When I went into the hospital before Christmas with a triple-broken elbow and dislocated arm, they understandably gave me the painkiller I needed to endure an overnight and all-next-day wait for surgery.

They started with Oxycodon, but that didn't do the job, so they went to Morphine, which did not do the job, and finally gave me Duragesic, which did. Duragesic is the patent name of a drug known on the street as Fentanyl. The Fentanyl didn't kill the pain either, it just quickly stripped away the will to stay awake, so I slept while my broken, dislocated arm throbbed.

After the surgery, Oxycodon sufficed, and they sent me home with a big bottle of it (no refill).

Lots and lots of opiods during that hospital stay, and over the next few weeks. I wasn't afraid of taking it, because it didn't make me high or anything, just sleepy. Not sure it really took the pain away all that much, just made me care less about it. One definitely should not drive or try anything intellectual while under that influence, though.

Thank God for opiods. Without them, people would go mad from the pain from really terrible injuries, and there's nothing as strong as morphine and fentanyl for quickly taking the edge off and putting out the lights.

Obviously there's an addiction problem for a lot of people, but we need to be sure that, if we need them, the full battery of opiods are there to deal with the grisliest of injuries.

"When Tylenol won't do, Fentanyl's got you covered." (TM)

Many millions of pills were dispensed at pain clinics in rural areas, fueling a vigorous street trade.

Hmmmm. I think I see the problem here, and it has nothing to do with the pharmaceutical companies or the doctors or the software.

a triple-broken elbow and dislocated arm

What is the first rule of Fight Club?

Not sure it really took the pain away all that much

Seriously, though, Vic. Sorry to hear about your terrible trauma and pain. Hope you are on the mend.

You bring up a good point...pain killers don't really relieve the pain. Whenever I have taken pain killers I couldn't wait for the opiate affect to wear off. Much better to deal with the pain WITHOUT the awful druggy feeling.

Of course, I might change my mind if I had a gaping wound.

I mostly agree with what you said, with two caveats.

(1) Aspirin really DOES relieve my headache pain, when I have it. But aspirin is a different kind of painkiller - an anti-inflammatory - and I think when I get headaches it's pressure on nerves and the anti-inflammatory effect of aspirin takes that pressure off.

(2) The fentanyl and morphine did not so much kill the pain as put me to sleep for hours at a time, and that was a blessing. A dislocation is worse than a broken bone, because all of that muscle meat and tendons is just hanging there, wrong, with the nerves screaming, and when it's hanging against the jagged edges of broken bones, there's actual damage being done as it hangs. They could not pop the arm back in joint because the elbow itself was broken off - there was no joint to put it in.

In that case, the fentanyl especially really helped. It still hurt, but I didn't feel it as long as I was asleep, so during that 23 hours of waiting for surgery I needed to sleep as much as possible, there being no relief for the pain. The opiods did yeoman's work at that.

They could not pop the arm back in joint because the elbow itself was broken off - there was no joint to put it in.

This is terrible, and the first I have heard you speak of it.

How is your (right or left?)arm now? What do the doctors say?

The doctors - and these are surgeons in the medical school teachers practice at Columbia University Hospital - the best in New York - are stunned at my recovery. "Never seen a better result". The surgeon who did the work called in the other surgeons when I came in for the six- week look. I was expected to gain back perhaps 50$ of the range of motion. I've already gained back 100% of it in one direction, and 95% in the other two (aiming at 100%). They were astonished, told me I was the luckiest "terrible triad" patient they'd ever had in the practice - that this just doesn't happened. Asked the name and location of my physical therapist. All shook my hand "Congratulations". They did great work, the therapist is great, I've worked the arm constantly since the cast came off, and God was exceptionally kind to me - again. (Broken neck once - should be dead; stabbed in the eye with a pencil - recovered full sight; severed the nerves in right arm, and lost the feeling and strength in half of it, but the nerves all grew back with no loss of anything. I've been blessed with a hardy constitution.