Pain Management: HepC Stigma Remains

Pain Management: HepC Stigma Remains

Seven months after my transplant, I began vomiting regularly for no apparent reason, sometimes, without warning. My new gastro doc diagnosed me with chronic pancreatitis, caused by calcium clogging the pancreatic duct. My old gastro first said it was viral-induced gastroparesis (delayed emptying of the stomach), and prescribed drugs to improve action in my intestines. He said it could last up to three months. It did, and I kept right on vomiting. After that, he changed his diagnosis to gastroenteritis. I switched gastroenterologists. His diagnosis of pancreatitis was based on my pancreatic enzyme levels, and a CT scan. I vomited so often, it kept me from social activities. I worried about vomiting in front of other people. I stopped eating in restaurants. Finally, the new guy prescribed a patch that I wear behind my ear to prevent nausea – so far, so good, except my symptom changed from vomiting to intense abdominal pain, so severe, I became a regular in the ER.

Now, I’d had a pain management doctor for a few years, for a back injury and sciatica, but she moved her practice twenty miles away, so I started looking for local docs. I kept running into a wall of denial. Apparently, docs are so concerned about prescription drug abuse, many have stopped prescribing narcotics for pain control. I had been on a combination of Oxycontin sustained release, coupled with Oxycodone. It was the only thing that worked, outside of the intravenous Dilaudid I’d get in the ER, and now, I couldn’t get those drugs anymore – drugs that are appropriate for my level of pain – my new gastro doc agrees. Not only did the doctors refuse to write me for narcotics, they did so in a stern – even mean-spirited manner.

Finally, I located my previous doctor. She was the most compassionate doctor I’d ever had – always gentle with me, and always expressed concern for the level of pain I was experiencing. My wife drove me to see this doctor yesterday, and she explained what was happening to me. She said, “Doctors have become suspicious of patients with a history of hepatitis C.” According to her, most pain doctors now assume a risk of continuing drug abuse, even if that abuse happened 45 years ago, as in my case. They don’t tell you that, but my doctor assured me it’s the first thing on their minds. In fact, because of the prevalence of prescription drug abuse, she had also incorporated an anti-narcotic policy in her new practice, except for her previous patients, like me. I signed an agreement with her promising not to sell or give the drugs to anyone else, and never to take more than prescribed. I left her office with a prescription for Oxycodone. When my drug test comes back next week, she’ll put me back on the combination therapy that helped me cope with intolerable pain.

Even after all these years, there is still stigma and prejudice associated with HCV. Somehow, this attitude must change. There is no reason for anyone to suffer needlessly. What do you think about this policy shift?

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