How many visits until you label a frequent flyer or drug seeker?

jadednurse · Sep 9, 2003

Hi z's playa and welcome!

As a nurse I can say it's hard sometimes not to have those little red flags pop up in situations like this. You see alot of people abuse the system...sometimes it's hard not to be at least a little suspicious.

However...

as a nurse who also suffers from migraines...

I feel your pain. It's got to be frustrating and stressful to deal with that kind of mentality on top of the excruciating pain you're having.

I guess if I were you my bigger concern would be better management of your migraines by your PCP. There are alot of options these days...not only abortive medicines but preventive as well.

I would discuss this w/ your PCP.

Good luck to you. But in the meantime, don't let your concerns about what the staff will think prevent you from getting the treatment you need,

z's playa · Sep 9, 2003

Thank you jadenurse and mjlrn97. I'm taking 60mg of Propranolol and I take Naprosyn at onset, or Imitrex. I've gone from 8 migraines a month, down to 3.

Thank you for your encouragement...it means the world to me.

Zplaya

Long Term Care Columnist / Guide · Sep 9, 2003

You're welcome, Z....and for future reference, you may want to reconsider the Pill, it's known to CAUSE migraines in some women (myself included----I had several a week during the entire 2 years I was on it, and I tried several brands).

Good Luck to you!

gwenith, BSN, RN · Sep 9, 2003

If you don't get a response on your original question it is quite Okay to "bump" a thread back up to the top by posting on it.

KaroSnowQueen, RN · Sep 9, 2003

I dont' know that there's a "magic number" of visits. Its more the things the patient does or doesn't do. Such as c/o severe nausea while gulping down food, or c/o severe incapacitating pain while showing absolutely NO outward symptoms. I know there are people who don't show pain, but they usually have some sign, such as quietness, or facial expression, etc. If someone comes in with a migraine, and I can tell they have a migraine: wanting things quiet and dark, holding their head, asking for the people in the next cubicle to take their Taco Bell out of the room, etc, then I don't care how many times they come in for treatment.

It's the people who come in smiling and laughing and saying I'm in great pain and I can't take Stadol, Lortab or Toradol. I need Demerol 100 mg with Phenergan 50 mg and nothing else works on me. Then they want something else in between doses of that if they are admitted, all the while complaining of ferocious pain but falling asleep between the time they ask for the med, and the time you get to them, and they are hard to wake up when you get there. THOSE are the people that I begin to get a little suspicious of.

caroladybelle, BSN, RN · Sep 9, 2003

As we should "never label" people drug seekers, due to pain regs, I don't know if you will get an honest answer on this.

My opinion is that it is more what you do or say, that indicates to us how much discomfort that you are in. I agree with the poster above, though it should be difficult to label anyone.

As far as frequent flyers go, what is wrong with that? Mant cancer patients, anemia patients and sickle cell patients are frequent visitors. Merely being FF is not a bad thing.

Perhaps for some of our patients, the phrase should be "drug/opiate tolerant".

z's playa · Sep 9, 2003

My best friend is an Rn in an ER around here and she's always telling stories about how she has to hunt down her pts AFTER giving i.v meds for migraines or abd.pain. She finds most of them in the smoking area out in the parking lot. Pisses her off to no end. I had to remind her that there are people who can still function, dispite the agony.

Dave ARNP · Sep 16, 2003

ZERO...

If the prescriber of that medication would like to make that determination after careful review and evaluation, then the diagnosis might be considered.

David

eldernurse · Sep 19, 2003

A frequent flyer is a person who has visited the ER instead of going to an MD's office for any ailment that is non-emergent. He may have visited more than one ER (ie, "the other hospital gives out cab tickets and meals"), or his doctor may have made an appointment for him in the next day or so, but they can't wait (the instant gratification type).

In your case, if you are truly doing everything you can to PREVENT a headache, and you understand that the ER is only a temporary solution for a chronic problem, most ER nurses and docs will not label you a FF or drug seeker. By the way, narcs only exacerbate your problem. Did you know that?

jadednurse · Sep 19, 2003

Originally posted by eldernurse
By the way, narcs only exacerbate your problem. Did you know that?

Could you elaborate on this...I'm curious.

TRobert · Sep 20, 2003

>>In your case, if you are truly doing everything you can to PREVENT a headache, and you understand that the ER is only a temporary solution for a chronic problem, most ER nurses and docs will not label you a FF or drug seeker. By the way, narcs only exacerbate your problem. Did you know that?

Just for information: Actually, Migraines are not headaches. Migraine has now been proven to be a genetic neurological disease. Headache is only ONE of many possible SYMPTOMS. There are also Migraineurs who have other symptoms, and never have head pain with a Migraine.

How would narcotics exacerbate the problem. Certainly, they're not the best first line medication for a Migraine attack, but if the Migraine is out of control, and abortives such as triptans or ergotamines aren't working, why would occasional narcotics exacerbate?