The Emergency Room Travel Guide

Stacy Community Member July 02, 2007
  • I have lived and traveled all over the United States.  Being a chronic pain patient, this also means that I have needed to visit an emergency room in pretty much every city I've lived in, and many that I've traveled to.                                 
                                                                                                     
    Going to the ER is a hard decision for every pain patient.  How bad do things have to be before you break down and visit?  What time is best to go? What do you tell the doctor once you're there?  Unfortunately, some of these questions I can't answer for you, but I can give you some tips to make your emergency room visits easier.
    1. Always have a copy of your medical records available, including any imaging and/or radiologist reports.  If a new doctor can take a look at your history and documentation of your pain problem, he or she will be more comfortable treating you.
    2. Visit the emergency room where your treating physician has privileges. This way, if a doctor needs to be called in, maybe it can be one that you are already familiar with.  If anything, just telling the doctor treating you that you see a physician affiliated with the hospital regularly might help establish some credibility.
    3. Discuss and form an emergency room "plan" with your doctor.  This could mean just discussing what to do when your pain gets out of control (maybe you can form a plan that allows you to avoid the ER all together!), or actually establishing an emergency room prescription.  An emergency room prescription would be a letter written by your doctor, stating your problem and how best the physician in the ER can assist you.  It also has your doctor's contact information in case the emergency room staff need to discuss your problem with him or her.  An ER prescription can be very helpful when the emergency room doctors are not likely to know much about your health problem. 
    4. Take a family member or friend with you.  When you are sick or in a lot of pain, sometimes your head gets fuzzy.  Someone who is familiar with your heath that you would allow to speak for you in an emergency can be very helpful.  Discuss with this person before you go to the ER what the problem is and how they can help.
    5. Try to avoid visiting the hospital on major holidays and late at night on weekends.  They are very busy during these times and chances are you will have to wait a long time to see a doctor. 
    6. If appropriate for your problem, find out if there is an emergency room nearby with a "Fast Track" program.  These programs are alternative areas in the hospital set up for less trauma-oriented emergencies. You can be seen more quickly and treated by perhaps a nurse practitioner or physician's assistant, but still have access to the hospital's myriad tests and medications (and of course have access to the trauma areas or in-patient facilities if needed).
    Going to the emergency room does not have to be a nightmare.  Preparing beforehand can give you the confidence to go to the ER when your pain is out of control, rather than suffering at home.  Hopefully these tips will help to make your next emergency room visit easier, and your care in the hospital better.

  • Do you have any tips for chronic pain patients and emergency room visits? What has worked for you?

53 Comments
  • Hlp4pain
    Mar. 10, 2010

    I am sorry. I do not have any helpful info for going to the ER. I myself would die at home before ever going to any ER for an out of control flare of chronic pain ever again. My last visit was about a year ago. However, I will say that the best policy is to be 100% honest about what your current medications are and how often you take them. I had a close friend...

    RHMLucky777

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    I am sorry. I do not have any helpful info for going to the ER. I myself would die at home before ever going to any ER for an out of control flare of chronic pain ever again. My last visit was about a year ago. However, I will say that the best policy is to be 100% honest about what your current medications are and how often you take them. I had a close friend recently take a trip to the ER for pain. she had a new "boyfriend"/a man she had only been seeing for a short while with her and she had not had a chance to explain her chronic pain in detail with him so she was embarrassed to tell the intake person her current medications. Because of this lapse in judgement the ER doctor belittled her infront of her new guy. He all but called her a criminal and then refused to treat her. Needless to say she hasn't heard from her new guy since. It is seriously sad and can be very lonely when you live with chronic pain. The fear of being judged and lack of dignity with which some people can treat you.

    I think the nice lady who started this thread has laid out some great advice. I myself have learned to suffer at home. Though let me say, I have been in pain for 29 years. I have seen a lot but I have never seen days like these.

    One of my conditions is Endometriosis. And when I get my period all heck breaks loose. Years ago I would go to one of the local ER's and the dr's knew me by sight. I would bypass intake. The dr on duty would take me to a quiet room. Then would bring me a hot wet towel for my belly, an extra warm blanket and say; "awe, is it your 'stomach' pain again?" and then the dr would go get me a shot of medication, dim the lights and let me get some rest. Then the dr would return about an hr or so later and ask how I was doing and if I needed an other shot!! Those days, sadly, are gone. I would do anything to bring that sort of compassion back to ER's all over the country. What has happened to make those of us who suffer to be treated with such malice? I hope one day to feel well enough to fight on Capital Hill for all of us and for people like my friend who was degraded in front of her new friend just because the ER automattically (sp?) assumed she was trying to pull the wool over his eyes. I suppose he had reason. However, where's the humanity? He just as easily could have asked to speak with her in private or given her a chance to him if they could speak privately. Be well everyone.

  • Anonymous
    Zoe Hope
    Feb. 01, 2008

    I have just been released from hospital after an attempted suicide due chronic pain and subsequent ignorance at er. I was comforted to know that there are others that get to that stage and appreciate the advise

    • Anonymous
      Amy
      Mar. 17, 2008

                                     "A Conversation with a Chronic Pain Sufferer and an ER Doctor"

       

      Doctor, I suffer with chronic pain and I am hurting severely. What happened to your eyes doctor,...

      RHMLucky777

      Read More

                                     "A Conversation with a Chronic Pain Sufferer and an ER Doctor"

       

      Doctor, I suffer with chronic pain and I am hurting severely. What happened to your eyes doctor, they just rolled up toward the ceiling?

      What does it matter what kind of pain it is? - it doesn't hurt any less that it is chronic. 

      Doctor, I never thought you could get rid of all my pain, don't think so highly of yourself. 

      What do I want you to do? - see if we can get the pain down to say a six. A six is so much better than a ten, pain wise wouldn't you say? 

      I am so sorry to put you out, but my pain specialist's crystal ball broke and he wasn't able to foresee that neither of my pain meds weren't going to work for me this weekend.   

      Wow, the pain is better with just the muscle relaxer and Vistaril, no narcotics right, well who would have thunk. 

      Sorry, I can't think of the answer to your question in the two seconds you gave me. Somebody who looked a whole lot like you just ordered a drug that tends to make most patients a bit groggy.  Do you maybe have a twin? 

      Why am I crying and anxious? Oh it's just that, I've been mistreated, I mean treated here before. 

      I thought since I'm feeling better, I'd be discharged shortly so someone else could have this bed. 

      Who is the lady with the clipboard? I should have known, Miss Behavioral Health.  Seems she is the only one happy to see me when I need help here.

      Why did I take more narcotic medicine then prescribed? I was in severe pain and I flipped a coin, more pain medicine or coming here.  I didn't realize I'd lose both ways. 

      Doc, the next time you are so quick to brush me aside as drug seeking, psychosomatic, or a pain in the *** along with the many others suffering with Chronic Pain, remember you could be the one positive thing in our life that ends up saving it.

       

      Chronic Pain Can Kill

      Undertreatment of CNP often results in suicide. In a 2002 survey, 50% of CNP patients had inadequate pain relief and had considered suicide to escape the unrelenting agony of their pain. -The Chronic Syndrome Support Association

       

  • Anonymous
    staci
    Dec. 15, 2007

    sorry this hasnt any thing to do with that is thinkits neet so see someone else that has the same last name

     

  • MD
    MD
    Nov. 19, 2007

    Perhaps you would appreciate an alternative point of view.  as an emergency room physician, I take care of people who are dying. which, I think we can agree, is worse than people who feel like they are. Just yesterday, I treated a 21 year old who will probably never speak again after a car accident. 

     

    I also see, daily, people who come in and...

    RHMLucky777

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    Perhaps you would appreciate an alternative point of view.  as an emergency room physician, I take care of people who are dying. which, I think we can agree, is worse than people who feel like they are. Just yesterday, I treated a 21 year old who will probably never speak again after a car accident. 

     

    I also see, daily, people who come in and lie to my face to get narcotics out of me.  There are people who ***** their fingers to feign blood in their urine for kidney stones. people lie about car accidents that never happened, or for which they have already been treated earlier that day at another er.  They tell fabulous stories of lost scripts, lie about how much pain meds they have been prescribed.  They look me in the eye and they lie to me.

     

    People, it turns out, use narcotics to get high. I know, shocking. People are also addicted to narcotics (no one here, though, right?).  People even sell their percocet...Gasp.  Sometimes, they even abuse the system to get narcs.

     

    Now, for every minute I spend with some one who is there trying to get narcotics, either for real chronic pain, or for faked chronic pain,  there is someone's grandmother, mother, father, or whatever, possibly dying, literally dying, from a disease process that I cannot interrupt.  Hmm.  And, if that other person actually dies, then their family can sue me personally, and place into jeopardy 11 years of training, not to mention publicly humiliate me, and threaten the livelihood upon which my family depends. 

     

     Every second you spend in an Emergency Room bed, you are keeping someone in the waiting room whose problem, if there is a delay in treating it,  might kill them, might make them blind, might cause a needless amputation.  maybe it is a kid with meningits whose care you are delaying by sitting in that bed, because you failed to plan for your 'breakthrough pain'.  will you be the one to tell the horrified and angry greiving parents of that kid that their hope and joy will be deaf or blind or in a persistant vegetative state because the antibiotics were delivered late? no. you will take your drugs and complain later on some website about how you were misunderstood.

     

     Here is an example, real, of what I mean. An MD friend of mine was in the room with a chronic pain person, or some type of drug seeker (honestly, how can we tell the difference?  Drug seekers forge notes all the time from md's they make up, they often have friends along who will share in the percs afterwards), while a woman who does not have a headache every week died in his waiting room from a brain aneurysm.  died. she had just given birth the week before, leaving her husband with a dead wife & a breastfed child with no mother. If that bed, and that dr.'s time had not been eaten up by someone who was there only for narcotics, that mother might be alive today.

     

      None of these posts mention or contemplate the cost to others of going to the er.   No mention that maybe hanging around in an ed all night ("I got my own room!") for a foreseeable and nonlifethreatening condition could kill someone else. My MD friend was devastated.  Absolutely devastated.  he had to be the one to tell the husband/father about it. he is being sued. I don't know if the narcotic deficient pt was satisfied.  Maybe that would make the death worth it, huh, if he could have handled that breakthrough in the ER?

     

      So, when you trundle into the er with your years of often medically unverifiable and (wow, really?) narcotic-requiring syndromic complaints which are responsive only, huh, to large amounts of addictive and euphoric drugs, (IV, please) and you bring your friends and your bring your extensive records you want me to memorize, and you expect a room right away, and you bristle when questioned about the need for IV narcotics, and you fail to explain why, if this has been going on for years and there have been 'breakthroughs' before you don't have some sort of plan in place, don't be surprised that the er staff is not delighted to see you.  You could be killing-literally killing-someone else, whom they are there to protect. and you could be placing their personal, hard-won livelihoods in jeopardy.

     

     Chronic pain, when real, is a terrible thing, and my heart goes out to those who truly suffer.  However, don't pretend that you have more of a right to me, my time, or that er bed, than the patient who is in an emergency room for something that might actually kill them.   take the responsibility for your ailment. Get a pain specialist, make a plan with that person for your 'breakthroughs'. Don't travel the earth hitting up ERs for narcotics, and don't publish guides on how to abuse the ER on the internet.

    • Anonymous
      EMS
      Nov. 19, 2007

       

      Let me begin this by saying that I do not suffer from chronic pain, so please understand that my response is purely a gut level reaction to your post.
      I feel that you did a disservice to your profession. I am shocked and dismayed at your cheap histrionics and find your comments highly insulting. They actually made me question your mental stability. There...

      RHMLucky777

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      Let me begin this by saying that I do not suffer from chronic pain, so please understand that my response is purely a gut level reaction to your post.
      I feel that you did a disservice to your profession. I am shocked and dismayed at your cheap histrionics and find your comments highly insulting. They actually made me question your mental stability. There is no question that you take care of people who are dying...and there is no question that they deserve your complete attention.

       

      "Now, for every minute I spend with some one who is there trying to get
      narcotics, either for real chronic pain, or for faked chronic pain,
      there is someone's grandmother, mother, father, or whatever, possibly
      dying, literally dying, from a disease process that I cannot
      interrupt."

       

      Gross exaggeration. I am a former paramedic, and I have spent a lot of time in ER's...trauma centers....Not once do I remember a doctor saying that for every minute he spends with someone in chronic pain, another patient dies...literally dies..possibly dies. Nope, not a grandmother, father, aunt...not even some "whatevers"

       

      "Every second you spend in an Emergency Room bed, you are keeping
      someone in the waiting room whose problem, if there is a delay in
      treating it, might kill them, might make them blind, might cause a
      needless amputation."

       

      What I wonder about is a physician/hospital who allows patients to die...amputate...vegetate....in a waiting room while treating ANY other patient who needs them to a lesser degree. The excuse that it happens because a pain patient is in one of the beds is ridiculous.

      What kind of a hospital do you work at? This is a little scary.

       

      "Will you be the one to tell the horrified
      and angry greiving parents of that kid that their hope and joy will be
      deaf or blind or in a persistant vegetative state because the
      antibiotics were delivered late? no. you will take your drugs and
      complain later on some website about how you were misunderstood."

       

      This is certainly a sad scenario, and one that you have hopefully fabricated. It implies that you have an issue with prioritizing your time, and then blaming it on someone else.

      I am sorry about your friend who lost the young Mother. I think you left out so many variables in your attempt to place blame on the chronic pain patient. A brain aneurysm is not a quick diagnosis, and sadly enough headaches are low priority on the triage scale. So, can we also blame the triage nurse who only knew that the woman had a headache? or perhaps the infant with the ear infection who got a bed before her. We could even blame the doctor who didn't know the woman had an aneurysm. Why place blame at all?

       

      "So, when you trundle into the er with your years of often medically
      unverifiable and (wow, really?) narcotic-requiring syndromic
      complaints which are responsive only, huh, to large amounts of
      addictive and euphoric drugs, (IV, please) and you bring your friends
      and your bring your extensive records you want me to memorize, and you
      expect a room right away, and you bristle when questioned about the
      need for IV narcotics, and you fail to explain why, if this has been
      going on for years and there have been 'breakthroughs' before you
      don't have some sort of plan in place, don't be surprised that the er
      staff is not delighted to see you."

       

      If you had even one redeeming point, you lost it here. Your arrogant condescending attitude only serves to prove what has been said over and over on this board about ER doctors. That really saddens me because I believe that there are many great ER docs out there, and as with anything else including chronic pain patients, it only takes one bad apple.....you know the rest.

    • MD
      MD
      Nov. 20, 2007

      I have nothing but respect for paramedics past and present.  If you really were one, hats off.   If you feel the prior post was provocative, that may be a good thing.The math here is very simple. Look at the prior posts. Ask your browser to highlight the word "wait."  see how many times it comes up?  To use a titanic analogy:...

      RHMLucky777

      Read More

      I have nothing but respect for paramedics past and present.  If you really were one, hats off.   If you feel the prior post was provocative, that may be a good thing.The math here is very simple. Look at the prior posts. Ask your browser to highlight the word "wait."  see how many times it comes up?  To use a titanic analogy: the ship is sinking at their are not enough boats.  You don't have to believe me, since you don't like me, here is an article from MSNBC http://www.msnbc.msn.com/id/7995137/#

       

      "At a time when the number of hospital emergency departments has been cut by 14 percent, visits to the ER reached a record high of nearly 114 million, according to Centers for Disease Control and Prevention data for 2003, the most recent data available.

      During the same time period, the U.S. population rose 12 percent and the 65-and-over population rose 9.6 percent."

       

      As someone who works in an ER (not, with all respect, someone who used to work in a related field) let me explain what this means. this means a third of the population comes annually to a shrinking resource . This means more older patients for every bed, which means more sick patients for every bed and more complicated patients for every bed. No major trauma center at which I have worked has enough ER beds, or enough ICU beds.  This is the reality.  

       

      Here is how the syllogism has to work: 1. There are a limited number of beds in ER's and that number is going down.  2. there are ever more patients of all varieties (from head bleeds, to chronic TMJ) who want one of those beds.  3. Therefore, more people will have to wait for beds. 4. waiting for a bed if you have a truly emergent condition can kill you.  5. even the best triage nurse (despite what you seem to think you know about this with your 'scary' comment--you're right it is scary, but your fear does not make it untrue) cannot always easily differentiate a life threatening complaint from a nonlifethreatening complaint from talking to a sick person for 5 minutes. they informedly guess, and usually they are very good.  But yes, not infrequently they have pts sitting next to you in the waiting room whose delay in getting back will contribute to death, amputation etc. Even if you don't think they look sick (as a prior poster suggested).

       

      Ask anyone in the business about it, it simply is not a controversial claim. In the last week alone, I had a heart transplant pt who could not get a bed because a chronic pain pt.  Don't tell me what happens in ERs unless you actually work in one

       

      6. therefore, the more nonlifethreatening people who clog this precious common & limited resource, the more delay that ensues, and delay in medical care kills people.   Ask any  paramedic how they feel about people calling 911 for nonemergent complaints, and you will get an earful.  It is the bane of their existence (that and obesity). 

       

      Finally, I don't

    • MD
      MD
      Nov. 20, 2007
      Finally, either you know what the facts are, or you don't. you don't. Insulting me doesn't change anything.
    • Anonymous
      EMS
      Nov. 20, 2007

      It is not my desire to kill the messenger, I have read the statistics.  My problem is with the way you send your message.  If you had in fact read the posts prior to yours you would know that nobody is advocating the use of the ER as a primary source of treatment for chronic pain.  Actually it is quite the opposite. Playing the "pin-the-tail-on-the-junkie"...

      RHMLucky777

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      It is not my desire to kill the messenger, I have read the statistics.  My problem is with the way you send your message.  If you had in fact read the posts prior to yours you would know that nobody is advocating the use of the ER as a primary source of treatment for chronic pain.  Actually it is quite the opposite. Playing the "pin-the-tail-on-the-junkie" game is de-humanizing to a group of people who have no need to apologize for being in severe pain.  If any doctor refused treatment to a patient who was in a car accident he would be sued.  Severe Chronic pain may not be as visible, but it is every bit as real.  The person who suffers from intense pain does not deserve to suffer the additional insult of humiliation, suspicion, lack of respect and understanding. 

       

      In an earlier post a very important point was made regarding ER visits. Perhaps you missed it.

       

      "The American College of Emergency Physicians recommends keeping an "emergency file" containing your insurance cards, a list of all medications you are taking, a list of any chronic conditions you may have, operations you have had, and allergies (particularly drug allergies) that you have. These can be kept in a folder that you can easily grab on the way out the door should an ER visit be necessary. You can also include copies of recent laboratory or diagnostic test results. Doing so may help reduce both the cost and waiting time associated with your ER visit."

       

      "ER visits are a legitimate part of pain management. Pathology is not static. Sometimes a fall, or activities that a pain patient should not be doing, or any number of other factors, can cause an acute exacerbation of the pain. That is where the ER fits in. However, the ER should NOT be a substitute for adequate pain management in the first place."

       

      In your first post you wrote:

       

      "People, it turns out, use narcotics to get high. I know, shocking. People are also addicted to narcotics (no one here, though, right?). People even sell their percocet...Gasp. Sometimes, they even abuse the system to get narcs."

       

      What is really true is that a person in Chronic pain does not receive a high, the euphoric sensation sought by an abuser is devoured in the chronic pain patient by the pain itself.  What does happen is that the person using the narcotics in a legitimate case will experience a lowering of the pain intensity. A recent survey of 11,884 patients who were treated with opioids over a 4 year period found that only 4 developed addiction problems.  

       

      Adding the snarky comment...

      "(no one here, though, right?)."  only serves to demean those on this board who so richly deserve the support of the medical community.

       

      "Chronic pain, when real, is a terrible thing, and my heart goes out to those who truly suffer."

       

      Spoken a little too late.

       

    • MD
      MD
      Nov. 20, 2007
      You once again fail to address the essential problem. Calling me "snarky" does not increase the number of beds in the department, it does not lessen the deadly effects of overcrowding. It does not relieve from responsibility those who make what I feel are selfish plans to go to the Emergency room in the face of a bed crisis.  You have not addressed...
      RHMLucky777
      Read More
      You once again fail to address the essential problem. Calling me "snarky" does not increase the number of beds in the department, it does not lessen the deadly effects of overcrowding. It does not relieve from responsibility those who make what I feel are selfish plans to go to the Emergency room in the face of a bed crisis.  You have not addressed the question of why, if breakthrough pain is such a routine aspect of this disease, there are no other plans appear to be in place except for dashing into the emergency room and taking a bed away from someone who might just die.

      I did read the posts, and the article as well. Take rec # 5:

      “Try to avoid visiting the hospital on major holidays and late at night on weekends.  They are very busy during these times and chances are you will have to wait a long time to see a doctor.”

      Honestly, does that sound like advice you would give to someone having a true medical emergency?  A myocardial infarction?  Absurd.  It sounds more like someone planning a trip to the zoo, or, more aptly, a bar.

      I think some of the posts you’d prefer I did not dissect too closely.

      You are right, though, my tone betrays exasperation with the “avoid major holidays” school of emergency department users.  This came across to you as dismissive of the pain that chronic pain sufferers feel.  You are here to rescue them.  Bravo. Not that it is particularly germane, or that I need to tell you about it, but I do not mean to dismiss anyone’s pain, and I said clearly that I didn’t. You even quoted me.  My job is to alleviate pain and I do it. Weekend nights, included.

       But let’s not pretend that the  ‘avoid major holiday’ er visitors don’t bump the heart transplant guy and the brain bleed girl out of a bed and into possible devastation.  There is more at stake in this than your instinct towards chivalry, or who is ‘snarky,’ or whether or not you feel that I feel that other people feel pain.  In the ER, we deal in things more real than that.   Those major holidays, I will be in the department, maybe with vomit or blood on me, trying to find and save that pt who just might not live to see the next one. Will you be at home?  Will you be assuming a bed will await you when you feel your heart start to stop?  I am sure you will be all lancelotty when your turn comes to wait for a bed occupied by someone with an “avoid major holidays” emergency. Or, maybe you'll wish you were a little more snarky.
    • Anonymous
      Consultant too
      Nov. 23, 2007

      I'm one of those that MD would hate... but, because of all the times they ignored and judged my chronic pain, every time they failed to assess me properly because they couldn't see me as a person, I became the statistic of the person who didn't receive the care they needed. Even as a healthcare professional, they then used my gender to evidence...

      RHMLucky777

      Read More

      I'm one of those that MD would hate... but, because of all the times they ignored and judged my chronic pain, every time they failed to assess me properly because they couldn't see me as a person, I became the statistic of the person who didn't receive the care they needed. Even as a healthcare professional, they then used my gender to evidence the hysteria, blaming my hormones for my inability to "hack" pain.He's not going to believe me like he didn't believe the Medic. See, he is alone on the peak of the mountain.

       

      You, MD, assessed me, saw me as obese, female, as having "nonsense" pain, and dismissed me. You blamed that I couldn't hanlde the stress of my demanding career and suggested Psych. You said my shortness of breath was because I was out of shape, and the shadows on my chest X-ray because of my fat. You, almighty one, judged me, saw me as a time waster keeping you from serving that noble, worthy patient who had the good sense to risk their life to see you.

       

      But you missed that my problem was beyond not your valuable time but your withered assessment skill, and as a result, I nearly lost use of my spinal cord from T4 down, because the real problem was infectious discitis- hard to diagnosis, hard to image, and only assessable when a doctor finally took the time to not remove my personhood before he put on his gloves.

       

       You missed the shadows weren't my fat, they were pleural effusions and fluid  brought about by the sepsis. All brought on from a cracked tooth and a dental abcess I didn't know I had. CRP over 800 and you still ignored me. ESR over 100.

       

      Only when a doctor worth his salt and his title finally looked a little deeper did they find out that I was not an attention seeker, I was in real trouble with less than a fraction of a mm between me and a wheelchair- then finally the whole history made sense.

       

      How in hell you can you tell if that person with chronic pain isn't facing a life threatening episode? How can you tell that they are not needier than anyone else? Truth is- you can't, thats the argument you yourself made. So instead of treating them like rubbish, assess them and give them your best: that's what you owe them, my friend.

       

      You were not deluded into taking up medicine; you knew the risks. You took an oath to do no harm- to keep the sick from harm or inustice... you have an obligation- its why you get the paycheck and privilege that you do- to treat people not only with your skills but also with your morality intact... "remaining free of all intentional injustice".

       

      When you start to judge people, seeing one as more worthy than another, then you have missed the boat and you are as close to disaster at your own hands as I was to the hands of the man who thought and acted as you do, arrogantly, with disregard for the needs of the people you "care" for.

       

      There IS room in ER/AE/Casualty for anyone who truly needs it, whether its chronic pain with exacerbation or MI. How many times do you do CYA procuedres onto to find out that there was really something wrong? Do blood work and find out Geeze, that big fat faker actually DOES have an elevated trip? How many of the people in crisis that you outline as being there because the beds are clogged with those you describe as unworthy, are actually there because one of your colleagues ignored them someplace else? The baby with meningitis- I will bet you the price of the seatcovers in your BMW that before that child came to ER, the mother called the GP who said "stop overreacting its a cold", or asked the nurse who rolled her eyes and handed her nappy rash cream.

       

      When we become as you are, we no longer educate or support patients, we punish them for our shortcomings and those of our colleagues. We no longer care for people, we tolerate them for the perks we ourselves receive; and we blame them, when we can't fix them, when we can't handle the stress, and when we have lost the plot because we have to face that we too have weakness and limitation to our almightiness which we find not so allmighty after all.

      I now have chronic pain- fibromyalgia- because of the months and months the very real symptoms and pain were ignored. Now, when I show up in your domain, the least you could do is treat me with compassion because its not my fault I am there, it's yours. And when I can't move becuase the allodinia is overwhelming me, and I am incontinent because I can't stand up without help and no one answers the call light, don't accuse me of looking for a high.

       

      You desperately need some pain, my friend, because without one, you are going to be either sued or you will someday be cared for someone just like you. Only then will you understand. Physician, heal thyself.

       

      Why can I say that? Because I was you. I was the consultant, judging others. I was the one with the answers, like you, and I was the one who could point my finger at the unworthiness around me. Then I became not healer but patient, and patient I remain, because like me, my healer decided to be judge instead.

       

      You went into medicine to heal. Get out of ER- its turning you into the monster you always said you never wanted to become. Think back- you know you said it, we all did - we saw the tyrant and said "I hope I never become like him".... You may have a nice car, a nice house, and a trophy partner, but all the money in the world can't make you human.

       

      Think back..." If I fulfill this oath and do not violate it, may it be granted to me to enjoy life and art, being honored with fame among all men for all time to come; if I transgress it and swear falsely, may the opposite of all this be my lot."

       

      Sounds like you are as addicted to the high of your prestige and "perks" as those you look down on for their "percs". Pride goes before a fall- better watch out- it's going  to be a doozy to fall from as high and mighty as you are.

    • MD
      MD
      Nov. 24, 2007

      So, she makes some good points through the nastiness.  1. she is correct, the more often you go to the emergency room, the harder it will be to get people to take you seriously when you are in danger of something besides your chronic pain. Maybe unfair, I am not trying to tell you how the world should be, just how it is.  I do not believe I make this...

      RHMLucky777

      Read More

      So, she makes some good points through the nastiness.  1. she is correct, the more often you go to the emergency room, the harder it will be to get people to take you seriously when you are in danger of something besides your chronic pain. Maybe unfair, I am not trying to tell you how the world should be, just how it is.  I do not believe I make this error, but I know it happens.

      2. Sometimes when you tell people something they don't want to hear (e.g., there is a bed shortage, and taking a bed through failure to plan can cause other people harm) you will be attacked. She even attacked my imagined wife, though she does not know my gender or my spouse.  Imagine standing trying to help this charming snarler and 10 like her every day.  Sure, lady, there is infinite room in ER's, no  one ever has to wait when you go in, I misdiagnosed you, my wife is a trophy, I have a bmw with seat covers and whatever else you say, you can do whatever you want, it never affects anyone and please don't hurt me.  Happy? unlikely.

    • Anonymous
      Consultant too
      Nov. 25, 2007

      I'm not really suprised by your answer: it all focuses on how you are right and good, and I am bad. I suspect the accurate points I made were as much about you and your attitudes as anything else, but you aren't going to go there, are you?

       

      Just to clarify, I was quite happy and a believer in the system before those who chose to judge me- without...

      RHMLucky777

      Read More

      I'm not really suprised by your answer: it all focuses on how you are right and good, and I am bad. I suspect the accurate points I made were as much about you and your attitudes as anything else, but you aren't going to go there, are you?

       

      Just to clarify, I was quite happy and a believer in the system before those who chose to judge me- without the benefit of me being able to appeal as you have been able to do about the impact or unfairness of that judgement- ruined my career prospects (who wants a consultant in a wheelchair?), left me with chronic and often intractable pain, doubts about the soundness of my mental state because of the frequent "mystery" admissions (even though my complaints were eventually proven to be a significant medical problem), and with a need for a level of assistance in my life that I neither want nor cherish.

       

      I stand firm in my assertion that everything you do in life has to do about power and appearing superiour, including the care you deliver; it's my assessment of your presenting symptoms : arrogance and diminished awareness of the personhood of those trusting you with their psyches and health;  and since as you are for all intents the patient being diagnosed,  once I assess you are a time waster and attention seeker its not your right to change or challenge that assessment, as by your assertion in your post, the assessor has a god-like right to cast judgement on worthiness and motivation.

       

      If I am happy in my life, which to be honest I really am considering the unceccessary nature and extent of the physical problems I now have, its because thank heavens Doctors like you get sued out or burned out of practice,  (or grow and learn from a mistake that didn't cost them as much as it should have) before you drive (or kill or maim) all the decent ones out.

       

      I have now a doctor who not only sees me as a person, caring for me based on what WE determine as my needs not just because of my qualifications but because he recognises that others don't see "pain patients" like he does; his care is set out to protect me from power junkies like you. Its better to crave heroin than power- at least the heroin addiction is out in the open; the power addict makes it look like something else. Can you really deny that you are in this for the healing and not the power? Can you honestly say you don't soak up the adrenalin and the allmightiness of your role? Be honest... there is research against which your answer can be measured (do you read the NEJM?)

       

      Now to get to teh allegory that you were too protective of your ego to notice: when others make judgements about you based only on their tainted opinion of your presentation rather than on an assessment of the real person, it can be hurtful, inaccurate and perhaps even misleading, preventing the person from being taken as seriously as they need to be.

      Doesn't that teach you anything?

       

      The fact in all this you haven't even stopped to think "Gee, maybe I should reflect- is any part of this me?" is most worrying- and the first thing the person defending you in a negligence or other malpractice complaint will ask you to do.

      Save them time, and save your patients: reflect now and look at yourself as patients have to see you. And heal yourself.

       

      If all you saw in my post was an attack from an angry person, then your assessment skills are again failing you- see yourself, doctor. And learn- and change. If all you do is cast blame on me, then you are missing the entire point. If you would like I can post some guidance on reflection for you... or do you have access to that yourself? If you never really look at what you do and how you do it, then you will never live up to your potential, and as it says in the oath, if I transgress it and swear falsely, may the opposite of all this be my lot.

       

      You have a chance many others never have. Grow and become a REAL healer and fight your power addiction! Judge not- or you know what comes next.

    • Anonymous
      Zoe Hope
      Feb. 01, 2008
      Shame on you. Did you not take an oath? We in the civilisized world i.e. Australia or UK take chronic pain seriously and it is in itself a life threatening condition. Perhaps you should seek employment within an environment that does not involve living things. Shame
    • Anonymous
      Heisenberg
      Jan. 20, 2014
      I hope this 'MD' gets an opportunity to treat a cartel member in pain like a drug seeker. When you go to the ER, take someone with you. When a loved one is in pain, I never let them go alone. I always go armed also carrying a wad of 100s, but that's just me. POS medical pretender.
  • Betty Boop Too
    Nov. 16, 2007

    I've been a chronic pain patient for nearly five years.  I have read and found so many horror stories that others have shared about their visits to the ER, that I am terrified to be forced into going.  Since my pain started in early 2003, I've only been to the ER on one occaision.  And it was my original weekend that I broke down in severe...

    RHMLucky777

    Read More

    I've been a chronic pain patient for nearly five years.  I have read and found so many horror stories that others have shared about their visits to the ER, that I am terrified to be forced into going.  Since my pain started in early 2003, I've only been to the ER on one occaision.  And it was my original weekend that I broke down in severe pain.

    I have discussed this situation with my PC physician and he and I have a emergency plan.  I have a file on my pc in Word, that has several pages of medical information listing all my physicians and their contact information, all the medical procedures that I have had done on my spine, and I also included my opiate paim medication 's contract, with an additional listing of dosages and every medication I take, so the ER doc has full knowledge of what I have agreed to with my own phyisicians.  My Primary care doctor actually recomended that I carry this information as he did not want me to be abused by an ER physician or his staff.  (his words not mine).

    When I travel I keep a manilla envelope packed in my suitcase or carry on, and when we spend weekends up in Seattle visiting our son in college, I also keep an envelope in my purse incase of any accident for paramedics to see too.

    I have recently been pondering the idea of a medical elert bracelet to put a note on the back for medical personel to see that I'm a chronic pain patient and to search my purse for additional medical info.

    I have been blessed that for the most part, I have plenty of medication on hand to treat myself, I've had a few occaisions that I've had to have my doctor contacted, to allow me to make any adjustments to my meds until the higher levels of pain have passed and then instructed to return to my regular baseline dosage after the pain comes back under control. 

    I have fallen a couple of times and I have also slipped in the tub or shower a couple of times too, that have required a temporary dosage change to handle the higher levels of pain.

    I know if I were to fall on the ice or snow this winter that I would have to call for help and depending on the level of pain, I would go to the ER if I needed too.  As we never know what other injury that we may have.

    I think that Stacy's advice to be prepared is very good and all pain patients should be prepared for the occaisional necessary visit to the ER.  I don't have migraines, but both my mother and sister do and they are forced a few times a year to be taken into the ER to get the series of two injections that help them to stop their headaches and sometimes are the only way they can regain any control, I am normally the person they call to go with them and drive them.

    I think it's tragic that some pain patients have been treated as criminals in the ER, but then on the other hand, we must place ourselves in the shoes of the doctors and staff in the ER and also consider their position and how many times they have had someone show up that is a drug seeker.  I choose to give them the benefit of the doubt and also to avoid having to use the ER, unless absolutely nesessary.

    When I have to go, I will be prepared with all my documentation, that also hold instructions from my pm /pc docs, as to what they need to do to treat me.

    I really think for some pain patients that for what ever reason, they may not of found their correct dosage, they may be severely undertreated and having the knowledge that I know that it takes several months to years to finally find the correct dosage of meds, these individuals may need to see the ER more than some of us who've already been through the dreaded undertreatment of pain in todays medical world.

    I have one more comment then I'll shut up!

    When you travel anywhere, you should always have your meds in their correct prescription bottle with the correct label on them.  Whether you are flying or driving.  You could be unfortunately delayed and also find your self in jail, if you carry your prescriptions in another container that does not have the correct and legitimate information on the bottles.  If you choose for what ever reason to carry your meds in a plastic baggie or what every you feel seems handy, you can find yourself a a bind, as you are transporting a controlled substance and without the rx label you can really get into trouble.

    I really think as Chronic Pain Patients that we have to really follow all the directions and be very responsible with our medications, it is up to us and our behavior to make sure we are always watching out for all who suffer in pain by being good stewards with our meds.

    Now I'll hushTongue

    Thank you Stacy for this share post and to everyone else who has shared their comments and concernes.

    Betty

    Betty

    • Stacy
      Nov. 17, 2007

      Wow!  Thank you so much, Betty, for your thoughtful reply.  You are truly an amazing asset to this website and I am glad you found us.

      Your tip about travelling with medication is so true and is a lesser known tip about being on opiates...you always have to travel with your meds in the same containers they came in with your prescribing info on them.....

      RHMLucky777

      Read More

      Wow!  Thank you so much, Betty, for your thoughtful reply.  You are truly an amazing asset to this website and I am glad you found us.

      Your tip about travelling with medication is so true and is a lesser known tip about being on opiates...you always have to travel with your meds in the same containers they came in with your prescribing info on them.. if you use medication that comes in big boxes, you have to bring the boxes as well.  If anyone was to find the meds on you without documentation you could be in big trouble.  

      As far as the fear of getting in an accident and not being able to communicate your problems, I totally understand and share that fear.  I have a SharePost about this exact subject coming up..  maybe I will move it up, because there is interest..I have about 10 SharePosts in the pipeline before the emergency/medical alert one, though. Anyway - keep an eye out for it!

      Let me know if you guys have any questions or comments!

      Sincerely,

       Stacy 

    • Betty Boop Too
      Nov. 17, 2007

      Your such a dear!  Heart

      It is I who is the blessed one to of stumbled through the door.

      I was going to add some more thoughts about travel and our meds, but went back and found the original topic and felt I was really swerving off course,Blush so I decided I'd wait till you created your next few sharepost and my additional comments may be better suited for your...

      RHMLucky777

      Read More

      Your such a dear!  Heart

      It is I who is the blessed one to of stumbled through the door.

      I was going to add some more thoughts about travel and our meds, but went back and found the original topic and felt I was really swerving off course,Blush so I decided I'd wait till you created your next few sharepost and my additional comments may be better suited for your new topics.Cool

      Sorry, I think the Fibro-Fog get's me off course, even when I think I'm all clear headed. BlinkLOL!  DUH!Cheesy

      TongueBetty

  • Anonymous
    Amy
    Nov. 10, 2007

    Hello,

    I suffer with fibromyalgia, muscle spasms, and Reflex Sympathetic Dystrophy. There have been times I had no resort but to go to the ER. When I moved to Indiana in July, I called every PCP in the phone book, they allwanted payment in full which I simply could not do.

     There were times that the pain got so bad I would have to call an ambulance,...

    RHMLucky777

    Read More

    Hello,

    I suffer with fibromyalgia, muscle spasms, and Reflex Sympathetic Dystrophy. There have been times I had no resort but to go to the ER. When I moved to Indiana in July, I called every PCP in the phone book, they allwanted payment in full which I simply could not do.

     There were times that the pain got so bad I would have to call an ambulance, my morphine just wasn't working. After 4-5 visits, I got my records from the hospital. I was totally misquoted, called psychosomatic, and my severe anxiety became the main issue.

    When I lived in NM, I was seeing a pain specialist who was in Pueblo, Colorado a good hour away. Because he knew he would not always be available to me, he wrote a letter for me to carry and give to an ER should I feel I need to go. He knew what I went through at our local ER. He stated my diagnosis and that I may need to visit an ER from time to time for pain management should I have breakthrough pain. Well, the inevitable happened, I had to go to the small town local ER and of course I got the same doctor I had seen on numerous occassions. He read the letter and told me this was entirely unacceptable. That the ER was not a pain clinic and my specialist needed to give me pain meds not him. I sarcasticaly stated, well I'll just run up to Pueblo tonight, its only Saturday about 10:00 pm. I'm sure my specialist will be happy to meet me at the surgery center for a spinal block. The ER doctor made sure I did not get pain medication and informed the other staff not to give me pain meds if I came in. Then he wondered why I overdosed on Hydrocodone twice. At one visit he arrived in the ER and looked at me and said, what's happening- I've got ten other patients. One doctor even asked me, have the Drs told you this is psychosomatic, to which I replied," no they haven't." She then asked if she could take a medicine bottle out of my purse. I replied yes, knowing exactly what she was wanting to see. When she asked what it was because I had taken the label off, I gladly told her "Tylenol and aspirin, if you look real close you can see that I wrote just that on the bottle but it has worn off a bit." Once after a syncope spell where I was put on a backboard with my head strapped down for a good hour or more, I started having severe pain in my left side and began to cry. The doctor asked me why I was crying and I replied because my side is killing me. To which he replied, well you've had that pain for a long time now. I just looked at him in disbelief. OK, that makes it feel so much better. 

    I am so afraid of being judged because I do have mental issues with depression and anxiety that I am afraid to say anything anymore. It is always twisted no matter what I say that makes me look like I'm bonkers.It's like I'm damned if I do and I'm damned if I don't.

    I advise everyone who has chronic pain to always take someone with them to the ER to help witness any inaccuracies. When your records recommend psychiatric counseling and your reporting inaccuracies in your records, it's a lot easier for the records department to believe you when you have someone backing you up.

     

    Amy Smith

    Geneva IN

    • Stacy
      Nov. 17, 2007

      Dear Amy,

      Gosh, I am so incredibly sorry about the cruel and brutal treatment you have received.  It is not fair and you have the RIGHT to be taken seriously!  I hope now that you have a primary care physician or pain specialist who does not allow this kind of thing to happen to you.  No one deserves to be treated with disrespect *just* because...

      RHMLucky777

      Read More

      Dear Amy,

      Gosh, I am so incredibly sorry about the cruel and brutal treatment you have received.  It is not fair and you have the RIGHT to be taken seriously!  I hope now that you have a primary care physician or pain specialist who does not allow this kind of thing to happen to you.  No one deserves to be treated with disrespect *just* because of the type of medications they are on... it's so awful that JUST because of a type of prescription med we are on we can be treated like second rate citizens .... diabetics would never be treated like this because they are on chronic medications.  I'm hoping that in the future this attitude is improved...but we have a long way to go, unfortunately.

      Hang in there!!!!!

      Sincerely,

       Stacy 

      PS - I also recommend getting a copy of your records from your doctors after every visit.  This way you have up to date records in case something happens.. you also know what your doctor is recording on them and can address any inaccuracies very quickly.  You might not be able to get your records for the appointment you just had *right* after the appointment... if that's the case, just get them after the next appointment.. that way you are only an appointment behind all the time.  hope this helps!
    • Anonymous
      Amy
      Nov. 18, 2007

      Thanks for the input, Stacy.

      Can anyone recommend how to go about getting mistakes in your medical records corrected? It is easy to fight that your temperature was incorrectly reported at 122*, but saying a doctor misquoted you is a little harder to fight. Foe example, a ER doctor had asked me when my last menstraul cycle was and I explained...

      RHMLucky777

      Read More

      Thanks for the input, Stacy.

      Can anyone recommend how to go about getting mistakes in your medical records corrected? It is easy to fight that your temperature was incorrectly reported at 122*, but saying a doctor misquoted you is a little harder to fight. Foe example, a ER doctor had asked me when my last menstraul cycle was and I explained to him that my gyno decided that since the menstraul bloating made my pain worse, he would put me on continous birth control pills. The ER doctor replied, "well you should be having a period at least every 3 months." To which I replied, "Oh, I was never told that." My record states that I told him,"I should never have a period."

      I also love the fact that they give pain meds that make you groggy and in a daze, then they expect you to answer them correctly and quickly. Heck, you may not even know what color the sky is, let alone your last BM.

      I have a doctor visit on 11/21 and I will see what my PCP recommends to do for mistakes made in medical records. I will report what she says.

      Ok,I will quit my griping but it sure feels good to get it out to people who understand. I also am in pain and I'm grumpy.

      Thanks Stacy for a great site.

      Chronic Pain Sufferers united we shall be!

       

      Amy Smith

  • Anonymous
    Mememarie
    Jul. 09, 2007

    I read the article, which, btw, I thought was an excellent guide to use for ER visits. I have a chronic pain condition, Reflex Sympathetic Dystrophy (RSD/CRPS). I have had to visit the ER before and I think the "travel guide" was GREAT. There seems to be some contention, though, with opinions flying to both sides of whether or not pain should be treated...

    RHMLucky777

    Read More

    I read the article, which, btw, I thought was an excellent guide to use for ER visits. I have a chronic pain condition, Reflex Sympathetic Dystrophy (RSD/CRPS). I have had to visit the ER before and I think the "travel guide" was GREAT. There seems to be some contention, though, with opinions flying to both sides of whether or not pain should be treated in the ER. I thought I would throw in my 2 cents worth, from the view of a chronic pain patient. First off - Do I think pain should be treated in the ER? NO, not usually. I say "not usually", because for the most part, I have pain medication which I use daily for pain control. BUT... something as simple as bumping into something can cause my pain to spike so badly that I cannot get control of it, no matter what! I have RSD in my neck, shoulders, back, sides and right arm. A few weeks ago, I was getting ice out of my freezer (top of fridge kind) and the small door came back and bumped against the back of my neck. Most people would think this would not be significant, but it was. Within 6 hours, I couldn't even begin to turn my head, extend my arm, or even have any sort of sound/vibration stimuli around me. Only someone who has looked up what RSD is would understand why this is, but I can tell you from my experience that I would put up with any other kind of pain, except this. I cried, which of course, did nothing but make the pain worse, but I could literally not move, my body was frozen in some kind of "pain hell" that there are no words to describe. It was a weekend, it was night time, there was no way to reach my family doctor... I had the pain meds I am regularly prescribed, but they were not even taking the edge off of the pain.


    Do I make a habit out of going to the ER? No... not at all, but THERE IS a time and a place for everything and this was one of them.


    For those of you who do not live in a rural place, and don't have to wait almost 6 months to see a Pain Management doctor to see you (let alone he is 3 hours away) probably have no concept of what it is like to truly be desperate. My family doctor is the one who treats my pain on a regular basis. He does not take calls on the weekend. His answering machine instructs his patients, that if they are experiencing something that cannot wait until Monday, to go to the ER. There is only ONE ER in our area, so there are no other choices.


    I think we all need to look at this issue from another person's point of view, try to put yourself in another's shoes. To try to say that if you don't go by ambulance, you shouldn't go, is just ludicrous! There are always exceptions to every rule, and I for one, would never again be afraid to go to the ER about my pain if/when it gets that bad again.


    I see my family doctor on the 26th of this month for my regular monthly visit and will ask him about making an "ER Prescription" as that is one of the smartest things I have read in a while...


    Thanks, Stacy, I found it very valuable!


    Kudos to you!

  • Synergy
    Jul. 05, 2007
    Ok. Guys…

    Can we all try to remember why we are here! If we disagree, we can be a bit more diplomatic. We don’t need to “call each other out”, so to speak. We are all here trying to help each other!

    Back when TMJ Friends was around, Stacy and I had knocked around the idea of creating a USB key template that could be loaded and hung from...
    RHMLucky777
    Read More
    Ok. Guys…

    Can we all try to remember why we are here! If we disagree, we can be a bit more diplomatic. We don’t need to “call each other out”, so to speak. We are all here trying to help each other!

    Back when TMJ Friends was around, Stacy and I had knocked around the idea of creating a USB key template that could be loaded and hung from your key ring that would store vital information. All an ER would have to do is plug it in, and your information would be readily available. Personally, I do worry about having an accident. My joint is currently cemented shut. What would happen if an emergency crew tried to intubate me… or used latex gloves?

    I have thought about taping the info to my steering wheel, but if the airbag deploys… the info would be gone. We also have to consider that emergency personnel would have to be trained to grab your keys. Short of tattooing the ever-changing information to my chest… I don’t know what the answer is

    In an ideal world, there would always be someone there to go with us, but that is not always the case. I have been to the ER a few times in the past few years from having bad reactions to new medications, not being able to stop throwing-up, falling down and hitting my head, or passing out and losing chunks of time. I have resisted more times than I have gone because they have no clue what is going on with me… and I am usually to sick to try and explain it!

    One of the problems with this type of medium is that we are not privy to the author’s inflection or intonation, so when we read, we apply our own. No, weekly or even monthly visits to the ER is not a good idea. If you find yourself going that often, talk to, or seek out a pain doctor to help you manage this. What you are doing is obviously not working, and continued visits will land you in a psych ward somewhere. Hospitals are networking. That said, things do happen in life and going to the ER is a fact for many of us. Be prepared… and do what you need to do to take care of you!

    Breathe……….
    • Kellissia
      Jul. 05, 2007

      well said, thank you.



      kellissia

    • Anonymous
      beth
      Nov. 23, 2007

      The medic Alert foundation, an international charity, can provide a necklace/ bracelet and wallet card that provides lifesaving medical information- the jewelry says something brief, maybe in your case "FROZEN TMJ" or something, and a registration number, and if the appropriate kind of person calls, the medic alert foundation will give them your...

      RHMLucky777

      Read More

      The medic Alert foundation, an international charity, can provide a necklace/ bracelet and wallet card that provides lifesaving medical information- the jewelry says something brief, maybe in your case "FROZEN TMJ" or something, and a registration number, and if the appropriate kind of person calls, the medic alert foundation will give them your name, doctor, hospital, medical info, medications, etc. Google Medic Alert Foundation. Its not expensive, and all health care and emergency personel are trained to look for them.

       

  • Candy Franks
    Jul. 04, 2007

    The American College of Emergency Physicians recommends keeping an “emergency file” containing your insurance cards, a list of all medications you are taking, a list of any chronic conditions you may have, operations you have had, and allergies (particularly drug allergies) that you have. These can be kept in a folder that you can easily grab on...

    RHMLucky777

    Read More

    The American College of Emergency Physicians recommends keeping an “emergency file” containing your insurance cards, a list of all medications you are taking, a list of any chronic conditions you may have, operations you have had, and allergies (particularly drug allergies) that you have. These can be kept in a folder that you can easily grab on the way out the door should an ER visit be necessary. You can also include copies of recent laboratory or diagnostic test results. Doing so may help reduce both the cost and waiting time associated with your ER visit.


    ER visits are a legitimate part of pain management. Pathology is not static. Sometimes a fall, or activities that a pain patient should not be doing, or any number of other factors, can cause an acute exacerbation of the pain. That is where the ER fits in. However, the ER should NOT be a substitute for adequate pain management in the first place.


    In women of childbearing age, migraine significantly increases the risk of ischaemic but not haemorrhagic stroke. This finding comes from a large European hospital based case-control study of women aged 20 to 44, in whom both simple and classical migraine were associated with about a threefold increase in risk of ischaemic stroke.


    A review conducted by a group of Canadian, Spanish, and United States scientists of 14 studies on the link between migraines and stroke suggests that migraine may be an independent risk factor for stroke.

    • annebeckett
      Jul. 04, 2007

      Candy; Yes, thanks for putting in these facts.


      What I was saying and will stick by, forever, is that e.r. visits should be LIMITED by chronic-pain patients as we should be treated for this pain by the doctors we see for this PAIN! Again, to me, the post by Stacy appeared as something different than, if you have an emergency; a fall, bronchitis, a headache that...

      RHMLucky777

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      Candy; Yes, thanks for putting in these facts.


      What I was saying and will stick by, forever, is that e.r. visits should be LIMITED by chronic-pain patients as we should be treated for this pain by the doctors we see for this PAIN! Again, to me, the post by Stacy appeared as something different than, if you have an emergency; a fall, bronchitis, a headache that seems different than a "usual migraine", then YES; ABSOLUTELY, you SHOULD go off to the e.r., esp. when it is after-hours for your regular doctor. However, for those of us who DO have terrible migraines or other break-through pain on a fairly regular basis, we need to be prepared with different medications, to be kept on file and filled by the pharmacist or kept at home for these urgent situations.


      Remember; the e.r. is for EMERGENCIES: NOT urgent situations. The walk-in/ ambulatory/ minor-e.r.'s are generally open (even those in the hospital) only during NORMAL doctor's hours, too! So, if you're going off to one of these, it would surely be better for you to see your OWN doctor, for that continuity of care! Mixing medications, no matter how innoccuous it may seem, can be DEADLY!


      And, I hope this is the last I will say about this!

    • Jenn B.
      Jul. 04, 2007

      I agree 100% with what you just said Anne. My only frustration is that we chronic-pain patients - who do need to use the ER, for emergency situations - are too often treated like rubbish simply because we have some label stamped on our file. Certain diagnoses have a lot of stigma and prejudice attached to them and it's very unfortunate for those who don't...

      RHMLucky777

      Read More

      I agree 100% with what you just said Anne. My only frustration is that we chronic-pain patients - who do need to use the ER, for emergency situations - are too often treated like rubbish simply because we have some label stamped on our file. Certain diagnoses have a lot of stigma and prejudice attached to them and it's very unfortunate for those who don't fall into that category because they pay the price for the abuse of the system done by others who are perhaps less in need.


      So I believe everyone needs to be sensitized to this issue - not only patients and medical personnel but also the general population as a whole... and it's coming along. Slowly, but there is headway being made. It's just frustrating and tiring and discouraring all too often.


      But hey, it's the turtle who won the race isn't it? :)

    • Kellissia
      Jul. 04, 2007

      I agree with both you, a big part is where I live that is hard to find a physician who knows the disease around here, let alone how to treat it (like i said the closest dr i have is 80 miles, like most of you)


      maybe this is why we are treated as we are, as they dont' understand it so they don't know the best to treat it?


      I'm guessing this also the...

      RHMLucky777

      Read More

      I agree with both you, a big part is where I live that is hard to find a physician who knows the disease around here, let alone how to treat it (like i said the closest dr i have is 80 miles, like most of you)


      maybe this is why we are treated as we are, as they dont' understand it so they don't know the best to treat it?


      I'm guessing this also the way it is around the country (other than the specialists out there)

  • Jenn B.
    Jul. 03, 2007

    Hi, I thought I'd chime in again, not to accuse or because I'm mad at anybody (except the system), but just to share my experience with the ER and show that you do not have to go often to be mistreated.


    I have gone twice to the ER for migraines. The first time was the worse I've ever had, I'd tried everything I had, nothing had worked, and after...

    RHMLucky777

    Read More

    Hi, I thought I'd chime in again, not to accuse or because I'm mad at anybody (except the system), but just to share my experience with the ER and show that you do not have to go often to be mistreated.


    I have gone twice to the ER for migraines. The first time was the worse I've ever had, I'd tried everything I had, nothing had worked, and after 4 days, it wasn't getting any better. I didn't want to go, I just wanted to wait it out, but my therapist insisted I go to the ER. So I went... I got an IV treatment, which didn't help. Then they gave me some pills, told me to wait half an hour, then I could go home - whether they helped or not.


    Then I went back a year later for bronchitis. I'd gone to a walk-in clinic when I started getting a cold to get a pump because I know I'm fragile and I wanted to fight this one off quickly. But one evening, I started coughing literally non-stop. I was there with a friend, so I was given the proper meds, but I had to wait 5 hours with only a mask and ice chips before seeing anyone. Even people in the waiting room were getting angry that I wasn't getting seen.


    My next visit to the ER was about 6 months later - for a migraine again. This time, I showed up alone. I was left sitting in the waiting room for 17 hours , given 3 Tylenol and 3 Advil by a nurse somewhere in the middle of that. The waiting room emptied out completely a few times. I was told I had to wait and see a specialist in the morning. Who was the specialist? A psychiatrist... go figure!


    My last ER visit was a year after that, this winter. I could barely walk I was in so much pain. I couldn't make it there on my own, if I didn't have a friend who was able to take me, I would have had to go by ambulance. All the time my friend was with me, I was treated wonderfully - I was even left in a room for the night!! The next morning, my friend had to leave to go to work for a few hours. They sent me for a last test, and finally found a huge ovarian cyst. The doctor told me that meant that I was fine. He sent me home with nothing and a note saying I could go back to school the next day.


    So I slept for the rest of the day and went to school in the morning, I felt a little better. I lasted 1 hour and had to leave. By that evening, I had to go back in. Advil just wasn't cutting it. I was treated fine, except just to 'reassure' (or quiet me) they sent me home the next morning with a couple of antibiotics and told me I could take Advil for the pain, but no more than max recommended dose.


    Luckily, by then I had the week-end to recover before going back to school. So it was the maximum dosage of Advil for me for the next couple of weeks. In the hospital, my intial reflex would be to refuse when they offered another dose of morphine because I hate having to take anything. Then I would convince myself that I was entitled to having it and I didn't need to endure the pain for no reason...


    Do these visits warrant being labelled as drug-seeking or being sent to psych or home instead of being appropriately treated? Are they exagerrated? Cluttering up the system?


    I do agree that often people do hold up the waiting time in ERs while they could wait until morning and go to a walk-in clinic, or simply start by asking for information by calling their family doctors, a healthline or their pharmacist. But I think that someone who chooses a career, whatever it may be, has no right to let their anger/fatigue/resentment/annoyance rub off on their clientele, especially when dealing with people in a vulnerable position. That's beating on people when they're down and it's just wrong.


    Wow, I've written way more than I intended to, sorry about that! :) So anyways, that's just my 2 cents' worth. Have a good night all!

    • Kellissia
      Jul. 04, 2007

      iwas not beating on anyone when they were down, i was just upset that i was being told that I was wrong by going to the er twice in one year, same as you.


      and it was the conception that people go to the er for MORE medications, with some that may be the case, but with my last visit, one of my medications was changed because the dr tried something different...

      RHMLucky777

      Read More

      iwas not beating on anyone when they were down, i was just upset that i was being told that I was wrong by going to the er twice in one year, same as you.


      and it was the conception that people go to the er for MORE medications, with some that may be the case, but with my last visit, one of my medications was changed because the dr tried something different and this med has been working great, so I am actually happy that I went to get this outcome.


      and stacy was only trying to help us out, it also wasn't right for her to be attacked from the get go.


       

      kellissia.

  • Anonymous
    sue
    Jul. 03, 2007

    Hmmmm...



    Sue

  • annebeckett
    Jul. 03, 2007

    No, first of all, I WAS advocating that we, as chronic pain patients, NEED to attempt to prepare ourselves for the WORST pain and that would include developing an honest and open relationship with our pain docs (or g.p.'s)...; This means preparing for those LONG weekends when the office will be closed and for when we, ourselves have to go out of town, making...

    RHMLucky777

    Read More

    No, first of all, I WAS advocating that we, as chronic pain patients, NEED to attempt to prepare ourselves for the WORST pain and that would include developing an honest and open relationship with our pain docs (or g.p.'s)...; This means preparing for those LONG weekends when the office will be closed and for when we, ourselves have to go out of town, making sure we've got enough of our usual medications and, if necessary and prescribed, break-through pain meds; YES, e.r.'s are overworked!


    And, for anyone who doesn't think I have pain, just think how you would feel if you had hardware in your tmjoints that had been loose for 13 years. I have gone through more than thirty (bilateral.. so, actually, more than 60 if you count it by procedure) tmj surgeries so, don't you try and say that I don't truly understand pain! Maybe I just handle it better? Just try and imagine what it is to be literally and actually stabbed in the head and face... by the loose FEP's and broken and loose screws (waking every day and feeling EXACTLY as I did following surgeries; that kind of pain) and then rag on me about pain, ok? Regarding migraines; I have migraines at least weekly. Some days they are worse than others. However, I have asked my doctor for a medication that works for me to prevent the migraine from really blowing out (If you've ever had migraines, you know what I mean; the kind of migraine that makes the room spin and, of course, causes repeated vomiting).


    You will never, however, convince me that going to the e.r., when you already have a pain doctor, is the reasonable thing to do. I did not label anyone as, "drug-seeking". However, EVERY e.r. doc has placed this label on MANY patients, including chronic-pain patients which, I agree is wrong. However, it does NOT mean it does NOT happen!


    Again, I stick by what I said. If you have a good relationship with your pain-specialist, there should be NO reason for you to have to call or wake-up anyone else to take you to the emergency room.


    Stacy; setting out a "plan" for going to the emergency room sounded a bit irresponsible to me. Perhaps you should have placed more emphasis on the doctor-patient relationhip; and, I am NOT referring to the e.r. doc!


    I also did not say that there is NEVER a time when the e.r. is necessary for pain patients. However, Stacy, your post made it sound like this should be your "secondary" care place! And, MOST hospitals do NOT have the ambulatory or minor-e.r.'s you noted.


    To the whiner with the stupid comment about how I must have been the nurse who treated you badly..; well, big whaah to you! Obviously, I am not the only person who thinks that taking up what little time the e.r. doc's have on what you could have prepared for is inane! You say you work in a hospital? Then do me, and yourself, a favor and THINK about this!


    • annebeckett
      Jul. 03, 2007

      For those of you with the MULTIPLE messages and nasty things to say to me, heres' one more thing..., "I forgot to say"...{to quote most of you}


      To me, this post about how to prepare youreself to get what you want from the docs at the e.r. or minor e.r. sounded JUST like that. Telling people you really do not know how to make sure they can get drugs prescribed...

      RHMLucky777

      Read More

      For those of you with the MULTIPLE messages and nasty things to say to me, heres' one more thing..., "I forgot to say"...{to quote most of you}


      To me, this post about how to prepare youreself to get what you want from the docs at the e.r. or minor e.r. sounded JUST like that. Telling people you really do not know how to make sure they can get drugs prescribed IS irresponsible.


      Now, again, I have NOT said that I do not ever go to the e.r. I went there about 4 weeks ago because I injured my thoracic spine (causing more pain than I've had since 1988; more than has been for years). I sat there for well over an hour and, as their chairs are uncomfortable, I decided to leave. When I went up to the front desk to explain that I could wait no longer, I noted 28 charts for people ahead of me ( I asked the nurse how many) waiting to be EVALUATED by the front/ triage nurse! NOBODY in the waiting area "looked" sick or like they were in pain.. except for me. Add this to the number of patients brought in by ambulance and I would hope that you could understand that these places are understaffed and what staff they do have IS overworked!


      My other point was about continuity of care; THIS IS IMPORTANT AND CAN SAVE YOUR LIFE!


      And, Stacy: NO, a true migraine cannot "cause a stroke" because it's left untreated. You may want to look that one up, huh? A stroke is caused by clot(s) and, if you have a TRUE migraine, you, almost always do NOT have a clot and, though it feels like it could kill you, it will not! So, please get your facts straight.


      I'm sure the lot of you will have more nasty commesnt to make; honestly, I do not care. I DO know of which I speak, though, as I used to go off to the e.r. for every little pain and, sure, I was labled as "drug-seeking". Then, I found myself a pain doc approx one-dozen years ago. Now, I RARELY have the need to go to the hospital. In fact, for my usual pain, the last time I went there was about 4 years ago; it was a holiday and I had not prepared for it! Other than that, I went last year when I broke my foot; and, I gave the info about the pain meds I take and left with a CAST and doc-referral ONLY!


      Maybe we all need to accept that we will have pain every day (I know I have pain all day, every day; I just go back to bed when it's that bad). Drugs; extra drugs, are not always the answer!

    • Kellissia
      Jul. 03, 2007

      first off, i never said that you don't have pain, we all do. especially those of us who have any multple surgeries. so you are saying you would never go to the er for your tmj pain before you killed yourself, i hope that's not what you're saying as for stroking out from a migraine, yes that actually can happen, i've seen a pt from that before,...

      RHMLucky777

      Read More

      first off, i never said that you don't have pain, we all do. especially those of us who have any multple surgeries. so you are saying you would never go to the er for your tmj pain before you killed yourself, i hope that's not what you're saying as for stroking out from a migraine, yes that actually can happen, i've seen a pt from that before, it might be rare, but it CAN happen so don't say that it can't


      (they stroked because the dr. neglected to give them the correct medication to treat it.)


      I do apologize for it posting three times, i have never posted. that is my bad and as for er's being overworked yes they are but that isn't a reason for someone not to go WHEN NEEd be. I also agree that people shouldn't go when they are in their normal pain that WE all have, and yes i have migraines all the time and know what they are like looks like we have to realize that we will always have our own opinions

    • Kellissia
      Jul. 03, 2007
      not EXTRA drugs, DIFFERENT drugs is the key word here
    • Teri Robert
      Health Guide
      Jul. 05, 2007

      Hi,

      My name is Teri Robert, and I'm the lead expert on MyMigraineConnection. You can read more about me in my profile.


      So, I do know about Migraine disease, the increased risk of stroke that just having Migraine disease presents, and that Migraines can and do cause strokes, some of them fatal.

      Anne said, "And, Stacy: NO, a true migraine cannot "cause...

      RHMLucky777

      Read More

      Hi,

      My name is Teri Robert, and I'm the lead expert on MyMigraineConnection. You can read more about me in my profile.


      So, I do know about Migraine disease, the increased risk of stroke that just having Migraine disease presents, and that Migraines can and do cause strokes, some of them fatal.

      Anne said, "And, Stacy: NO, a true migraine cannot "cause a stroke" because it's left untreated. You may want to look that one up, huh? A stroke is caused by clot(s) and, if you have a TRUE migraine, you, almost always do NOT have a clot and, though it feels like it could kill you, it will not! So, please get your facts straight."

      There are two kinds of stroke:

      An ischemic stroke is caused by a clot. Hemorrhagic strokes occur when a blood vessel ruptures or leakes into the brain. That's the kind of stroke that Migraine tends to cause. Specialists in the field of Migraine disease consider the International Headache Society's International Classification of Headache Disorders, 2nd Edition (ICHD-II), to be the gold standard for headache and Migraine diagnosis and classification. According to the ICHD-II, when the pain of a Migraine lasts longer than 72 hours without at least a solid four-hour pain-free period, while awake, it's termed Status Migrainous, and emergency treatment should be sought because of the increased risk of stroke. You can find more information in Status Migrainous - The Basics.


      I just returned from the American Headache Society conference, where I spent time with some of the world's leading experts. They agree with this. There was even a session about emergency room treatment for Migraine at the conference.

      As I said, just having Migraine increases our risk of stroke. You can find more about that in Migraine and Stroke Risk.

      So, to those of you with Migraines, if you have the worst Migraine or your life, or if your Migraine has put you in Status Migrainous, go to your doctor. If your doctor is unavailable, please do not hesitate to go to the ER. This most certainly IS an emergency.

       

      I have now lost two young forum members who died because they were in Status Migrainous, did not seek emergency care, and suffered fatal strokes. Please do NOT follow their example.

      Best wishes,

      Teri Robert

    • Anonymous
      NeuroScientist56
      Nov. 17, 2011
      Sounds like your "good relationship" with your pain doctor is more of a "drug dealer relationship." For someone preaching that "medicine is not always need" you seem to have plenty. Your doctor gives you extra breakthrough medication. Unless he is giving you morphine or one its relatives for breakthrough pain your pretty much screwed if you are trying to treat...
      RHMLucky777
      Read More
      Sounds like your "good relationship" with your pain doctor is more of a "drug dealer relationship." For someone preaching that "medicine is not always need" you seem to have plenty. Your doctor gives you extra breakthrough medication. Unless he is giving you morphine or one its relatives for breakthrough pain your pretty much screwed if you are trying to treat what is considered a chronic pain flare up. With all of that being said, I am an anastasiaolgest that specializes in pain managment. I tell my patients two things when suffering from a chronic flare up. First, call my office if your pain get unbearable. Even during off house there is an answering service that pages me or a doctor that I have left on call. This allows me to assess if the patient needs to go in or not. It also allows me to call ahead and let them know a patient is arriving. Second,I tell them to always take my treatment letter (this includes their condition, current treatment plan & a suggested abortive medication list) in with them. Bring a copy they can keep. So yeah the ED's in are way over crowded, fact! However the notion that YOU (Not a doctor or even familiar with the patient history) are quallified to give advice against seeking medical attention is not only wrong but it's also a bit unethical(as your a nurse?). So people call your pain doctor before you leave for the ED and TAKE ONLY THEIR ADVICE! Also I am posting this from am iPhone so please disreguard any miss spelling. Hope this helps.
    • Anonymous
      NeuroScientist
      Nov. 17, 2011
      The message a above was for Ann! Also look up some mirgrane research. There are plenty of unknown causes of migraines but research has shown that some are do to extreme vasoconstriction. That along with an increased BP due to pain can cause either a bleed or a clot. So migranes are not mini stroked in that sense. Althogh vasoconstriction of the blood vessels...
      RHMLucky777
      Read More
      The message a above was for Ann! Also look up some mirgrane research. There are plenty of unknown causes of migraines but research has shown that some are do to extreme vasoconstriction. That along with an increased BP due to pain can cause either a bleed or a clot. So migranes are not mini stroked in that sense. Althogh vasoconstriction of the blood vessels in the brain leads to lower oxygen transport. Ann since your a nurse what does this mean? In case your stumped; A stroke starves the brain of vital oxygen, killing brain cells. So If someone suffering from a migrane cause from vasoconstriction, they are also depriving some oxygen to their brain. Once again I am a doctor, but not anyone's here so check with your doctor about what he/she would like you to do. Also a word to all the HP's out there Be carful you don't exceed your scope and limits of your training. I.e. RN's are not diagnostitions and should allow the doctors to do their jobs.
    • Kellissia
      Jul. 04, 2007

      anne, just curious, I am not trying to get snotty or anything, trying to learn from those who have been here longer than me


      you believe that when you have a pain dr. that you shouldn't have to go to the er, in the case that you wake up in the middle of the night or even 10pm in excruciating pain and none of your medications works, what do you do (other than...

      RHMLucky777

      Read More

      anne, just curious, I am not trying to get snotty or anything, trying to learn from those who have been here longer than me


      you believe that when you have a pain dr. that you shouldn't have to go to the er, in the case that you wake up in the middle of the night or even 10pm in excruciating pain and none of your medications works, what do you do (other than wait it out), do you have a good relationship where you can call your pain doc at night?


      I live in a tiny town, and am lucky to have a pain dr. 80 miles away, when awaking by myself, i can't call them at home, the only thing i can do is leave a msg at the clinic and wait for a call, which doesn't do me any good until the next day around 11+


       

      Kellissia

  • Kellissia
    Jul. 03, 2007

    the last time I went to the er, the experience was horrible. the nurse was totally mean and when the dr came this is what he said


    "well you know you have tmj, so you don't need me to diagnose you, you have pain medication, so what do you need refills on them today or what, what do yo expect me to do for you here today?!?" and this is the hospital that I...

    RHMLucky777

    Read More

    the last time I went to the er, the experience was horrible. the nurse was totally mean and when the dr came this is what he said


    "well you know you have tmj, so you don't need me to diagnose you, you have pain medication, so what do you need refills on them today or what, what do yo expect me to do for you here today?!?" and this is the hospital that I work in, makes me feel comfortable ever going in again, other than I will refuse to be treated by this dr. again.

    • Kellissia
      Jul. 03, 2007
      oh anne one more thing i forgot to ask, were you the nurse that took care of me earlier this year that i mentioned before?
    • Kellissia
      Jul. 03, 2007

      oh anne one more thing i forgot to ask, were you the nurse that took care of me earlier this year that i mentioned before?


      No reason to attack someone who is trying to help other people who suffer like she does. Stacy has done nothing but try to help those people like her. I'm sure I speak for other people, other than Anne, when I say I have learned many...

      RHMLucky777

      Read More

      oh anne one more thing i forgot to ask, were you the nurse that took care of me earlier this year that i mentioned before?


      No reason to attack someone who is trying to help other people who suffer like she does. Stacy has done nothing but try to help those people like her. I'm sure I speak for other people, other than Anne, when I say I have learned many things, and gotten through many tough times. My mom and I also like reading Candy's stories as they mirror our relationship and situation so much, so stacy thank you so much for all you do, and don't listen to those who "disagree" (I guess we'll call it that to be nice) with you!


      Kellissia


      (troyal147)

    • Kellissia
      Jul. 03, 2007

      oh anne one more thing i forgot to ask, were you the nurse that took care of me earlier this year that i mentioned before?


      No reason to attack someone who is trying to help other people who suffer like she does. Stacy has done nothing but try to help those people like her. I'm sure I speak for other people, other than Anne, when I say I have learned many...

      RHMLucky777

      Read More

      oh anne one more thing i forgot to ask, were you the nurse that took care of me earlier this year that i mentioned before?


      No reason to attack someone who is trying to help other people who suffer like she does. Stacy has done nothing but try to help those people like her. I'm sure I speak for other people, other than Anne, when I say I have learned many things, and gotten through many tough times. My mom and I also like reading Candy's stories as they mirror our relationship and situation so much, so stacy thank you so much for all you do, and don't listen to those who "disagree" (I guess we'll call it that to be nice) with you!


      Kellissia

      (troyal147)

  • Alex
    Jul. 02, 2007
    Taking someone along isn't an option for everyone, unfortunately. I live alone, and my circle of friends isn't local. Not that I'd want most of them around for something like that anyway. I really wish every provider had access to shared electronic medical records.

    My own belief is that the ERs are abused. I hear of people going to them for ear aches...
    RHMLucky777
    Read More
    Taking someone along isn't an option for everyone, unfortunately. I live alone, and my circle of friends isn't local. Not that I'd want most of them around for something like that anyway. I really wish every provider had access to shared electronic medical records.

    My own belief is that the ERs are abused. I hear of people going to them for ear aches or mild flu symptoms, all kinds of things that just don't sound "emergency" to me. If you aren't headed there in an ambulance, I think you really need to consider if they are the right place to seek treatment. On the other hand, I do understand that on weekends or holidays or after hours, there's no other choice.

    It's very unfortunate that most nonessential things in America are 24/7 while essential services, like primary care medicine, aren't. You can get a triple patty cheeseburger with bacon at 2am on a Sunday, but if you're having a serious but not necessarily urgent mecical problem, too bad. It makes me wonder about our priorities.


    • annebeckett
      Jul. 03, 2007

      Hmm... No matter where you live in the U.S., Emergency Rooms are OVERWORKED and understaffed and, if you're adding to the problem, you've got little room to complain about them being so slow. Perhaps, rather than making plans to go to the e.r. so often, it would be best, especially for continuity of YOUR care, to see your OWN doc! I do know that hospitals...

      RHMLucky777

      Read More

      Hmm... No matter where you live in the U.S., Emergency Rooms are OVERWORKED and understaffed and, if you're adding to the problem, you've got little room to complain about them being so slow. Perhaps, rather than making plans to go to the e.r. so often, it would be best, especially for continuity of YOUR care, to see your OWN doc! I do know that hospitals keep track of what is called, "drug-seeking" behaviour...; for this reason, and many others, chronic pain patients really do not need to be treated there and it is a poor second to maintaining a good and regular doctor-patient relationship.


      Now, I have told my pain doc (recently) that there ARE times that my meds do not work as well as I need or my pain simply breaks-though the medication. According to him and his staff, this should NOT be happening; after all, he IS my PAIN DOC and, if I am experiencing PAIN, I need to call or see him! He will, then, add meds or up my dosage. I joke that I sometimes have to get myself to the e.r. for a shot or two of morphine and, occasionally, I do. However, this does NOT happen often; not even once a year!


      My suggestion, rather than worry about lugging around suitcases filled with charts, xrays, and scans, and forcing your friends or family out of bed to take you, yet again, to the hospital, is to be completely open and honest with your own doctor! There will come a time, otherwise, when the e.r. docs will NOT treat your pain..; certainly, not as you think it needs treatment! Then, where will you be?

    • Stacy
      Jul. 03, 2007

      Hi Anne,


      I was wondering if you were replying to me, or Alex?


      Yes, emergency rooms are understaffed and overworked, unfortunately. I don't think that this is all because people are going for non-emergencies, though. I have travelled all over the world and talked with people in other countries. They can't even dream of waiting more than an hour in the...

      RHMLucky777

      Read More

      Hi Anne,


      I was wondering if you were replying to me, or Alex?


      Yes, emergency rooms are understaffed and overworked, unfortunately. I don't think that this is all because people are going for non-emergencies, though. I have travelled all over the world and talked with people in other countries. They can't even dream of waiting more than an hour in the ER. This is a very complicated topic that can't be summed up in one or two sentences, that's for sure.


      Anne, I do not visit the emergency room often... actually, I have hardly had to go at all for years since I have been seeing a pain specialist. However, sometimes, as you point out, things get out of control. Also, because doctors can be busy and/or travel a lot, they aren't always available when you need them. If the pain is excruciating and there is no one else to help, I believe going to the emergency room is a viable solution.


      There are also certain pain conditions that can NOT get out of control, like migraines. If one has had a migraine for too long they can turn into a stroke.

      It seems you think that I am going to the ER a lot, or approving of others going a lot...but I am not. I am not advocating going to the emergency room at every turn. It is always better to call your doctor first (or talk with him about an emergency plan, like I mentioned).. however, there are simply times when this does not work out.. and I do not think that people should suffer.

      Stacy

    • Stacy
      Jul. 03, 2007
      I also mention in the article the idea of fast track care, which if you have not seen before in your area, is a part of the hospital where non-emergent cases can be seen. This allows for the cost to come down because you are not utilizing trauma capabilities and can be treated for your problem at night/on the weekend/holiday/etc. Another idea is going to one...
      RHMLucky777
      Read More
      I also mention in the article the idea of fast track care, which if you have not seen before in your area, is a part of the hospital where non-emergent cases can be seen. This allows for the cost to come down because you are not utilizing trauma capabilities and can be treated for your problem at night/on the weekend/holiday/etc. Another idea is going to one of the many walk in clinics that are open (usually) 7 days a week and are set up for non-emergencies like bronchitis, strep, broken bones, etc. Sometimes these clinics also offer primary care physician service/internal medicine/physicals/etc if you need one.
      :)
      stacy
    • Kellissia
      Jul. 03, 2007
      so anne, when you wake up in the middle of the night or even late evening after hours when YOUR dr is out and won't be "bothered" at home, and you are in excruciating pain, you want to kill yourself rather than bare through it you wouldn't go add ONE patient to the OVERLOADED DR's at the er, give me a break, stacy meant nothing like that! Me being...
      RHMLucky777
      Read More
      so anne, when you wake up in the middle of the night or even late evening after hours when YOUR dr is out and won't be "bothered" at home, and you are in excruciating pain, you want to kill yourself rather than bare through it you wouldn't go add ONE patient to the OVERLOADED DR's at the er, give me a break, stacy meant nothing like that! Me being a true chronic pain patient understand what she meant, and when OCCASIONALLY (once MAYBE twice a year) when your meds don't cut it, that does NOT put you into the drug seeking category, i know the kind and we are not them and am sick of being treated as such, I work with patient's who are such and they often get treated better than we do and i work in that hospital.
    • Hlp4pain
      Mar. 10, 2010

      Um, Yaaa Wow. Have you stopped to consider that every single person is different? And that some people have medical conditions that require emergancy care? Would your doctor allow you to keep a vial of morphine in the fridge ... just incase?? Some people, like myself have chronic conditions that flare beyond the lack of reality of getting your doctor out of...

      RHMLucky777

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      Um, Yaaa Wow. Have you stopped to consider that every single person is different? And that some people have medical conditions that require emergancy care? Would your doctor allow you to keep a vial of morphine in the fridge ... just incase?? Some people, like myself have chronic conditions that flare beyond the lack of reality of getting your doctor out of bed and away from his/her family at 3am when a kidney stone decides to pass, or when a ovarian cyst ruptures and all sorts of other conditions which make it impossible for someone to avoid the ER. In a perfect world none of us would require an emergancy room. However, for some it is an inevitable event and certainly not one any person enjoys. Seems far more logical to me to have an 'ER plan' and what is family for if not to be there when you're sick and in need of support and comfort. If you know of a doctor who would prefer to be bothered at all hours day and night, by all means please let me know because I would move to where this doc practices so fast there would be a level 5 hurricane trail'n behind me! Just my thoughts. And btw, I love the idea of an ER plan. Seems logical and as if it would help to save the ER time as well as letting the dr know you are a legit pain patient and not simply seeking drugs. Having your pain doc work something out with the ER is the most logical and Brilliant idea ever. I had said I would never go back to an ER. However, if I could have my doctor write out a plan of action for me and I knew I would be treated with dignity ... i'd never pass an other stone at home ever again. So, thank you to the nice smart lady who enlightend me! And please forgive my spelling. I am dyslexic. Maybe because of that I shouldn't visit any chat rooms? lol ... just josh'n. 'Judge Not Less Yee Be Judged" Hmmmm? didn't someone pretty darn important give us this advice? Peace out.

    • Anonymous
      beth
      Nov. 23, 2007

      The reason non-essential things are 24/7 is because the people providing them are lowly paid, easy to recruit and replace. Telling a top-flight pain doctor he needs to work news-year eve and every-other weekend is going to make a vacancy in your medical team that takes not 10 minutes but 10 months to fill.

      The staff who are working those shifts that...

      RHMLucky777

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      The reason non-essential things are 24/7 is because the people providing them are lowly paid, easy to recruit and replace. Telling a top-flight pain doctor he needs to work news-year eve and every-other weekend is going to make a vacancy in your medical team that takes not 10 minutes but 10 months to fill.

      The staff who are working those shifts that are "out of the norm" are those who are generally either junior or in teh case of doctors, in educational roles such as (in UK) Senior House Officer. There is not enough expertise to spread around- and even if there was, its not affordable. Paying someone 40 grand a year and then paying time and a half for out of hours is one thing- a higher level person makeing 2-3 times as much and then paying time and a half (or more) is something entirely different.

      For me, having a plan on what can go wrong and having ideas on how to fix it is better than a spontaneous ER visit- for most people with chronic pain, you have some idea in the hours/days preceeding that things aren't going well. Its having the relationship and honesty with your ncare team about your needs, but also being willing to say "I am not doing well- I better slow down and take care of myself" before you crash.

      Oh, if a patient showed up with their records and I was the nurse in Casualty, I would class them as an attention-seeker/ munchausens-type. If however they had a brief overview from their doctor, a letter and a brief history, I would see that as someone who had genuine needs and was getting support that I needed to cooperate with. I'm not labelling anyone- but that is the truth about how you will be perceived by many if not all the staff: "civilians" who carry their medical records around like being sick.

      Its amazing how nursing perspective for a changes when you develop chronic pain yourself! Now, I might be a bit more willing to see that maybe this person is used to fighitng to prove they really need help, but before my own illness the label would have gone right on the foreheard: "CALL PSYCH".

      Sad, but its true: no one else can see your pain, and if you "protest too much" you will lose credibility. 

  • Jenn B.
    Jul. 02, 2007

    Thanks for the avice Stacy! I like the idea of the ER prescription - could come in very handy for times when you have to go to emerg. and have no one to accompany you.


    My #1 suggestion (in my case anyways), is always bring someone with you. Even if they're just a friend and don't know the whole story, I've noticed the staff takes me more seriously...

    RHMLucky777

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    Thanks for the avice Stacy! I like the idea of the ER prescription - could come in very handy for times when you have to go to emerg. and have no one to accompany you.


    My #1 suggestion (in my case anyways), is always bring someone with you. Even if they're just a friend and don't know the whole story, I've noticed the staff takes me more seriously when I'm accompanied. When I show up by myself, I usually get lousy treatment (i.e. Tylenol and Advil) and get sent to psych.


    I don't have any copy of tests I can bring along with me if need be, but I imagine that would help. When I had my cyst this winter, the doctor gave me copies and told me to carry them with me in case I needed to go to another ER. So I guess it makes their jobs simpler, saves times and tests, and they appreciate it when we come in prepared.


    Thanks again Stacy.


    Jenn

    • Stacy
      Jul. 02, 2007
      Hi Jenn,
      Yes, bringing someone with you is definitely helpful.. I would really avoid going to the emergency room alone. This is also because if they need to do any tests or give you medications that might make you sleepy or out of it, they will want someone to accompany you home... and I don't know about you guys, but I always feel better when there is...
      RHMLucky777
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      Hi Jenn,
      Yes, bringing someone with you is definitely helpful.. I would really avoid going to the emergency room alone. This is also because if they need to do any tests or give you medications that might make you sleepy or out of it, they will want someone to accompany you home... and I don't know about you guys, but I always feel better when there is someone there to hold my hand if things get rough.
      :)
      stacy
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