Drug Seeker Antics and Dramas - page 3

They are an everyday event in almost every ER around the country. What is the drug of choice in your area? I've noticed around here it is Vicodin. Our latest little treasure was an ex RN... Read More

  1. by   MyReign1
    If you go to the ER can you request a CT. Is that something the can do that day or will they refer you elsewhere. I have had chronic headaches all of my life. I don't know If they are migraines because sometimes I have the pain on both sides of my head, though rarely. I don't believe my DR is doing enough. I was prescribed Hydrocodone 10 and Naproxsen. The Hydrocodone makes me vomit. I've tried it with and without food. When I cut it in half I didn't vomit but it did not get rid of the pain. I am afraid of going to the ER because I don't want to be treated as a drug seeker. In fact, I don't want drugs I want a CT. Something has to be going on in my head to make me feel this way. I'm scared I'm going to have a stroke. Lately I can even hear the blood rushing in my head. I don't believe that is normal but I don't know. I was told to take one Naproxsen, can I take two and not OD?
  2. by   ang75
    SLOW DOWN! No one was trying to offend you here. I am perfectly aware that there are pts with little to no relief for what ails them. I wasn't pointing fingers at you or anyone else. If you will recall, the title to this thread was drug seekers and their antics. That's exactly what I was talking about...seeking. Sorry to have struck a nerve with you. Never intended it that way.
    Quote from z's playa
    :chuckle :chuckle Here we go. I get migraines and Imitrex and Maxeran do wonders....however not all the time. Every 4 months or so I get one that won't go away. After 72 hours, status migrainous, and after about 6 Naprosyn, Tylenols, 2 Imitrex and the dark room full of ice....I haul a*** to the ER. Here I feel like I'm getting the "looks". Even armed with my letter from my PCP that states narcotics are sometimes needed, I follow up every 3 months and I'm on Propranolol daily. I'm very happy that you get relief every time you take your rescue meds, but not everyone does. Always.

    And believe me it is HELL going to the ER for that complaint. And I do dry heave as well since I'm always dry as a bone by the time I get there. 180/90, 37.3 Total pain

    I get the dark room upon arrival, a bolus of saline, 30 Torodol, 10 Maxeran, 50 x 3 Demerol. (over a period of 6 hours mind you.)

    Severe adverse reactions with Stemetil, DHE and Decadron.

    Sucks.
  3. by   z's playa
    Quote from MyReign1
    If you go to the ER can you request a CT. Is that something the can do that day or will they refer you elsewhere. I have had chronic headaches all of my life. I don't know If they are migraines because sometimes I have the pain on both sides of my head, though rarely. I don't believe my DR is doing enough. I was prescribed Hydrocodone 10 and Naproxsen. The Hydrocodone makes me vomit. I've tried it with and without food. When I cut it in half I didn't vomit but it did not get rid of the pain. I am afraid of going to the ER because I don't want to be treated as a drug seeker. In fact, I don't want drugs I want a CT. Something has to be going on in my head to make me feel this way. I'm scared I'm going to have a stroke. Lately I can even hear the blood rushing in my head. I don't believe that is normal but I don't know. I was told to take one Naproxsen, can I take two and not OD?
    I take 6 over a period of 2 days. I take 2 at onset as prescribed by my doctor. I think it works great BUT.....not always. Why is it so hard for people to understand that I wonder? Even birth control doesn't always work.
  4. by   z's playa
    Quote from ang75
    SLOW DOWN! No one was trying to offend you here. I am perfectly aware that there are pts with little to no relief for what ails them. I wasn't pointing fingers at you or anyone else. If you will recall, the title to this thread was drug seekers and their antics. That's exactly what I was talking about...seeking. Sorry to have struck a nerve with you. Never intended it that way.
    No nerves struck None by you folks here anyways. I just find the whole issue maddening. I believe if there ever was such a thing as a picture perfect migraineur, it would be moi, and I get hurt when I get treated otherwise upon arrival at my hospital. It is so hard to figure out who's seeking for the right reasons, and who isn't.
  5. by   delta32
    Quote from stevielynn
    This same story about "mofine, 1 pound" has been going around for years. It is in an Echo Heron book. My ER doc told me it happened in med school. I've heard this story from numerous nurses through the years.

    Urban myth? Old-wives-tale?

    steph

    off note-Echo Heron -excellent author, very enjoyable reading!
  6. by   Katnip
    "If you go to the ER can you request a CT. Is that something the can do that day or will they refer you elsewhere. I have had chronic headaches all of my life. I don't know If they are migraines because sometimes I have the pain on both sides of my head, though rarely. I don't believe my DR is doing enough."


    Sounds like you need to see a new doctor, MyReign1.

    (couldn't find the quote thingy)
  7. by   ang75
    I have had a couple that nothing short of barfing and Kevorkian? would make me feel better. It hurts just to take a deep breath. So I know what you mean. I worked with a ER doc once that believed in 5omg Benadryl and 1 liter of NS for migraines. Amazingly, he had quite a bit of success. I hope you find some relief for yours. Good luck.

    Quote from z's playa
    No nerves struck None by you folks here anyways. I just find the whole issue maddening. I believe if there ever was such a thing as a picture perfect migraineur, it would be moi, and I get hurt when I get treated otherwise upon arrival at my hospital. It is so hard to figure out who's seeking for the right reasons, and who isn't.
  8. by   warrior woman
    It just annoys me that a few rotten apples has messed things up so that E.R. staff casts a jaundiced eye on EVERYBODY. Not that I blame them for it, they have to be skeptical to make sure the complaint is legit and not just a Dr. Feelgood run. It really ends up hurting the people who are in pain the most and that just sucks.
  9. by   z's playa
    Quote from ang75
    I have had a couple that nothing short of barfing and Kevorkian? would make me feel better. It hurts just to take a deep breath. So I know what you mean. I worked with a ER doc once that believed in 5omg Benadryl and 1 liter of NS for migraines. Amazingly, he had quite a bit of success. I hope you find some relief for yours. Good luck.

    {{{{{ang75}}}}
    Yes I totally understand. Many times I wished for Dr Kovorkian to be on duty but alas....it was not meant to be :chuckle

    NS and Benadryl? Whatever. It never worked for me. If it worked for others, hats off to them. Like I said before, by the time I get my butt into the ER, I'm dehydrated, heaving, pissed off, depressed and in so much pain (after 72 hours) I want to be euthanized. I just pray that there's a doctor and nurse that understands me on shift that night. Like I said before...I even have a letter from my PCP that states I sometimes need to come into ER for pain control...but....they probably don't beleive me. WHY????? :stone
  10. by   SWFlorida
    "It just annoys me that a few rotten apples has messed things up so that E.R. staff casts a jaundiced eye on EVERYBODY. Not that I blame them for it, they have to be skeptical to make sure the complaint is legit and not just a Dr. Feelgood run."

    In general a person who presents in a lot of pain will also display other signs to back up their claim, Vital signs, palor, dry mucus membranes etc. Most of the frequent flyers have found it so easy to come in and get their supply they barely try to perform for us anymore. You'll see them drive up and pop out of the car and come striding up to the door. They may even stop and have a quick smoke. A lot of times they will smell of ETOH.

    The ones who are truely in pain are wonderful to work with, you can help alleviate their pain. That makes the nurse feel good.

    When you have to take time away from legitimately ill pts to take care of someone who is there like clockwork it drives you a bit nuts.

    One tip: If you have a private Dr for your migraines and chronic pains have him or her write out an emergency pain plan for you. Have him/her also have their phone number for the ER doc to call if needed. It keeps care consistant and hopefully speed the process up for everyone involved. Most pain management Dr s want to be informed if their client has to utilize emergency facilities often. It may mean that their pain management care needs to be re-evaluated.

    True pain is always an emergency!
  11. by   ang75
    The ones that really drive me nuts are the ones that come in with Burger King in hand and 5 people in tow, laughing joking all out having a great time and tell me they have a migraine that is so terrible that they just can't take it anymore. And, it's not always migraines. I have had a seeker who was working off of back pain too.
  12. by   hogan4736
    Quote from z's playa
    {{{{{ang75}}}}
    ...Like I said before...I even have a letter from my PCP that states I sometimes need to come into ER for pain control...but....they probably don't beleive me. WHY????? :stone
    Why, because we have seem MANY people forge, alter, and make up those notes (yes, even on "official" letterhead)...

    And part of the problem is many PCPs will write anything to get rid of a seeker, then not return a page to verify, or just say "I have 10,000 patients, I don't know so and so"

    sean
  13. by   RainbowSkye
    Okay, I hope I don't offend anyone here:

    To the person who has a note from her doctor telling the ER that the patient has "real" migraines and apparently will require narcotics: A note like that is often looked at with skepticism in the ER. I once had a patient bring a note from her doctor instructing the ER doctor how much po dilaudid to prescribe for her. Turns out her doctor didn't exist. I do like the idea of a care plan and calling the primary care doctor to ensure appropriate, consistent care.

    To the person asking about a CT in the ER: Please find a different doctor and get a consult for a neurologist. This is the most appropriate way to find out what's going on and to get the best treatment (and it's actually much less expensive than the ER).

    Here's my experience with migraines in the ER: Nothing will work but Demerol for patients who want Demerol. I've seen Benadryl and IV fluids work great, I've seen Benadryl and Reglan IV work great, I've seen Compazine IV work great (when you could get Compazine), I've seen Imitrex work great, I've seen Toradol work great. But I have never seen any of those work at all when a patient says that "only Demerol works". And as far as I can tell in the recent literature narcotics are contraindicated in migraine treatment these days except in very rare cases.

    In the old days we used to keep a file card on migraine patients with orders for pain medications. When the patient came in to the ER, we gave them whatever the card instructed, no need to see a doc. Some patients came in daily, some weekly, some monthly... This practice stopped after someone's pain was not a migraine, but a subarachnoid hemorrhage.

    I do doubt that someone had a "real" migraine when the nanosecond I remove the needle from their behind they ask me if 1.)they can go outside and smoke 2.)they can go home without waiting the customary 15 minutes because they've never been allergic to Demerol or 3.)if they can use the portable phone to call their boyfriend to chat.

    Anyway, I could go on and on, but I'm tired. I don't want to have anyone suffer pain, but I also don't want to facilitate anyone's addiction. I agree with Tom who says the pain docs need to be available outside of usual business hours.

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