Since When Is Going To The Er.like Playing A Game Of Crap"s

[tmj southie]

hey all,
i find it so unbeliveable that for the majority of us ( by us i mean thse of us in pain) when we are in so much pain that we need to go to the ER. for help.
we practically have to be on our death bed to get the help we seek .
I just read a post about how this persons back went out and needed to take an ambulance to the hospital. that is some serious pain,so my point is that the attending doctor gave this person a hard time ,we all know this right guy's, "THE JUNKIE TREATMENT" this person has a documented history of surgeries and other back issue's. Right off the bat the doc just assumed this person was looking for a fix. come on doc look at the computer call their Primary ,listen to what he or she has to say just don't walk in mind set "not another junkie looking for a fix", but I understand there are people that do abuse the system but just don't assume. It's happened to me many of a time.
I hate going to the ER. I never no if i'll be treated like a person in pain or a "junkie" trying to get a quick fix.
Then there is the time you go and you get DR. what can i do that wil help you, WhAT ???are you talking to me or is the president here???wholly crap did i take to much pain killer?? am i dead?? lol .Seriously though this type of Doctor the one that is not going to let you leave until you are the best you can be are far and very few in between .
I dont know why i wrote this but i'm just curious how many of you this has happened to?? so I hope at your next visit to th ER. ( God willing you don't to go) you get DR. I do this because i care. well thats it good night all and be well and dont be a stranger drop a line and do tell of some of your trips' to the "crap's table"

[alex44]

I went to a level 1 Truma Hospital with a feeling of someone standing on my chest. The first time they said it was heartburn, the second time the doctor took me into a room and asked me what i wanted, as in drugs. I left after telling him in no uncertain terrrms that I was in pain and he was useless. The third time, i went to a differant hospital, this all being several days apart, and this was a community hospital, not a trauma center, and the first thing they did was an ulta sound. Next tthing I know, they are filling me with Diluidid, came back, asked was I still in pain, yes, another IV shot and when did I eat last. told them this morning, they said good as i was off to surgery for a hot gallbladder. Thirteen Stones people - I could have died. they also got some kind of insurance to pay for it. ust goes to show, you never know what you will get. ER,s can be good or bad but if you get treated badly, assert your rights.good lucl
Alex44

[Boxerlover]

It is absolutely amazing the different reactions you get depending on the doc. I went into the ER with a suspected kidney stone. It was very odd, they first gave me torodol and when that didn't work, they did give me 1 shot of demerol and then made a big deal of leaving another syringe supposedly filled with demerol on the counter. I knew immediately they thought I was there for meds because they would never leave a syringe filled with 100mg of demerol out on the counter. Then in about 15 minutes they came in with another shot and made a big deal about it. I told them I already got the meds and they were like are you sure....? Ah yea, I think I'd know if I got a sharp pinch with someone telling me they are giving me a shot. They let me lay there a little while then came in and said it was busy and they needed the room. I was still having a lot of pain and they said if I stayed I was going to get cathed. I do not do well with a cath and at this point I was tired of being treated that way so we left. I live in Florida and that night a hurricane was coming in. By the next day I had not peed in like 30 hours and my doc was like go back to the ER NOW,even though it was in the middle of a hurricane. Fortunately the girl at the desk saw that I had been in the night before and got me back quick. The doc I got next was wonderful, every 30 minutes he kept checking if I needed more meds and gave it to me anytime I said I hurt. After being pumped with I.V. fluid he gave me time to try and pee myself so I didn't have to get cathed and he did a CT and when we asked him how many stones did he find he said too many to count!!!

I can't believe the treatment from the night before but it all depends on the doc.

Melissa

[alex44]

You are absolutely right. It all depends on the doc on duty but do NOT piss off the nurses - they do their best but they are often overworked and can be not so nice.. Glad you are better, hope you stay that way
Alex44

[moose53]

Southie,

I thought you might be interested in reading this:

from: http://www.medicalnewstoday.com/articles/163491.php


95% Of Patients In Pain Are Still In Moderate To Severe Chronic Pain Despite One Year Of Treatment

Main Category: Pain / Anesthetics
Article Date: 10 Sep 2009 - 3:00 PDT

95% of patients are suffering from moderate to severe chronic pain after one year of treatment[1] and only 12% are being prescribed strong opioids, according to a year-long survey presented today at the EFIC congress. The research reveals that more than half of patients' pain levels fail to improve over the course of a year's treatment and for 19%, their pain has become worse. Despite the high proportion of patients continuing to suffer pain, 64% of patients believe they are taking the most appropriate level of medication and 58% believe that everything is being done to help them.

The new survey, entitled PainSTORY (Pain Study Tracking Ongoing Responses for a Year), is the first of its kind to track the impact of chronic pain on patients' lives over the course of a year and involved 294 patients in 13 European countries.

Regarding pain management, the survey demonstrates that out of all patients who took part in the survey, 83% are prescribed medication but 30% also resort to over the counter (OTC) medication to try to manage their pain either alone or in combination with other therapies. Despite the fact that 95% of patients receiving treatment are suffering from moderate-to-severe pain, only 12% of them are being prescribed a strong opioid treatment, 25% a weak opioid and 43% are prescribed a non-opioid treatment. The research also reveals that only 23% had their prescription changed to a stronger type of pain medication over the course of the year.

The survey illustrates almost half of all patients report side effects as a result of their medication, the most common of which is constipation[2], experienced by almost half of patients, 49% of whom are receiving treatment with opioids. Although highly effective in controlling pain, opioids can be associated with opioid-induced constipation (OIC). The research indicates that 26% of patients taking opioid medication turn to laxatives to help relieve their constipation, which may alleviate symptoms but will not address the cause of the problem.

Commenting on the findings, Dr Tony O'Brien, Consultant Physician in Palliative Medicine at Cork University Hospital said: 'This research reveals an alarmingly high prevalence of uncontrolled chronic pain in our communities. This serious public health problem must be addressed as a matter of urgency. Patients suffering pain require comprehensive evaluation and assessment by skilled healthcare professionals. Selected patients will benefit from a supervised trial of opioid medication in order to achieve an optimal level of analgesia, whilst preventing unwanted opioid adverse effects, including opioid induced constipation. The objective is to ensure that patients can experience the best possible quality of life.'

The research provides some valuable insights into patients' experience of the healthcare professional team. Despite the high proportion of patients continuing to suffer pain, the number of patients visiting a doctor declined over the course of the year from 83% at the beginning of the survey to 70% at the end. By the end of the survey, 58% had been given a physical examination, 22% were rated on a pain scale, 19% were sent for further tests and only 2% had seen a pain specialist consistently throughout the year.

Across the year, 44% of patients report feeling alone in tackling their pain and two thirds of patients feel anxious or depressed as a result of their pain. For 28% of patients, their pain is so bad they report they sometimes want to die. Patients report feeling trapped by a pain which may vary in intensity, but continuously affects every aspect of their life.

Commenting on the findings of the survey, Hans Kress, President Elect, European Federation of Chapters of the International Association for the Study of Pain said: "This research presents a unique insight into patients' journey in pain across Europe. It is shocking to observe that one year on, patients are still trapped in an ongoing cycle of pain and a large proportion seem to be losing hope. I urge patients to speak to their doctor if they are experiencing chronic pain or are concerned about side effects and not suffer in silence".

About the survey

PainSTORY (Pain Study Tracking Ongoing Responses for a Year) is the first study of its kind to track patients with chronic pain over one year, providing in depth insight into how pain impacts the daily lives of patients and the management of pain in 13 European countries.

The PainSTORY survey was conducted by an independent research company, Ipsos MORI, in collaboration with the following independent third parties:

- European Federation of IASP Chapters
- World Institute of Pain
- OPEN Minds

The survey was sponsored by a restricted educational grant from, and prepared in association with, Mundipharma International Limited.

Methodology

294 patients suffering from non-malignant (osteoarthritis, back pain / lower back pain, osteoporosis, neuropathic pain, mixed pain, other long term pain), chronic pain (i.e. lasting for more than three months) rating >5-10 on a pain scale at screening stage (where 0 = no pain and 10 = the worst pain imaginable) completed the survey. At the evaluation stage of the survey, patients' pain levels were ranked as mild (1-3), moderate (4-7) or severe (8-10). Respondents were studied for 12 months and research was carried out in 13 countries across Europe: United Kingdom, France, Germany, Switzerland, Italy, Spain, Ireland, Belgium, Sweden, Denmark, Finland, Netherlands and Norway by an independent research company, Ipsos MORI.

The study consisted of four waves of qualitative interviews between April 2008 and May 2009. Interim engagement activities such as diaries and 'life books' were sent to patients between the four waves to provide additional insight. Comparisons between baseline data and subsequent wave results showed how the impact of pain and pain management changes over the course of a year.

[1] Treatment includes prescription medication, over the counter medication and alternative medication
[2] The term 'constipation' incorporated bloating, stomach ache and stomach cramps

Source
PainSTORY

Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a health care professional. For more information, please read our terms and conditions.

Contact Our News Editors

For any corrections of factual information, or to contact the editors please use our feedback form.

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It seems that there are a lot of us out here that are experiencing poor pain-control. It almost sounds like poor pain control is the standard, rather than the anomaly.

I don't even bother going to pain management anymore. Since they do absolutely nothing for me. One time I had an ESI with fluoroscope and it worked magnificently (close to a year with no pain in that area). So ... what they do ... they refuse to use the fluoroscope again during the procedure. Might as well just open the needle and pour the drug on the floor.

I really feel for people that don't get adequate pain control. It's an obscenity.

Barb

[Mark N]

I agree that ER treatment depends a lot on the doctor on duty. My one episode with ER was a result of heart attack symptoms from my thoracic spinal problems. This time the symptoms didn't subside and got worse. My wife took me to the ER and my treatment was great. Because of the heart attack symptoms I was put to the front of the line and immediately hooked up to an heart monitor. They took blood to run test. While waiting on the results the doctor came round and I explained I was sure it was my thoracic spine using the terms all us spineys know. The doctor said "boy you sure know a lot about spines" and I told him after three surgeries I better know what my surgeons were doing. Fortunately, after initial results were mixed on whether I was having a heart attack when the second round of blood showed stress levels but no hear attack I was given a dose of my pin med and kept until the symptoms subsided. I know I was fortunate with my one visit but it was a good one for being 5 hours starting at 1 am.

[Kira]

I just got out of the hospital on Tues afternoon after yet another episode of rhabdomyolysis (life-threatening complication of flares of my mitochondrial disorder).

I knew I was having another episode of rhabdo since last Thurs. By Fri morning I knew it was bad enough that I had to go to the hospital. I called my PCP's office to see if he could do a direct admission to the hospital, but he didn't have any appointments and told me to go to the ER. I went to the ER Friday morning and they did check my labs. At that time, my CK (lab measuring how much muscle tissue is dead) was only a little elevated. Definitely above normal, even for me, but not super scary yet.

I told the ER attending that I knew I was having rhabdo and that it was definitely not normal for me. I told him that the past few times I have been hospitalized with rhabdo, exactly this same thing has happened. I am getting better at being able to tell when I'm getting rhabdo, and get to the Dr while my labs are still just bad, not horrible (this is what I'm supposed to do, to prevent kidney failure). Then, they blow me off and send me home, and I end up coming back within the next 12-24 hrs with horrible labs and get admitted to the hospital for several days.

What sucks, besides the obvious insult of them being dismissive, is that the risk of kidney failure and other life-threatening complications from rhabdo is much, much lower if they intervene early. Yet I have to fight them so much on it.

So, this time, they did give me a single liter of IV fluids in the ER that Friday, but then told me that if I thought I was having rhabdo I would just have to come back to get labs rechecked. I kept telling the ER doc that I DID think I was having rhabdo and that if he would just read my chart, this is what always happens. EVERY time.

I got him to call my PCP, and my PCP says he told the ER doc that I know when I'm getting rhabdo, that they need to take it seriously, that that was NOT a normal CK for me, and so on. But the ER docs still thought that it would be fine to just give me a liter of fluids and send me home.

Then, of course, I kept feeling worse and worse afterwards, and ended up going to the Infusion Center (outpatient IV therapy clinic) to get more fluids and labs rechecked. The nurse doing scheduling at the Infusion Center gave me all sorts of crap about how they were "so busy" and couldn't possibly fit me in that Saturday... then when I got there, the 2 nurses on duty were sitting there chatting about decorating & new couches, and there was only 1 other patient there and 6 empty rooms. Yeah, clearly SO busy. That nurse was acting like there was clearly nothing wrong with me since the ER had let me go home the day before... kept literally saying "the ER wouldn't have let you go if you weren't fine."

Then my labs came back and no one had even checked them in the computer, and the lab didn't call to "flag" the super-abnormal result like they are supposed to. I found out they were horrible because I asked the nurses to check again as I was leaving. She looked and, lo and behold, they were horrible. This was Saturday, on Labor Day weekend. If I hadn't made them look my labs up, no one would have looked at them until my PCP got into work on Tuesday, and I would have spent the whole weekend assuming they were fine since no one called me to say otherwise... getting no treatment for my rhabdo and having a dramatically increased risk of kidney failure and other serious complications.

Even after I got them to look and the nurses saw the horrible labs, they didn't bother to call the on-call doctor at my PCP's office like they are supposed to. The lab was also supposed to call with super abnormal results like that, and they didn't either. I know because I called my PCP's office and the on-call doctor didn't know anything about it. He sent me back to the ER to be admitted to the hospital. They admitted me to the hospital and I was there for a few days.

The hospitalization itself actually went okay, except for some communication issues about orders between my team & the cross-cover intern when no one was there on Labor Day. I had a great nurse that afternoon, though, and she totally stuck up for me. We made the intern call my attending, who promptly told him he was wrong and got him to fix the orders.

As far as pain meds go with the ER, I don't even ask for them until my labs come back bad enough that the ER docs clearly believe me and I'm being admitted. I never, ever want to give them the opportunity to act like I am just there for drugs. If they blow me off as a drug-seeker and it means leaving an episode of rhabdo go untreated, then I have a significant risk of kidney failure. So I don't want to give them any more reason to blow me off when I have rhabdo.

Sorry for the long post. I wish I could say that this was an isolated experience and they usally handle things better. But, more often than not, this is how things play out. Not once or twice, but over and over and over (13 documented rhabdos in the past 4 years, and probably several more that were missed because I didn't know to get my CK rechecked the next day after the ER blew me off once). It is a good example of why you HAVE TO be a good advocate for yourself and stay on top of what's going on with your body.

[Boxerlover]

Barb, it's good to see studies like this since it proves we are being under-medicated. Hopefully over time as more of these studies are done we can reverse this trend of backing off of pain meds.

Kira, this is one of the things that frustrates me about the "system". With as long as you have been sick and know what is going on with your body, you should be a direct admit ALL the time. The same goes for me and if I get my normal Uro he just does it that way but if it's a doc on call I usually have to go through the ER. Two times ago if I didn't have a great triage nurse I could have sat there for 13 hours with a temp of 103 from an infection from surgery and about 7 kidney stones. She immediately admitted me so I was lucky. Like you I usually know what I need and we have gone in and said I need 3 bags I.V. fluids, these meds and wait and then either I can go or get admitted. Some ER docs are great and others get very cranky and we kind of feel them out before we say anything.

Yes Alex you are right about the nurses. I have always had good ER nurses. On the floors that is another story.

Melissa

[Mark N]

Kira, with your history you would think they would have a hospital bed reserved for you and a set of instructions posted on what to do for you. There has to be a better way because most doctors don't understand your condition and the severity of it. I wish your doctor or the hospital would have some system in place to get you admitted when you come in and have levels that are off.

It is good to hear from you again and to hear you are home again. How has the pic line worked? Has it helped you avoid being put in the hospital?

[Kira]

Thanks for the empathy. The system is broken, that's all there is to it.

Mark, as far as the Port goes, I have to say it was WAAYYY easier this hospitalization from an IV access standpoint. No more spending 1-2 hrs getting poked by multiple people in the ER only to end up with an IV in my foot that blows a few hours later... now they just access the Port and I'm good to go. That is a big relief. As far as cutting down on hospitalizations, it's hard to say. I am doing IV fluids outpatient on a more regular basis now to try to cut down on flares, but still have to go to the Infusion Center for it because of some issues with getting set up to do fluids at home. Hopefully that will be fixed soon, though. The past 5-6 weeks have been really rotten, health-wise, so I'm not sure how much having the Port is helping with prevention. I moved to a new apartment Aug 1st (with lots of help) and my mito has been acting up ever since... haven't been able to get it quieted down. That is pretty common for me to have something trigger a flare and then the flare just lingers a while. Once the moving flare quiets down, we will see if the extra fluids help. Thanks for asking. Hope you're doing well. I haven't gotten a chance to read back through the older posts so I'm not too up-to-date on everyone.

[Mark N]

Kira, Hey a new apartment, I hope it fits your life better than your old place did. I remember the stories about trying to put a line in at the hospital and all the troubles the nurses had while you were feeling terrible needing the fluids. The pic line has to be a godsend with all that is going on when you are admitted to the hospital.

It is too bad that a simple thing like moving is such a dangerous thing for your health. I hope this flare calms down soon without causing you much more trouble. It is good to have in posting again and sharing your knowledge with the new people here.

[Smithc]

Hi Kira,

I hope you are feeling better. If not, could something in your new appt be aggravating your condition? New carpeting or paint?

Claire

[Kira]

Claire,

Still hanging in there trying to recover from this last episode of rhabdomyolysis.

I don't think it is because of anything in the new apartment. The way mito works, I am really sensitive to anything that disrupts my cells' delicate energy balance... any little thing that costs a little more energy (like exertion, fever, illness, heat/cold, etc) or that causes me to take in less energy (vomiting... i have horrible fasting intolerance).

I have a genetic mutation in an enzyme that is vital for our cells' ability to metabolize food into a molecule called ATP, which is our cells' primary source of energy. We need ATP to run all of the little reactions and things that keep our cells alive and functioning.

So, even when I am at my baseline, my cells barely make enough energy (ATP) to meet their needs. Then, when something happens to disrupt that energy balance, my cells don't have the energy reserves to meet their needs, and it causes a "mito flare."

For me, when I have mito flares, one of the things that happens is my muscle tissue gets damaged and some of the muscle cells die, because the muscle cells can't meet their basic energy needs (this is called rhabdomyolysis). I have a lot of problems with other organ systems, too, from the mito (GI, autonomic, CNS, heart, acid/base, breathing, kidney, muscles, severe fatigue, etc).

Anyway, the way moving is related to this flare is probably because moving was such a big energy expenditure for me. Once something like that happens, it takes me a really long time to get back to baseline (a lot of the time I never get back to where I was at before the flare). And with moving, it isn't like I sat there and packed and cleaned and carried boxes and moved couches myself. My brother and parents came up and did pretty much everything for me. But I had to be up and giving input onto what to keep, where to put things, and all of that.

Normally I lay on the couch almost all of the time. Sometimes I go out for appointments or very minor errands, but for me "exertion" doesn't mean exercise or anything like that... it means taking a shower, driving to an appointment 10 min away, sitting up & typing for too long, whatever. The "illness" that triggers a flare can be as minor as a cold or sinus infection. Getting overheated can happen when it's 75 degrees out (I have major heat intolerance from my autonomic dysfunction and literally get fevers from being overheated, which seriously stresses out my body & my poor mitochondria). "Fasting" doesn't mean days on end with no food, it means 7-8 hrs (I have to eat something in the middle of the night).

When seemingly little triggers like that happen, I get these big mito flares, which can be life-threatening and almost always result in an increased level of disability because I never seem to get back to my baseline.

Sorry for the babbling. I guess I just wanted to explain how the moving could trigger a mito flare. Thanks for caring...