Treating pain in ER

[Butterfly0328]

Do you nurses typically see patients undermedicated in the ER for pain? I had the worst experience this past weekend. I have suffered chronic pain for about 10 years and at one time was on 600mg of oxycontin a day for about 5 years. I have weaned myself off of the oxycontin and now am on 120mg of roxycondone. I recently learned I have spinal stenosis in my lumbar, along with chronic kidney stones and neuropathy. So early sunday morning, after waiting over 8 hours for the pain to let up, I finally went to the ER. The ER doctor would only give me toradol and phenergan for nausea/vomiting ( I was also vomiting blood ). Finally he agreed to give me 1 ml of dilaudid (what a nice man. gag) which literally only took the edge off of my pain for about 15 minutes. Worst experence ever. I left in about the same pain I arrived in, only not vomiting. I made it a point to tell the Dr that I unfortunatelly have a high tolerance to pain meds, but he didn't care. Said chronic pain isn't treated in the ER. I thought if someone comes into the ER in chronic pain it must be treated, regardless of the cause. I wasn't asking or and RX or narcs, as I already had that at home, just wasn't working with this severe pain. Now I know the addicts probably mess things up for us who really need the relief, but shouldn't the doctor be able to tell the difference? Just curious about what you ER nurses see with regards to the subject. Thanks

[Poochiewoochie]

I too have spinal stenosis plus foraminal stenosis, Both are in my cervical spinal column. One section is 5 mm and the other is 6.6 mm. I also have been to the ER and it was an ER doctor who told me I needed an MRI-not my PCP. I just found all this out last Wednesday after suffering for 5 weeks and I'm awaiting a referral to a spine doctor.

I want to say that unless you have had this condition you are in no position to judge anyone who is. The pain can be unrelenting-NOTHING has worked-Percocet, Vicodin or Valium. A week ago last Saturday I went to the ER because the pain was so bad and he gave me 4 IM injections-morphine, torodal(sp?) decadron and valium. Plus scripts for another muscle relaxer and percocet. I got a MRI this Wednesday and my PCP called me Friday night to tell me that I have 2 bulging discs that are pressing on my spinal cord and she is referring me to a spine doctor first thing Monday, She also tells me to wear the cervical collar that the last ER doc gave me all the time and if the pain in my arms that comes and goes becomes constant and won't go away to go to the ER right away.

I have no insurance and go to the local Community Health Center. I can't just walk into the doctors office for a flare up of pain. I have to call at 7:30 in the morning to try and get a same day appointment. So you tell me where the heck I'm going to go at 1 in the afternoon or midnight when I have a flare up that my regular pain meds won't control? Certainly not my PCP.

I've had to go to the ER 4 times in the past 5 weeks because the pain was unbearable. I've had wonderful care all times. The collar has helped and I haven't had to go back to the ER this week. I can totally sympathize with the OP when it comes to this. I'm not a medical professional and I admire and respect those who have chosen the field to work in. I mainly posted because I wanted to say that spinal stenosis is no picnic and was mad after reading some of the replies to the OP posts. Like I said, unless you've ever had to live with pain for more than a couple of weeks don't be so quick to judge someone else who has. When you are in pain, and I mean the kind that makes you cry because you see no relief in site and are just tired of having to deal with it, you might find yourself running to an ER for immediate relief-I'd like to see how many of you who said see your PCP would be willing to wait the next day for relief if your pain was that intense.

[Butterfly0328]

Poochie- I am so very sorry you have been going through so much- I will be praying for you. I am so glad you have been having positive experiences each time you have had to go to the ER. Perhaps the bad experience I had may have a little bit to do with where I live - Las Vegas. I do have a much better understanding of why administering narcs in the ER has become a very difficult decision for the doctors to make because drug seeking has become such a national problem. But I do believe that there are some who are quick to judge and advise those of us who have had a major flare up of pain to just wait to see our PM doctor just don't understand the depth of our pain and the NEED for pain relief via the big guns like morphine or dilaudid. It really has become such an epidemic problem, thanks to the addicts who are just looking for their next fix. I totally wish you the best if luck and will be praying for you.:redpinkhe