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Putting in some work in the ORs at @WRBethesda - got to help with some interesting cases and saw several people get Tylenol and other meds to help provide anesthesia and post-op pain relief with minimal opioids. They all woke up comfy and happy! 
@ASALifelinepic.twitter.com/J5ukgkok37
FYI to all- sorry if you’ve had bad experiences. Flip side is that many people have bad experiences (short and long term) WITH opioids every day. I’m not against opioids for those that need it. But people should know that for many, pain relief is possible- even better- without!
IV Tylenol is awesome for pain, but it is simply not accessible to everyone. Oral Tylenol just isn't the same, and you know that. Some pain requires opioids.
1) studies show oral Tylenol works just as well for pain (though not for fever) in most people, when given at right time and right dose. And it’s a LOT cheaper than IV 2) I’ve consistently said (and tweeted) that some pain requires opioids. Just not all (or even most) pain.
People do know. This message has thoroughly, completely saturated both major political parties and every news outlet for years now. Flip side is, people who *do* need opioid medication are being forcibly separated from their best quality life. And that needs a counter-message.
As in balanced prescribing policy, we need balanced messaging about Rxing. For ea person who will be okay on Tylenol there is someone who won't. For ea person who doesn't do well with opioids, there will be someone who does & for whom that is the only reasonable post surg choice.
What you do not see are the long term effects of recommending OTC meds and alcohol (yes, some docs are now!). These are not sustainable for long term or even short term high doses. I’m willing to bet your patients weren’t on those doses long.
The last thing I’ll say is, it is disturbing if you administered Tylenol on unconscious, uninformed people, not because of medical indication, but for personal morals, not knowing if they would receive appropriate relief. Don’t experiment on people. That makes them victims.
My husband fractured his wrist in Jan. He hasnt been able to get the pain under control with OTC meds. He had taken so much Tylenol and ibuprofen that his stomach has been constantly upset. The pain wakes him(&me) up sev X a night. His Dr told him to try whisky!
Holy shit that sounds like malpractice tbh
Correct- many don’t need opiates- I did not need opiates after I had surgery, however to claim that opiates are equivalent to Tylenol is misleading, from a scientific point- they hit different receptors, & have different mechanisms, so it’s impossible for them to be equivalent.
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