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Old 05-06-2007, 01:52 PM   #1
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doctor said no pain med. in E.R

Fugured I'd share this with yous in the ongoing saga of doc. not caring,or scared to give out proper pain med. to people who need them!

My friend went to the E.R this morning he has a infection,[he thinks] in his jaw bone.His left side of his face was swollen like a grapefruit! Just for the record,my friend doesn't have a history of ever even being on med. in the past for anything,he's quite healthy. When the doc. finally came to the exam. room to see him,right off the bat the doc. said "we don't believe in perscribing narcotics for pain!!! " The doc. didn't even bother to first look at the chart,or to even ask what the problem was! Which it didn't take a doc. to realize with the grapefruit growing out of the side of his face what the problem was.Before he went to the E.R, he asked my opnion,and I sad go to the E.R,and what you need is some type of ati-biotic ,and a mild pain reliever. They gave him the anti. but not even a tylonol to go with it! The funny thing is,my friend is not upset or anything,because his intentions werejust to be seen,I'm more upset over this than he is!
When does it end?

 
Old 05-06-2007, 05:20 PM   #2
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Re: doctor said no pain med. in E.R

I would certainly get that dr.'s name and report your exact experience to the hospital management. Everyone has the right to be properly cared for and that includes pain control. This is a form of malpractice and I am sure when the management hears the word malpractice their eyes will light up. I dont think there is much that can be done for your freind as of now, but to throw some fire on that dr. would give you some sort of releif. Sorry things went bad for your freind, hope he is feeling better. Mud.

 
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Old 05-06-2007, 06:35 PM   #3
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Re: doctor said no pain med. in E.R

I just got off the phone with my friend,man,he can barely talk! He said its worse!
He is in so much pain,but he's more worried to find out whats wrong.I don't think they consider a doctor refusing to despence pain med. malpractice ,but its definitley a bad judgement call on behalf of the doctor!

 
Old 05-06-2007, 06:35 PM   #4
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conductor HB User
Re: doctor said no pain med. in E.R

Dear madhatter,

In answer to your last question, I don't think it ever ends!

Back in 1995 (I think), I went to the ER because of a tremendous migraine headache (versus a terrible muscle tension headache) and received similar treatment from a doctor who was notorious for his lack of compassion and appropriate treatment.

A friend of mine worked in the ER...He was the head administrative assistant in the ER, and he told me exactly who I should write: the head ER nurse, the head of case review, and the President (CEO) of the hospital. Frankly, I didn't expect anything in the way of assistance. However, the day after my ER visit, I wrote the letter in the MOST PROFESSIONAL MANNER--MENTIONING MANY OF THE ITEMS MUDBONE STATED!

Honestly, I'm a stickler for well-written letters. This includes properly composed sentences, correct grammar and spelling, and composition that brings the major point to a swift ending. (My Mother is a retired English teacher, so I have no choice.)

The response I received was from the CEO--an apology, no less. Because my friend worked in a position to know what was happening, he informed me that this particular doctor was "reamed out" for the lack of adequate treatment I received. In fact, my friend actually received a copy of my letter since it was to be placed in the physician's file.

While none of this helped me with that headache, the situation certainly helped me with the next one that occurred nearly a year later! SO...YOUR FRIEND SHOULD CONSTRUCT THE LETTER IN A MATTER-OF-FACT MANNER, MAKE SURE IT IS CORRECTLY WRITTEN, AND BE SURE THE APPROPRIATE PEOPLE RECEIVE IT!

Just a side note...This same doctor refused to treat me during an earlier visit when my PM doctor called in the order for an injection of Demerol/Phenergan. The PM doctor practiced IN THE HOSPITAL because the Pain Clinic was located within sight of the ER. Since it was Saturday, the Pain Clinic was not open. Therefore, there was little my PM doctor could do except call in Lortab 10 to my pharmacy. During my next appointment, the PM physician expressed how UNhappy he was with this doctor!! And, my PM doc had "set him [ER doc] straight"--his words, not mine.

Madhatter, I hope you'll have your friend write that letter and mention the malpractice and pain control issues. Even if the letter doesn't help him, it might help the next person. OK...I WILL GET DOWN FROM THIS PARTICULAR SOAP BOX!

Sincerely,
Jon (Conductor)

P.S. My friend also instructed me to mention the breach of patient confidentiality because the ER kept a file (open to every ER employee) on those people they believed to be "drug seekers". This friend was instructed to destroy the file directly due to my letter. I don't remember how I worded it, but I mentioned patient confidentiality and the possibility of bringing it to the attention of the Joint Commission on the Accreditation of Hospitals (JCAH) and the Joint Commission on Accreditation of Healthcare Organizations (JCAHO). Truthfully, my friend deserves the credit for this part!

Last edited by conductor; 05-06-2007 at 06:39 PM. Reason: Fix Problems

 
Old 05-06-2007, 08:05 PM   #5
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Re: doctor said no pain med. in E.R

Pain is now considered one of the vital signs that a patient is asked about.

I would certainly follow-up with that letter so that this Doc will not fail to relieve one's pain again!

Alan

 
Old 05-07-2007, 05:58 AM   #6
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Re: doctor said no pain med. in E.R

Just to clear up the 5th vital sign rule, It does not mandate docs treat pain to a patients satsifaction. It mandates they must ask what their pain level is, and act acordingly "in their judgement" If in their judgment they suggest you take motrin as soon as you get home, they have asked and made a treatment recomendation. It in no way forces them to give opiates and continue to give opiates untill the patients says they are pain free.

No law will ever be passed that forces a doc to treat pain with narcotic pain meds or any set given dose of medication. This is a misconception that many feel they are entitled to a shot of demi or morphine if they state their pain is a 10. If that were the case, people would bleed to death in the waiting room while waiting for every junkie to be satisfied with the dose of medication given by this law.. A doc can certainly play the game and admin 1 mg of IM morphine which is basically a plecebo dose and puts the patient at greater risk of a sight infection than it would actually relieve pain. They can admin toraradol, give tylenol or oral IBU or sugest taking it upon returning home and have also satisfied the 5th vital sign ruling.

Please don't think simply because there is a writen statement by Hippa or whatever hospital oversight commitee has made pain a vital sign and a question to be asked as a gaurentee off satisfaction for pain treatment. That will never happen.

Years ago there was that show on discovery or AE where they followed ER Internes and the exact same thing happened. A patient showed up at 1am friday night with a toothache and the 2 year resident said on the show she would much rather treat a MVA with multiple fractures than see another junkie looking for a fix after hours when the dentist was closed.

I thought this was pretty sad at the time that someone so new to the profession would have such an attitude, but its what is being tought by docs in med school by 60 year old professors and their peers at the ER.

On the other hand, I ended up with osteo mylitis from a tooth extraction where my face swelled up to grapefruit size a week after an extraction. I was sent from the oral surgeon to the ER and admitted to a room within hours, had a consult with an infectious disease doc and was on PCA dilauid and IV antiB's within 3 hours of being admittted. A simple extraction or infection can get bad really quick and your friend needs to follow uo with a dentist or oral surgeon that preferably has hospital privlidges asap. Their are more and more unresponsive bacterial infections out there due to patient demand for anti biotics for evrything from a comon cold to what a patient thinks is a sinus infection. It's a monster problem that has created flesh eating bacterial that's unresponsive to the most potent antiB simply because we feel better knowing were taking an an anti biotic for something we believe to be an infection that may easily be a virus.

My hospital saty tuirned into 6 days in patient and I was sent home with an IV pick line and I continued to give myself 3 bags of clindomyacin a day for the next month and then had 4 surgeries to repair the jaw,, bone and lifgament damage caused by the infection that the oral surgeon refused to prescribe an anti biotic on the day of extraction and 4 subsequent visits because he didn't feel their was an infection.

I saw a mal practice attorney and when it comes down to malpractice, it comes down to damages. What were the consequences of this treatment and what were the damages. A lost month of work and a few thousand in medical bills doesn't even begin to cover the expense of bringing in an outside doctor to testify a doc acted so grossly outside the guidelines of normal practice their is a case to be filed or won.

Malpractice is thrown around a lot, but what would the damages be at this point from not recieving a shot of demi? Are you prepared to be pay an outside ER physician 3K simply to review the case and then 5K a day to be on standby should his testimony actually be needed. If you win the aposing od pays your fees, if you oose you pay them. We do have to be realistic and not expect much more than an apology if your lucky to get that if your only damge was an additional 4 hours of discomfort because a shot wasn't given.

Just being relistic guys, not that I condone this behavior, I've just been down that path and it led nowhere even if I was willing to pay 4K upfront to have the case reviewed by another oral surgeon outside of my area. My damages were not significant enough to even pursue the case. Had I lost my lower Jaw and been disfigured or lost vision in one eye, that's compensable damges. Hurting that night isn't. Using the word malpractice means very little to a hopital admin that has faced multi milion dollar cliams for negelegence and damge that results in the loss of life/ limb or sight that makes an unhappy ER patinet unhappy with treatment as easy to resolve as an apology and the belief some form of sanction or censure will be taken against the offending doc.

Good luck to your friend and unfortunately The ER is going to be changed for CPpatients by thislaw that went into effect 5 or 6 years ago where publicaly funded hospitals could be at risk of loosing that funding if they don't folow the guidlines of asking and making a recomendation. No gaurentee of morphine or demerol was built into this law.

It's a weekday, I suggest your friend get to a dentist asap and go from their.

Take care, Dave

 
Old 05-07-2007, 06:58 AM   #7
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Re: doctor said no pain med. in E.R

wow shore,that really must have sucked,alot to have to go thru.i am just wondering here tho,did they not actually pass some sort of a law that just dictates that any patient who actually complains of pain has to have it at the very least,fully evaluated and "appropriately" treated?i mean seriously,was this man really "appropriately" treated at all?while the anti Bs were most definitely needed,if he had that much obvious swelling going on and this doc KNEW this was obviously infected just by looking at it,isn't that negligence at the very least here?this doc would have had to have been a total and complete idiot to not have had a clue that what this man was actually dealing with must also have a pretty high level of pain involved?he was really seriously suffering here.i know there was some sort of a law passed within the last five? or so years that addressed this very problem somewhere.i can totally understand any docs hesitance to just start writing Rxs because somebody 'says' they are in pain,but when it is sitting there staring you in the face with an obvious painful type condition,well geez,in my mind and i would think in the average docs mind that this condition would have also very much needed some sort of actual narcotic pain relief.head pain in any shape or form is some of the worst just because of high level of innervation,even a first year would know that.i just don't see how this would even be considered acceptable or appropriate treatment in any way shape or form.you presented with pretty much the same symptoms in your case shore,and look at the level of care you recieved?this man was not even given a smidge of that except for the anti Bs.thats just wrong in my book.when you can actually see a deformity with infection,well,come on.

i would write a letter just to make them aware of this doc and his practices,who knows how many other complaints he may already have against him for inappropriate care for his patients.it could help alot.its docs like this one that do make it very hard for any chronic pain patient to be just taken seriously.i personally have never gone to any ER for just my pain being too out of control,mostly because of the enforced wait i would have to go thru that would just really exacerbate an already bad nasty situation.but if I should ever actually have to,it would be one hell of a really ugly situation in order for me to do that and i would want a doc who really actually gives a damn about my suffering.its just basic care,nothing more.

that whole situation was just not right.JMO,marcia
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Old 05-07-2007, 04:48 PM   #8
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Re: doctor said no pain med. in E.R

I had this happen to me to back in the late eighties. I went to the er with a migraine and extreme tmj pain. They drilled me and drilled me and made me sit for hours and then just sent me home without so much as a tylenol! I was so mad that I wrote a letter to the head of the er and got an apology and didn't have to pay my bill. This was long before I was on opiates and just wanted the pain to stop...I didn't ask for anything. ~Mush
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Old 05-07-2007, 05:21 PM   #9
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Re: doctor said no pain med. in E.R

Any doctor that starts out saying, "we don't prescribe opiates for pain", should be fired, and at the very least, I would run from that ER and go somewhere else if need be.

I have read story, after story, after story, of this type of cruelty. And, I have experienced it myself, to the point that I didn't have pain management AFTER SURGERY! Sure they gave me demerol................so little demerol that I didn't sleep for four days, and cried and begged (AND I AM NO BEGGER TO ANYONE) for help.

Now I need another major, abdominal surgery. It's three weeks away, and I am already suffering from so much anxiety I cannot sleep at night. (I take no meds for anxiety, or depression) It is strictly the thought of sufferly that way again that haunts me.

Bottom Line: We are PEOPLE. No one should suffer. No one.

Write the letter, call whoever will listen. Do what you can to at least know you and your friend will be heard.

 
Old 05-08-2007, 04:47 PM   #10
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Re: doctor said no pain med. in E.R

That happened to me. I went into the ER a day after receiving a nerve block which happened to "hit" something in my lower back/sacro area. The first thing the doctor said was he would not prescribe pain meds. My husband & I couldn't believe he said that. He ended up giving me a morphine shot. The last flare-up, I suffered & waited til my pain doc was in. He asked why I didn't go to the ER & I told him. Anyways, it's undignified the way they treat us & we shouldn't have to suffer the emotional abuse they give us when we already have the physical pain.
Linmarie

 
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