All Pain, No Gain
Anyone that has had breast surgery knows that it’s painful. And not like a minor inconvenient pain. This is a whole-body effort. After my surgery, my arms, chest, back, and neck hurt. It hurt to try to sit up, and hurt to lie back.
After my DIEP surgery, my plastic surgeon prescribed me Percocet. Before my release from the hospital, a Black female doctor came in with an Rx for me to take home and asked if I also wanted to take the Rx for Naloxone, the overdose reversal drug. I told her no and declined to accept that Rx. I told her that I knew how to take my meds and wasn’t in danger of overdosing or overmedicating. She told me that she too had had breast cancer and had chosen to do implants; that they prescribed the Naloxone for her as well and she didn’t accept the Rx either. So, I went home with the Percocet Rx thinking it would be fine. I was only prescribed 20 pills, and I ran out within the first five days of being home. I called and asked for a refill and was asked if I was also taking Tylenol for the pain. I told them if I didn’t need to take something stronger I wouldn’t, but that I had just had an 11.5 hour surgery that kept me in the hospital for four days, and that Tylenol wasn’t going to cut it. They gave me another Rx for Percocet, but I hung up feeling like they had formed an impression about me based on me asking for another Rx for pain meds.
A few months later, I decided that the DIEP flap wasn’t for me and I asked my plastic surgeon to remove the flap and give me a flat closure rather than revise the initial surgery. He didn’t seem pleased at all about my decision and tried to convince me that I was making a mistake. He went so far as to tell me certain clothes wouldn’t look good on me anymore if I chose to go flat. I stuck to my guns and went ahead with the explant. But my plastic surgeon ended up leaving me extra skin and did not do as I wished and give me a flat closure, and upon my release, I was prescribed Norco 5-325. 20 pills, to be taken every six hours. That’s four pills a day, for five days. Which again meant I’d run have run out before my post op appt. the following Monday.
I woke up on the second morning being home, still in pretty intense pain (an 8) and my tolerance for pain is pretty high. I took my Norco as directed and it wasn’t helping. I called Triage and spoke with the nurse. She looked at my chart and asked me why I was taking Tramadol? I told her that I’m almost always in pain due to developing osteoporosis, and the Tramadol was prescribed by my oncologist for it. She asked if I had tried to take Tramadol with the Norco and I told her yes, I had tried that, and it didn’t help. Didn’t even dull the pain. She said she’d reach out to the PS on call and tell him all of this so he could prescribe me something stronger. His advice was to take “800 mg Ibuprofen, 500 mg Tylenol, and 1-2 of my Norco every six hours for 3-4 days. But do not go over 4,000mg of Acetaminophen in 24 hours. This regimen will manage the pain, and you might not even need to take the Norco if you take the ibuprofen and Tylenol.”
I felt like this was way too many medications and called my plastic surgeon’s office and let them know I was in pain and that I didn’t feel comfortable taking that much medication. At the same time, my sister tweeted out to the hospital I was being treated at that I was being denied adequate pain medication because of my race. They quickly responded and a patient advocate reached out to me, saying she’d contact my plastic surgeon about my medication. He called back and said he didn’t realize I’d be in so much pain since this was just a short surgery but went ahead and prescribed me Oxycodone. I was in so much pain, my drain sites had become infected due to what I can only imagine was a rushed surgery (the entire surgery was less than two hours and I was sent home once I woke up), and it still took an additional two days for the Rx to go through.
When I went for my post op the following Monday, the nurse practitioner asked why I was in so much pain and what was hurting exactly? I told her that removing all that tissue had been painful, and that my drain sites were becoming infected. She looked at my drain sites and said they “weren’t infected at all; that was completely normal” even though this had never happened to me before with any other surgeries I’ve had. The entire visit felt like I was getting the brush off, my pain was diminished and though they prescribed the pain meds as I had asked, it didn’t feel like they sincerely cared about me or my pain.
This type of treatment happens more often than people think. Black women and other WOC are often overlooked or treated as if their pain isn’t real and thus not prescribed adequate pain medication because of a preconceived idea that BIPOC don’t feel pain the same way as our White counterparts. I wish it wasn’t this way. I am not a drug addict. I’ve never abused my medication. I just don’t want to be in pain. – Shar Schmidt