shitty doctor, IMHO. 

Sounds like a guy who makes his mind up about treatment plans before ever meeting/discussing with his patients. That is not someone I'd want caring for me.

You treat the patient, not the disease. You interview the patient about symptoms, history and expectations and build a relationship of both trust and monitoring of treatment and results. If competent, a doctor does not need to blindly refuse to give pain meds because he can know you're having issues without that incompetently drastic stance.

There is certainly an epidemic, but it's not from prescribing the apropriate pain meds for the pain and closely monitoring your patients usage. It is from massive abuse by several types of MD's, mostly pain clinics and the refusal of our government to target those places and/or pharmacies/pharmD's who do not question ridiculous scripts. The apropriate amount of medication will leave you level, with greatly reduced pain, not high. 

Kidney stones can be anywhere from unnoticable to incredibly painful. I would find another doctor before i had the latter and an asshole refusing to help.


Excellent post and advice.

I agree with everything you said, plus I got kind of a bad vibe from this doc (aside from the pain med issue).

I'll be getting a second opinion.

6/12/18 1:31 PM
4/5/09
Posts: 17448
blood fist -

I've been dealing with kidney stones the last few weeks. I've had some moderate pain, but was taking advil and tylenol for it and barely getting by.

I finally got an ultrasound which showed definite stones in the kidney...some as large as 8mm. 

I went to the urologist who had studied the ultrasound. Almost before we started talking, and without me even mentioning it, he said "I'm not giving you any pain meds for this".

I know there is a general crackdown on opioids, but shit, kidney stones can get painful as hell.

I had the impression that he had dealt with some patients faking kidney stones so they could get oxy or norco.

Also, since the stones are up in the kidney, and don't appear to be passing, I may be looking at a procedure where they put a roto rooter up your dick with a camera and a laser to blast the stones. Sounds like great fun!

FWIW, I'm not a big pot smoker, but I have found that pot plus CBD oil gets rid of the pain better than anything else.

 

True on pot.  As long as its not a pure sativa

I once broke both my ankles.  Pain meds didn't help much but weed did big time

6/12/18 1:31 PM
1/1/01
Posts: 13890

It might not feel like it. But he did you a favor.  You probably feel like you're in hell, but once you get through this you won't be an oxy addict.  That's one way to look at it. That shit is evil.  

6/12/18 1:34 PM
6/13/09
Posts: 10128
buddie - 

It might not feel like it. But he did you a favor.  You probably feel like you're in hell, but once you get through this you won't be an oxy addict.  That's one way to look at it. That shit is evil.  


I hear what you're saying, but I'm pretty positive I'd never become an oxy addict. I just don't like them that much.

But yeh, that shit is evil and costing a LOT of lives.

Edited: 6/12/18 1:50 PM
12/10/09
Posts: 8613
buddie -

It might not feel like it. But he did you a favor.  You probably feel like you're in hell, but once you get through this you won't be an oxy addict.  That's one way to look at it. That shit is evil.  

It is entirely possible to use pain medications properly and never become addicted. tens of millions do it every year.

 

That said, if you feel you don't have that ability or have a history of addiction and decide to stay away, good for you. I have no problem in some refusing them, but that is a personal decision just as deciding to have help with the pain is one as well. A proper MD should be able to have the discussion and help you with alternative meds or methods. Some find relief from accupuncter or even Reiki (even though I think it's BS). 

I feel the proper way to do it is write the script for however many the patient may need short-term for the current issue. 30 oxycodone 5mg is a pretty good start for moderate pain in a person with no drug history. They may run out and need more, so you have them check in with you, maybe don't even bill for the visit, so that you can monitor and document pain level and usage. Maybe it's justifieded, maybe not.  It's not super hard to tell but we shouldn't be treating everyone the exact same way. You don't write for 90 oxycontin on Dec 1 then another 90 on Jan 1 without ever seeing the patient, who also has a history of opioid addiction. I SAW THIS HAPPEN. He is dead. 

We all process pain and medications differently, have different histories and maladies. Like I said, you treat the individual patient. You cannot look at a chart ad treat someone based solely on that unless you're a hack.

 

Opiates are not the devil. Neither are steroids or alcohol or guns or knives. The devil is in how the people entrusted with the ability to sell, advise and use them can abuse those rights for reasons ranging from carelessness, stupidity to money. As with everything, there are legitimate uses an their are abuses. Do not throw the baby out with the bathwater.

6/12/18 1:44 PM
5/5/07
Posts: 11137

Narcotics are never the first line for kidney stones anyways .

nsaids work way better .  Typically use iv toradol for acute pain and Flomax to ease passage of stone.

motrin or oral toradol is much better choice than narcotics . 

Maybe ur doc was leaning u into that direction.  Dunno can’t speak for him 

6/12/18 1:44 PM
1/1/01
Posts: 13701
I needed a dental implant, after the consultation the Dr gave me a script for Oxy. Told me to fill it before the procedure so I'll have it when I need.

All the pills are still in the bottle, never opened it thank god. but nice to know if I had a ton of pain I'd have something.

As someone else said I find a new Dr.
Edited: 6/12/18 1:49 PM
12/10/09
Posts: 8614
Rahjai MD -

Narcotics are never the first line for kidney stones anyways .

nsaids work way better .  Typically use iv toradol for acute pain and Flomax to ease passage of stone.

motrin or oral toradol is much better choice than narcotics . 

Maybe ur doc was leaning u into that direction.  Dunno can’t speak for him 

No offense, but i tend to disagree. Sure, for the most mild pain you can go the NSAID route, but any signifigant kidney stone pain is not going to respolved by NSAIDS alone. Maybe this practice is in an area with lots of drug-seekers and the doc is worn out, but that shouldn’t be put on you. You need a doc who treats you, not one who’s lumping you in with what he assumes you are before the visit even starts

6/12/18 1:57 PM
1/1/01
Posts: 13891
scrapdo -
buddie -

It might not feel like it. But he did you a favor.  You probably feel like you're in hell, but once you get through this you won't be an oxy addict.  That's one way to look at it. That shit is evil.  

It is entirely possible to use pain medications properly and never become addicted. tens of millions do it every year.

 

That said, if you feel you don't have that ability or have a history of addiction and decide to stay away, good for you. I have no problem in some refusing them, but that is a personal decision just as deciding to have help with the pain is one as well. A proper MD should be able to have the discussion and help you with alternative meds or methods. Some find relief from accupuncter or even Reiki (even though I think it's BS). 

I feel the proper way to do it is write the script for however many the patient may need short-term for the current issue. 30 oxycodone 5mg is a pretty good start for moderate pain in a person with no drug history. They may run out and need more, so you have them check in with you, maybe don't even bill for the visit, so that you can monitor and document pain level and usage. Maybe it's justifieded, maybe not.  It's not super hard to tell but we shouldn't be treating everyone the exact same way. You don't write for 90 oxycontin on Dec 1 then another 90 on Jan 1 without ever seeing the patient, who also has a history of opioid addiction. I SAW THIS HAPPEN. He is dead. 

We all process pain and medications differently, have different histories and maladies. Like I said, you treat the individual patient. You cannot look at a chart ad treat someone based solely on that unless you're a hack.

 

Opiates are not the devil. Neither are steroids or alcohol or guns or knives. The devil is in how the people entrusted with the ability to sell, advise and use them can abuse those rights for reasons ranging from carelessness, stupidity to money. As with everything, there are legitimate uses an their are abuses. Do not throw the baby out with the bathwater.

Ok great reply.  I agree.  

6/12/18 2:09 PM
8/7/12
Posts: 9930

Before they started the major crackdown I was involved in an attempted hit and run while i was on the job site. Had all the required safety precautions with the exception of an areo board which is not required if you occupy the intersection for less then 5 minutes. As I walked out as well as looking both ways in the now coned off intersection some dick head not paying attention literally ran me over lucky for me I keep my shoelaces very loose and he literally knocked me out of my shoes  when I came too there were several bystanders who had surrounded this guy with their vehicles and when he saw me try to get up he started all this religious bullshit about being thankful I'm still a living. I'm a very rugged 6' 242lbs at that time as well as fully dressed and some would even consider that I was over wearing safety colors and wanted to shake it off and pound this dumb ass into oblivion. Lucky for me the emergency helicopter was already landing. Was flown to shock trauma for a fun filled night of repairing my orbital socket as well as 94 staples to keep my noggin attached together. 

 

One of the young PA's had the audacity to ask me if I do drugs because my heart rate was still going crazy. I told him that I didn't get an oppurtunity to set the guy who hit me "straight" but I would happily use him instead. No you dumb mfer I just got almost turned into pavement gravy and your asking me why my heart rate is still elevated! 

 

Point is it was an overnight stay and the pain was bearable but once the initial cocktail they gave me in the helicopter wore off I was hurting. Wouldn't even subscribe me anything to take home. Was told that if I was still in pain to call the Pa on call when I got home. Called that mfer and it was the same asshole who questioned my heart rate and drug use. Mfer!!! Basically said I'd live and hung up on me, twice. 

6/12/18 2:12 PM
12/10/09
Posts: 8618
buddie -
scrapdo -
buddie -

It might not feel like it. But he did you a favor.  You probably feel like you're in hell, but once you get through this you won't be an oxy addict.  That's one way to look at it. That shit is evil.  

It is entirely possible to use pain medications properly and never become addicted. tens of millions do it every year.

 

That said, if you feel you don't have that ability or have a history of addiction and decide to stay away, good for you. I have no problem in some refusing them, but that is a personal decision just as deciding to have help with the pain is one as well. A proper MD should be able to have the discussion and help you with alternative meds or methods. Some find relief from accupuncter or even Reiki (even though I think it's BS). 

I feel the proper way to do it is write the script for however many the patient may need short-term for the current issue. 30 oxycodone 5mg is a pretty good start for moderate pain in a person with no drug history. They may run out and need more, so you have them check in with you, maybe don't even bill for the visit, so that you can monitor and document pain level and usage. Maybe it's justifieded, maybe not.  It's not super hard to tell but we shouldn't be treating everyone the exact same way. You don't write for 90 oxycontin on Dec 1 then another 90 on Jan 1 without ever seeing the patient, who also has a history of opioid addiction. I SAW THIS HAPPEN. He is dead. 

We all process pain and medications differently, have different histories and maladies. Like I said, you treat the individual patient. You cannot look at a chart ad treat someone based solely on that unless you're a hack.

 

Opiates are not the devil. Neither are steroids or alcohol or guns or knives. The devil is in how the people entrusted with the ability to sell, advise and use them can abuse those rights for reasons ranging from carelessness, stupidity to money. As with everything, there are legitimate uses an their are abuses. Do not throw the baby out with the bathwater.

Ok great reply.  I agree.  

Impossible. 

This is the OG! Where is my “F you” or whatever?

 I feel like I was robbed of a time-consuming unproductive argument here! 

6/12/18 2:30 PM
12/2/05
Posts: 72407
blood fist -

I've been dealing with kidney stones the last few weeks. I've had some moderate pain, but was taking advil and tylenol for it and barely getting by.

I finally got an ultrasound which showed definite stones in the kidney...some as large as 8mm. 

I went to the urologist who had studied the ultrasound. Almost before we started talking, and without me even mentioning it, he said "I'm not giving you any pain meds for this".

I know there is a general crackdown on opioids, but shit, kidney stones can get painful as hell.

I had the impression that he had dealt with some patients faking kidney stones so they could get oxy or norco.

Also, since the stones are up in the kidney, and don't appear to be passing, I may be looking at a procedure where they put a roto rooter up your dick with a camera and a laser to blast the stones. Sounds like great fun!

FWIW, I'm not a big pot smoker, but I have found that pot plus CBD oil gets rid of the pain better than anything else.

 

Ive had the camera with no drugs. It's not bad. 

6/12/18 2:47 PM
5/7/08
Posts: 19369
Rahjai MD -

Narcotics are never the first line for kidney stones anyways .

nsaids work way better .  Typically use iv toradol for acute pain and Flomax to ease passage of stone.

motrin or oral toradol is much better choice than narcotics . 

Maybe ur doc was leaning u into that direction.  Dunno can’t speak for him 

You couldn't pay me to take a pain med of any kind, but gun to my head I'm choosing a narc over a NSAID.

6/12/18 2:51 PM
10/23/05
Posts: 1910
scrapdo -
Rahjai MD -

Narcotics are never the first line for kidney stones anyways .

nsaids work way better .  Typically use iv toradol for acute pain and Flomax to ease passage of stone.

motrin or oral toradol is much better choice than narcotics . 

Maybe ur doc was leaning u into that direction.  Dunno can’t speak for him 

No offense, but i tend to disagree. Sure, for the most mild pain you can go the NSAID route, but any signifigant kidney stone pain is not going to respolved by NSAIDS alone. Maybe this practice is in an area with lots of drug-seekers and the doc is worn out, but that shouldn’t be put on you. You need a doc who treats you, not one who’s lumping you in with what he assumes you are before the visit even starts

Rahjaj is right. NSAIDS were shown superior to opioids in a very good meta -analysis (2017). More sustained pain relief and less side-effects. I always start out with strong NSAIDS 

6/12/18 2:55 PM
1/1/01
Posts: 39830

are your kidnety stones too big for Lithotripsy?  I had a large one blasted a few years ago and it worked out fine.

6/12/18 3:03 PM
8/15/07
Posts: 12944
He's a shitty doctor who shouldn't be practicing if that's his attitude.
6/12/18 3:04 PM
8/11/12
Posts: 6555
blood fist -
buddie - 

It might not feel like it. But he did you a favor.  You probably feel like you're in hell, but once you get through this you won't be an oxy addict.  That's one way to look at it. That shit is evil.  


I hear what you're saying, but I'm pretty positive I'd never become an oxy addict. I just don't like them that much.

But yeh, that shit is evil and costing a LOT of lives.

It really seems like you do like opiods, be careful. Maybe try some kratom instead.

6/12/18 3:06 PM
5/15/15
Posts: 841

In UK here and I've had stones 3 times. Never been given pain meds. F ing kills but pains only temporary.  They should be able to do a non invasive ultrasound through the skin not up your japs eye????

6/12/18 3:16 PM
12/10/09
Posts: 8620
mataleo1 -
scrapdo -
Rahjai MD -

Narcotics are never the first line for kidney stones anyways .

nsaids work way better .  Typically use iv toradol for acute pain and Flomax to ease passage of stone.

motrin or oral toradol is much better choice than narcotics . 

Maybe ur doc was leaning u into that direction.  Dunno can’t speak for him 

No offense, but i tend to disagree. Sure, for the most mild pain you can go the NSAID route, but any signifigant kidney stone pain is not going to respolved by NSAIDS alone. Maybe this practice is in an area with lots of drug-seekers and the doc is worn out, but that shouldn’t be put on you. You need a doc who treats you, not one who’s lumping you in with what he assumes you are before the visit even starts

Rahjaj is right. NSAIDS were shown superior to opioids in a very good meta -analysis (2017). More sustained pain relief and less side-effects. I always start out with strong NSAIDS 

Point me to that research?

6/12/18 3:22 PM
10/23/05
Posts: 1911
scrapdo - 
mataleo1 -
scrapdo -
Rahjai MD -

Narcotics are never the first line for kidney stones anyways .

nsaids work way better .  Typically use iv toradol for acute pain and Flomax to ease passage of stone.

motrin or oral toradol is much better choice than narcotics . 

Maybe ur doc was leaning u into that direction.  Dunno can’t speak for him 

No offense, but i tend to disagree. Sure, for the most mild pain you can go the NSAID route, but any signifigant kidney stone pain is not going to respolved by NSAIDS alone. Maybe this practice is in an area with lots of drug-seekers and the doc is worn out, but that shouldn’t be put on you. You need a doc who treats you, not one who’s lumping you in with what he assumes you are before the visit even starts

Rahjaj is right. NSAIDS were shown superior to opioids in a very good meta -analysis (2017). More sustained pain relief and less side-effects. I always start out with strong NSAIDS 

Point me to that research?


https://www.ncbi.nlm.nih.gov/pubmed/29174580

Plenty of other ones too, but this is a very solid systematic review.
Edited: 6/12/18 3:26 PM
12/10/09
Posts: 8621
scrapdo -
mataleo1 -
scrapdo -
Rahjai MD -

Narcotics are never the first line for kidney stones anyways .

nsaids work way better .  Typically use iv toradol for acute pain and Flomax to ease passage of stone.

motrin or oral toradol is much better choice than narcotics . 

Maybe ur doc was leaning u into that direction.  Dunno can’t speak for him 

No offense, but i tend to disagree. Sure, for the most mild pain you can go the NSAID route, but any signifigant kidney stone pain is not going to respolved by NSAIDS alone. Maybe this practice is in an area with lots of drug-seekers and the doc is worn out, but that shouldn’t be put on you. You need a doc who treats you, not one who’s lumping you in with what he assumes you are before the visit even starts

Rahjaj is right. NSAIDS were shown superior to opioids in a very good meta -analysis (2017). More sustained pain relief and less side-effects. I always start out with strong NSAIDS 

Point me to that research?

NM, found it, but you've misrepresented the results. They were not found to be superior, rather equivalent for the pain metric. I'll admit that is interesting though I have some issues with that analysis and it's application to what we're talking about here, but point taken.