Fibromyalgia - page 11

What are your opinions, nurses? Is Fibromyalgia a justified condition or just a basket term ? I am interested in your feedback. It seems like we see a large number of patients (usually women) with... Read More

  1. by   missmercy
    Veetach & teeituptom ( and others too)
    I think you have a good point -- ER should not be a place for the long term or routine treatment of chronic pain. It is too easy for a person to avoid trending, adequate research into symptoms and finding a physician who is skilled and trained to deal with their pain. Our ERs are filled with folks who just don't want to wait 'til monday (many who really COULD) or who don't want the "bother" of finding a regular doc. And that takes up some of the time that those folks who are legitimate ER patients NEED!!! So, I can sure understand your frustrations!! I hope you aren't feeling too terribly beaten up by us all -- I think you sound like a couple of pretty intelligent people (especially avoiding the PMS discussions!!-- that could get ugly fast!) and I am sure you are good nurses! I would merely caution that sometimes you come across as pretty severe. I am sure that if I were to visit your ER, presenting with severe FM symptoms that you would be gracious, professional and hopefully that you wouldn't be muttering about me. As I understand your postings, your frustrations seem to center around ffs and their abuse of the system.
    If I remember correctly, the thread did start with questioning the validity of the diagnosis and it did get rather nasty toward folks who "claim" to have it. I think those of us with it can't help but get a bit defensive when we are lumped together with hypocondriacs, drug seekers and such -- wouldn't you?! I am sorry if I offended you with my responses.

    I know that what I suffer with and DEAL with is real. I know that it is not merely uncomfortable, but painful and life altering. However, I also relaize that there are many out there who may be abusing the dx, may be abusing the ER and the system as a whole and that you probably see lots of them. Just remeber, we aren't all that way!
  2. by   zenman
    Posted by teeituptom: Is the ER the best place to handle these problems.
    No, and the problems faced by ERs today are the exact same ones we faced in the early 70s. You will never change the patients, you have to change the system. Reserve the ER for emergencies and funnel the others down the hall to your primary care center staffed by MDs, PAs, and NPs.
  3. by   RNin92
    Quote from zenman
    No, and the problems faced by ERs today are the exact same ones we faced in the early 70s. You will never change the patients, you have to change the system. Reserve the ER for emergencies and funnel the others down the hall to your primary care center staffed by MDs, PAs, and NPs.
    Well, until EMTALA laws change...there isn't an ER in the country who will redirect someone back to the PMD's office.

    Personally, I don't think directing someone to their PMD is "refusing care" but I am a nurse not a litigator. No one wants to be the one to stand up and recognize that our EDs are overcrowded not because of overpopulation or an aging society...but because of misuse of the ED as a clinic.

    The ED is definetly NOT the place for chronic pain sufferers or drug seekers. We are MIS-treating both. It has nothing to do with the disease process or diagnosis...

    But the problem is bigger than all of us...

    Why do the PMDs send their patients into the ED for an "office"/non-emergent problem?

    Why do the PMDs have office hours only until 4pm...most families have 2 working adults?

    Why do we have a public aid system set up with few clinics to back them up?

    The ED is not going to change until society changes...and I just don't see that happening.
  4. by   Over-the-hill-Nurse
    I agree whole heartedly that the ER is not the place for chronic pain sufferers or the minor colds, flu's, etc.. but with today's society and our economy it is difficult for people to find a PMD that will accept a patient with no insurance, on medical cards, medicaid etc... Our hospital tried to start a clinic for those minor injuries, colds, flus etc but it didn't last very long. Probably about a year. The difficulty was finding physicians to staff it. So we are back to having a very busy ER. It is sad that with all the technologies that are now available that people can't afford health care but that is the way things are. So our ER's will continue to get abused.
  5. by   NannaNurse
    Boy oh boy....I'm not sure if I should even comment. I'm almost embarassed to admit I suffer from FM.......have for about 15 yrs now. Depressed?? Sometimes I am. If you can't imagine moderate to severe pain 24 hours a day, then you don't know what 'we' go through. You get really sick and tired of hurting all the time. You know how you hurt when you feel sick?? How your skin even hurts just to touch it??
    Please don't judge those of us with FM as people who are babies or can't handle 'alittle pain'. We are everywhere and all we are asking is that people TRY to understand we just want some relief. Those of us who are nurses should be the most understanding. Please don't ROLL YOUR EYES when you see FM as a dx....
    I also agree that the ER is just that......emergency room. I worked in ER years ago and we would have the same people come in night after night. It would be nice to have a special screening room for all those who are not in immediate need of care.
  6. by   zenman
    Posted by RNin92: Well, until EMTALA laws change...there isn't an ER in the country who will redirect someone back to the PMD's office.
    Read my post again. I said direct them "down the hall" to your fast track or own primary care center. Lack of primary care acess 24 hours a day is one reason people go to the ER even when it is not the appropriate place. It's the only place open 24/7. Market it as such and let the masses in.
  7. by   DavidFR
    I believe this is a real disease and not a wastebasket diagnosis.

    I live with a fibromyalgia sufferer, who was not depressed before this terrible disease. I have seen an energetic go-getter who loved life turned into a miserable heap who is some days tired out by taking a bath. Please let's not marginalise this disease just because we don't yet fully understand it.
  8. by   nicki2
    Quote from ccunurse
    i agree whole heartedly that the er is not the place for chronic pain sufferers or the minor colds, flu's, etc.. but with today's society and our economy it is difficult for people to find a pmd that will accept a patient with no insurance, on medical cards, medicaid etc... our hospital tried to start a clinic for those minor injuries, colds, flus etc but it didn't last very long. probably about a year. the difficulty was finding physicians to staff it. so we are back to having a very busy er. it is sad that with all the technologies that are now available that people can't afford health care but that is the way things are. so our er's will continue to get abused.
    boy do i know what you mean!! i have been reluctant to tell others i have fm. when i was first diagnosed, i did not believe it. i went to another doctor and then to the university of fl's rheumatology department. i never mentioned fm and low and behold...that is what they said. when i brought my results back to a new neurologist...he said he did not believe it and would have to reexamine me....guess what...he too said i had fm....thought i was one of a few that truly had it. and was surprised i was not a depressed fm patient. one can get depressed with it considering all the pain and other symptoms. the migraines, ibs, photosensitivity, aching like you have the flu all the time, bruising so easily, dizziness with balance issues, fatigue, numbness, ....i could go on and on...but who cares....not many of the er nurses on this thread.
  9. by   littleun
    Quote from SmilingBluEyes
    IF exercise and "doing something about it" FAIL US (and they do for some of us), what do you suggest then??????

    Just "get over it" perhaps, right? Forget it cause it's bogus?

    Whatever--- but do NOT get medical tx, cause someone might roll their eyes at such people? Just drug-seeking depressive hypochondriac types, after all, clogging up the health care system.

    Puuuhleeze, depression varies in severity and so does FM. I will willingly concur, some people use their illnesses and/or afflictions for secondary gain and this is reprehensible. It only screws it up for people like me, who only go to the doctor when all other options to deal with it run out and we want to HELP OURSELVES get better.

    It's not a "disease du jour" or "fashionable" to me....it SUCKS to live with and makes life miserable at times. But til you walk in my shoes, please don't judge or generalize me. I think that is fair and really should not have to even be argued on a board of supposedly caring health-care professionals.

    Good day everyone!
    Thank-you Deb!
    I was recently diagnosed with FMS myself and the rheumatologist that gave me that diagnosis was not in the least supportive or informative about it. She actually got angry with me because I refused to take any narcotics or hypnotics and was quite aggressive with finding the tender points. I could not believe the pressure that she applied and was actually in tears by the end of the exam. I remain very active in daily life despite the pain and fatigue and follow a very strict dietary regimen every day. This has not alleviated the pain and fatigue completely but does help. No, I am no longer able to function as a nurse in the way I would like to, but I miss that calling terribly and I hate to see other professionals bash people who are truly in desparate pain the way I see them doing in this thread.
  10. by   veetach
    Quote from teeituptom
    What is discussed here is all that it is, discussed here.

    You tell me you hurt in the ER, I will med you with whatever the doctor orders. And not even think anything about it. And I will recheck your vitals and your rsponse to it in 15 to 30 minutes and document it. Im a firm believer in keeping everything simple at work.

    ER nurses are a proud and pompous lot, you have to be to work ER. But is ER the proper place for all the FFers with Chronic pain of anykind. Is ER turning into an Extended Pain Care Clinic. Isnt chronic pain, whatever the source best handled by a Primary Care Physician. Isnt that better than frequently hopping from one ER to another.

    I mean no disrespect to anyone with FM, who truly has it. But there are those who abuse it as a Dx along with all the other chronic pain syndromes.

    Answer this

    Is the ER the best place to handle these problems.

    amen, Tom. Thank you.

    Now, I would like to thank many of you who have responded in a civil manner to this thread. You have really given me some insight into this illness. I am very sorry that there are so many people who are suffering here....

    As a dedicated ED RN, I am committed as a patient advocate to make sure that my patients get the medications prescribed for them by the docs. I would never EVER be rude or judgemental to a patient. It is not my style.

    It is also not my job to judge them, even though we all know how frustrating it is in a very very busy ER, to see patients attempting to use us as a pain management setting. In situations like this, we go to the break room, ***** and whine and complain, then put on the ER RN face and go back out and take care of our patients.

    I have learned some interesting stuff on this thread that I did not know. Thanks to all!
    Last edit by veetach on Apr 10, '04
  11. by   spiritus
    i could go on and on...but who cares....not many of the er nurses on this thread.[/quote]
    nicki, *i* care!! i'm a niurse to be, eithe rin community or a&e which is er
    to my fellow americans!! the economy is crap, the government is crap,
    the president is a real piece of work and i want bill back!!! but since some ]
    irate republican may damn well tar and feather me, i'll shut up now, me, the wide mouthed frog!! i have 'fm. had cfs, also diagnosed as me...and every morning is a struggle, but i am blessed...for i'm that rare idiot(and this is no
    slur on rare people or idjits so puh-leeze don't hit me)that the rest of you would call an optimist...why, i''ll never know...how? i was never a really
    happy or sunny kid, until i died at the age of thirteen....then things got, and i mean, really got, my attention... i realised that it was my choice that i got up in the morning, and i won't go on here, cause you all have heard the "i can do it, so you can too!" speech...for me, getting up in the morning has never had the clarity and resolution that my mother's death has brought, until now...i am more peaceful(although i dread the funeral!), serene, and commonsensical, than i have ever been in my entire life...but my fight with
    fms( i **hate**, as both a nurse, and a patient, the word, "syndrome"!)
    centers on one thing...getting up in the morning and choosing to make a difference in somebody's life...that day. yeah, sure, there are days i really hurt, somedays so badly that i cannot bear to have my believed touch my skin, and he has the most tender touch of any man i have ever know, biblically or otherwise!!!

    nicki, don't give up crying, screaming,k shouting, and getting pissed off about this disease...the people who call you a frequent flier and a wastebasket diagnosis don't deserve the chance to lick your slippers, kid!!!

    vehemently, spiritus
  12. by   veetach
    Geez, take some Ativan, Spiritus.
  13. by   Enfermera7a
    [QUOTE=Silkybo]Everyone I know with fibromyalgia is A. A hypochondriac B. Clinically depressed or C. a drug seeker. I dont believe in this diagnosis. Throwing oxycontin at aches and pains is like killing mosquitos with a sledgehammer. I am not against appropriate pain meds, especially in the terminal patient....dose 'em up, I say, but not for people who are just not facing life square on...I hurt too after lifting obese geriatrics all night, but Im not going to
    w I am really disappointed in the replies I have just read about fibromyalgia.
    I guess you guys are many of the nurses who looked at me "funny" because I
    was having overwhelming fatigue ("she must be lazy"), muscle pain ("drug
    seeker"). Then came the bilateral papilledema which was not a brain tumor
    and so......6 years later they finally decide I have MS.

    Those who fight monsters must be careful that they do not become one.

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