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Pain Management during Hospital Stay

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2

Comments

  • I had to spend the day in the hospital after a myleogram. I was in excruciating pain and the nurse asked me if I had any narcotics with me! The best she could offer me was Tylenol. Needless to say, I couldn't wait to get home to take something!
    Shari
    Lumbar laminectomy L-4/L-5, 2006
    XLIF with posterior pedicle screws L-4/L-5, 4-23-2013
  • thoracic spine painthoracic spine pain Posts: 566
    edited 12/22/2013 - 11:30 AM
    In Australia you are allowed to use your own meds, they don't like it, but my partner was on warfarin for years and plotted his dosage everyday so knew how much he needed to keep it stable. It is a long acting medication so you do not see the results until about 3 days after the dosage.

    He had to sign a form saying he was self medicating with his warfarin - he wasn't having an operation so they were not putting him on heparin. he only had started to take pain meds - the morphine that our GP gave him for pain really effected his breathing and I was scared he would stop breathing so took him back to our GP and who directed me to take him to the ER. He was sent home but then the Dr called me at 6 in the morning and said he had been thinking about it all night and wanted him to be admitted to hospital - thank heavens - I was up all night for three days monitoring him - so the hospital gave him pain meds and monitored them really well. If you want to self medicate here you have to sign a form that states the hospital is not responsible if anything happens. They don't like self medication - I don't blame them so if I was in hospital I would let them deal with my pain meds.

    But it your choice here as long as you sign a form negating the hospital from responsibility. Really don't know why you would chose to take your own pain meds if the hospital can give them to you, they usually monitor your pain meds really well.
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  • Can I ask those who have had cellulitis when should you be hospitalized? I have had outbreaks since April. Mine goes into a 2 week cycle where I get a high fever, the redness and horrible pain. Then by the third or fourth day it slowly starts to get better. Sometimes the skin where it had been red hot red will peel. Then I get like 2 days where I feel so good I think it's gone and then bam, I get it again. My primary has done about 5 sets of antibiotics. They then got worried about inflammatory breast cancer so sent me to a breast surgeon who said no it wasn't breast cancer and put me on a 21 day regimen of stronger antibiotics. Within 4 days of stopping it, the cellulitis was back. Now I am going to be seeing an infectious doc on Dec. 31st. Because of lost records and errors it took a month for them to get me an appointment. I've been told my both my primary and family to go to the ER if it's to bad so I was wondering what to bad is. Can those of you with experience give me some input?

    As far as pain meds when admitted, they usually admit me with what I am currently on, and then add a pain med. It's usually the PCA with Dilaudid in it. I have chronic kidney stones so I am in a lot with those. The hospital has always supplied my meds, even the ones I am regularly on .I know one time they did not have the strength I was on so they gave me 2 of the lower strengths to make up for it.

    Hope you can get this resolved!

  • Terror I do not mean to argue, but you are allowed to bring in your own narcotics if the hospital does not have your kind or strength BUT you MUST turn all of it in to the nurse who then documents it and gives it to you as directed. Then at discharge, they give you back what is remaining. I would never do this because I have heard of too many stories where the hospital lost your meds so you don't get anything back. The best bet is to have your doc and PM consult together to make sure your pain is being managed.
  • if you have cellilitus, go to the hospital and get admitted asap. oral antibiotics do not cut it. only iv meds seemed to work. they can also do other tests to see if it is from your bones or whatever. i was in for 4 days with iv antibiotics and narcotics. they drew a line around my infection to see if it would grow. if it did, then possible amputation of the leg. it is very serious. it is a staph infection and needs to be taken care of. every time i had it i went to my dr to get me admitted to the hospital. i have had it twice in 2 years.
    jon
    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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  • My husband recently had it so bad it took over his whole left leg. He had the high fever and the whole nine yards. He was on oral antibiotics and did just fine. The hospital didn't even admit him, they just kept him long enough for his fever to go down. He has had it twice on his leg. Oral antibiotics worked great both times.
    Discectomies 05/08 and 04/11, fusions L4-5 Feb 9,2012 and L3-L4 June 28,2012, Staph infection washout 3/2/2012, Bulged L5-S1. SCS trial on January 17th, 2014, which was a success! Permanent SCS on February 20th.
  • After re-reading the original post again, my understanding is that she used her own pain meds without the hospitals permission based on they wouldn't give her any due to low blood pressure. Basically regardless of being in the hospital or not, that is still considered self-medicating. When you are in the hospital the hospital is solely responsible for you and they would NOT allow narcotic meds to be self administered, no way. With the lawsuits these days, there is absolutely NO WAY, they will let that happen. They may allow it for other meds, but not for narcotics.

    I had an issue similar recently. I was in the hospital for a reason unrelated to my pain, but laying in the ICU for a week caused a LOT of pain. one nurse was very hesitant to give me anything because my BP was low (it was before they realized that my BP is chronically low) and I ended up lying in that bed for 15 hours with no relief what-so-ever and of course they couldn't figure out why i had a hard time moving after that. So i talked to the day nurse that morning and told her to get me the paperwork, I was signing out AMA because there was no way I could handle that anymore and I would continue my treatment at home rather than in the ICU (yea I know it sounded silly, but it really was that bad) and she spoke with the doctor and got it taken care of. Regardless, i wouldn't have even considered taking my own meds. You never know what it may be contradicted with, with the meds they give you to get you better. Doing something like that can kill you and leave the hospital liable.

    So basically to answer your question, the only thing you can do is tell your pain doctor what you did and hopefully he won't dismiss you as a patient for doing it. I would also advise to never do it again and get things prearranged for next time.
  • terror8396tterror8396 Posts: 1,832
    edited 12/24/2013 - 4:38 AM
    by the way the comment about not having your strength is not true. i have my oxy compounded and the strength i use is 45 mg and for 300 micrograms in the lollipops. hospitals do not use these strengths. so they gave me 4o mg of oxy and 250 micograms of the lollipops. they did not ask me to use my own. so this is not true. most hospitals have the required strenghts of narcotics. they have all types and strengths in their inventories. they told me they did not have these strengths of narcotics due to them not compounding the meds so they told me they were giving me the regular strengths. most hospitals carry every med and strengths available in their pharmacies. this is their business and their business is also to treat patients with appropriate meds and dosages. and i am sure if there is a med or dose not available they would contact another pharmacy or get permission from an appropriate doctor. like was stated before, lawsuit, lawsuit, lawsuit. hospitals, drrs and pharmacies are under a microscope now a days and they would not do anything to get them in trouble, narcotic or not.
    jon
    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.
  • Again, not to argue, but hospitals sometimes do not have the strength or med or the med you are on. I too am on the pops and one hospital didn't have my strength so they added 2 together and then a different hospital does not keep them in stock. So it can happen.
  • yes i had the same with my lollipops but my pain dr had to give the ok. they called him. they just did not give it to me at a different dose. apparently the issue of liability is not an issue. if hospitals gave a dose that is not around without permission from the patient's dr then there would be a law suit
    jon
    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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