Post-operative Pain in Taiwan - Beware


#21

It's reading this sort of thing that convinces me I really do want to go into medicine in Taiwan. Llook out, Llary's coming!


#22

I wouldn't count on it. I had two knee operations. Know one mentioned pain management before the operation. I was in a lot of pain. They gave me the regular dosage of demorel (sp?) that they give everyone regardless of the fact that I way quite a lot more. They would absolutely not give me a shot more than every four hours, and even then they were stingy about it. It was effective for about an hour, marginal for the next and unbearable for the last two, each time. The fucking nurse even gave me a placebo shot at some time to shut me up. Needless to say, it didn't work.

It also bugged me that the docotrs and nurses would keep saying I was 'pa tong' - afraid of pain. Well yes, and no. I don't like pain, and wish to avoid it. That's normal. I can put up with it if I have to and am very good at doing necessary things that I know will cause pain. But fuck it. IO don't want to suffer when there's good painkillers around.

So yeah. First talk to your doctor and make sure they're going to give you good painkillers.

Brian


#23

You should have sprung for the self-administered pump that they offer. You are correct--the nurses especially have some very old-fashioned ideas about how its better to suffer than take drugs etc. If you have the pump, you control your pain relief.


#24

I've had that patronising "pa tong" comment directed at me a few times by dentists and doctors. Not sure whether most people here do have higher pain thresholds or whether they're just used to grinning and bearing it. I'm definitely not one to take medication when it's not strictly necessary -- I have this radiculopathy problem in my neck/arm and mostly I just have the physical therapy and don't take any medication for it. But for acute, "sharp" pain then medication can make things much easier. (I think that sometimes it can also speed up healing and rehabilitation).


#25

crest


#26

A friend of mine had a bad scooter accident with about 15 bones broken. I've lost count, so did the doctors. Anyhow, they wanted to give him Panadol as well, but thanks to my digging deeper, we found out that morphine is indeed available, but they seem to forget to mention that.


#27

I'm currently recuperating from a scooter accident (5 broken bones) and had the pump in the hospital here in Taiwan. Even though I have great extra insurance, providing me with my own room at the hospital, the pump wasn't covered. It costed $5,500NT, but was well worth it. Although it didn't eliminate my pain completely, it cut down on it considerably. I had the pump for four days after my operation.

One downside to the pump is that I couldn't go to the bathroom with it. I knew from a past-experience in the hospital that opiate-based painkillers do that to me. I feared having to get a catheter, as was the case with the previous time. My fears turned into nightmares as they inserted and removed a catheter from me not once, but three times! They kept thinking I would regain the ability to urinate, even though I was still using the pump, so they removed the catheter. Then, when I couldn't go, they stuck it back up my nyao nyao. It wasn't a pleasant experience, to say the least. I wished they would have just left it there. Then they had this notion that I would lose all sense of when my bladder was full, so they clamped the hose connecting me to the bag, until I was almost bursting. I never had that kind of medieval treatment the previous time in a hospital (a USA hospital).

The surgeons told me that they would give me a really strong painkiller for when I went home. I asked what it would be and they said an anti-inflammatory. They laughed at me when I asked if I could get an opiate-based painkiller. Even though I'm into week two of my rehabilitation and am experiencing a lot of pain, the doctor only switched me to another anti-inflammatory drug. I'm not even sure he knows about any opiate-based painkillers, let alone can prescribe one. I even wrote down "hydrocodone" on a piece of paper for him and he gave me a puzzled look. My pain is so bad that I cannot sleep for more than an hour at a time, and the doctors won't (or can't) do a thing for me. I really hate their lack of concern for dealing with pain here.


#28

I was told that, this kind of pain that you're experiencing now, is nothing compared to the pain to get of from the drugs such as morphine/heroin later. My friend I mentioned above said, that the only thing they did right in Taiwan, was that they did not put him on drugs. As soon as he was home for treatment, they've put him on morphine and then treated him like junky, when he tried to get off it again. His whole recovery took 30 months....


#29

There is a huge difference between dependency and addiction. It sounds like your friend was experiencing the latter. It will be a great day when Taiwan finally embraces things such as social development, obedience to traffic laws, and pain control medication.


#30

He won a lawsuit against his doctor, who prescribed him the drugs. It was a physical addition.


#31

I was hit by a car here in Taiwan about 4.5 years ago. I had to have surgery to stop bleeding in my leg (which ended up leaving me with a 6 inch incision up my thigh)

Not only did I wake up on the operating table as they were stapling my leg closed, but I also got to live through the further experience of feeling them pull the breathing tube out of my throat.

Needless to say I was in severe shock and pain from what I just endured. Thank goodness they had let 2 of my foreign friends into the post op to see me. One of the girls screamed at the nurses and doctors in Chinese until they gave me an injection for pain. I remember feeling like a chicken as they had me under warm blankets and a hot light trying to get me out of shock!

Morons! Like the heat was going to help with the severe pain I had just endured and woke up to.

I still look back as the whole surgery in the hospital as one of the most traumatizing experiences I have ever had in Taiwan (or anywhere for that matter).

I wanted to spend as little time as I possibly could in that hospital. I was up out of my bed within 2 hours after the surgery, taking myself to the bathroom. I pleaded with the DR for more pain meds, which he DID prescribe but the flipping nurses would NEVER bring them to me. I had to get a Chinese friend (parent of a student) in to deal with them. When she was done speaking to them ... I was well taken care of.

Not the best experience in my lifetime ... I would advise any foreigner who has to get surgery here to make sure they have a Chinese friend also speak very specifically with the doctor. Make it crystal clear that ASA is NOT going to cut it!

Good Luck.


#32

After my c-section, the nurses didn't want to give me anything but Tylenol. After begging, I got a shot of demoral, but this didn't even register. I finally was at the point of jumping out the window, so they offered the morphine pump. It didn't knock the pain out entirely, but it did make it bearable. It thinks it was about five thousand NT and not covered by health insurance. They had a nurse type in to ask survey questions about how well the pump worked. She seemed dis-believing when I told her that I still had pain even with the pump.

But it was really marvelous. I was able to get up and around with the pump. Without it, recovery would have been much, much longer and more physically and emotionally draining. I needed to recover and get on with being a new mommy.

And, by the way, this was after a three day labor during which I did not take a single thing for pain. So I was kinda ticked when they looked at me like I was a pansy for wanting the morphine.


#33

I think it's all basically a don't care attitude. Surprising really, as you would expect the greed thing to kick in when they're charging 5000 bucks for the cheapest painkiller known to man.

I am glad I bought medical insurance which allows me to choose where I'm treated, which would be Bangkok or Singapore, or for something serious, in Ireland with my family beside me. But I didn't get it until after I went through my ridiculous farce in Taiwan.


#34

No gain.


#35

I had 3 steel pins hammered into my right hand 2 weeks ago at a major tpe hospital.

They tried regional anestesia and when that failed they put me under.

When I woke up in the recovery room, the nurse asked me if I was feeling any pain. I was in a bit but not unmanageable, however her offer og 30mg of something morphine related was too good to turn down. It worked.

Once i got back into the ward, the nurses there offered me a shot of Demerol. It worked too.

After 3 hours I started to feel pain. I asked for another shot and got it. It worked.

Toward the evening when it was established that I was able to eat, drink and pee, they gave me a strong long lasting NSAID (should last 24 hours). It did not work, so after one hr I told the nurses. They looked disbelieving at me, and got a shot of Demerol hustled up in no time. Once that kicked in, the NSAID took over and kept me free from pain for 24 hours, or till they gaveme the next tablet. They then sternly told me to let them know when the pain started, after all the first 24-36 hours their objective was to ensure that i was comfortable enough to sleep and eat, if i was in serious pain after that, then something serious would be wrong. I must admit that they managed the pain rather well.

I speak Chinese and my wife was on hand to drive the message in [I briefed her beforehand]. That said, all I had to do wasto ask when they checked up on me.

I was let to believe that it was the standard modus operandum at that hospital.

Interestingly enough demerol and other painkillers was refused by a lot of the chinese, as they believe that it's bad for you. The guy next to me refused all painkillers after a knee operation and he looked suffering. Poor bloke, when he finally asked for one, his wife instructed the nurses not to give him anything.

From day 2 I did OK on NSAID's and from the moment I left the hospital, I haven't taken anything.

Interestingly enough my wife talked about the chinese aversion to opiate painkillers. I asked her if she wanted me to refuse painkillers on her behalf in case she has to have surgery done. [Note I have a rather dark sense of humor]. My wife's reply was that she was not like most Chinese.

Funnier still, my dad does the kind of surgery I was subjected roughly 50-100 times per year. he told me that 600mg of ibobrufene works better than opiates on localized pain after orthopaedic surgery. Local orthopaedics however don't use it as it has a small negative impact on bone healing times afterward.


#36

a hangover from the bad days of the opium wars, perhaps?

the picture is complicated as different types of pain responmd differently to the various classes of pain management drugs available, and also because different people handle pain differently. a man recently underwent abdominal surgery after hypnotising himself, with no other pain relief or anaesthetic. acupuncture is also used for much anaesthesia in some hospitals in china. stoicism is part of many cultures, and pain control is certainly somehting one can teach oneself... the body has good mechanisms for suppressing pain that can be activated in the right circumstances.

but the goal of all medical staff should be to relieve pain where it exists, before it becomes debilitating. undue pain slows recovery times too, so there is a financial cost to the hospital that they may not be aware of.

hospital staff who refuse to give or offer pain medication ought to be sued, or at least loudly berated in public as the uncaring bastards they are, hospital policy be damned.


#37

Veteran's General Hospital is perfectly aware that pain slows recovery time, or the nurses in the ward I was in were. At least they said something to that effect when asked.


#38

I broke my femur about three years ago and I was given demerol post-op and it worked fine. Too fine, in fact. I enjoyed it so much that i insisted they stop giving it to me. They actually objected to my objection. Apparently the pain would be too excruciating or some such nonsense. They also told me I wouldn't walk for six months. I was walking and running after 3 1/2 months.


#39

Damn right they objected. If you are in pain, the healing slows, as you eat less, and sleep less well.

Demerol is one of the milder opiates, and usually the issue is that it isn't strong enough, or that it wears off too fast. (Demerol only last 2 hours on me).

The doses given aren't where it's extremely enjoyable, unless you consider freedom for pain a forbidden indulgence, or you are very susceptible to opiates.

If youi really pushed, I guess you could get some 600mg tablets of Ibubrufen, they are effective against bone/joint pain.


#40

Yeah, only lasts 2 hours for me too, but they only gave it to me every 4. 1st hour was actually very nice, next hour pain free, and last two hours frickin awful.

Anyone know what's the strongest painkiller you can buy over the counter? I'm guessing it's NSAIDs such as Ibuprofen, Voltaren etc, but is their anything stronger?