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Treatment at ER

Hope it is OK to post this here.

This is the only forum I have ever used so far.

My daughter has had pain in her rib area for the last 2 weeks.

She saw the PA at our local clinic.

She is really good and usually right on the money with her diagnosis.

They did an x-ray and told her that it was pnemonia so they gave her an antibiotic, an inhaler, and a few Lortabs for the pain.

That was on Tuesday.

Last night she called me from work in tears because the pain was so bad and said it was on the right side under her ribs.

I immediately thought gallbladder because that is how mine presented when I had it.

Took her to the ER and I must say they didn't seem concerned in the least.

Gave her a shot of Toradol and did blood work.

The doctor came back in an hour and said the blood work looked perfect so he was going to send her home.

He asked how her pain was and she said it was a 7.

He said he found it hard to believe that the Toradol didn't help at all and left the room.

Next a nurse came in with her discharge papers.

Needless to say she was so upset to be going home in the same pain she went in there with.

Told her to make an appointment first thing in the morning with my MD.

She saw him this morning and he did another x-ray and said he saw no pnemonia but was concerned about either gallbladder or a blood clot in her lung due to the symptoms she was still having and since the antibiotic the PA gave her doesn't seem to be helping.

He told us to head to Hospital Admissions so he could admit her for a gallbladder scan and a CAT scan.

Said he was appalled that the ER didn't even attempt to control her pain and thought that needed to be addressed ASAP and thought admitting her at this point would be the best way to handle that as well.

I asked why the ER couldn't have done the tests last night and given her pain meds instead of making her suffer.

He said they should have and if anything like this ever happens again, to have them page him and he will handle it.

Told us that some of the ER docs just won't give strong pain meds unless you have a bone sticking out or a missing limb or something.

Anyway, I am thinking about having her write a letter to the hospital administrators to complain about her treatment last night.

We have had problems there before.

I figure if everyone that had less than adequate treatment at this ER would complain, maybe things would change.

Thanks for reading this and please keep her in your prayers.

I read this Forum all the time and have just started posting here.

There seem to be some truly wonderful, knowledgeable folks here and I want you to know that I appreciate each and everyone of your posts.

They are so helpful to me. Sorry this was so long.

Hope everyone is having a pain free weekend.


  • Kiki48KKiki48 Posts: 196
    edited 05/11/2013 - 11:47 AM
    Don't apologize, I didn't think your post was long at all. I tried Toradol before and it did nothing for me. It's a antiflamitory medication. They never did a thing for me. Narcotics work the best for me. The spice Tumeric helps me with inflamation. That's quite an ordeal you through with your daughter. I stopped going to the ER for my Migraines because everytime I went they'd give me a shot of an antiflamitory med and it just made the migraines worse with throwing up. I do know that most ER doctors won't give pain meds unless you do have a bone sticking out. Actually I had a friend who broke his leg and the bone was sticking out but they said they couldn't give him any pain meds until they did a full work up. Oh that was really hard for him. I'm so happy that you have such a good doctor on your side. That makes all the difference in the world! Yes, you never know how many other people have complained about the ER. Your letter may be the one to tip it over where things will change. That must have been scary for you I can only imagine. Again, it's so nice to hear about your regular doctor. I'm glad you shared and I hope you'll keep us updated.

  • Thank you so much for your reply.

    I too have had migraines and neck pain since about 1993 so I have had my share of ER visits.

    When they offer me the Toradol or other meds that I know from past experience don't work, I am always willing to try them because I know they have a protocol they follow, but when it doesn't work, I am always hopeful that they will give me something that does.

    They know me well so some of them will, but it solely depends on which ER Doc you end up with.

    Have had a few that treated me like a drug seeker and it always makes me feel like crap when they do.

    Not to mention how miserable it is to go home in the same shape you went there in.

    Anyway, being a Mom it is very hard for me to see my babies in pain.

    I will let you know how she is doing tomorrow.

    Getting ready to leave for the Hospital now.

    Thanks so much for the support!

    It means so much.

    Take care.
  • Kiki48KKiki48 Posts: 196
    edited 05/11/2013 - 3:20 PM
    I'll be looking forward to hear how she is :) Take care of yourself today too.
  • Got to the hospital tonight about 6:00 and the nurse was putting a hot compress on my daughter's arm.

    Seems that when they were doing her CAT scan the contrast leaked from the vein and into the tissues of her arm.

    The nurse said it is called Contrast Extravasation.

    When I asked what treatment was, the nurse said they did not expect her arm to swell to almost twice it's normal size so they are consulting the Radiology Dept on what to do next.

    I looked this condition up online and in rare cases there can be tissue necrosis requiring plastic surgery.

    Please pray that the swelling will go down and she won't have any further problems from this.

    Has anyone else ever heard of this happening and what was the outcome?

    Thanks everyone for your support and input. It is greatly appreciated.

    Will keep you updated.

  • Oh geez, just what you and your daughter needed. You got it I have her and you in my thoughts. Sending light and love to you both!

  • jlrfryejjlrfrye ohioPosts: 1,110
    It involves 4 hospitals and 97 private practices. We have monthly meetings that everyone must attend including the docs and the topic of last months meeting was pain control.The higher ups from corporate was stressing to the docs that it is ok to prescribe pain meds. Long story short after the meeting we all went back to our office and all the docs were saying "I am not doing it" or "corporate has lost their minds". I could not stand it any longer and approached 3 docs that were in conversation. I asked them Are you happy with my work? Do you trust me with your accounts? Which I know they are I just had my second year review. After all replied yes I took a big chance and told them what medications I take daily. Opana, neurotin, zanaflex and loratab. I told them without my meds I wouldnt be standing in front of them. After saying that I just walked into my office and hoped that might make them think a little different. I doubt it does, but I couldnt keep my mouth shut any longer
  • N2braves,

    I'm hoping your daughter is doing much better.......keeping her in my prayers and sending positive thoughts!

  • jlrfryejjlrfrye ohioPosts: 1,110
    edited 05/12/2013 - 11:15 PM
    They are afraid to prescribe meds. Period. Afraid. Our area along with many others is having a huge heroin epidemic. Patients that these Drs trusted have become heroin addicts , ect,ect ect.. My docs all knew that I have a extensive medical history and they knew I took medication they just didnt know what. I really thought one of them would of came into my office to discuss pain issues but not one of them did, One of them is hell bent on making sure I quit smoking though. There have been many days I have sat in my office and heard the docs tell patients over the phone if your pain is that bad then go to the er. The problem with that for me is that we all know very rarely will the ER help with pain control.
    I think we are a long way away from phy. not having the fear of prescribing meds.
  • i has what i thought was a blood clot in my right leg last month. i went to a doc in the box through my dr's office and they said i should go to the er. i hate going due to having to wait for hours. well i went and had to wait but i found out i did not have a blood clot, i had celulitis a staph infection that if gone unchecked i could lose my leg. they immediately started me on pain meds, dialulid intervenously. i told them immediately that i was under the care of a pain dr and i told them his name. they said fine but they would give me the pain meds when needed. i was put into the hospital for 4 days and given intervenous pain meds along with my oxycontin that i told them i was getting. so instead of my fentanyl lollipops, i was given the dialudid along with the oxy. there were not hassles and they appreciated me telling them that i was under the care of a pain dr. sometimes i think that it is the hospital that is the problem. i have a ppo not an hmo. there are some hmo hosptials and doctors that do not give the best care and one has to beg to get meds and care.
    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.
  • terror8396tterror8396 Posts: 1,832
    edited 05/13/2013 - 7:47 AM
    it's hard to believe but with my insurance the hmo is more expensive than the ppo, by this i mean taken out of my check. i have a $250 deductable but i make that the first month of the year. I can go to any doctor any hospital with no referrals and have surgeries performed without denial from the insurance. i would pay the money with respect to the deductable any day. i am not a hmo kind of a guy. once when my wife was on a hmo, my son was sick and they would not give him an antibiotic. i threw a fit and they gave him some and what do you know he got well. that was the last time my wife or i used an hmo. that was 15 years ago. i think the service at hospitals is better also. i have never had a problem at all with any hospital at all. love the ppo
    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.
  • aaron
    it is the urgent care clinics that i have issues with. beside having to wait 83 hours, i just don't like the vibe from them. i have not had major problems with them, but if something is bad they will refer you to the hospital where one has to wait 96 hours which means 96+83+79 hours of waiting. that is what happened with my celulisis staph infection. went to a urgent care they looked at leg, threw up their hands and sent me to the er. then you have to wait for a guy with a cough before you are seen. what is bad are the county hospitals where 79 hour wait is considered a short time. i just wasted my time and my money instead of going straight to the hospital and the er.
    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.
  • As an outsider I am the first to admit PPO and HMO are foreign terms to me. That being said I would pay almost anything to have available to me the options you seem to have in the States. I injured my thoracic spine a little over a year ago, I waited 4 weeks for an x-ray appointment, then 4 months for an MRI (that was the wait on the emergency but not life threatening list). After the MRI I waited 8 weeks to see PM specialist, then when he wanted a second MRI of a different segment I paid $1100 out of pocket for the MRI at our recently opened private clinic. After the second MRI I waited another four weeks to get back into the PM specialist for facet injections and now have to wait six weeks for an available follow up appointment. All of this waiting and I actually have the best private medical insurance money can buy as I work for Blue Cross (major medical insurance company) on contract for the provincial government in Emergency Medical Services.

    All of this being said I would be curious to know if I can somehow purchase medical insurance in the US (I have dual citizenship) that would allow me access to your medical system (maybe no one can answer this)? I read on here about all of the treatments that seem to be going on in the US and find that I just cannot gain access to many of them here in Canada (east coast). I have contacted a couple of PM clinics in Maine however was politely told that they do not take cash payments (Visa etc).

  • There is a post on upper spine pain thoracic where a girls arm swelled up. Don't know if your daughter had the same experience, it may be different but its worth reading. It is by Erikam240.
  • karenikkareni Posts: 58
    edited 05/13/2013 - 6:29 PM
    Hi Janelle Here in South Carolina you can pay cash at dr visits not sure why a dr wouldn't want that since they wouldn't have to deal with the paperwork of filing with ins companies.The drs I see even offer discounts to patients paying cash because it is so expensive without insurance. I get coverage through buy employer. A premium gets deducted from my paycheck and then I pay co-pays and in the case of surgeries (for example) after I reach my deductable then I pay a percentage of the cost. You can also my insurance online. You will end up paying more that way but it if something catastrophic happened could save you a ton. I looked into purchasing my own insurance at one point and it's pretty easy to find. Hope this helps!
  • jenelle
    feel sorry for you canadians. what you have up there is what the obama care people want here. i feel sorry for people under socialized medicine. having to wait for a procedure for months at a time. the only advantage i see is it is free, if you don't count the taxes taken out to pay for it. i also have a ppo which you are familar with and i would not trade it for anything. as far as having duel citizenship, and this is just a guess because i don't know and i am not a lawyer, but i think you would be able to purchase it here with duel citizenship. you might want to check with your insurance company or a lawyer just to make sure. my premiums and costs of meds have gone up over the last couple of years and i think it is due to the obama care coming. i can't believe there are thousands of rules and regulations people have to know. and no one knows exactly what will happen down the road. that is what is scary. i just want to keep my ppo and when i retire, keep substituting at schools to keep it. i also have medical and if need be i can go on my wife's ppo eventhough she has to pay for it. i want to make my own decisions about doctors and surgery not have the government make them for me. good luck and let us know what you find out
    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 think it's unfortunate that the coming years could/are going to be devastating to the medical community and their patients. I work in an office for a privately owned franchise of a well known pizza company and we have about 500 employees at any given time. Because of our business being in the food industry the majority of our employees are part time. I don't know everything about the law and neither do the people that passed it. We have had several meetings about the new health care law and how it will affect our company. I know the CEO personally and I hate how some people paint them as greedy. He puts everything into the business and treats us like family. So who knows where are future will be as patients maybe it won't change much, maybe it will be better, or worse. Point being that it is a shame that we don't know and it's even more shameful that the people that passed and signed the bill have been unable to tell us clearly what's in it and how it will (truthfully) affect us.
  • kamgramkkamgram Posts: 483
    edited 05/14/2013 - 7:44 PM
    I worked in the medical field in a doctors office and just so you know it is illegal for doctors to take cash payments if a patient has insurance. We must file with insurance.As well we are not allowed to fill prexcriptions with cash if you have insurance either. At least this is the insurance laws in NC. My daughter had just received her insurance after 90 day period at new job and dd not have her insurance cards yet and came to our office for OV and they just held the claim until she received her insurance and would not let us pay cash as they said it is considered insurance fraud. We dismissed patients who were coming to us and saying they did not have insurance and wanted to pay cash only to find out later that they did have insurance and were seeing more than one GP which is also against the law. I was not even aware of this until our insurance director at work informed me that I could not see my primary of 25+ yrs. and the doctor I worked for. I usually only seen her for colds and then when my back problems (sciatica) started back up in 2008 I was being treated by her since I workd with her daily and did not have to leave work. My original GP died last yr. from suicide :( so now I am with my employer/GP. Not sure if these are laws in all 50 states but in NC they are. We only have 2 pain clinics within a 3 hr. drive of where I live and it is very hard to get people into them as they are so full. This is why my GP does treat chronic pain patients with narcotics including myself but I know that those 2 offices do not accept cash only patients with insurance and you can understand why. Cash payments are harder to trace. I hope this helps Janelle :)

  • Kiki48KKiki48 Posts: 196
    edited 05/14/2013 - 8:26 PM
    Hi Kelli, that's interesting. In the west both North and South it isn't like that. I'm still trying to wrap my head around that one. I'm glad it's not like that here because some of the most helpful doctors for me have been the ones who don't bill insurance and I pay cash. I bill the insurance. I had a PPO. Do they have PPO's and HMO's in NC?
  • Hi Kiki, let me say that there are some doctors who will not file insurance and do accept cash and you file your own insurance. What I was saying is that we have patients who will come in and will say they do have insurance but want to pay cash and we are not allowed to do that as this is considered fraud. There are few offices here in Western NC who accept cash and let you file with insurance but Im talking about the people who come to us as a new patient claiming they have no insurance when they do and have more than one GP and are receiving care and meds from each one. Sorry for the confusion. We do have both HMOs and PPOs here and I am on a PPO through my husbands job. Our deductable is 5400 a yr. and then we pay 0 for rest of yr. on anything we have done or one meds. Not a problem the last few yrs. because of so many surgeries but before my knee surgery in Jan. we had to take 5400 out of 401k before they would do my surgery. Between my husbands heart surgery in 2011 and my thoracic surgery last yr plus a complet workup including heart cath when they thought my thoracic pain was heart related we owe our doctors over 15000 and they is with insurance, PPO. Insurance is just getting out of hand and my son has no insurance at all at age 22 and is already having spine and sciatic problems :(

  • terror8396tterror8396 Posts: 1,832
    edited 05/15/2013 - 5:53 AM
    years ago when i first started teaching for my new district, i signed up for a ppo, whoopie , i hate hmo's. there was one catch, if i got a presciption, i had to pay the pharmacy first, then get reimbursed next. the problem was when i had my first fusion, my doctor gave me oxycontin and fenatyl lollipops. well fenatyl is very very very very very expensive. they cost me $1500 for 120 of the lollipops and $450 or so for 120 oxycontin pills which both were compounded. having drugs compounded is supposed to be cheaper. well after the fit hit the shan, we paid then got reimbursed about 2 weeks later. this was a major problem because paying major bucks for my meds was putting me in the poor house. well good news, later that year, the district and insurance company revised their policy and now i just pay a co-pay. well i still have to have a co-pay of $400 for both the oxy and lollipops. 5 years ago all i had to pay was $275 for both. i called the insurance co and they gave me a bad time. well 5 years later, i found a pharmacy where i only have to pay $75 a month for both. i was so p...ed so now i will drive over the hill for 25 miles to pay $75 from this pharmancy instead of $450 for the pharmacy closer to me. i can't believe how the closer one can get away with charging more money. i did not talk to them because i would have gotten no where but i told my pain doctor and hopefully he will let his other patients know about the cheaper one. the lollipops are $3000 a month for regular ones and not compounded ones. so take a guess of which ones i use, yes if you can find a pharmacy that compounds meds. yes they can compound oxy and other narcotics if need be. it is cheaper. google compounding pharmacies in your area and call them. oxy is usually 40mg but when they compound they make the oxy 45 mg. i guess it is a legal issue where they have to do this
    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 have a PPO also, and I wouldn't change it for the world. I have a $400 per person, $1000 family max deductible, then they pay 85%, but the awesome part is it doesn't include office visits or prescriptions. My office visits are $15 co-pay and prescriptions are $10 generic, $20 brand - formulary, or $30 brand non-formulary. To top this all off, i pay absolutely nothing for the monthly premiums, my employer pays the entire amount. (that's one of the reasons I mentioned that I have the best boss in the world) 8-)
  • one of the benefits of teaching is the great insurance you get. we have a choice of a ppo or hmo. you pay more for the hmo overall but my deductible for my ppo is $250 a year. co pays are $5 and prescriptions are supposed to also be $5. but with narcotics they charge you up the wazoo. like i said, instead of $5 for oxy and the lollipops, it can cost up to $400 a month for both or $75 at the other pharmacy, both compounded. my pay for my blood pressure and cholesterol meds are $5 each so i guess they have me over the barrel with narcotics and they can charge anything because we have to take it. when i calld the insurance co the woman acted like i farted in her face. i guess her attitude was towards the fact that i used narcotics for 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.
  • I have long thought that school teachers should make some of the greatest income for preparing children for the adult world. At least you get the great health-care, and the district I worked for this was also true. As a SRP (school related personnel), I also had good health care.

    It's truly a shame when any person "looks down their nose" at someone because they need potent medicine to help them function. To me, it's a crime that this medicine takes a great portion of your income so that you can feel relief. I'm grateful that my medicine is a low-dollar co-pay because without it, I would be in trouble.

  • My Dad was pharmacist. He built his own Apothecary with a medical building in Southern California. Later he owned another Pharmacy-drug store in La Jolla, California. I worked at several different pharmacy's. When my Father had the Apothecary he compounded alot. In La Jolla not so much. To have something compounded...especially narcotics is great. Rare but fantastic!! And find it cheaper. Even frickin' better! I've known to have it compounded that it's cleaner and more expensive. Which makes sense so to find it cheaper than pre-made- very nice! A few years ago I was prescribed something..non-pain related... and had to have it compounded so I found it from NC because they were the cheapest with the best quality. Where I live now there is a pharmacy down the street that only does compounding. To get a doctor to prescribe that for narcotics is another story. I think that's great. Compounding would be my first choice.
  • all of the pain doctors use this particular pharmacy for compounding and mine also has a list of others in the area. this is where i found the one 30 miles away but $325 cheaper per month. with the oxy, the use a chemical for the filler which lets the med get into the blood stream at a certain rate. i never had a problem with it. it comes in a capsule not a pill. the lollipops take longer but are flavored and look like a tootsie pop except the sucker itself is not dark in color. if you are interested, google compounding pharmacies in your area and tell your pain doctor so he can write the appropriate prescription, 45 mg instead of 40mg for oxy. i'm sure if there are compounding pharmacies in your area your pain doctor would be aware of them.
    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.
  • Thanx Jon, I'll look into it :-)
  • jlrfryejjlrfrye ohioPosts: 1,110
    More then likely the Drs are not providers of insurance companies. That is the only way legally a Dr can charge cash without billing insurance. If a Dr doesnt want to be providers of insurance he doesnt have to be nor does he have to file a claim with the insurance companies, but if a patient files their own claim it allows for the patient to re-coup the money they have spent for out of network benefits or get reimbursed by their HSA accounts
  • A few years ago, before Christmas, I was opening a package that was delivered and sliced my thumb wide open.. there was so much blood and I was home alone. I called an ex BF and he took me to the local ER...of course at the time I was in PM and had been for years...at the same Hospital even. The nurse was great...told me I had to have stitches so I waited... Then an actual DR. came in to do it and then after reading my file she noticed I was in PM and on Pain Meds.. She then told me about how she was in a major car accident, broke her leg and pelvis and how she went through a year of recovery without one Pain Pill... Ok? She then made me listen to her lecture on the evil of taking pain pills and how I shouldn't be relying on them... This went on for an hour... I kept thinking "Bully for you"...and please hurry up. I felt like she was holding me hostage and forcing me to listen to her..and she wasn't very nice about it... So, ER's are a hit or miss on empathy...
  • when i was recovering from one of my fusions, i had for the most part competent nurses. one however was a jerk. she would always lecture me on when i should be taking my pain meds. i was on the piv and also getting oral meds. when she was late, i buzzed her and she slowly came in and said it is 5 minutes early. well one time i had to go big duck and i buzzed her to help me. she did not answer me at all. finally after a while i had my wife go to her and tell her i needed help to go to the bathroom because they were waiting for the evidence before i could go home. she told my wife that she did not show up because she thought i wanted a pain pill. after the hospital called me for a survey about the treatment of the hospital. when it came to the nurses i reamed her out right and left. i said it was the worse service i ever had and you should fire that nurse for incompetence. i doubt if they did but i let everyone know. when i went back for check ups i made sure all people i came in contact with knew about this nurse.
    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.
  • Good caring medical care is hit or miss. I try to be nice. It seems to help.

    My back surgery was a nightmare. One bad thing after another. I think the worse was when a nurse stepped on my full pee bag! Thought I was gonna punch her...
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