Bed Rest in the Digital Age plus Over-Prescribing Meds

Today I learned:

1. Bed Rest in a Digital Age: Prior to yesterday’s ACL reconstruction, I had two previous arthroscopies on the same knee in the early-1990’s. It was almost 20 years ago but I have two vivid recollections:

  • Dialling my own home phone number from downstairs to make it ring upstairs so I could ask my mom to bring down some ice cream, without getting off my lazy butt. I remember this, partially, because she reminds me of it every chance she gets.
  • Watching ALOT of crappy TV.

As a high-school student who actually attended all my classes, this was my first exposure to the Soap Opera genre. Try as I might I never took to Days of Our Lives and General Hospital, but there just weren’t many other options in those days.

The world is different this time.

I stacked months of reading by my bed in preparation for the down-time but one day out of a general anesthetic and still hooped up on pain meds, my head is not so much into books.  Instead I have watched a few shows recommended by friends on Netflix – The Hour and Justified are favourites so far – and watched a work-related webinar.

As I look at myself now, surrounded by my iPhone, iPad, and macBook Pro, as well as my work laptop and blackberry, I have a sense this round of bed rest will be very plugged in. This blog may in fact prove to be therapeutic as it forces some form of daily creation, rather than consumption.

All the technology comes in handy too – this time I have 4 separate devices that I can use to Skype my mom to see if she can drop by with a bowl if Ice Cream.

2. Over-prescribing Meds:  On discharge from hospital I assumed I would be sent off with a small script for T3’s, but in fact I was given a prescription for a fairly heavy narcotic.  Interestingly, I was prescribed 60 tablets which my close friend (a pharmacist) described as “an awful lot for knee surgery.”

Taken at the recommended dosage of 1-2 tablets every 4-6 hours, the 60 tablets would be depleted at a rate of between 4 and 12 per day. Essentially, worst case I have 5 days of meds, but best case I have 15 days (or more if I don’t need them frequently).

This made me wonder: Why prescribe so many tablets?

Surely if I am in so much pain that I run through these meds at the fastest pace then someone should see me before 5 days to assess the problem. Alternatively it could be that I will have so many tablets leftover when I am done that they end up sitting around in my medicine cabinet long after I need them. This invites abuse by me or someone else.

I trust my doctor – I think he’s great and I am sure he did a good job on my knee – but I wonder how much thought went into the follow-up medications.  It may be that he assessed me and felt a large prescription was safe and low risk. I hope that is the case.

It seems to me though that it is more likely the script size was just a convenience factor for both him and me – an attempt to reduce follow-up visits just to write a new script. If that is the case then I am not too impressed. A smaller prescription would potentially catch and save problems at both ends of the spectrum.

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