VA ER fails to address severe pain. Advised to take Tylenol

[FloridaNative]

I am a 100% disabled vet. I am also a retired registered nurse. Last year I went to the ER at a VA facility when I had a severe exacerbation of chronic lower back pain and siatica. The CT scan revealed severe Foraminal Stenosis in one area along with multiple herniated discs. I was told to take Tylenol and make an appointment with my primary care physician. The pain was so severe I could barely walk. I had to use the rail on the wall to get to and from the ER. I spent the next 3 days in bed with excruciating pain unable to do much of anything.  Just getting in bed caused tremendous. I was unable to extend my right leg without severe pain. The solution according to the VA was physical therapy. I was in too much pain to particate. Several months later after seeing VA pain management I was sent to acupuncture which has helped considerably. I was still not given medication to relieve some of the pain. After doing some research I discovered multiple studies that indicate Tylenol is NOT appropriate for severe pain. I saw a VA pain management pharmacist who recommended pregabalin which I agreed to. It was my understanding they were going to recommend it to my physician. A week later I discovered the recommendation was not made. I was told since the acupuncture was helping they were planning to wait. Acupuncture is not going to correct the structional problems in my back. The surgeon I saw didn't want to operate even though the procedure would have been minimally invasive. I explained to the pharmacist that after my prior experience with the ER I feared another exacerbation. If that occurs  I expect I would be treated in the same manner as the last visit. Basically we don't care how much you hurt we are not going to treat it on a timely basis. I will be seen again in a month to discuss starting the pregabalin. The VA has become so fearful of appropriately treating pain that they send veterans home without treatment. I did further research into veteran suicide and as I suspected chronic pain is a significant cause. There have even been successful malpractice lawsuits filed by survivors of persons with severe chronic pain who committed suicide after their medication was cut. No every veteran who goes to the ER complaining of pain is malingering. From the attitude and care I saw I strongly suspect the physician thought I was malingering.  I am afraid to go to the ER for any reason after the episode because I suspect I will not be take seriously by the physicians.  Has anyone else had a similar problem getting chronic pain addressed? 

[Vync]

@FloridaNative I can definitely sympathize with your situation.

Around 2011 was a big push to get marijuana legalized. The FDA suddenly changed their guidelines for prescribing opiates. Almost overnight, the VA docs began refusing to issue or renew opiate prescriptions without a lot of headache and outright refusals. 

The VA medical centers had a "VA patients bill of rights" posted all over their facilities. With it was a right to have your pain treated. That section seemed to disappear for a while. However, it is back as of checking this morning at https://www.va.gov/health/rights/patientrights.asp

Quote

You have the right to have your pain assessed and to receive treatment to manage your pain. You and your treatment team will develop a pain management plan together. You are expected to help the treatment team by telling them if you have pain and if the treatment is working.

That sounds promising, but it has became increasingly more difficult to get effective pain treatment lately. And what works for one vet might not work for another.

[john999]

I totally agree with Vync.   I have been treated for pain at the VA for over 20 years.  The VA has steadily reduced my pain meds with zero other realistic options for pain control.  They gave me anti-depressants. I suffer pain and it has nothing to do with psychological issues.  The whole thing is the VA is scared of the DEA.  When in doubt throw the vets under the bus.