Patient

"Vital signs will always show some reaction to pain." Not necessarily. I've been a chronic pain patient for a few years, and in addition to opiate therapy I use self-hypnosis to keep me out of the hospital. I've seen too many nurses look cross-eyed at me and heard too many snarky comments to ever willingly set foot in a hospital. Self-hypnosis actually works during a pain crisis, but it took me years to reach this point. My pulse and BP decrease to nearly normal when I'm in "a state." It doesn't help that my underlying condition is pretty much invisible. I have abdominal adhesions out the wazoo and live with pretty constant SBO, and as you know they don't generally show up on imaging studies. It makes no difference if I show up with 10 years of medical records proving my condition, some nurse or doctor will always believe I'm a drug seeker. No, I would rather die than go to a hospital - and probably will some day. At least then I won't have to deal with pain any longer - or doubting, second-guessing medical staff.

knoxvegas wizard nailed it. I had a mumford a few years ago and it took a full year before all the pain finally resolved. It was worth it though. The rehab is extremely painful and the polar care unit was my best friend for many months. As with any ortho surgery, the surgeon can only do so much. The recovery is up to the patient as to how much pain they can stand while enduring physical therapy. In my experience, I found ice and naproxen to work better at pain relief than narcotics after the first few weeks. It always seems like it you'll never recover until one day you realize you've been using that arm without noticing a thing. Time and patience. Lots and lots of time and patience. :-)

My good friend's 16 year old son suffered a compound tib/fib fracure in a football game yesterday afternoon. Surgery was done early this morning and he just got home sprouting 9 pins and a couple of plates holding his leg together. His mother has had zero sleep and I'm not certain she understood the home care instructions. The son was sent home with vicodin for pain relief, and I suspect that isn't going to cut it - particularly when the muscle spasms really kick in. I also think he was sent home too soon and should have been kept in at least overnight for pain management alone. What would you recommend for home care for this type of injury? Obviously I'm not a nurse, but I'm very interested in all things medical and thought I'd go to the experts - the nurses. Please understand, I am NOT asking anyone to practice medicine without a license, but rather, I'm looking for general information in caring for a tib/fib injury. Is there a "one size fits all" treatment, or does it vary from doctor-to-doctor and hospital-to-hospital? Many thanks!

Having used the patch myself for over three years, I've found that the gel patches (generic or brand) dispense too quickly the first two days and withdrawal begins some 12+ hours before it's due for replacement. The Mylan generic is hands-down the better patch. It dispenses evenly and actually lasts the full 3 days. Tegaderm is an excellent cover during sweaty summer months.

Yes, I am deadly serious. Of course, this was back in the Dark Ages in 1981, but at a very well-respected, large teaching hospital. I still remember the nurse looking me in the eye saying, "I just got to RELAX in this place you know. I can't get through a day without this stuff." Puff puff pass it on... I had no self-esteem or any kind of backbone back then, had never had any kind of medical problem in my life, and was scared to death that if I said something, she would someway retaliate in my care. I was one dumb teenager. My roommate was the worst drug seeker I've ever seen in my life, and I didn't even know there was such a name for that behavior back then. She had been in a minor MVA, and screamed bloody murder in front of the docs that she was dying in pain. The docs believed her, were very sympathetic, and trying to figure out why she had this horrible pain. Lord only knows what kind of pain meds they gave her, but she always had to have more. As soon as the docs would leave, off came the c-collar, and she was partying with her brother. She even diverted some of her po meds to share with him. Sorry, I didn't mean to hijack the thread - just to illustrate a problem with visitors that probably doesn't get much consideration because who would ever believe it could happen? Yes, I really was assaulted as a patient, in broad daylight and during visiting hours that were strictly enforced. Nobody was around to witness the event except the perp's sister, who was drugged out of her mind. How much easier is it for this type of thing to happen now with multiple visitors per patient at all hours of the day and night?

From a patient's perspective, I have never wanted visitors other than my husband while I was in hospital. My sister seems to think that bringing her 4 children in the room with her is a good thing. Wrong. It's not good for me, and it's not good for my roomie. I'm SICK! And no, I don't feel like entertaining visitors while tied to an IV and drugged out of my mind. The worst visitor episode was my first hospitalization when I was 17. My roommate's brother sexually assaulted me while I was heavily sedated following surgery. I could barely speak, and the only reason he stopped was because the nurse came in. She didn't witness the act because I was on the far side of the room behind the curtain. Turns out that the brother was bringing sister some weed to smoke, and the nurse smoked it with them! All I wanted to do was get the h*ll out of that place, and I was too scared and embarrassed to say anything.

I got the Patient Advocate involved on Thursday, and she was fantastic. Finally got all the specialists on the same page so the right hand and left hands are actually communicating. When the Mother found out a social worker was getting involved, she became frantic saying, "Why do we need a social worker? Are they coming to see what kind of mother I am?" Yeah, it's all about her all right. I'm getting more and more alarmed with every passing day. Do I have to be the one to do something that will have my brother's child taken away from him when he has done nothing wrong?

GAG! I'm with you on the Susan Smith case. I lost track of it since I'm not in that state, but it was obvious from the start she killed her kids in order to try to keep a man in her life. "Evil" doesn't begin to describe that woman!

Wow. Some sites look at Munchausen's as an "illness", others... well, don't... like this paragraph: MBP Confirmation-Disconfirmation Process MBP is a recognized kind of maltreatment (abuse/neglect) - it is something someone does, NOT something someone "has" or "suffers from". It is behavior that one person deliberately perpetrates on another. For MBP to be confirmed, there must be: (1) proof, through direct or circumstantial evidence (usually strong circumstantial evidence), that the suspected perpetrator has deliberately exaggerated and/or fabricated and/or induced a problem (physical and/or psychological-behavioral-mental health) regarding another person, and (2) rationale that the behavior is consistent with MBP maltreatment, rather than something else. There is no mental health test or evaluation that can rule MBP maltreatment in or out. There is no "profile" or combination of personal characteristics or traits that can determine whether someone is or is not an MBP perpetrator. The MBP confirmation-disconfirmation process involves the gathering and specialized evaluation of all possible information regarded suspected perpetrator(s), suspected victim(s), other children presently or formerly in the home - even if now adults or deceased, and sometimes others - depending on the case situation. MBP physical and emotional victim risk results from medical and mental health interventions as well as from actual symptoms/illness induced by the perpetrator. Although labeling a case MBP maltreatment may not be necessary in criminal cases, a confirmation of MBP maltreatment by or with the assistance of a credible MBP professional, and finding of MBP maltreatment in child protection courts, is extremely important. Child protection case plans must correspond to the kind of maltreatment that is confirmed. Appropriate MBP case plans include elements unique to MBP maltreatment - activities that must be successfully completed prior to consideration of reunification between victim and perpetrator, and other activities related to where the victim will live, other children in the home, contact between perpetrator and victim and potential victims, visitation with others, and other short and long term issues related to child protection. **************************** Like so many mental health issues, there seem to be more opinions than answers. Nanny cameras are the obvious first line of defense though, and the family is currently trying to figure out how to get that done. I suppose I was wondering if anyone has ever dealt with a Munchausen's patient up close, and if there is any "good" way of confronting the person. "Confrontation" is a really bad word, but someone has got to do something for this child before irreparable harm is done. The mother has been strangely apathetic about this child's illness. If any of her other children had so much as a bruise, she'd be on the roof about it. But not this one. I'll keep on reading. Thanks for the replies!

I'm wondering if anyone can direct me to a FACTUAL website regarding this syndrome, if anyone has had direct contact with a Munchausen's patient. A 2.5 year old nephew who has been 100% healthy since birth, got an ear infection over 2 months ago and since then has had febrile seizures of increasing severity. The mom is a stay-at-home mom who has a history of "just deciding" not to give various meds for whatever reason. If Dad doesn't do it himself, it doesn't get done. The situation in a nutshell is this: child goes to hospital, all tests (EEG, spinal, MRI, CT scan) normal. No epilepsy, but febrile seizures due to ear infection. Funny that the ear infection only responds to antibiotics given by a pediatrician wielding a needle. Funny also that the seizures only respond to meds given in hospital or by father. As soon as child goes on oral meds, and father goes back to work, infection returns, and seizures escalate. Child is now on so many meds he has no normal baseline between seizures which are short lived in duration, but occur average 3x an hour. The mother has other "issues", but has already been documented with bizarre harmful behavior regarding this child abd another one a year older. Primarily overfeeding to the point they both vomited several times a day and were 99 percentile for weight. Three different pediatricians told her she was "actively harming" the children, and it wasn't until they got old enough to refuse food that they got down to normal weight. Everyone involved (including father) is becoming increasingly suspicious of the mother, but how to prove she is the one either actively harming the child, or actively neglecting treatment or "augmenting"?

I have to disagree on using bp as an indicator of pain. My bp is naturally low - most days 90/60. When I'm in pain, it runs around 130/85. So you're going to tell me I'm not experiencing "real" pain? Gimme a break! Also consider patients who regularly follow a physical exercise routine. We all know weightlifting and cardio exercise can really lower bp, and it STAYS low even with a high level of pain.

I couldn't take it. Tried it for 2 months and couldn't feel a thing in my hands and feet, and as already posted, everything I ate or drank tasted like... well... orifice. :-) Since it wasn't even touching my pain, the doc agreed it was useless to continue. I have heard of many people who get relief and very few side effects, so hope you're one of them.

Glad you started this thread. Having been a patient myself too many times, I find myself avoiding that call button like the plague. I know how busy all the nurses are, and further, am so afraid of being labeled as a "drug seeker" that I'll lay there and suffer for it. I guess I try so hard not to be a pain in the a$$, I end up being just that sometimes. :-)

What a horror story! It brings to mind a question I've had for many years, being a chronic pain patient due to abdominal adhesions for so long. If a patient presents with mental problems, he/she is referred for counseling; a patient with cardiac issues gets a referral to a cardiac specialist; a patient with back pain gets referred to an orthopedist. So why is it, that when a patient presents with pain, they are immediately labeled a drug seeker or an out-and-out addict, and are not referred to a pain specialist? I can understand why ED workers tend to throw such patients out when they appear time and time again, but do they never at least try to explain that pain issues should be treated by a pain doctor and at least attempt a referral? Why are such patients just labeled and thrown out the door? I hear ED workers in particular gripe all the time about the frequent flyers and "drug seekers," but do they ever at least try to listen and educate the patient? If one has a good pain doc, trips to the ED for pain crises are about non-existent. At least, that's been my own personal experience, and that of several people I know who have chronic pain. Instead of worrying about giving a junkie a fix, how about educating the patient for a change? You are so right - your husband was betrayed by his pain doc, and IMHO, is a reportable offense. OK, end of rant. :-)

After reading this thread, my jaw is hanging to the floor. I'm amazed any ER nurse has any patience left for the snot-nose-kid and free-medical-care-seeking-parents that continually use the ER for non-emergent care. God bless you all!