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?
"Doctors will -never- treat my pain because I'm honest about being an addict. One exception was the car accident, where they gave me morphine every hour and dilaudid every third."
Wow. That's cold. Because you are honest about your addiction they're just assuming that you never, never have pain unless you're in a car accident. A human being in a human body will have pain some time even when not in a car accident. They need to reevaluate their assumption and praise your honesty.
"There are plenty of non-narcotic pain relievers out there for addicts, and I disagree that Docs never treat pain of those who suffer an addiction. It's kind of unfair to suggest that a physician refuses to treat you because you are an addict... Perhaps it's more like.....We refuse to give you narcotics...and you feel because narcotics aren't offered, they are refusing to care/RX your pain.:twocents:"
You're a nurse? Interesting that you defend that docs never treat pain for addiction "sufferers". I said that docs never treat -my- pain when I'm honest about being an addict. What non-narcotic analgesics -really- work for severe pain? I'm not talking about local anesthesia. The truth is, and has been since Hippocrates' day (and he actually mentions the value of poppy derivatives in treating pain and as a styptic), that narcotics calm a patient, they mute the pain experience. "We" (doctors, not nurses, and nurse practitioners have their place as well) refuse to give me narcotics because -you're- afraid of something. You're a nurse. Alcohol is addictive, but it's legal. Until the early 1900s, opiates were legal in the US. Opiates do not cause organic damage at even the doses that I would use. I have used 700mg+ of MS daily. Yet, my problem only cropped up when my supply was interrupted.
I'm off on a tangent. I'm currently on 50mg methadone daily to treat pain. It does not work as well as hydromorphone, morphine, or oxycodone, but the government and my doctors feel more comfortable with methadone because I am an addict. That's only been a convention since the 60s or 70s I believe.
The point I'd like to make is this:
Opiate and Opioid analgesics treat the pain and the experience of the pain. There are no other comparative pharmakinetic mechanisms for alleviating pain suffering. Opiates make me feel better, but because I am dependent on them doctors aren't -as- willing to prescribe them. My problem is that I prefer to be honest so that the doctor can have a better scientific data. In fact, I could grow the flowers myself. My complaint was that that people who fake pain and do all the dramatics probably put doctors off and annoy medical practitioners more than an honest addict, and drug seeking behavior potentially makes MDs employ skepticism and sometimes refuse to prescribe the good stuff when it would be well indicated.
No, doctors never treat my pain with narcotics if I tell them that I am an addict up front. The exception was when I was struck by a car and I told them so that they would consider a higher dose because of my tolerance. In that case it worked to my advantage.
Thanks for attempting to belittle an addict. I take 1800mg of Ibuprofen daily along with my 50mg of methadone. When the pain gets so bad that I can't cope with it, I will approach a doctor, being honest, and explain that I would like to look at what options there are to give me a quality of life worth living.
I shouldn't judge the migraine fakers if it makes me anything like you. I can't help it though. I have the courage to be up front about what I want, and see them as an interference in me getting what makes life better for me.
I do not see any belittling here either. As a nurse, I see drug seekers, addicts, recovering addicts, nondrugseekers, and so on. If you come to the ER with chronic severe pain and say to the doctor you're an addict, our doctors discuss the bennefits of other avenues used to treat a patient's chronic severe pain. As a chronic pain sufferer, I take 800mg motrin, do my stretching, and sometimes hot tub it or ice...daily....and then I head off to work........
"you're a nurse? interesting that you defend that docs never treat pain for addiction "sufferers". i said that docs never treat -my- pain when i'm honest about being an addict. what non-narcotic analgesics -really- work for severe pain? i'm not talking about local anesthesia. the truth is, and has been since hippocrates' day (and he actually mentions the value of poppy derivatives in treating pain and as a styptic), that narcotics calm a patient, they mute the pain experience. "we" (doctors, not nurses, and nurse practitioners have their place as well) refuse to give me narcotics because -you're- afraid of something. you're a nurse. alcohol is addictive, but it's legal. until the early 1900s, opiates were legal in the us. opiates do not cause organic damage at even the doses that i would use. i have used 700mg+ of ms daily. yet, my problem only cropped up when my supply was interrupted."
we do not prescribe alcohol to anyone....lol...not sure what that analogy is for. you are describing opiates as if they aren't bad for you personally, and defending their use with recovering addicts. i don't understand that....call me crazy...lol...if you want narcs...then don't tell the er doc you are an addict....
and if you are coming to the er for chronic pain of any sort.....realize the er cannot cure your pain, nor is chronic pain an emergency. just as your methadone does not cure your addiction giving you narcotics wouldn't be a good or ethical decision either.
New school , if you come to the ED with a c/o of migraine all you get is reglan benedryl and IV fluid. Nothing else.
I've done lots of non-narcotic helps as well. I get an order for 100% O2 via Nonrebreather @ 15 lpm.....cool cloth to the forehead, warm blanket, lights out ,door shut.....Sometimes that coupled with narcs, or we've given what's called caffiene IV...etc... It worked for me before and many of my patients who suffer Migraines say it seemed to reduce the duration of the migraine. I monitor their BP too as that is a good indicator of where their HA might be coming from at times. We've even given BP meds assist in a BP migraine. There's lots of methods to reduce migraine and headaches...and pain for that matter. Whether acute/injury or chronic....there are so many ways to reduce the pain. Some work, some don't.
i'm an ER nurse and also a migraineur. we see legit's and a few faker's I can usually pick them out. I've been to an er once for a migraine, it was the night before my acls mock code/ exam. I got a shot of toradol. I was offered demerol, I declined. toradol works great for me. My PCP gave me a RX for stadol at one point, I staggered all over my house, my kids thought it was hysterical, the headache came back twice as hard, I ended up vomiting twice as bad, the other symtoms were as bad too. Triptans were hit and miss. I finally went on Topamax, what a godsend. Basically headache free. when I do get them, imitrex po works so quick now. Can't believe I put up with them for so long
New school , if you come to the ED with a c/o of migraine all you get is reglan benedryl and IV fluid. Nothing else.
Does benedryl really work for a migraine?? I understand the reglan because I am often nauseous when I get migraines, but never heard of benedryl. I have some for allergies, maybe I will try some next time I suffer from a migraine.
Does benedryl really work for a migraine?? I understand the reglan because I am often nauseous when I get migraines, but never heard of benedryl. I have some for allergies, maybe I will try some next time I suffer from a migraine.[/quote
there is a "thing" called a histamine headache....for that benadryl should help.....i get tyramine mediated migraines....if you take benadryl before the exposure it is supposed to help.....i was never one for mixing drugs unnec.
however, for a migraine, i did try benadryl 50, and ibuprofen 800 and quiet.....worked in sl less than an hour.....i can not explain why.......but gosh it was a great discovery!! i rarely get them since i know what not to eat.....
It kinda sounds like some (note the word some and not all) recovering addicts that admit to their addiction and then get angry at non narcotic pain interventions want the doc to tell them "Hey its ok to take the narcotics again". I have had recovering addicts even say they would prefer not to go back on narcotics due to addiction but if the doctor feels it is best, then who are they to argue. It comes down to people being honest within themselves. I have always heard alcoholics say that one drink is falling off the wagon, is it different for narcotic abusers? We will never keep a person from their addiction if they "choose" to not help themselves first.
"Doctors will -never- treat my pain because I'm honest about being an addict. One exception was the car accident, where they gave me morphine every hour and dilaudid every third."
Wow. That's cold. Because you are honest about your addiction they're just assuming that you never, never have pain unless you're in a car accident. A human being in a human body will have pain some time even when not in a car accident. They need to reevaluate their assumption and praise your honesty.
"There are plenty of non-narcotic pain relievers out there for addicts, and I disagree that Docs never treat pain of those who suffer an addiction. It's kind of unfair to suggest that a physician refuses to treat you because you are an addict... Perhaps it's more like.....We refuse to give you narcotics...and you feel because narcotics aren't offered, they are refusing to care/RX your pain.:twocents:"
You're a nurse? Interesting that you defend that docs never treat pain for addiction "sufferers". I said that docs never treat -my- pain when I'm honest about being an addict. What non-narcotic analgesics -really- work for severe pain? I'm not talking about local anesthesia. The truth is, and has been since Hippocrates' day (and he actually mentions the value of poppy derivatives in treating pain and as a styptic), that narcotics calm a patient, they mute the pain experience. "We" (doctors, not nurses, and nurse practitioners have their place as well) refuse to give me narcotics because -you're- afraid of something. You're a nurse. Alcohol is addictive, but it's legal. Until the early 1900s, opiates were legal in the US. Opiates do not cause organic damage at even the doses that I would use. I have used 700mg+ of MS daily. Yet, my problem only cropped up when my supply was interrupted.
I'm off on a tangent. I'm currently on 50mg methadone daily to treat pain. It does not work as well as hydromorphone, morphine, or oxycodone, but the government and my doctors feel more comfortable with methadone because I am an addict. That's only been a convention since the 60s or 70s I believe.
Are you a nurse? I do not want you in my ER as a pt or nurse.
it kinda sounds like some (note the word some and not all) recovering addicts that admit to their addiction and then get angry at non narcotic pain interventions want the doc to tell them "hey its ok to take the narcotics again". i have had recovering addicts even say they would prefer not to go back on narcotics due to addiction but if the doctor feels it is best, then who are they to argue. it comes down to people being honest within themselves. i have always heard alcoholics
say that one drink is falling off the wagon, is it different for narcotic abusers? we will never keep a person from their addiction if they "choose" to not help themselves first.
couldn't have said it better. if you are truely a recovered addict you would not want narcotics. they could throw you back into addiction. i have taken care of several people who are honest and tell us they are a recovering addict and they also tell us they wish to avoid narcotics at all costs.
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utsuprainfra
2 Posts
Originally Posted by GLORIAmunchkin72
"There are plenty of non-narcotic pain relievers out there for addicts, and I disagree that Docs never treat pain of those who suffer an addiction. It's kind of unfair to suggest that a physician refuses to treat you because you are an addict... Perhaps it's more like.....We refuse to give you narcotics...and you feel because narcotics aren't offered, they are refusing to care/RX your pain.:twocents:"
You're a nurse? Interesting that you defend that docs never treat pain for addiction "sufferers". I said that docs never treat -my- pain when I'm honest about being an addict. What non-narcotic analgesics -really- work for severe pain? I'm not talking about local anesthesia. The truth is, and has been since Hippocrates' day (and he actually mentions the value of poppy derivatives in treating pain and as a styptic), that narcotics calm a patient, they mute the pain experience. "We" (doctors, not nurses, and nurse practitioners have their place as well) refuse to give me narcotics because -you're- afraid of something. You're a nurse. Alcohol is addictive, but it's legal. Until the early 1900s, opiates were legal in the US. Opiates do not cause organic damage at even the doses that I would use. I have used 700mg+ of MS daily. Yet, my problem only cropped up when my supply was interrupted.
I'm off on a tangent. I'm currently on 50mg methadone daily to treat pain. It does not work as well as hydromorphone, morphine, or oxycodone, but the government and my doctors feel more comfortable with methadone because I am an addict. That's only been a convention since the 60s or 70s I believe.
The point I'd like to make is this:
Opiate and Opioid analgesics treat the pain and the experience of the pain. There are no other comparative pharmakinetic mechanisms for alleviating pain suffering. Opiates make me feel better, but because I am dependent on them doctors aren't -as- willing to prescribe them. My problem is that I prefer to be honest so that the doctor can have a better scientific data. In fact, I could grow the flowers myself. My complaint was that that people who fake pain and do all the dramatics probably put doctors off and annoy medical practitioners more than an honest addict, and drug seeking behavior potentially makes MDs employ skepticism and sometimes refuse to prescribe the good stuff when it would be well indicated.
No, doctors never treat my pain with narcotics if I tell them that I am an addict up front. The exception was when I was struck by a car and I told them so that they would consider a higher dose because of my tolerance. In that case it worked to my advantage.
Thanks for attempting to belittle an addict. I take 1800mg of Ibuprofen daily along with my 50mg of methadone. When the pain gets so bad that I can't cope with it, I will approach a doctor, being honest, and explain that I would like to look at what options there are to give me a quality of life worth living.
I shouldn't judge the migraine fakers if it makes me anything like you. I can't help it though. I have the courage to be up front about what I want, and see them as an interference in me getting what makes life better for me.