 |
Bogleheads
Investing Advice Inspired by Jack Bogle
|
| View previous topic :: View next topic |
| Author |
Message |
LH
Joined: 14 Mar 2007
Posts: 2477
|
 Posted: Mon Dec 07, 2009 2:44 am Post subject: This is my life in the ER |
 |
|
This is my life in the ER, no joke, I mean its funny to watch, but its no joke. Heh, it appears to actually take place in a grocery store, but thats besides the point : P
http://www.youtube.com/watch?v....p;aia=true
Some offhand Terminology
xanax, valium = drug of abuse, a benzodiazepine, used to treat anxiety and other things.
vicodin = drug of abuse, a narcotic pain medicine
vuh, vi vi, vic, vicodin? = equal to d, duh, duh, dilaudid? equal to duh duh dem demorol? equal to whats that drug, puh, puh, percocet? = narcotics = drug seeker 90+ percent of the time, where the + is equal to approximately 10 percent.
NSAIDS, ultram, tramadol, tylenol, darvocet, codeine, = non addictive, and some low addictive/"poor high" pain treating drugs which are hard to abuse, which will often be on the allergy list of drug abusers. Not a good buzz I guess. |
|
| Back to top |
|
 |
norookie
Joined: 07 Jul 2009
Posts: 539
|
| Posted: Mon Dec 07, 2009 3:22 am Post subject: |
|
|
I'd bet on it. Its only going to get worse IMO. I was in for a "neurological"(brain-spinal) major"procedure again 40days ago. 2003 was the last one. A multi-linguial advocate  came around advising me/us we could stay longer...............wtf? A childhod Dr. friend said the longer your in the Hospital,.. the closer you are to death! I believed him! I guess some** want the "treatment" of a bed, food, meds and a nurse on the house*. Im being quiet now, btw. I've a 12-18mo best recovery time outlook thats as best as your going to get I was told. fwiw. No Big deal..........many DESERVING are far worse off in .gov run hospitals IYKWIM , I know. ETA :Funny post LH + ERDoc! 
_________________
"Follow the money"......JMO
Last edited by norookie on Mon Dec 07, 2009 7:27 pm; edited 4 times in total |
|
| Back to top |
|
|
MahoningValley
Joined: 01 Dec 2007
Posts: 143
|
| Posted: Mon Dec 07, 2009 8:16 am Post subject: |
|
|
| LOL . . . you ain't kidding, that is funny stuff. Sad but true. Love that allergy list. |
|
| Back to top |
|
|
legio XX
Joined: 15 Jul 2008
Posts: 180
Location: New York City
|
| Posted: Mon Dec 07, 2009 11:37 am Post subject: |
|
|
Somehow I don't see the humor in this. About 45 years ago I began to suffer from head-banging gut-wringing migraines. No insurance, no "family doctor" so I saw a lot of ERs. It was years later that I figured out that the a-holes who didn't blow me off as a neurotic thought I was a junkie. The solution came when I was taking my grandmother to see her doctor. Something she said alerted him, and he asked me a few questions on the QT. Problem solved. BTW, it was iatrogenic. The cure was to stop taking something that should never have been prescribed in the first place. Great safety net there . . . .
As for that lame cartoon: Anyone suffering from migraine is "allergic" to anything by mouth. Telling a migraine sufferer to take Advil is the same as saying "Stick your fingers down your throat." Which, btw, was better than some of the "care" I got. Worked faster.
Vic |
|
| Back to top |
|
|
chaz
Joined: 27 Feb 2007
Posts: 6639
|
| Posted: Mon Dec 07, 2009 12:44 pm Post subject: |
|
|
| legio XX wrote: | Somehow I don't see the humor in this. About 45 years ago I began to suffer from head-banging gut-wringing migraines. No insurance, no "family doctor" so I saw a lot of ERs. It was years later that I figured out that the a-holes who didn't blow me off as a neurotic thought I was a junkie. The solution came when I was taking my grandmother to see her doctor. Something she said alerted him, and he asked me a few questions on the QT. Problem solved. BTW, it was iatrogenic. The cure was to stop taking something that should never have been prescribed in the first place. Great safety net there . . . .
As for that lame cartoon: Anyone suffering from migraine is "allergic" to anything by mouth. Telling a migraine sufferer to take Advil is the same as saying "Stick your fingers down your throat." Which, btw, was better than some of the "care" I got. Worked faster.
Vic |
ER docs don't like to give oxycontin to a patient with a migraine.
_________________
Chaz
"It is better to travel well than to arrive." - Buddha
http://www.bogleheads.org/wiki/index.php/Main_Page |
|
| Back to top |
|
|
Larry Johnson
Joined: 08 Dec 2008
Posts: 123
Location: Tulsa, Oklahoma
|
| Posted: Mon Dec 07, 2009 1:27 pm Post subject: life in the ER |
|
|
| my father used to have his medical bags stolen frequently. He solved the problem by labeling his morphine bottle and putting apomorphine in it. I guess you couldn't get away with it today. Too bad |
|
| Back to top |
|
|
mhalley
Joined: 20 Nov 2007
Posts: 367
|
| Posted: Mon Dec 07, 2009 1:51 pm Post subject: |
|
|
This is why I believe that narcotics and benzodiazapines should be otc. Sure, I would see a few more ODs, but it would free up about 1/3 of my time to take care of sick people in the ED.
Mike |
|
| Back to top |
|
|
EmergDoc
Joined: 02 Mar 2007
Posts: 6068
Location: Greatest Snow On Earth
|
| Posted: Mon Dec 07, 2009 2:29 pm Post subject: |
|
|
| mhalley wrote: | This is why I believe that narcotics and benzodiazapines should be otc. Sure, I would see a few more ODs, but it would free up about 1/3 of my time to take care of sick people in the ED.
Mike |
Besides, you've got to admit an OD is more interesting to take care of than another patient with lumbar strain. I mean you get an intubation, some critical care time, and if you're lucky, you can get your least favorite nurse puked on after the narcan.
legio XX-
You wouldn't believe how difficult it can be to separate out people with severe pain from those with a drug problem +/- severe pain. I try to err on the side of giving too much analgesic, and I'm confident I've fed many a druggie's habit because of it. I'd rather prolong the habit of 9 drug-abusers than withhold analgesic from one person with honest to goodness severe pain. But I've also seen a fair number of patients exactly like the cartoon, including the allergy list. (BTW, an allergy is different from "it doesn't work for me.")
This is one of those jobs where if you don't laugh, you'll cry. Not only do we have to interact on a daily basis with drug-addicted people who don't pay us yet can still sue us for literally millions of dollars if we screw up, but those same people also can determine our salary and whether we keep our jobs via the ubiquitous all-powerful patient satisfaction surveys. Hospital administrators don't care if the person who was "very dissatisfied" was very dissatisfied because I didn't give her another percocet prescription after her dog ate the last one, it is still a ding on me. Not to mention the fact that the police, medical board, and DEA expect us to be the enforcers of government drug policies.
So cut us a little slack and whatever you do, don't go here:
http://www.qfever.com/issues/20051005/mylabs.html
or here:
http://forums.studentdoctor.ne....p?t=257985
BTW, the safety net is to keep you from dying, not to keep you from having pain. And advil works for lots of people with migraines. If you don't like the ER, stay away from the police. They're the only ones who make people come to the ER. As near as I can tell, the rest are there voluntarily.
Have a great day. I'm off to work. I hope you don't have to come see me, but if you do, I promise I'll listen to you, do an appropriate exam and testing, and if I think you need them, prescribe you some pain meds (after I do a search on your prescription history  .)
I sense a thread lock coming....
_________________
1) Invest you must 2) Time is your friend 3) Impulse is your enemy
4) Basic arithmetic works 5) Stick to simplicity 6) Stay the course |
|
| Back to top |
|
|
Quasimodo
Joined: 03 May 2007
Posts: 735
|
| Posted: Mon Dec 07, 2009 3:26 pm Post subject: |
|
|
Our son has chronic head pain from an unknown cause. It just started suddenly about ten years ago for no apparent reason. We went to every medical and non-medical caregiver we could think of in our metro area, with no relief. Eventually we went to a head pain specialist in another state, and after two trips to the out-of-state hospital they came up with a combination of non-narcotic meds that help him be pain-free most of the time.
Some of the patients at that hospital were there because of a single severe head trauma (I recall patients who had been in snowmobile or water skiing accidents ), but many of the head pain patients could not be clearly diagnosed as to the cause.
There are probably also those with terrible mental or emotional traumas that led them to narcotics. I don't believe it's always just poor morals.
John
_________________
I once met a man who had forgiven an injury. I hope some day to meet the man who has forgiven an insult.
Charles Buxton, writer (1823-1871) |
|
| Back to top |
|
|
mhalley
Joined: 20 Nov 2007
Posts: 367
|
| Posted: Mon Dec 07, 2009 6:09 pm Post subject: |
|
|
I have no problem giving someone that has a reason to have severe pain all the dilaudid I have in the pyxus if that is what it takes. The most frustrating part about pain management in the ED is that we can never be sure about the underlying pain. People that don't have experience in health care have no idea about what actually goes on in the ED. We see many patients that come in with a cut that might need one stitch that act like they are dying of severe pain, and after a while you do become somewhat jaded and cynical. If I didn't have to worry about the DEA on my back, or getting letters from the patients insurance or medicaid about their drug utilization, I wouldn't care about giving people their Lortab refill if I didn't have to delay seeing someone that has a true medical emergency to do it.
Mike |
|
| Back to top |
|
|
LH
Joined: 14 Mar 2007
Posts: 2477
|
| Posted: Mon Dec 07, 2009 6:55 pm Post subject: |
|
|
| legio XX wrote: | Somehow I don't see the humor in this. About 45 years ago I began to suffer from head-banging gut-wringing migraines. No insurance, no "family doctor" so I saw a lot of ERs. It was years later that I figured out that the a-holes who didn't blow me off as a neurotic thought I was a junkie. The solution came when I was taking my grandmother to see her doctor. Something she said alerted him, and he asked me a few questions on the QT. Problem solved. BTW, it was iatrogenic. The cure was to stop taking something that should never have been prescribed in the first place. Great safety net there . . . .
As for that lame cartoon: Anyone suffering from migraine is "allergic" to anything by mouth. Telling a migraine sufferer to take Advil is the same as saying "Stick your fingers down your throat." Which, btw, was better than some of the "care" I got. Worked faster.
Vic |
What was the "something that should never have been prescribed in the first place?"
What about health clinics for a family md versus repetitive ER visits? If for whatever reason, utterly no health clinics in your area, what about paying money to see a family doctor if it was going on for years?
Those people you call "a-holes" trained for 7 years after college, at great personal expense monetarily, what 150K average debt, and personally, little life at all for years and years, I would assume must have been seeing you for FREE??????? So no money paid, otherwise, why not get a family MD for the chronic problem its far less than a paid ER bill, and no gratitude, far from it, instead, they are "a-holes". No payment for services rendered, no gratitude for free care? "a-holes"?
Have a nice day,
LH |
|
| Back to top |
|
|
allsop
Joined: 15 Jun 2008
Posts: 378
|
| Posted: Tue Dec 08, 2009 2:48 pm Post subject: |
|
|
| LH wrote: | | legio XX wrote: | Somehow I don't see the humor in this. About 45 years ago I began to suffer from head-banging gut-wringing migraines. No insurance, no "family doctor" so I saw a lot of ERs. It was years later that I figured out that the a-holes who didn't blow me off as a neurotic thought I was a junkie. The solution came when I was taking my grandmother to see her doctor. Something she said alerted him, and he asked me a few questions on the QT. Problem solved. BTW, it was iatrogenic. The cure was to stop taking something that should never have been prescribed in the first place. Great safety net there . . . .
As for that lame cartoon: Anyone suffering from migraine is "allergic" to anything by mouth. Telling a migraine sufferer to take Advil is the same as saying "Stick your fingers down your throat." Which, btw, was better than some of the "care" I got. Worked faster.
Vic |
What was the "something that should never have been prescribed in the first place?"
What about health clinics for a family md versus repetitive ER visits? If for whatever reason, utterly no health clinics in your area, what about paying money to see a family doctor if it was going on for years?
Those people you call "a-holes" trained for 7 years after college, at great personal expense monetarily, what 150K average debt, and personally, little life at all for years and years, I would assume must have been seeing you for FREE??????? So no money paid, otherwise, why not get a family MD for the chronic problem its far less than a paid ER bill, and no gratitude, far from it, instead, they are "a-holes". No payment for services rendered, no gratitude for free care? "a-holes"?
Have a nice day,
LH |
Gee, I wish there was a boogleheads.org focusing on appropriate, competent, science-based, low-cost and affordable health care.
Your post shows why the US "health care" system is in such dire straits with very high costs and statistically very little benefits for the general population health. Not to say that European doctors are above reproach, far from it, but whining for very, very high student loans are not that common.
As an European, however, we have to suffer import of sh*tty US health "business" and politics of no benefit for the population as a whole. |
|
| Back to top |
|
|
ddb
Joined: 26 Feb 2007
Posts: 4386
Location: Manhattan
|
| Posted: Tue Dec 08, 2009 4:08 pm Post subject: |
|
|
| MahoningValley wrote: | | LOL . . . you ain't kidding, that is funny stuff. Sad but true. Love that allergy list. |
Yeah, loved how she claimed to be allergic to "non-narcotics"!
_________________
"I know that your friends are my friends and, uh... I've thought about that. You can have 'em" - PB |
|
| Back to top |
|
|
DaveH
Joined: 16 May 2008
Posts: 663
Location: Los Angeles, Bangkok, Louisiana, New York City
|
| Posted: Tue Dec 08, 2009 4:28 pm Post subject: |
|
|
| EmergDoc wrote: | | Besides, you've got to admit an OD is more interesting to take care of than another patient with lumbar strain. I mean you get an intubation, some critical care time, and if you're lucky, you can get your least favorite nurse puked on after the narcan. |
This all brings back memories of when I was a paramedic during early 90's in Los Angeles. I saw a LOT of faked heart attacks and seizures, and even as a paramedic it was easy to tell the real ones from the fake ones.
We used to cover the area that included the LA county jail, and faking a seizure was a popular way to try and get taken out of the jail by ambulance and up to the 13th floor (the jail ward) at County USC hospital. Some of the fake seizures were truly comical, but due to protocol we had to take many of them to the hospital.
Fake heart attacks were simple enough to handle - we'd run a strip and they were almost always look like a normal rhythm. Unfortunately, when someone says they have chest pain they are almost guaranteed a ride to the hospital because paramedics aren't qualified to diagnose.
Then there were the drug-chasers. People would ask us to just 'give them' some meds but not take them to the hospital. Others would get in the unit and start trying to rummage through drawers, looking for opiates/benzos (like an ambulance would have Xanax!). I've been asked if I could start a line and push some morphine then just leave. It never ended.
Most of the patients were honest, appreciative, good people. But by no means all!
_________________
The fewer our wants, the nearer we resemble the gods. — Socrates |
|
| Back to top |
|
|
DaveH
Joined: 16 May 2008
Posts: 663
Location: Los Angeles, Bangkok, Louisiana, New York City
|
| Posted: Tue Dec 08, 2009 4:33 pm Post subject: |
|
|
| allsop wrote: | | As an European, however, we have to suffer import of sh*tty US health "business" and politics of no benefit for the population as a whole. |
That seems a bit strong. The US health care system has provided huge benefits to people all over the world, and many Americans enjoy excellent health care (whether they realize it or not).
I personally had my life saved by this 'no benefit' system (dissecting aneurysm + triple stroke, coiled through catheter, 2007) after being diagnosed by a foreign health care system. Our system is far from perfect but there are some excellent things about health care in the US and to deny that suggests that you aren't honestly looking at the situation.
_________________
The fewer our wants, the nearer we resemble the gods. — Socrates |
|
| Back to top |
|
|
ddb
Joined: 26 Feb 2007
Posts: 4386
Location: Manhattan
|
| Posted: Tue Dec 08, 2009 4:34 pm Post subject: |
|
|
Oh man, that thread has me in tears, despite the fact that I'm not even in the medical field!
- DDB
_________________
"I know that your friends are my friends and, uh... I've thought about that. You can have 'em" - PB |
|
| Back to top |
|
|
Christine_NM
Joined: 20 Feb 2007
Posts: 849
Location: Albuquerque
|
| Posted: Tue Dec 08, 2009 5:40 pm Post subject: |
|
|
| legio XX wrote: | Somehow I don't see the humor in this. About 45 years ago I began to suffer from head-banging gut-wringing migraines. No insurance, no "family doctor" so I saw a lot of ERs. It was years later that I figured out that the a-holes who didn't blow me off as a neurotic thought I was a junkie. The solution came when I was taking my grandmother to see her doctor. Something she said alerted him, and he asked me a few questions on the QT. Problem solved. BTW, it was iatrogenic. The cure was to stop taking something that should never have been prescribed in the first place. Great safety net there . . . .
As for that lame cartoon: Anyone suffering from migraine is "allergic" to anything by mouth. Telling a migraine sufferer to take Advil is the same as saying "Stick your fingers down your throat." Which, btw, was better than some of the "care" I got. Worked faster.
Vic |
Amen, Vic.
_________________
Savor the moment. |
|
| Back to top |
|
|
VictoriaF
Joined: 27 Feb 2007
Posts: 3159
Location: Arlington, VA
|
| Posted: Tue Dec 08, 2009 7:10 pm Post subject: |
|
|
| ddb wrote: |
Oh man, that thread has me in tears, despite the fact that I'm not even in the medical field!
- DDB |
Ditto.
I did not understand this one:
| Quote: | | If you are having chest pain, don't go to the bathroom. Period. |
Thanks,
Victoria
_________________
TIPS, James TIPS.
Ian Fleming, revisited |
|
| Back to top |
|
|
EmergDoc
Joined: 02 Mar 2007
Posts: 6068
Location: Greatest Snow On Earth
|
| Posted: Tue Dec 08, 2009 8:05 pm Post subject: |
|
|
| VictoriaF wrote: | | ddb wrote: |
Oh man, that thread has me in tears, despite the fact that I'm not even in the medical field!
- DDB |
Ditto.
I did not understand this one:
| Quote: | | If you are having chest pain, don't go to the bathroom. Period. |
Thanks,
Victoria |
Don't know why, but the bathroom is like radiology--people go there to die.
_________________
1) Invest you must 2) Time is your friend 3) Impulse is your enemy
4) Basic arithmetic works 5) Stick to simplicity 6) Stay the course |
|
| Back to top |
|
|
Dan Moroboshi
Joined: 07 Jul 2007
Posts: 551
|
| Posted: Tue Dec 08, 2009 8:16 pm Post subject: |
|
|
| VictoriaF wrote: | I did not understand this one:
| Quote: | | If you are having chest pain, don't go to the bathroom. Period. |
|
I think it refers to the phenomenon in which a patient straining to have a bowel movement or to urinate may inadvertently perform a Valsalva maneuver, which could cause fainting (syncope). If the patient is having an acute MI or is otherwise hemodynamically unstable, further badness may result. |
|
| Back to top |
|
|
LH
Joined: 14 Mar 2007
Posts: 2477
|
| Posted: Wed Dec 09, 2009 2:47 am Post subject: |
|
|
| Dan Moroboshi wrote: | | VictoriaF wrote: | I did not understand this one:
| Quote: | | If you are having chest pain, don't go to the bathroom. Period. |
|
I think it refers to the phenomenon in which a patient straining to have a bowel movement or to urinate may inadvertently perform a Valsalva maneuver, which could cause fainting (syncope). If the patient is having an acute MI or is otherwise hemodynamically unstable, further badness may result. |
heh, I actually passed out in the bathroom myself, woke up pins and needles and sweat, what am I, who am I, where am I progression, and my wife is looking down on my talking to the 911 operator on the phone hehehheh. I told em it was alright. Classic parasympathetic type deal. |
|
| Back to top |
|
|
verbose
Joined: 28 Aug 2008
Posts: 171
|
| Posted: Thu Dec 10, 2009 11:00 am Post subject: |
|
|
Drug addicts who game the system and prejudice health care providers have cost me (and my health insurer) a fair amount of money.
About a year ago, I popped out some previously-herniated discs (by dropping into a squat, of all things). I found that I'd ran out of Vicodin, which I hadn't needed in over a year. My doctor's office is legally not allowed to call in a prescription without seeing me, and it was after hours. I took Advil, but after an hour, ended up on the floor in such severe pain that I couldn't get up and my husband couldn't pull me up.
So, instead of just sending my husband to get a prescription, here's what I got:
- Ambulance ride
- Attempted IV (I told them it wouldn't work, but they tried it anyway, and it hurt like heck)
- Pregnancy test (via catheter, since I couldn't stand up)
- X-rays
- Torodol (I didn't ask for this, but got an injection anyway)
- Ibuprofen (for what purpose?? it already failed to work)
- Vicodin (hey, that's what I actually needed!!)
- A migraine from the smoke-filled taxicab I had to take home
- A full day of vomiting and heaving after the migraine med I took interacted with all the pain meds they gave me in the ER
- Bills for $462 (deductible and copay amounts)
The best part was when the ER doctor came in and announced I really did have herniated discs (he seemed surprised), handed me a prescription and said I could go. My back muscles were still so stiff that I couldn't get up if I wanted to (and after 4 hours, I really, really wanted to get out of there). I had to beg him to please give me something so I could actually stand up. |
|
| Back to top |
|
|
Bounca
Joined: 26 Feb 2007
Posts: 735
|
| Posted: Thu Dec 10, 2009 12:02 pm Post subject: |
|
|
My mother in law is a shining example of prescription drug abuse xanax, valium, wellbutrin, etc. No wonder she’s been divorced twice after years of this cocktail. Whenever she visits, you never know which of the four personalities you’ll get.
Whats scary (and funny at the same time) is she went through nursing school only to (thankfully) flunk some acceptance test. |
|
| Back to top |
|
|
|
|
You cannot post new topics in this forum
You cannot reply to topics in this forum
You cannot edit your posts in this forum
You cannot delete your posts in this forum
You cannot vote in polls in this forum
|
Powered by phpBB © 2001, 2005 phpBB Group
|
Wiki
FAQ
Search
Memberlist
Usergroups
Register
Profile
Log in to check your private messages
Log in
