Tag Archives: narcotics

Straight, No Chaser: Getting Your Pain Treated at the Emergency Room

Chronic-Pain ER

Both the American College of Emergency Physicians and the American Chronic Pain Association have worked diligently to offer information and recommendations to protect patient interests and prevent inappropriate emergency room utilization while respecting the needs of chronic pain patients experiencing acute exacerbations.
In a word, it’s about expectations. Learning to understand what’s reasonable and not so much in an emergency room setting is important in helping patients to avoid disappointment.
Here are some tips to help your emergency room team help you.
If you don’t prepare for an emergency room visit, you’re the one who’s going to end up disappointed.

Chronic Pain ER info

  • You should be able to tell the staff the name of the condition from which you suffer.
  • You should know the name and the contact information of your primary physician and any pain management specialist you see.
  • You should know the names of your medications, including over the counter and herbal preparations.
  • You should know any medical allergies you have. (A word about this. There is a difference between a medical allergy and an adverse reaction to a medication. Just because a medicine upsets you stomach or isn’t as effective as another doesn’t mean you’re allergic to it. It’s insulting to your physician to insist that you have an allergy when you don’t. You can assume that taking this posture starts the relationship off poorly because the physician will often know better and in many cases can check or test you for true allergies. It’s ok to be honest about your concerns, including medications that seem to work better than others. Your physicians will work with you and will do so more willingly when you are completely honest.)

At the ER
If you’re dealing with chronic pain, you’re going to end up in an emergency room at some point. The experience doesn’t have to be unpleasant. Emergency physicians are quite aware that pain is woefully under-treated and really do want to address it when it exists. That said, it’s important to be aware that physicians’ first charge is to “Do No Harm,” and if the situation is such that it could lead to inappropriate treatment, other and possible greater concerns than your immediate pain may take priority in the mind of the physician. It’s not that this applies to you, but this is what we have to protect against:

Chronic Pain ER script deaths

Here are other things to appreciate when you come to visit:

  • Your presence doesn’t change the reality that life-threatening conditions may be present at the same time in the emergency room. Be patient. You’re not being ignored.
  • Your physicians are going to treat your pain, but they’re even more interested in finding and treating any disease that exists. Be patient.
  • Your physicians are going to attempt to coordinate your care with your primary physicians and/or your pain management physicians.
  • You can’t just come to the emergency room and start demanding narcotics, even if it’s what is eventually going to happen. I shouldn’t have to explain that.

Chronic pain ER donts

  • You can’t come to the emergency room and claim medical allergies to every medication except for a specific pain cocktail. Your physician understands that your body doesn’t work that way.
  • You shouldn’t expect an emergency physician to immediately be able to make a diagnosis of your condition that has eluded other physicians who have been evaluating you for months or years.
  • You shouldn’t expect an emergency physician to provide you with more than a few days of pain medication (or any without a discussion with one of your physicians).
  • You should expect to receive a thorough evaluation of your condition and to be treated with respect.
  • You should expect to receive treatment based on the evaluation performed in the emergency room.

chronic pain ER help

You have a role to play in the treatment of your pain in an emergency room. The more prepared you are and better able you are to discuss your current situation in the context of your long-term care, the more likely you are to have a successful interaction and treatment experience. Although you never know when pain will strike, taking the time to organize the information described above will work to your advantage.
Feel free to ask any questions you may have on this topic.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2016 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Getting Your Pain Treated at the Emergency Room

Chronic-Pain ER

Both the American College of Emergency Physicians and the American Chronic Pain Association have worked diligently to offer information and recommendations to protect patient interests and prevent inappropriate emergency room utilization while respecting the needs of chronic pain patients experiencing acute exacerbations.
In a word, it’s about expectations. Learning to understand what’s reasonable and not so much in an emergency room setting is important in helping patients to avoid disappointment.
Here are some tips to help your emergency room team help you.
If you don’t prepare for an emergency room visit, you’re the one who’s going to end up disappointed.

Chronic Pain ER info

  • You should be able to tell the staff the name of the condition from which you suffer.
  • You should know the name and the contact information of your primary physician and any pain management specialist you see.
  • You should know the names of your medications, including over the counter and herbal preparations.
  • You should know any medical allergies you have. (A word about this. There is a difference between a medical allergy and an adverse reaction to a medication. Just because a medicine upsets you stomach or isn’t as effective as another doesn’t mean you’re allergic to it. It’s insulting to your physician to insist that you have an allergy when you don’t. You can assume that taking this posture starts the relationship off poorly because the physician will often know better and in many cases can check or test you for true allergies. It’s ok to be honest about your concerns, including medications that seem to work better than others. Your physicians will work with you and will do so more willingly when you are completely honest.)

At the ER
If you’re dealing with chronic pain, you’re going to end up in an emergency room at some point. The experience doesn’t have to be unpleasant. Emergency physicians are quite aware that pain is woefully under-treated and really do want to address it when it exists. That said, it’s important to be aware that physicians’ first charge is to “Do No Harm,” and if the situation is such that it could lead to inappropriate treatment, other and possible greater concerns than your immediate pain may take priority in the mind of the physician. It’s not that this applies to you, but this is what we have to protect against:

Chronic Pain ER script deaths

Here are other things to appreciate when you come to visit:

  • Your presence doesn’t change the reality that life-threatening conditions may be present at the same time in the emergency room. Be patient. You’re not being ignored.
  • Your physicians are going to treat your pain, but they’re even more interested in finding and treating any disease that exists. Be patient.
  • Your physicians are going to attempt to coordinate your care with your primary physicians and/or your pain management physicians.
  • You can’t just come to the emergency room and start demanding narcotics, even if it’s what is eventually going to happen. I shouldn’t have to explain that.

Chronic pain ER donts

  • You can’t come to the emergency room and claim medical allergies to every medication except for a specific pain cocktail. Your physician understands that your body doesn’t work that way.
  • You shouldn’t expect an emergency physician to immediately be able to make a diagnosis of your condition that has eluded other physicians who have been evaluating you for months or years.
  • You shouldn’t expect an emergency physician to provide you with more than a few days of pain medication (or any without a discussion with one of your physicians).
  • You should expect to receive a thorough evaluation of your condition and to be treated with respect.
  • You should expect to receive treatment based on the evaluation performed in the emergency room.

chronic pain ER help

You have a role to play in the treatment of your pain in an emergency room. The more prepared you are and better able you are to discuss your current situation in the context of your long-term care, the more likely you are to have a successful interaction and treatment experience. Although you never know when pain will strike, taking the time to organize the information described above will work to your advantage.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, AmazonBarnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright, Sterling Initiatives, LLC. 2013-2015

Straight, No Chaser: Prescription Pain Killer (Opioid) Abuse

opioid-withdrawal-symptoms-1

One of the more challenging aspects of emergency medicine is pain management. Emergency departments are filled with patients suffering from terminal and chronic diseases, including cancer, lupus and sickle cell anemia. Unfortunately they are also frequented by drug-seeking patients with manufactured complaints meant to obtain prescription pain medications, particularly opioids.

 opioid30p

Opioids are among the strongest medications that will be prescribed by your physician. You know these drugs well. They include codeine, hydrocodone (e.g., Vicodin), morphine and oxycodone (e.g. OxyContin and Percocet). Other opioids include remedies for cough and diarrhea, including codeine preparations and diphenoxylate (Lomotil), respectively.

 opioid increase

The US Centers for Disease Control and Prevention (CDC) notes marked increases in unintentional poisoning deaths over the last 25 years. Opioid pain medication abuse, often in combination with alcohol or other medications are a major reason for this increase. You may or may not be surprised to know that approximately 10% of high school seniors have used opioids in the last year for non-medical purposes. At the other end of the age spectrum, elderly patients prescribed these medicines for various reasons often find their supplies pilfered.

opioid HS students

You know at least half of the reason why, based on the pleasurable acute effects of opiates. Acute effects of opioids involve relieving pain by dulling the intensity of pain signals headed toward the brain (according to our brains, that tree in the forest with no one around doesn’t make a sound). Basically, if the brain doesn’t receive the signals coming from painful stimuli, you don’t know you’re having pain. Opioids also stimulate pleasure centers within the brain, additionally helping us to ignore sensations of pain. Other acute effects include nausea, drowsiness and constipation.
The other half of the story regarding acute effects of opiates often involve the consequences of snorting or injecting medications meant to be taken orally, or misusing/abusing prescribed medication even if taken orally. Opioids also lead to depressed breathing (respirations), which facilitates coma and death – particularly when used while drinking alcohol.
Long-term effects of opioids are often not thought of by those looking for a high, but they are devastating. In addition to developing tolerance (decreasing effects if taking the same dose over time) and addiction (cravings and inability to function without ongoing drug use), opioids are associated with spontaneous abortions and births of low birth weight babies.

rehabilitation

One of the reasons to avoid getting started down the road of becoming addicted to opioids is ending the addiction is difficult. The withdrawal syndrome includes vomiting, diarrhea, involvement leg movements, restlessness, insomnia, muscle and bone pain and cold flashes. Many individuals attempting to end addiction find themselves relapsing due to the severity of withdrawal symptoms. That said, good treatment options exist for combatting opioid addiction. These include both medications and behavioral therapies that have been proven effective.
There is a time and place for strong pain management. When this is the case, get the medicine you need. Just be aware that there’s a very slippery slope involved with opioids, and a level of caution should be applied when deciding to take pain medications. Feel free to contact your SMA expert consultant for any questions you may have on this topic.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what 844-SMA-TALK and http://www.SterlingMedicalAdvice.com (SMA) offers. Please share our page with your friends on WordPress, Facebook @ SterlingMedicalAdvice.com and Twitter at @asksterlingmd.
Copyright © 2014 · Sterling Initiatives, LLC · Powered by WordPress.