Part 1- What I Need to Know

 I used to shadow an anesthesiologist at various locations, including Northside Hospital Forsyth and Atlanta, Meridian Mark Outpatient Center, as well as a private joint center. I would mainly observe spinal and regional blocks most commonly used for joint surgeries. For these joint procedures, the patient would come in, get a spinal and regional block, be taken off to surgery, come out in forty minutes with a completely replaced joint and be on the way home in the next hour and a half. This sounds absurd, of course, how could one get an entire new body part with a tolerable amount of pain and okay to go home? I began to learn the methods these doctors used to minimize time patients spent in the hospital, and that started with a limited prescription of strong painkillers. After shadowing an esteemed anesthesiologist and block nurse since August, I have developed insight on different types of medicines used pre and post op, various approaches to take to treat pain while avoiding opioids, and gained insight on how closely the medical field and addiction go hand in hand with each other. I believe that if I study this topic closely, I can help more people become aware of the dangers of the effects of opioids and help put a stop to the crisis especially in the Atlanta area.

 

 

Part 2- What I Know or Assume

Although I have not done too much  research on the effects of opioids, the opioid addiction and whether or not opioids are necessary to counter pain post-op, I have gathered what I have learned at my mentorship site, as well as what my mentors have taught me about pain management.

• The presence of an extreme opioid addiction, particularly in the Atlanta area( I have only ever heard about the serious opioid epidemic, I have not researched it)

• Most patients believe they need stronger meds than over the counter meds like ibuprofen or advil, and prepare themselves to take opioids before they really need them

• Taking opioids can make a human body develop opioid induced hyperalgesia (when the body becomes more sensitive to pain- taking these hard drugs can cause ones body to develop an enhanced pain response

• I know that doctors can over prescribe for a medicine, and the patient unknowingly follows the doctors orders, takes as prescribed, and becomes addicted

• I know and have looked into alternative methods of multimodal pain treatment such as heat, icing, elevation, OTC (over the counter) meds, and physical therapy

• I assume patients somewhat rely on the ‘harder’ drugs for immediate pain relief 

• I used to shadow an anesthesiologist at a private joint center not owned by Northside Hospital, so I know the regime those doctors made their patients follow before and after surgery which improved the patient's overall care for after. This includes going to a joint class to learn how to properly take care of the joint after surgery, learning about the possible side effects of meds, almost immediate practice with a physical therapist close to  thirty minutes after the patient is awake and an enhanced opposition to the prescription of opioids unless necessary 

 

Part 3- The Search:

    I began my research by gathering some crucial knowledge, like

• What are Opioids?

• What medications are considered Opioids?

• What effects do Opioids have on human bodies?

• What pain control options are there to somewhat eliminate the use of opioids?

    In my research I gathered that Opioids by definition are , “ a class of drugs that include the illegal drug heroin, synthetic opioids such as fentanyl, and pain relievers available legally by prescription, such as oxycodone (OxyContin®), hydrocodone (Vicodin®), codeine, morphine, and many others”(National Institute on Drug Abuse 1). Ocycodone, Vicodin and Morphine are some of the most common opioids used for post-op pain. Opioids are prescribed to patients for post-op pain  control as a way to decrease pain as fast as possible. Drugs like Oxycodone, give a quick pain free solution that works faster than OTC (over the counter) drugs like Advil or Ibuprofen would. What some patients do not realize are the effects opioids leave on our bodies. During my interview with my mentor, Lara, she discusses the side effects opioids have such as ,“Altered mentation (mental activity), drowsiness, they slow down gut muscles so they can cause bowel obstruction or constipation.”. These symptoms are rather harsh on a patient especially after a surgery so avoiding opioids would be more beneficial.  A portion of my knowledge I gathered from my mentors, Dr. Hamilton and Lara at Northside, while also discovering multiple websites that discuss opioids relating to the medical field. I conducted an interview with Lara discussing questions that she could answer from a medical professional standpoint.

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Part 4- What I discovered

 

I believe that all my assumptions I made before I started my research are still accurate. Being with Dr. Hamilton in the beginning of the year, and then shadowing Lara, a block nurse, really helped educate me on opioids from a medical standpoint. Through my research I have concluded that opioids  are not necessary for pain control but can be a last resort for patients dealing with post-op pain, although medical professionals should prescribe multimodal methods of pain before opioids are even an option. I have never had to undergo surgery, thankfully other than wisdom teeth surgery, in which they prescribed me Hydrocodone-acetaminophen, a 325 mg percocet  that I was to take every 4-6 hours as needed. I took the percocet around every four hours, as directed, and my mom attempted to wean me off, and try to have me take an over the counter pill (ibuprofen) instead. I became very irritable, emotional and I did not like how the OTC pill handled my pain like the opioid did. Remembering this experience now, helps me gain an insight as to what most patients probably feel after their surgery: they want the quickest way to ease their pain. If it weren't for my mom controlling my dosage and trying to slow down my intake of percocets I probably would have kept using them until I had no pain at all. I believe that prescription opioid reduction starts in the medical community, and patients need to opt for healthier pain control methods so that we can stop the opioid epidemic all together.

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