If you, or a loved one have chronic pain, you understand what an ordeal going to the Emergency Room can be when the pain becomes more than your home arsenal of medications can handle. I have been to the Emergency Room at least a dozen times over the past couple of years due to chronic/idiopathic(?) pancreatitis; basically really bad gut pain caused by an inflamed pancreas which is yet to be fully diagnosed. It can be frustrating, to say the least, if you wind up going in when the A-hole doctor is working. You know the one. No matter how obvious the problem, or extensive your record at the facility is, absolutely will not give anything for pain until he/she has run every test under the sun. I know why they used to do this. They used to do this in case you had to be rushed into surgery. With the modern techniques, of medicine, and advances in pain management, as well as anesthesiology, pain medications can be given on the front end of the visit, especially at a facility you are known, and where they have treated you for the exact same thing before. Now then, before I get too high on my soap box, I also know the Emergency Department can give pain medications on the front end of the visit, in my case, because they have done it during all but ONE visit. The one visit they made me wait was the one time Dr. A-hole was working, and I told him he was an asshole. 
It did not change the bottom line, the protocols called for me to receive a pain shot, so even though he was against it, and wanted to deny it, in the end he had no choice but to give it me. By the way, I have been admitted every time I went into the Emergency Room, save one. Just so I am clear on this, I am speaking of a civilian hospital, NOT the Department of Veterans Affairs. I figured I would give them a break, at least in this paragraph.
I found a useful website for those of us suffering with chronic pain, if we wind up having to go to the Emergency Room. Here is the link http://www.theacpa.org/Going-to-the-ER This is a very useful site for more than suggestions on what to do on an ER visit. I found its link while nosing around medline plus. If you have chronic pain, know someone dealing with chronic pain, or are a caregiver, I highly recommend a visit to their home page. They are called the American Chronic Pain Association, and here is the link to their homepage: http://www.theacpa.org/ I found their information easy to understand, and complete. If you deal with pain, it will not hurt to check out these people, their great information, and tools. I have amassed a great wealth of knowledge over the past 28 years, and still found information on their site that was helpful to me.
The other day, while I was at the Veterans Administration, for one of my appointments, I overheard a doctor tell a veteran “The VA prescribes more narcotic pain medication than any facility in the country. The DEA is making us cut people’s medications”. I almost fell to the floor when I heard this. Obviously no one has examined just why the Department of Veterans Affairs (VA) is in a unique position to be the number one prescriber of pain medications, narcotic, and otherwise. We have men, and women, who have been in battles these doctors could never even come close to imagining. Many of our Veterans have been shot, blowed up, stabbed, beaten, bones broken, tortured, etc, etc, etc – I could go on forever as to the myriad of problems Veterans have with pain because they served their nation, many as volunteers; henceforth, and since the draft was abolished all returning service members, new Veterans, are indeed volunteers. The horrors of their pain are NOT in their head. They have real pain. They come from the military, where most are treated compassionately, and properly for their pain, into an archaic VA system that is hell-bent on denying proper pain management, even when it is obvious it is the only thing that will make the Veteran capable of existing anywhere near comfortable. Let me tell you, it is not my fault some idiot doctor, and a bunch of hop heads decided to use the state of Florida as their sources for money (the crooked doctors), and to feed their addictions (the hop heads who would load up charter buses to Florida with the sole intent of acquiring pain meds). These people have created a real problem for Florida’s veterans, and senior citizens, as well as other Floridians suffering severe chronic pain. The DEA is dictating to the doctors what they can, and cannot prescribe? I can understand them doing this to the ones who only accepted cash, and their only source of business was tour busses full of addicts. They should be jailed, in my humble opinion. As for the VA, and the Veteran, we are a unique class of citizen. Those of us suffering the trials, and tribulations of chronic pain have real, documented, and painful conditions, most of which are incurable. This is a serious situation. Many Veterans will turn to whatever they can get to relieve their pain. Military/Combat wounds, and diseases are some of the most painful conditions known to medicine. It is supposed to be our right, as patients of the VA to have our pain assessed, and treated, yet when I hear comments like the one I heard the other day, it sends chills down my spine remembering the days, under Reagan, and Bush 1 when the VA would give people dying of cancer Tylenol #3 because they did not want them getting hooked. Am I reaching you? Our Veterans are going to turn to alcohol, and illegal substances to treat their pain. Veterans with chronic pain do not need to see a shrink per se, they need to see a Pain Management Doctor, and that Pain Management Doctor MUST be a real one, not one assigned the title by the VA because he/she is willing to cut the most patients off their needed pain medications. There is a place for all the new mental health care workers to assist Veterans dealing with the fallout of chronic pain, but it is not labeling them, nor recommending their pain medications be cut off because a higher up says the organisation is dispensing too much pain medication. The mission of the VA should be a mission to help the veteran, not count how much pain medication is being prescribed. If the Veteran needs the medications, then he/she should be given the medication. Proper pain management can do wonders for a person suffering chronic pain. Improper pain management will only harm the patient, mentally, and physically, in the long-term, and is not in keeping with standards of compassionate, quality care the American taxpayers want their Veterans to receive.
Please contact your Congressman, Senator, The President of The United States Barack Obama, and the Director of The Department of Veterans Affairs about this alarming trend at the local VA Outpatient Clinics. I would hate to hear of a veteran commiting suicide because the VA failed to treat his/her chronic pain.
Cheers,
mark
