Anybody encountered a patient with this diagnosis? I had a pt come in the other day, report of vomiting x23 during past 4 hours, severe pain 10/10 in abdomen, letter from GI doctor stating she was diagnosed with cyclical vomiting syndrome and gastroparesis. Pt was begging for phenergen and dilaudid. Pt had previous rx for dilaudid 2mg PO, phenergen 25mg PO, and reglan 10mg PO. I gave her phenergen IV and IM, bentyl IM, protonix IV, tigan IM. Pt seemed to calm down but still begging for pain medication, asking for dilaudid by name. Became irritated when ED doc explained dilaudid may increase n/v and would not be given. (ED doc did not believe report of pain and flagged pt as drug seeker). Pt would only wretch and dry heave when I left the room or when doc was in room talking to pt. She was good enough to walk around and keep asking for pain medication. I witnessed vomiting x3 during 2.5 hour stay, watery undigested food, no bile. Im not sure what to think...........
