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I changed the ER's perception of chronic pain--Long

AnonymousUserAAnonymousUser Posts: 49,671
edited 06/11/2012 - 8:28 AM in Chronic Pain
Good morning to all. I havent been here in such a long time but have a bit of good news from my last visit to the ER. This is going to be long so grab a cuppa!

Several weeks ago I fell while bringing in some groceries. Of course the first thing I did when I realized I was laying on the ground was to look around to see who might have seen such an ungracious landing-lol. I then stood up and realized I hadnt even dropped my grocery bags.

When I came in the house I assessed 'the damage'. My back was already starting to throb and my left arm hurt as well. I put away the groceries and then decided to ice/heat. Two hours later and both my arm and back were in agony. I couldnt decide which was worse. As much as I hate going to the ER for pain I couldnt imagine a whole night ahead of me like this. (I was not taking presrcription pain meds at this time--only enbrel, and occasionally tylenol #2 with codeine when I have them)

When I got to the ER I could see the waiting room was full-standing room only. I checked in 'slip and fall' I said and waited for triage.

Once triaged the nurse was shocked that my blood pressure was so high. I'm in agony I said--I have a bad back. It took only moments after that to get to an examining room.

I was lucky that it was my family Dr. on call that night and he sent me to x-ray for the arm. Well the radiologist was so rude!!! He didnt even offer to help carry my jacket, purse or anything. Just barked orders from his cubicle.

All of a sudden his demeanor changed and he came out and took my stuff and gently escorted me back to the examining room. I then heard the family dr. on the phone to a neighboring hospital. I overheard that I needed immediate surgery and would require both an orthopedic surgeon and a neurosurgeon and they would be transporting me by ambulance.

The nurse came in and gave me a shot and told me they were going to stabilize my arm. So I was wheeled to the cast
room and my family dr. came in-along with the nurse and the ambulance driver who would transport me.

My family dr. stated I had a severe fracture of the arm -
my understanding it wasnt the length but rather it was wide.

It was at this point that he asked"why I had waited so long to come to the er. TA DA!!!!! Here was my opportuniy and my audience to explain about chronic back pain.

I said that my back always hurts as bad as my arm. I had to
weigh the options of the 'looks+comments' from these staff
members had I just come in stating I needed something for
my back. I talked to him for 20 min. about chronic pain and
the impacts on people and how it is grossly undertreated by
the medical professionals in general.

Anyway fast forward--I had surgery on the arm--they needed
to graft bone from my hip because of the width of the break.
I spent 3 nights and 4 full days in the hospital. Yuck!

When it was time for the staple removal (14 of them) the nurse told me the dr. would like to speak with me.

BEST visit ever for me and hopefully many other chronic pain sufferers out there. He informed me that my case had been reviewed at the monthly mtg. He felt it was gross
negligence that I had chosed to wait so long at home in
obvious terrible pain because I felt I wouldnt be treated

He stated that on that night he and his nurses agreed that
many have become desensitized to people with chronic pain.

He also gave me a script for 300 percocet. I could fill 100
at a time and to come back when I needed another script. He promised that he and the er were going to be more aware
and diligent about care and diagnosing of chronic pain patients--especially back pain.

Gee I wouldnt have broken my arm by myself years ago if I
knew thats all it would take to get treatment. LOL-kidding

Thanks for reading this long winded book--I truly hope that iit helps at least one person to get the treatment they
deserve and lesses the 'stigma' attached to using the ER




  • I have not had to visit the ER fortunately, but I have read about many that have and have been treated just the way you described.
    So sorry about your broken arm and hope you are healing well.
    Thanks for sharing and for sharing with the doctor at the time when he listening.
    Take care.
  • Sorry for the added pain you had to go through jsut to get attention but THANKS! I also went to the ER when my back went out just to be sent home and told to take some tyenol and call the doctor in the morning. Ha! What a jerk, he will certainly have back pain a later in life just to show him. I was really angry with the guy treating my chronic back pain that way. I have also stayed home and toughed it out before my surgery. Thank you for opening the eyes of some of the staff and good call from your family doctor to take it to the next level.
  • Hi Shalom,
    I'm sorry to hear about your arm but very proud of you for being honest with the doc and ER and in return this worked out the best for you. By doing this you acted as an advocate for other chronic pain sufferers who may be in your situation and will hopefully, be taken better care of because of you. It only stinks that you had to suffer.

    Thank you for your sacrifice in hopes you may help others some day.

  • Well done Shalom. I'm sorry you broke your arm but am amazed that you took the opportunity to raise awareness about our plight with chronic back pain. I hope your arm heals soon and I am so glad the staff wound up treating well and were willing to listen to you.

    I too am guilty of avoiding ER's because I think I'll be dismissed or treated rudely. I have heard horror story after horror stories about people being accused of being drug seekers (Turkey, frequent fliers, gomers)and then to find out they had something serious going on. It is certainly an egg in the face of medical professionals but it happens so much because they're accosted by real dope fiends every day. If I feel I need to go, I call my regular doctor first so that I am referred over there by him. Sometimes the office will call the ER dept. ahead of my arrival so the staff knows what's going on and have instructions on how to treat me.
  • the fact that your family doctor was there..i know that if my family doctor was on call at the local hospital ..he would do everything in his powers to help me ASAP as he is a kind and compassionate man.i hope that you will mend soon and that your pain is at a manageable level.
  • I went to the er after an esi a little over a year ago. I felt like my head and neck was exploding. Pain up and down my bad shoulder and arm.

    First I called the PM who did the ESI and was told, "we don't prescribe pain meds" and very rudely at that! Plus the nurse told me to call my PCP.

    I call my PCP, instead of him conferring with the PM or a pain specialist at the institution they both work for he told me he did not know what to do either and go ahead and go to the er!

    As you may imagine I was now in a lot of pain and furious! I had my wife take me to the er. It took forever for them to process me and get me in the back. Now when they finally got me in the treatment are they placed my out on a gurney in the hallway! They would not even give me a room!

    While sitting out in the open for all to hear the male nurse asks me why I am there and, "what works for you!" I explained I was in pain and I did not want to be there and had no idea of "what works for me". He finally got it and went away.

    A little while later the doctor finally comes over and asks me for details of my pain and tells the staff to get me out of the hallway! Finally! He then talked to me in a room for a while and understood I was not shopping. I truly was in pain. He then called my PCP from the nurses station phone! He proceeded to yell at my PCP for sending me to an er! He told him that he did not understand why I had been sent to an er to treat pain and that in the future he expected my PCP to do his job and take care of me!

    I have never had an issue with getting my PCP to take care of my pain since then. He still sucks at it though!

    I think shaloms doctors may have understood the issue better, but at least I changed one doctors perception!

  • First off I do hope you are healing well.
    I had a very bad pain day last week. My husband came home from work only to find me crying in so much pain. This concerned & scared him, & wanted to take me to the ER. I refused because of all of the horror stories I have read here about the ER & pain. He did not understand why I refused to go until I told him about the horrors. I ended up doubling up on my pain pills. He didn't like that either but agreed not to take me.
    I am glad that your Doctor heard you & addressed the staff. If only more Dr.s were trained better maybe we wouldn't be so ill treated? I"m sorry you had to go through it all & hope that you are doing better now. >:D<
  • I would never go to A&E, like most people have said you have to wait hours, you feel like a criminal/junkie & the staff can be very unhelpful to say the least. I've sat at home crying my eyes out rocking backwards & forwards & ended up increasing & possibly overdosing on medication to aviod having to go in. If people had to swap with us even for 10 minutes they would understand what chronic pain is like & things would be very different.
  • I agree with the hesitation to go to the er. Right before Christmas - something new happened to my pain....and I drove to the er 2 times after working over night and sat there and cried, wondering if i should go in or not - for the reasons you described I did not - but I too paid a price for it - 17 days in major back spasms. It intimadated me to know that all is reported back to pm docs - what would they think. In the end I did call my pm docs directly and figured they knew me best.

    I do hope that er/staff and so on - can tell the difference - but I guess sometimes they get burnt out - I guess I would to if I had their job.

    thank you in any case - I am sure the staff there will rethink their judgements - and hopefully this is all for the best.
  • I really am embarrassed to admit that I didn't realize er's had such a bad reputation and could be like that until my 1st experince.... after suffering all night my pain was so bad I went to the er. It was the biggest mistake I ever made! I had never been before but the nurse told me I just pulled a muscle, to toughen up and get over it even though I explained something bad was wrong because I never had pain like that. My husband tried to tell her too but she told us it was nothing serious, a pulled muscle at most and ...then she talked to the doc outside the room explaining I had a pulled muscle and he agreed even though I couldn't walk, sit, get on the table, I was in exreme pain and with no fever and just high blood pressure(wonder why?)they didn't do anything, no blood, x-ray, nothing, they gave me skelaxin and told me see my reg. dr. in a few days if I wasn't better. I cried and told my husband I must have bone infection or cancer the way my legs, back hurt and Br issues....then went to my reg.dr., he said it might be your back and ordered the mri. When they saw the results with my symptoms they knew I needed surgery yesterday! Then we had to find an ortho in another city to do it! No ER for me! At least not at that hospital, not for anyone I love or care for!
    But thank you for telling them like it is! We need all the help we can get! I hope your arm heals good as new! And hopefully, your back issues will be taken seriously from now on!
  • I had a major flareup over a week ago. I was at the point that others stated above. I was hurting so bad I was crying, curled in fetal position and took double dose of all my pain meds. I didn't care if it caused an overdose at that point. I only wanted some releif from this pain. I didn't even consider going to ER cuz of the horror stories I've heard on here and really wasn't looking forward to the 30min drive to ER anyway. I eventually passed out for the night and woke up feeling a little better.

    It is a darn shame that we have to suffer like this cuz of junkies who abuse our pain medications.
  • I saw my doc a week after the botox injections in my trap muscle (which hasn't improved anything - unfortunately) - discussed my meds with him...he is trying again to get Lyrica approved for me (which is still being denied by my insurance) and told me that i could take the max of ultram 8-50mg a day if i need to. Since my appt. some days i have had to take the max - but not all - what has happened of course is that i went thru it quicker, so now at refill time, i have to wait 2 days to get the refill. i do respect the idea behind why, but it still leaves me in a hell of a lot of pain for 2 days!

    here is the deal - not looking forward to what the next 2 days are going to be like, and dang I look like I am over using my perscribtion to the pharmasist...it was approved by my doc - do i have my doc call, do i talk to the pharmasist?

    Same problem, just different loop of the system
  • for the above, if its an increase or change in dose that dr ordered, you can get a refill, when the increase has you runnin out. that is when you are now due for a refill. hope this is helpfulo and you ger your meds.
  • Baffled, That is really just an awful thing for your doctor to do to you! My doctor has told me I am allowed 6 Norco a day. He writes me a script for 5 a day. As long as I do not ask for more before the 25 day mark he writes me a refill and we continue on in that fashion.

    If he is telling you 8 is ok, he should be taking care of your needs in that fashion. I don't know your relationship with your doctor, but when mine was running me around on scripts like this I got angry and laid the facts down in front of him in writing. That is how we reached the current working arrangement.

    Before, he would write me a script for 4 a day, then tell me I could take more. I would run out in 2- 3 weeks or less. He took care of me, but he would write me a one week script! I then had to make an extra co-pay to cover that week. I told him he was not being fair. He understood my point, did not want to move me to a longer acting med, so we reached the arrangement we use now.

    You may want to write down your concerns and approach the doctor to see what he says.
  • A few months ago, I was asked to speak to a group of second year nursing students on the impacts of chronic pain. (Here is the link to my post on Good News: http://www.spine-health.com/forum/good-news/my-debut-a-chronic-pain-spokesperson)

    One of the things I really stressed to these young nurses is NOT to judge people who attend at the ER, because they may look as "good" as I do, but feel shattered inside. I also stressed that as a chronic pain patient, we go through a lot of steps at home (i.e. heat, ice, rest, stretching, breakthrough meds, etc.) before we take that last step....going into the ER.

    So often there is a stigma attached to reaching out for help, and why is that?? If we had a broken arm, such as you did, shalom, or if we had an asthma attack, we wouldn't hesitate to attend at the ER, and the doctors and nurses wouldn't hesitate to treat us. It shouldn't be any different for those of us with chronic pain.

  • I dealt with just this ER issue last night with no resolution and basically being told that what I think is the problem "simply can't be" and that it "cant possibly be" as painful as I said either! So fast forward to now...I do what I was told-called my PM Doc's office first thing this morning @ 8:30 when they open...have heard nothing back (calling again in 5 minutes!). Havent slept in 2 days, been in massive pain for nearly 20 hours now sobbing immensely for at least 16 of those hours...

    You can read the story under the "spine injections" section where I posted that I think I may have "spinal headache" due to CSF leak from yesterdays L4/5 injections...it explains the whole ER thing and then some.

    Believe you me, if and when I find out what IS wrong...and if it IS what I think it is...I WILL be taking the proof in to personally show the Doc that treated me, or should I say mis-treated me, last night in the ER. This happens to too many of us and I'm not going to take this one lying down (once I can physically get back up again first, haha).

    Thank you to those that have stood up for us CP'ers! Let us ALL stand up to these "Medical Professionals"...education is key!
  • I took your advise and wrote a note to the doc - went in the mail today. ty for your suggestion. I also, made an appt to see the doc who did the botox injectins to report back that i seem to be worse than ever (both in the pain mgt dept at the hospital).

    He said the first time I met him, 'stop diagnosising yourself, that is my job - your job is too complain" Well, hopefully I can do this - so that my pain gets addressed appropriately.

    thanks again
  • wow...I was just reading this old thread and am amazed that you did not get slammed for taking more meds than you should have or talking about overdosing.
  • The worst irony of going to the ER is all the signs up encouraging people to speak up about their pain. A huge sad face with different 'pain' expressions below to categorize the levels of pain. When I went to the ER last for pain(my condition had not been diagnosed yet) at the admit desk after they took my temp and blood pressure, they immediately hooked me up to a heart monitor? because my blood pressure and heart rate was so high. I was then taken to the area to be seen immediately( waited about 20 more minutes) when the RN saw my chart, saw that the other department had not given me anything for pain. Unfortunately, she chose that time to go scream at the other nurses for doing that. Her assessment is that the admittance nurses are too lazy, desensitized to treat people individually. They do see a lot of drug seekers, but that is no reason to treat pain as a throwaway symptom. Studies have shown how much a body can deteriorate under the stress of pain.
    I also have a hard time dealing with pharmacists. Just because they are not familiar with my disease, they always give me a hard time when refilling my prescription. They give me a blank look when I tell them what condition I have. They shut up quickly when I tell them, if they have such a problem, I have no problem with them calling my doctor and questioning HIM about my condition and whether or not my prescription is warranted.I always get this "well, I'll fill it this time" vibe from the pharmacist. Cheap power trips for all around, I guess.
  • I guess it just depends on the situation whether or not we take more of our meds than we should...or take some that isn't ours if we are out. Both actions are prohibited by the pain clinic. Wondering why I caught so much crap for my post earlier titled "Well I guess this is it"
  • Just like a couple here said earlier, I understand why someone would take an extra dose of break through medicine before thinking of going to the ER first. I would try to stick it out til morning until my clinic opens and try to get in with them, than going to the hospital. Why does it have to be this way? Who wants to go there and be ridiculed, ostracized, chided, or have their pain dismissed as just a longing to get high? This scenario has to change!

  • I NEVER go to the ER unless its a life or death situation.The treatment you get as a pain patient going to the ER is what makes the medical community look like a bunch of hypocrites.I certainly would rather take an extra dose and make it to my doctors office the next day.I adhere to the rules, but this is one case where its better to take care of oneself than be embarrassed and lectured while your hurting.

    Even on these boards its sad to see some take a moral high ground at another's expense, when most everyone here has faced this situation at one time or another in their course of treatment.If you are one of the fortunate few that has had an easy ride getting proper treatment and not faced this, then be more understanding as well.

    It really adds more misery/pain to have family,friends and so-called caretakers reduce you to some govt. statistic that you will either die or become an addict due to these medications.Real pain, needs to be treated better and with more sympathy.
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