Thursday, July 17, 2008


(on a scale from 1-10). This adding pain as a vital sign has really got me worried. It seems that every patient I see in the ER describes their pain as 11 on the 1-10 scale. It doesn't seem to matter what is wrong with them. I go and look at their medications and of course they are on lortab and oxycontin for chronic pain so their receptors are totally screwed up and the little bump that they sustained from falling has interrupted their narcotic induced altered state of existance. One friend of mine put it to me clearly. He said, "look, they think normal is how they feel when they are on their narcs so just being normal causes them to think they are in pain!" I don't know when people began to just write prescriptions for chronic lortab or percocet but I sure would like them to have to see what has happened to their patients. Personally, I have an occaisional sore back that vioxx and bextra helped and I wonder how many of these people did well on these meds before they went off the market. Now, they can't get relief and some poor "good intentioned sod" started them on narcotics making them total addicts.

Of course there are the chronic drug seekers. You can spot them pretty easily because their pain is always a 11 and secondly they cant describe the pain. You ask them is it a stabbing or aching pain, burning or throbbing and all they will say is that it hurts. You ask them where it hurts and they will be vague about it as well, not to mention they can't precisely tell you when it started. The guy with the rib fracture will tell you the millisecond it happened, that it throbs when he takes a deep breath and will point right to it. (His pain was a 4) Drug seekers are always allergic to NSAIDS, have anaphalaxis from toradol, hives from Ultram and the only thing that seems to help there pain soulds like laudid. People in real pain just look at you and say, "I don't care what it is, just make it not hurt so much!".

I got a fax from a group of doctors that it trying to see if a vioxx or bextra can come back to the market. It was a petition, I signed it.

I can't wait for the next JACHO vital signs like anxiety, mood, appetitie, sexual eagerness, and favorite color. It is a good thing that I am not in charge because I would add vital signs like intellegence, probability of following medical advise and body odor listed.


SeaSpray said...

I see you appreciated the post.

I have a lot I would say here but after the anonymous comment directed toward me over there,I am reluctant to do so because maybe I have looked at posts all wrong and missed the mark with my comments. I hope he appreciates my loong comment..didn't know how else to explain. I am trying to take it constructively just as I said and I know it's important to learn from these things.

I do want to tell you that I appreciate this good post and you have helped me more than you know.

Thank you! :)

While I appreciate the irritation with JCAHO, I don't understand the latter part. ?

Chrysalis Angel said...

Don't give them any ideas.

It's got to be frustrating day in and day out.

SeaSpray said...

I took Bextra briefly after I injured my meniscus a second time. It really helped the knee pain.

I did get concerned being on it because it hadn't been taken off the market yet but they were talking about the dangers of it. My ortho doc wasn't as concerned and so I used it awhile longer but soon stopped.

My otc drug of choice is I-buprofen. THAT drug works so well on me for so many things!!!!!!

But it's not good for the kidneys..or maybe mine more so because of urologic hx.

So I take tramadl at 1st sign of a headache..or it won't work and I use it for knee pain. It does help...but NOTHING (not even Percocet) works as good on these things like the NSAIDS do.

It must be tough having back pain when you are a surgeon having to maintain certain positions for long periods.