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Hospital Visits to get pain under control

Matt GreebMMatt Greeb Posts: 6
edited 06/11/2012 - 8:51 AM in Chronic Pain
I have posted here before for recommendations and i guess this is more of a show of hands question. I take Norco 10/325 4 x and MS Contin 30mg 2x . Ever Since i had a Facet injection i have had serverly increased pain in my legs and back . My leg pain previously was almost never a problem .

Right now i have been awake for well over 24 hours laying in bed for 10 and doubling up on my meds. I cant break this pain cycle . I just have some "basic" injuries which dont seem "severe" 3 bulging discs and nerve damage @ L5S1.

I called and em waiting for a call back from my PM doc to see what to do , but im scared i may soon be seen as a drug seeker because in the past 4 months i have visted the ER and been admitted for pain management 3 times. Not under the radar , always telling my doc , just the meds dont 2 of which have been since my procedure that has seemed to increase my pain.

is it a common thing for chronic pain sufferers to visit ER's to get over that pain hump? My ER is really good and i never try and cover anything up and always share info and keep all doctors informed.

just i dont want to run the risk of getting flagged or anything like that . All times i have been admitted for at-least 2 days .

please share similar stories if available.


  • Matt,

    If your that much pain that you can't take it at home with the meds you have, then the hospital is where you need to go, to get it under control. Sometimes pain can be so bad, that it is unhealthy to leave it out of control for so long. I think the key here is if your using the Er to get medications, which it doesn't sound that way to me at all. The key thing is never assume your doctors have been notified you are in the hospital for pain, but be sure to call them yourself.

    But you might want to talk to your pm doctor about having something when it is that bad and what you should do? Personally my pm doctor said if it is that bad then go to the ER, just be sure to call him and make them aware of any meds given to me. But typically they get it under control and then back to my normal medicine and I don't have any extra scripts to fill. I think the key thing is to be sure your not getting double scripts from a pm doctor and then from the hospital.
  • I have to go to the ER on occasion. They can assess me quickly and bring things down. Waiting is the hard part.

    I must admit that it has been a year since I have had to get to the ER, but before being on ER and IR meds, I was in there at least every 3 months.

    I always keep my DR in the loop and will write him a page of what was going on. He also gets the reports from my visits through the system. It was due to this that he started bumping up my meds, to reduce the visits to the ER.

    Do take care - look after yourself
  • i have never used the er for pain. never. if you go too often then the hospital will label you a drug seeker. i am surprised they have not called your dr especially if you signed a contract. if you have pain GO TO YOUR PAIN DR AND TELL HIM NOT THE ER. IF YOU DON'T HAVE A PAIN DR GET ONE ASAP. it is really bad news
    I have 4 fusions from L5-3, the latest last May '12 where they fixed my disc that broke.They went through my side this time. I take 40 mg of oxycontin 4x a day and 4 fenatyl lollipops 300 micro gms 4x a day.
  • Jon,

    So glad to hear you've never had to go to the ER for pain flares, but did you even READ his original post before you slammed him? He has a PM, he does keep his PM in the loop. Geesh...

    I agree with Tamtam, if you need to go to the ER, then you need to go. It isn't like you're running out of pain meds and then using the ER as your pain clinic. I hope your PM can find a mixture that works better for you.

    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • i disagree 100%.
    one should never use er period for pain control. like i said if it ain't workin
    go to pain dr. i think most pain drs would get upset if one went to er and i have never heard of one being in the loop. goes against most contracts. most drs at er feel that pain patients go to the er for more meds not pain control. like i said, go to pain dr. why have one if you don't use him for pain control. i would be dropped in a heart beat by my pain dr if i went to er or another dr. this is why pain drs are suspicious because of this. it would be like going to 2 dentists for tooth ache. i belive most pain drs and er drs would agree with me on this one
    I have 4 fusions from L5-3, the latest last May '12 where they fixed my disc that broke.They went through my side this time. I take 40 mg of oxycontin 4x a day and 4 fenatyl lollipops 300 micro gms 4x a day.
  • MetalneckMetalneck Island of Misfit toysPosts: 1,364
    No need for ER pain management.
    If I had 700 mics of Fentnyl lolli's available to me and 45 mg X 4 of Oxycontin - I would never need to go to an ER for pain management either. Where has your compassion gone? I believe that you have stated that you still work and that would mean you drive everyday with that load on. I have concern and compassion for you and your situation - I don't know how you do it!You are a substantial man. Kudos to you!

    With Concern,


    Spine-health Moderator
    Welcome to Spine-Health  Please read the linked guidelines!!

  • jon you have made your opinion known and that is fine. It was just like in the other thread about the contracts, you *assumed* that because a person had UAs that they didn't either look as honest as you, or they must be on some type of disability or medicaid program, when in reality, another persons pain and Drs have nothing to do with your particular situation. Every persons situation is unique unto them. If you want to know why I brought it up here , well, it's because you said "If anyone knows why , tell me WHY". Since you and your Dr have such an open dialogue, why don't you simply ask him.

    Pain can become an emergency situation when a persons pain is out of control to the point that it affects their BP and heart rate. These are the times when the ER might be the only solution. Waiting to see your PMD in a situation such as this one can be dangerous.

    Doubling up on your RX's is (IMO) not a very good idea and can really mess up your tolerance, making your regular dosage no longer affective, so getting up with your Dr is imperative, but when you are in pain we all know what comes first at that moment in time.
  • I had to go to the er for the first time ever because of out of control pain this week. My pain doctor doesn't prescribe my meds, my pcp does. I do not have a contract with either my pm or my pcp. I can not simply go to my pain doctor, he is always booked solid at least 2 weeks in advance. I called my pcp the next day to let her know, and because nobody can figure out the source of the extreme acute pain in my back right now, my pcp has told me to go back to the ER if it spikes again. Matt, as long as you keep your doctor in the loop, then you should not have anything to worry about. If the ER staff gives you any flack, just tell them to call your doctor.

    Judgements should not be made when all the details are not known, especially since everyone's situation is different. I'm getting tired of holier than thou attitudes and snap judgments.
    APROUD CANADIANveteranButNOTa doctor, my thoughts are my own
  • MetalneckMetalneck Island of Misfit toysPosts: 1,364
    who is at my towns site only 3 days a week stated (on voice mail message) that if you are having any problems on days the clinic is closed ,,,, call 911 or go to the nearest ED.

    Different strokes for different folks. there are no absolutes.No Black or White .... just varied shades of grey.

    Spine-health Moderator
    Welcome to Spine-Health  Please read the linked guidelines!!

  • I've recently had to go to the emergency room because of a bowel blockage. I am on my regular pain medications for chronic pain which are considerable in dose. If I have "additional" pain (which I did have with the blockage" the hospital has twice offered me more pain medication for the acute pain. I've declined for two reasons: 1) there is absolutely nothing that they have at the hospital that is stronger than the meds I am currently on and 2) I've been afraid to mask any new symptoms and would rather they get to the cause of the pain and fix it. I have a contract with my pain management doctor and I've always advised his office if I've been in the hospital for any reason. I just want to make sure he knows what's going on with me. I see him once a month as well. I've been in a position to over hear a patient literally crying to the emergency room doctor and begging for additional pain meds, only to be turned down because she apparently was a "frequent flyer" in the ER. It really bothered me to hear her begging for pain meds.
  • My pain contract states "if you receive narcotic meds. from any ER or other source, you must notify us within 24 hrs of receiving said meds. If our office is closed we have a answering system. Leave your name, name and dose of meds, dr/place who gave it to you and diagnosis or situation meds was given for".

    Matt, so I guess what I am saying is check your pain contract and/or talk with your Dr about his/her thoughts on these visits to the ER.

    My concern with this many is that your pain is not very well under control. Or maybe something unknown is flaring it up and you need more tests?

    The fact that you are being admitted each time, tells me that the ER Drs have concerns for your health/pain levels.

    Most people who go for break through pain control are treated and released the same day, usually within a nfew hours.

    I am sorry your pain and/or the controlling of it is so very hard to do :(

    Please let us know how you are doing.

    L1 - S2 "gone" useless in 1 way or another. DDD. RA. Bone Spurs. Tons of nerve damage/issues. Stenosis. Both knees replaced. 50 yrs old. I had a great fall (hence my user name) at age 41 and it has been a domino effect every since.
  • a load on
    wow i'm glad you know what is going on with my. first of all i have been on these for years almost 10. as people know you get used to pain meds and taking pain meds to me is like taking aspirin. i don't even feel it i am so used to them. my pain dr prescribes them unlike some of people here who up their own dosage. i have read about people who take 180 mgs of oxy and have done it themselves. my dr talks to me to make sure my body is ok. i don't go around drooling or falling asleep it sounds like some jealously by you since i am on this dose. maybe some here wish their drs would dose them also. i think my dr knows what he is doing. i have had 2 pain drs who have written this dose for me. if i had a problem working, i would be off them. my co-workers would not know if i was on meds unless i told them. my principal knows and so does the school nurse. i have never had complaints from others or parents or principals about being on my dose. never had a ticket driving, and have not fallen asleep at the wheel. so people who criticize my meds, talk to my dr if you have a probelm. so once again, i believe most drs would agree with me and most hospitals about going to er for pain control. there are too many people here who dose themselves and go to er on premise that their pain is not under control. i bet those are breaking their pain contract and once again for the MILLIONITH TIME. it is the trips to the er and the dosing of oneself that makes it harder for those who abide by their contract and take the dose they are supposed to. when drs and congressmen hear these stories, they try to make it harder for us who take meds. i am angry at these people who make it harder for legitimate pain patients who follow their contracts and their drs
    I have 4 fusions from L5-3, the latest last May '12 where they fixed my disc that broke.They went through my side this time. I take 40 mg of oxycontin 4x a day and 4 fenatyl lollipops 300 micro gms 4x a day.
  • I've not yet had to go to the ER for pain control, (knocking on wood) but I totally get how that could happen.

    I woke up early on a Saturday a few weeks ago with much worse pain than usual, all I had was Vicodin. I took that with ibuprofen & put an ice pack on my back as my DH stood by waiting to see if he was going to have to take me to the hospital.

    That incident prompted me to push my GP for stronger pain meds.

    It almost happened again, but I took another percocet & used the ice pack & things eventually calmed down.

    But, believe me, I can totally understand how the pain can get bad enough to justify a trip to the ER.

    I don't know what else you can do on a weekend or at night when your regular doctor isn't available.

    Everyone's pain is different, I think if you are suffering that badly, you need to do what you need to do to take care of yourself.
  • MetalneckMetalneck Island of Misfit toysPosts: 1,364


    Spine-health Moderator
    Welcome to Spine-Health  Please read the linked guidelines!!

  • dilaurodilauro ConnecticutPosts: 9,850
    Everyone has made valid points regarding ER visits, Medication dosages, etc.

    I think one thing we all need to consider is that One man's poison, another man's medicine

    Really, all I am trying to say is that we are all individuals with different circumstances, different doctors and different tolerances.

    I do believe in ER visits, but for just that emergencies

    And yes, that can also mean when your pain level is totally out of control, you can not get to or even talk to your normal doctor.

    There have been times over weekends when I had some major problems and was thinking about going to the ER. I never did, just found other alternative and safe ways to deal with the pain. When I would visit my doctor, I would tell her about almost going to the ER. Her reply has always been If you are in a lot of pain and can not control it, then you should go to the ER, dont try to be stoic

    But that has also come from years of building trust and confidence between my physiatrist and myself.

    For many other patients, she has told them IF they need to go to the ER, make sure that they tell the attending ER physician to contact her. This way she knows everything that is going on.

    So really reading all the previous posts, no one is totally right and no one is totally wrong. Thats just the mechanics of pain control.
    Ron DiLauro Spine-Health System Administrator
    I am not a medical professional. I comment on personal experiences
    You can email me at: rdilauro@veritashealth.com
  • I think although we have many common experiences, everyone experiences pain differently & our bodies react to things differently.

    Sometimes, we have to balance the equities & make a decision at a time when we are in terrible pain.

    I was thinking about this thread today & what our bodies go thru when our pain is extreme. My BP is generally normal, even a bit low, but if my pain levels are high, my BP often goes up. My doctor said pain will do that.

    So I wonder if someone who already has high BP has to decide whether the pain is at an unmanagable level, which is worse--to go to the ER for pain control or try to tough it out until he can see his regular doctor.

    IMO, it's a completely individual matter & we all have to factor in what our own bodies can handle.

    It's sad that we even have to have these discussions at all, isn't it?
  • Yes. I mentioned BP & HR in post #7 yesterday, and of course when our health is concerned there are so many different things to take into consideration, and we are all so different that it is almost ludicrous to say that "no one should ever go to the ER for PM..ever, under any circumstances, but only to your PMD". I have never gone to the ER for PM, but how lucky am I then, and there have been so many times that I have thought about it, needed it, and know that I probably should have even, but it's this very attitude that kept me in pain and suffering at home. Because I have read to many posts and understand that this is the way a lot of CP patients are viewed in the ER. I just hope that if I ever do have to go that they keep records, and know that I am not a "regular", but really a patient in need. Actually I hope I can just keep doing what I do now and not have to go, but life doesn't always work in my favor and there may come a day.
  • I have indeed gone to the ER for pain control. Many years ago when I was in college & staying with my sister over the holidays, I developed the worst abcessed tooth of my life.

    My sister tried to contact her dentist, on NY Eve (it fell on a weekend that year), forget it. I made myself sick with every OTC pain med known to humanity.

    My sister finally took me to the ER & they gave me pain meds after taking a quick look at my abcess. That got me through until Monday when I could see her dentist.

    I don't recall giving a rip at that point whether anyone thought I should be there or not, I justed needed something for the pain or my head cut off.
  • It's not common to go to the ER for pain management but I had to go when my back was first injured and my Dr. was on vacation and had no narcotic meds. Went to one ER and was offered Toradol or Tyl. #3 and took the Toradol because I get a rash with Tyl. #3s and received no shot of nothing.

    Too bad where I work was closed as they're only open as Urgent care from 7am until 10pm or would have gone there for a shot. I went to another hospital and got percocet until my Dr. was back but no injection.

    I started like you at MS Contin 30mg once a day a few days later back to Dr. for MS Contin twice a day then went back a few days later and got MS Contin worked up to 4x day and there I stayed for two years at 120mg day and then was told that during the day when you're walking etc. to take MS Contin 60mg in the day and 30mg at night and could use another 30mg if needed. But you need to see your Dr. to find your amount you need. Especially if facet injections cause more pain you could ask for something to stop you from going to ER. Keep calling him daily to get in for an appointment to get your meds adjusted. The weekend seems to bring more people to the ER. I'm sure my Dr. was tired of seeing me every few days but I had to get the pain under control and it wasn't easy driving and so much pain from the vibration of the car.

    Sometimes I feel like I could go to ER as the pain is an 8 and I'm looking for taxi money to get there or get my husband to drive me knowing I probably will have to wait hours for something extra for pain. I try everything get in the tub for a soak, try ice/heat, deep breathing watching a comedy fall asleep. I hate the ER except when I'm working there and try to avoid going but I do have a good Dr. that has adjusted my meds and now I take Oxycontin which works pretty well for pain control. I hope you get into see your Dr. and hope he helps you as you can't keep going to ER for pain management.

    It's not fair that some are so lucky to have good pain meds and others have to fight for pain meds and hope your Dr. will help you. Best wishes. Charry
    DDD of lumbar spine with sciatica to left hip,leg and foot. L4-L5 posterior disc bulge with prominent facets, L5-S1 prominent facets with a posterior osteocartilaginous bar. Mild bilateral foraminal narrowing c-spine c4-c7 RN
  • er means to me emergency emergency emergency, life threatening. if it is not that bad go to a doctor in the box. they are all around and open on weekends and holidays. the only time i have gone to er is for kidney stones, before i was on pain meds for back and last year when i almost died due to an infected liver which was caused by gall bladder problem. i had 104 temp, throwing up and peeing billirubin from gall stones. i had it during the week and next day went to my dr and she told me it was life threatening and i should have gone to er. i was admitted to dr then had surgery. thought stones were out then i woke up with extreem pain in heart area. i thought i was having a heart attack. called paramedics and they did heart work up with ekg. it was not heart but stones that they did not get out which were stuck. the surgery to get them out has bad side effects, pancreatisis. was out for 10 days. so er to me means i go only when i think i will die or for something extreem like stones. back pain at it's worse is not even on the scale of stones. i would take extreem back pain over kidney stones any day. stones are so bad you can't function, drive, do anything except cry and throw up. back pain is bad but i can still work and drive if need be. my back pain has never been so bad that i could not function and i have had 4 surgeries with 3 fusions. problem is that costs go up insurance wise and hospital bills with unnecessary visits. also one has to wait longer due to these visits. if you need to wait 4-6 hours and pay over a grand then go to the er for back pain. for me, i can take the pain
    I have 4 fusions from L5-3, the latest last May '12 where they fixed my disc that broke.They went through my side this time. I take 40 mg of oxycontin 4x a day and 4 fenatyl lollipops 300 micro gms 4x a day.
  • hi matt,
    I am lucky to have docs that will do a direct admit so i dont wait in the er...
    I think the hospital staff at my hospital is great now the er staff of docs..it depends on what you are there for... i have gone thru the er for different things asthma outta control...
    and the last esi injection i swelled up and the er doc thought i was a drug seeker...well i report that jerk...he labeled me cronic pain asap i said my body is swollen duh...
    so if you have to go to er yes go asap...
    they seem to have helped you before if you can call your pm or primary doc and perhaps they will direct admit you..
    I do not think you should suffer ever...have your docs paged and get things moving ...
    i was in for 2 days and it sure helped me

    just my 2cents worth
    tc hope you get that pain under control
    neck,bone spurs pain started 04, back issues and fusion l4,l5 06~hardware removed.
    good few yrs. 09 pain sharp, numbness feet,legs, diagnosed fibro, neurop. legs.lung issues.
    daily goal do good thing for someone.
  • Our local urgent care facilities are absolutely not open 24/7. They keep normal business hours, some are open till 12 or 3 pm on Saturdays & most are closed on Sundays.

    I found out the hard way when I was extremely sick on a weekend. Turned out to be MERSA.

    I ended up suffering until Monday, saw my regular doc & he was horrified that I had waited so long.
  • Not everyone has 24 hour urgent care centers. In our small town we have an urgent care center that is open M-F 8am=6pm and Saturday 9am-2pm. It is better than nothing, but still leaves something to be desired. So what are we supposed to do after hours if something is really wrong.
    Earlier someone posted that the doc even says to go to the ER after hours on his answering machine.
    I have also gone to the ER for kidney stones. Yes, they do hurt bad==real bad, but THEY ARE NOT off the scale.
    The pain scale is ONE to TEN. ONE being NO pain and TEN being the WORST pain you can imagine (ie. kidney stones)
    Kidney stones ARE my ten==they ARE the worst pain I can imagine. So if my back pain is at a 10, and I want to go to the ER, then I have every right to be ther. (as you stated in your post, stones are a pain so bad that you can't function, and that would be the kind of pain I am in ON MY SCALE)
    You should not judge anyones pain level--it certainly sounds like you and I interpret the pain scale differently. And also, you don'y know what kind of urgent care facilities are available to him.
    His BP might have been elevated to the point of having a stroke. He may have been almost crazy or suicidal. You don't know, so don't criticize what you don't understand.
    They pain meds you have should take care of you pretty well, especially now that we know how you use the pain scale.
  • Pain does so much damage to the whole body. Blood pressure certainly is one big concern; there are adrenaline spikes & other serious stressors on the body that cause a lot of harm if the pain isn't controlled.

    I applaud those who choose to do what it takes to take proper care of themselves. If that means a trip to the ER, so be it.
  • it is amazing the some always have an excuse for back pain. there is always a reason to find yourself in the er. why don't you talk to er doctors or nurses and see how they feel about back patients going to er for chronic pain. they call them frequent fliers. i hope those of you that are compelled to go tell the drs and nurses that you have a dr for chronic pain. i still am surprised that this visit does not go against your pain contract. this is the same for those who up their doseage for pain. same excuse. pain too bad, can't get my dr etc. my back pain has never been so bad that i had to go even before i was on meds. i called pain dr and said i needed to be seen asap. i am also surprised that nurse or ddr in er does not call you on being a pain patient. if you have a deal with your dr so be it but i have never heard of a dr saying it is ok to go to er for pain.
    there are always those who up their dose and go to er and argue with those who say it is not right to do this. i have gotten in arguments with people on this site who get mad when i say it is not ok to up your dosage on your own so i guess it will be the same when i say er visits are bad. but remember, this is why our meds and visits are so pricy. too many er visits make the costs go up. in california that is why hospitals are going bankrupt. too many people wh o go to the er for treatment.
    I have 4 fusions from L5-3, the latest last May '12 where they fixed my disc that broke.They went through my side this time. I take 40 mg of oxycontin 4x a day and 4 fenatyl lollipops 300 micro gms 4x a day.
  • Where do you think that people should go if someone has pain to the point that they feel it is an emergency and:
    1. It is after office hours.
    2. They call the PM doc number and get the message that says, "if this is an emergency, go to ER."

    How can you judge whether or not someone is experiencing enough pain toconsider it an emergency.
    1. If they are experiencing pain equal to a kidney stone, they have every right to go to ER, just like you had the right to go when you had a kidney stone.

    Why do you think that Matt's trip to the ER is having an impact on hat you pay for anything. He never said that he went to the ER and sent you the bill for it. Do you know what kind of insurance he has?? Do you know if he paid cash up front? Don't judge if you don't know the facts.

    One good reason that medical costs are so high is that medical supply companies get away with charging a fortune for their products, and the hospitals pay it. Insurance companies pay less, while others with large co-pays end up paying more.

    If he is a "requent flyer,' the doctors and nurses know how to handle it. If he is not a frequent flyer, then he will get the treatment he needs. He stated that both times he went to the ER, he was admitted for two days. That seems to indicate to me that there was a problem.

    Yes, he needs to find a doctor that will address his needs and not use the er for breakthrough pain management. But to me, it sounds like he went to the er because it was an EMERGENCY.

    I have never NEEDED to go to the ER for pain management, but I would go if I had to. I have a good doctor, and my pain is usually under pretty good control. I went to the ER for a kidney stone. (If I had level 10 back pain, that would be equal to a kidney stone) I am not sure you understand the pain scale as wort pain you can imagine if Kidney Stone is off the chart for you. What do you consider a 10?? Bee sting?

    I know from experience (I AM a RN) what many of them think and how the situation is handled. I must have missed it in your posts, are you a doctor or are you a nurse?
  • if you have a deal with your dr so be it but i have never heard of a dr saying it is ok to go to er for pain.
    Well, my doctor has told me multiple times that if my pain gets too bad, to go to the ER, which I did for the first time this past week. And after talking to her about it the next day, she told me to go again over the weekend if I needed to. Same as with almost everyone here, who have said their doctors have told them to go as well, if it's after hours. Not all of us live in places that have 24/7 after hour clinics. But, I guess we're all liars...

    As someone else mentioned, if you don't know all the facts, weren't there to see the person or don't know the person at all, except from them asking a question, then don't judge. Just because "you" have never heard a doctor say go to the ER, doesn't mean it doesn't happen. Also, not all of us are on contract. Not all of us up our dosage on our own. Most of us pay into insurance that covers the costs, and if we need to use the resources that we pay for, then so be it. Actually, some of us are lucky enough to have free health care, and most of us with that, don't abuse it.

    I don't care if my 10 is not the same as yours, it's mine, and we are 2 completely different people. I also don't care how many surgeries you've had. I've had several myself, just not all spine related. I also have almost died when I went into septic shock. I don't shove it down everyone's throat, because we are all different, and I would not expect that someone else's pain, or pain tolerance, is the same as mine. Who knows? Maybe because I've gone so long without having more spine related surgery, my 10 is actually worse pain than yours is. Maybe not. Maybe my pain tolerance is better than yours. Maybe not. There is no way to ever know, not with anyone. It's not comparable.

    So, seeing as this new pain that I'm now in is now my new "10", if I can't handle it any longer as it's been over a week, and I'm under medicated because my doctor doesn't like to prescribe a lot of meds, I will be going back to the ER, just as my doctor instructed me to, and actually, as the ER docs did as well, if my pain spiked again...
    APROUD CANADIANveteranButNOTa doctor, my thoughts are my own
  • jon, you made your point clear the first time, after that it was only putting it out there to come back and haunt you later, because remember, what goes around comes around, and there may certainly come a day when your pain is not in control as much as you need it to be. I do not wish this to be, but this is just how the world and karma seems to work. Things change and they change every day, so it's best when you make your opinion known to understand that it is, in affect, only yours, and others opinions are okay too. That and the fact that others have different ideas about what is and what is not acceptable as far as dealing with CP at home and if it becomes unmanageable. Obviously a 10 is a ten and at some point a person makes a decision to go to the ER..or not, If the Dr(s) there at the ER assume something else, that is a totally different story, and one for them to tell.
  • MetalneckMetalneck Island of Misfit toysPosts: 1,364
    Okay the real defination of emergent IS defect of Airway Breathing or Circulation (The ABC's) of emergent medicine. So Kidney Stones (And I've had three only 2 requiring ER visits)and would officially not qualify under this ancient thinking. If I happened to have Some IV Dilaudid or maybe Fentynl Lolli's around for me to suck on I would have no need to even consider the ER. Id treat at home.(As I did with my third stone).

    This issue becomes very simply what is considered by one person is not considered an emergency by another - I worked in QA/UR for a well know H.M.O. in the mid 80's and applied to ABC'c rule strictly.

    Back pain, neck pain, kidney stone(s) would have been all denied unless preapproved by your primary care doctor.

    But guess what .... this isn't the mid 80's anymore and like it or not ER's are faced with a great deal of "primary care" for fractures to infections and lacerations to rashes of unknown etiology.

    There is a federal law that currently applies to all ER's ..... It is call EMTLA (Emergency Medical Treatment and Active Labor Act. What this law stipulates is that it is the duty of every er to treat the patient with what ever the presenting problem is until they are determined to be stable (or the baby is born). So pain contract or not .... the hospital DOES have a duty to perform. That fact should say something about this issue.

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  • imho
    a visit to the er, one should be admitted, not sit on a gurney for a few hours, but admitted to a room,. have a dr treat you appropriately.the few times i went, gall bladder infection and stones, i was admitted to a room and then the dr ordered a battery of tests such as mri, cat scan, x-rays, a battery of blood tests. the tests were looked over and if it was that bad i would be in for a few days and the dr would notify my primary dr and my pain dr and my orthopedic surgeon. remember, something must be causing the pain and it needs to be treated. if one has a herniated disc then maybe surgery is needed or some type of invasion. i don't know of people who just get meds then looked at briefly then sent home with their meds. if a hospital did that to me, i would have a problem especially if i went to the trouble of waiting for hours and paying thousands of dollars to be seen in the er. i hope you guys don't go in get meds, talk for a whille maybe get a simple x-ray then sent home. a more comprehensive treatment plan should be implemented and if the pain was that bad, i hope one did not drive themselves. i hope someone would wait to see what would happen. and if it is an emergency, most drs have a message on their phone to call 911. the times i had medical emergencies, i called 911 and had an ambulance drive me. this is what an emergency means.
    I have 4 fusions from L5-3, the latest last May '12 where they fixed my disc that broke.They went through my side this time. I take 40 mg of oxycontin 4x a day and 4 fenatyl lollipops 300 micro gms 4x a day.
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