Huh...where do I go to sign up for the upgrade and does it come with any more respect than a diagnosis of Fibromyalgia?
Yes, I have a diagnosis. Yes, I know in medical professional's language that means "We don't know what your problem is. We're pretending to believe you have pain, but we really think you're fat and lazy." No, I won't show up in your ED seeking drugs because the strongest thing I take for the pain is an occasional naproxen sodium. And, no, that doesn't take away the pain, but I survive anyway.
And, yes, I am snarky and sarcastic and I enjoy life and have a great life in spite of the pain. And someday when someone figures out exactly what causes some of us to be in constant pain, I'm going to be very thankful.
Love your blog, BTW! I was in the ED a while back (appendicitis not fibro) and "recognized" some of your favorite patients from the things they were yelling in the adjacent cubicles. :)
Beth, I just mean in the sense that this is now the condition that many a non narcotic allergic, pseudo seizure having, at the ER more than I am patients are now saying they have, much like fibro before it became as well known. Not to say it's not a legit phenomenon. It's the presentation, not the condition, that elicits judgement from me.
Been caring for RSD (reflex sympathetic dystrophy) patients since early 1990's. We have a RN run pain clinic and these patients usually come for 5-8 hours for an IV marcaine infusion. Seems to work quite well, after a couple of treatments these patients rarely come back. Not fibro- like at all.
IV marcaine? That is interesting. Naw, RSD is obviously a legit complaint, but I think in the sense that it's hard to test for it's becoming the go to chief complaint for our repeat ER offenders.
I've been saying that for years!!! By the way, you blog my thoughts exactly...I spent 8 of my 10 years in the ED and finally decided it was making me a jerk. Now I get my ED kicks from reading your blog. Well done.
I think flank pain is the new "back pain." The seekers know we're on to their BS back pain complaints so they now say "flank pain" so they can get the narcs until kidney stones are ruled out by CT.
TOTALLY. We have some little sorority girl lookin' type that comes in for "chronic kidney stones" and refuses CT scans because she says she gets exposed to too much radiation with all the stones. Sure was getting away with it on a pretty frequent basis, too, until she started checking in with fake names and leaving with her IVs still in. @Katie B- I know the feeling, dude. That's definitely why I'm going back to school. I was so much purer of heart before I became an ER nurse.
nurse k - naw, because the narc withdrawals are usually puking into their kidney basins. The CVS'ers storm in wanting their phenergan and benadryl but, hell, I'd never seen one even pretend a dry heave in the hours and hours they ended up sitting in the waiting room. :)
girlvet: chronic pain patients can be caregivers. I spent years doing first response, am going for my BScN, and am working on doing prep work for a large scale disaster response training scenario for my city. I have trigeminal neuralgia and am going through testing for MS. Not only do I get a good laugh out of blogs like this, it's also a good reminder to me as a patient of all the crap ER nurses have to deal with when it comes to chronic pain complaints, helping me along with my genuine complaints and coping with some of the burnt-out attitudes of some ER staff (and no I have never asked for narcs, not in the ER or from my docs).
One more thing about narcs: narcs BEFORE kidney stones are ruled out?! wtf? That doesn't seem insane to anyone else? When I went in with kidney stones I didn't get anything until after I passed the stones in a urine sample.
Good luck to you girl. MS really IS a pain, and lots of people will tell you that. Most of my MS patients will do anything not to take a narc if they can avoid it. They'll take their Baclofen, etc., (if they haven't developed a phobia for that...talk about withdrawal!) and stay far, far away from narcs.
I have only seen a couple of CRPS patients and one was legit and the other faked us so well, he got a free trip to the ER and his IV narcs.
The bastard then came in for a followup after he put on an Oscar-winning performance. I just think he was mad at his wife and didn't have anything going on that day (the drama is sometimes a boredom alleviator for retirees.)
I worked nights in our small town ER over the weekend and took a call from a chick who was on vacation on an island about 2 hours away by car. She announced that she had cyclic vomiting syndrome and needed an ambulance to come get her right at daylight and make sure they brought dilauded. Ummm, No.
I didn't know what that was, so I googled it. I went to a website about it, which included the "Central Pain Patient's Bill of Rights".
ReplyDeleteHuh...where do I go to sign up for the upgrade and does it come with any more respect than a diagnosis of Fibromyalgia?
ReplyDeleteYes, I have a diagnosis. Yes, I know in medical professional's language that means "We don't know what your problem is. We're pretending to believe you have pain, but we really think you're fat and lazy." No, I won't show up in your ED seeking drugs because the strongest thing I take for the pain is an occasional naproxen sodium. And, no, that doesn't take away the pain, but I survive anyway.
And, yes, I am snarky and sarcastic and I enjoy life and have a great life in spite of the pain. And someday when someone figures out exactly what causes some of us to be in constant pain, I'm going to be very thankful.
Love your blog, BTW! I was in the ED a while back (appendicitis not fibro) and "recognized" some of your favorite patients from the things they were yelling in the adjacent cubicles. :)
This was about five years ago but I swear I saw waaay more CVS patients than fibro patients.
ReplyDeleteBeth, I just mean in the sense that this is now the condition that many a non narcotic allergic, pseudo seizure having, at the ER more than I am patients are now saying they have, much like fibro before it became as well known. Not to say it's not a legit phenomenon. It's the presentation, not the condition, that elicits judgement from me.
ReplyDeleteI understand.
ReplyDeleteBeen caring for RSD (reflex sympathetic dystrophy) patients since early 1990's. We have a RN run pain clinic and these patients usually come for 5-8 hours for an IV marcaine infusion. Seems to work quite well, after a couple of treatments these patients rarely come back. Not fibro- like at all.
ReplyDeleteIV marcaine? That is interesting. Naw, RSD is obviously a legit complaint, but I think in the sense that it's hard to test for it's becoming the go to chief complaint for our repeat ER offenders.
ReplyDeleteI've been saying that for years!!! By the way, you blog my thoughts exactly...I spent 8 of my 10 years in the ED and finally decided it was making me a jerk. Now I get my ED kicks from reading your blog. Well done.
ReplyDeleteI think flank pain is the new "back pain." The seekers know we're on to their BS back pain complaints so they now say "flank pain" so they can get the narcs until kidney stones are ruled out by CT.
ReplyDeleteTOTALLY. We have some little sorority girl lookin' type that comes in for "chronic kidney stones" and refuses CT scans because she says she gets exposed to too much radiation with all the stones. Sure was getting away with it on a pretty frequent basis, too, until she started checking in with fake names and leaving with her IVs still in.
ReplyDelete@Katie B- I know the feeling, dude. That's definitely why I'm going back to school. I was so much purer of heart before I became an ER nurse.
1) Why do chronic pain people read ER blogs?
ReplyDelete2) Hood nurse, you don't have to justify your feelings or legitimate observations about wackos.
3) Marcaine infusions? So what does that do make your whole body numb? Bizarre and kind of hard to believe.
4) All the muscles in my body are sore right nowl No I don't have fibromyalgia, I worked 3 12 hour shifts this past week and ran my ass off.
Cyclical vomiting syndrome is the new code for "narcotic withdrawal" FYI.
ReplyDeleteAlso, now that it's Fall, the seekers have all joined football leagues.
nurse k - naw, because the narc withdrawals are usually puking into their kidney basins. The CVS'ers storm in wanting their phenergan and benadryl but, hell, I'd never seen one even pretend a dry heave in the hours and hours they ended up sitting in the waiting room. :)
ReplyDelete"Cyclic vomiting syndrome" = CRAZYEE- period. No further diagnostic workup required.
ReplyDeletegirlvet: chronic pain patients can be caregivers. I spent years doing first response, am going for my BScN, and am working on doing prep work for a large scale disaster response training scenario for my city. I have trigeminal neuralgia and am going through testing for MS. Not only do I get a good laugh out of blogs like this, it's also a good reminder to me as a patient of all the crap ER nurses have to deal with when it comes to chronic pain complaints, helping me along with my genuine complaints and coping with some of the burnt-out attitudes of some ER staff (and no I have never asked for narcs, not in the ER or from my docs).
ReplyDeleteOne more thing about narcs: narcs BEFORE kidney stones are ruled out?! wtf? That doesn't seem insane to anyone else? When I went in with kidney stones I didn't get anything until after I passed the stones in a urine sample.
Prisoneroftoday:
ReplyDeleteGood luck to you girl. MS really IS a pain, and lots of people will tell you that. Most of my MS patients will do anything not to take a narc if they can avoid it. They'll take their Baclofen, etc., (if they haven't developed a phobia for that...talk about withdrawal!) and stay far, far away from narcs.
I have only seen a couple of CRPS patients and one was legit and the other faked us so well, he got a free trip to the ER and his IV narcs.
The bastard then came in for a followup after he put on an Oscar-winning performance. I just think he was mad at his wife and didn't have anything going on that day (the drama is sometimes a boredom alleviator for retirees.)
Yep, some of our ED providers (docs & PAs) will gladly give IV narcs before any imaging is done.
ReplyDeleteYou know what I want to know? Who comes up with these names like "cyclic vomitting syndrome". I mean seriously...
ReplyDeleteI worked nights in our small town ER over the weekend and took a call from a chick who was on vacation on an island about 2 hours away by car. She announced that she had cyclic vomiting syndrome and needed an ambulance to come get her right at daylight and make sure they brought dilauded. Ummm, No.
ReplyDelete