Last Wednesday I encountered the reason for the sometimes crappy treatment I get in the ED concerning my migraines. I actually met a real life in the flesh migraine faker! :
I was waiting in the Ed waiting room, waiting for my boyfriend to get off work, and noticed a couple sitting across from me. They were chatting happily, laughing and pigging out on candy bars and chips and cokes. I noticed the hospital bracelet on the girl and after about 10 minutes, I couldn't help myself.... I asked her what brought her to the ED at 3:00 in the morning. She looked at me and says..."Migraine"
I'm in shock at this point but then I get angry!
I say" YOU have a migraine and you can EAT and DRINK? Isn't the light bothering your eyes? You do NOT have a migraine and you know it!"
I turn away disgusted. Well....guess what...she goes into "migraine mode". Gone are the chips, the chocolate and the cokes, and out come the dark sunglasses, the cold ice pack and she puts her head down on her boyfriend's shoulder and starts to grimace in "pain"
I start laughing out loud. :chuckle I could not believe it! I still can't!
I have to drag myself into the ED, feeling half dead, wishing I was, and I get the red flag because the staff encounters people like this girl!
When I finish nursing school I want to work in the ED and I'm guessing I can't do what I did Wed, but I think I'm going to have a hard time keeping my mouth shut.
Honestly, I never quite understood how the cynicism towards migraineurs came about until now. Another part of me can't see how the real thing can be confused with these obvious cases of faking it. A dilemna that shouldn't exist I suppose.
How do you handle people like this? Can you get your license taken away?
but he asked me for a bandaid for where he pricked his finger
Now, do you think he peed on his finger as he was collecting your sample or did he use the finger with the owie as a little stir stick after he was all done? Yummy. Tell him as he signs the discharge papers, "you can keep that pen"
Cath ua was negative of course --- awe tom, you spoil sport!
Very rarely, I have a migraine that will make me vomit. Depending upon how early I catch it, 1000mg ibuprofen + caffeine is usually pretty helpful. Ketoprofen is another good option. Sometimes Midrin if I need it.
Had a caucasion male try to tell me he had sickle cell
had a kidney stone pt give a urine, dip pos.
but he asked me for a bandaid for where he pricked his finger
Cath ua was negative of course
Um, Tom, Caucasians (sp?) CAN be sicklers, it's just much more prominent in the African American world. Speaking as a former peds nurse and one who currently works with sicklers, I can say with authority that not all of mine are African-Americans. Now I haven't seen into any background to see whether they have African-American in their backgrounds from way back.
Its one of those damned if you do, damned if you don't things. You may get sued for not adequately treating pain, but you may get sued if you contribute to a patient's addiction. So I just tend to make the best decision I can. And while I try to consider the fact that not everyone responds to pain the same way, I cannot ignore the classical presentation when evaluating a patient. I only write for 12 doses of narcotics, except on Fridays, when I write for 20. And if your pain cannot be controlled on an out-patient basis by Schedule III meds, you will have to be admitted.
You know, the more I read posts like this, the more I think about suing for how badly my pain was undertreated(not treated at all). But, I know me and I might think about it, but I wont do it because I have an aversion to lawsuits. The times that I broke down and tried to get help in the ER, I was in such agony that I would've jumped at the chance to be admitted, I would've stayed as long as they'd let me if it meant escape from the pain. I can't stress enough how much pain I was in, and for so long. I went so far as to ask them to just sedate me if they didn't want to give me something for pain. Anything would've been okay with me.
The one time out of all of those visits that I did get something for pain, I did ask them to admit me and was told no. They thought it was funny but I was serious. I knew that whatever they gave me had to be pretty strong stuff, and that they certainly weren't going to give me a scrip for it, and that unfortunately it was going to wear off pretty soon. I would have gladly stayed.
Still have no idea what they gave me.
When you say you were in pain "So long" how long are you talking. I guess my point of view might be, why did you wait so long that your primary was unable to see you and prescribe meds, perhaps direct admit you for your intractable pain?
Wow, I get migraines, and can't imagine being able to laugh, talk, or do anything! I can barely move, the light kills my eyes, and I want to vomit. I need to lay down in a dark room, put a cool washcloth on my head, and not move for hours. I have a high tolerance for pain as well. As bad as they get, I don't see myself going to an ER for one, unless it didn't end.
So just because you don't recall having the pain, means you didn't have it? j/k People don't recall having the pain after having conscious sedation because of amnesia producing medications such as versed, which is NOT a pain medicine. As far as sleeping while in pain goes... some people escape pain by sleeping. They shut down to escape it, so yes, you can sleep and still hurt.
okay,...so if your in pain but don't know it,.or can't remember then are you really in pain? Pain meds are to make people feel better, to allow them to rest or relax,..morphine isn't intended to "cure" any disease process,.it's purpose is to make you feel better. If you are asleep, what is the point of waking you up for pain meds? If your pain isn't enough to interrupt your normal functioning does it really require narcotics? Just ranting here,..I understand the whole "pain is what the pt says it is", but sometimes it really makes no sense to me!
okay,...so if your in pain but don't know it,.or can't remember then are you really in pain? Pain meds are to make people feel better, to allow them to rest or relax,..morphine isn't intended to "cure" any disease process,.it's purpose is to make you feel better. If you are asleep, what is the point of waking you up for pain meds? If your pain isn't enough to interrupt your normal functioning does it really require narcotics? Just ranting here,..I understand the whole "pain is what the pt says it is", but sometimes it really makes no sense to me!
I was taught and firmly believe that pain meds should be put on a schedule because if you lapse in doses it takes more to bring you back to a tolerable threshold once the pain returns. I have experienced this as well.....I have had severe pain, ex: shingles, migraine, pleurisy, joint pain, post surgery....have taken a narcotic, fallen asleep and the pain is what wakes me up. So being able to sleep during pain I feel is a combo of narcotic pain relief, exhaustion from "dealing with the pain" and then the pain waking me up. I firmly believe in waking someone to give pain meds as scheduled.
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gwenhyfar
20 Posts
And, try migraines and cluster headaches at the same time. You won't eat, drink, and you sure as heck won't be playing and laughing. :angryfire