20 posts to get to that. I think we’re slipping.
Soooooo I guess you don’t want to hear about my elaborate “permanent insanity via cockroaches slowly burrowing through his eye sockets” fantasies about that bus driver who left the bus stop early on a rainy day, so I had to sit there for an hour seething?
It’s posts like this that make me glad I’m retired.
Yes, I’d prescribe about 5000mg.
No, harsh would have been wishing him a dose of what had put me in the hospital, harsher still would have been wishing any of my ward-mates ailments on him. Instead I only wished on him the minor inconvenience of having to waste some of his shower time picking up the soap again. 
Username/post combo wins the thread, I feel. 
Understood. Do they then walk quietly and with no visible difficulty to the john or the shower?
That, I think, was what he was counting on. Wasn’t working last time I saw. I was transferred to another ward at 6 a.m. as they had to bring someone else in, but once the doctor had agreed I could be discharged I wandered over to the other ward to say thanks. There was another warder there, a woman, so in tones of great concern I asked how poor Saeed was getting on. She rolled her eyes: he was still playing the “be a disgusting, filthy nuisance” card and had moved on to spitting on the floor.
I hate drug seekers because it makes it so damn hard for the rest of us to get drugs when we they would vastly improve our quality of life at no cost. I had an emergency ear infection once, blood and pus running out of my ear, and the urgent care doctor wouldn’t give me anything, even after I got up the nerve to ask (didn’t want to look like a drug seeker myself, but I was in too much pain to breathe). My dentist gave my husband ten vicoden when he had a dozen teeth pulled at once, and wouldn’t give me anything for a root canal. For both the ear infection and the root canal, 3 vicoden would have made all the difference in the world and saved me a half day of misery without any risk to my health. It still pisses me off.
Howcome you were in the hospital, Malacandra?
Regards,
Shodan
Given that this is the UK, those warders(prison officers to use the correct term) will not be armed.
Most Pakistani prisoners are inside for drug related offences in the UK, and yes, I do look up their records regular, rather than the wider spread of crime from violence, theft armed robbery and the like that you get from the prison population as a whole.I’m goong by the name here, Saeed - Saied or the variants of it.
I am willing to gamble (and I would almost certainly win) that this person claims he is free from drugs, but is actually part of the internal prison drugs market, he will still be on them but there is a good chance he got into debt or could not meet his commitments - a lot of prison drug dealers do not resort to viloence to obtain payment, they just stop supplying- this is because intel supplied can often break up the dealers racket so they prefer a quieter approach, the user makes the rounds of all the dealers in one prison, gets shipped out to another prison, until the word gets out their credit is bad, and thats when they find other means - such as overnights in external medical facilities.
Ii’s also quite difficult to get an overnight in hospital, since medically ill prisoners are usually shipped to prisons where there are more comprehensive facilities, hospital stays tend to be reserved for invasive procedures or serious conditions.
Unless you’ve been in contact with these folk, its hard to imagine just how manipulative or to what depths they will sink to get what they want, especially their self portrayals as victims.
Cellulitis. A week ago I’d never heard of it, and thought the feverish night I’d just had was “the bug going around” as we’ve had several teachers off work, plus post-exam stress. I’d no idea what the soreness in my leg was all about, and barely looked at the rash, figuring a weekend in bed would see me better, or if not, I’d go into surgery on Monday.
Sunday, about one-thirty, Mrs M asks if she should call NHS Direct for me (the rash is worse by now). I say no, I figure the morning will be soon enough. Then, on impulse, I change my mind. They say it could be an infection and I should go to one of the out-of-hours surgeries. We’re booked in for 2:20 but when we get there they are having computer problems and I have to wait. Mrs M goes back to the car to keep our sons company. As time wears on I feel too warm and slip my pullover off. I feel slightly nauseated and almost call out “Help!” but I wait my turn patiently as people are now being seen. As five to three rolls round I am feeling sleepy…
Just after three a woman touches me and calls my name. I come round with a yell, having trouble remembering where I am. The opposite wall is scrolling like a TV picture that’s out of sync. There is a man kneeling by my right side. Apparently I have gone into a dead faint and started shaking. As my vision stabilises he begins asking me questions and I answer them, deliberately but clearly. He says I have gone into septicaemic shock, cannulises me (never had that before) and gives me a shot of broad-spectrum antibiotics. I mention my wife and she is called. There’s an ambulance on its way.
Soon the paramedics get me on the trolley and wheel me out. I give the boys a brave two thumbs up as I’m loaded onto the ambulance and I’m straight away on my first-ever drip feed. The para asks me some more questions - my name and date of birth come up again and I smile. I may be sick but I’m still in my right wits.
We arrive and I’m taken to a bay, still chatting contentedly with the paramedic, and I’m handed over to an ER team who start taking blood samples. A doctor quizzes me and after a while it turns out I have cellulitis. Too bad penicillin would only make me sicker as that is the kick-ass treatment for this, but they have alternatives. They’ll try the weaker one for now, Clarithromycin, as if the infection responds well I will be able to go home soon. Otherwise they have another drug that will need five days on a ward as I will need to be kept under observation.
I’m taken to the emergency admissions unit. I can get about with difficulty attached to a drip-stand as my leg is getting more inflamed, but mostly I lie quiet and in not too much pain. I’m kinda hungry but I’ve missed mealtimes, and it’s no worse than “kinda” so I don’t sweat it. No sleep to speak of that night but as I listen to the disturbances I’m not too resentful: the other patients on the unit seem to have it worse than me.
Next morning, the leg is worse, and when I’m told there’s a call for me I try to get to the desk but I can’t make it. I know if I can get started I can keep going, but right now I can’t get started. Still, when the doctor comes by he confirms that Clarithromycin is just as effective orally, and they’ve got enough saline in me that I don’t need the drip any longer. I ask if it’s possible they can rustle up any crutches for me, and even one, or a stick, will be better than nothing. After a while one turns up and I’m mobile again; I soon learn that the brisker I walk the better, and a slow start is worse than useless.
That night I’m transferred from the EAU up to a ward, arriving just as they’re settling down for the night. I’m entertaining hopes of some sleep but these are quickly dashed. I’m initially resentful, but scold myself at once for there are many sick elderly people up here. Next morning, I now have a viewscreen with free Internet at my disposal, so I Google up some info on cellulitis. It’s not comforting. I listen as the doctors make their rounds of my fellow patients and all of them in my section have bigger worries than me.
They say you never sleep in a hospital bed. That makes the days very long. But I divert myself learning how to get about with my crutch, how to pee with my left leg elevated (after a while I figure it’s easiest standing up) and how to get myself a little symptomatic relief with cold water and paper towels at the toilet visits. As my third 2am rolls around and still no sleep, I find myself drifting into an almost ethereal state not least because of the incredible images I see when I close my eyes, and I concentrate on thinking happy thoughts about my ward-mates whose medical problems I’ve been earwigging on, and the medical staff who are running their socks off after them.
Apart from the Saeed interlude, it was an almost spiritual experience, not least when I found myself looking at something on the far wall with uncorrected vision in poor light and it looked like a white cross 
(turns out it was just a section of cable trunking flanked by switches) - and even for Saeed, I guess what I mostly hope is that he gets dry, clean, straight and settled into doing something useful with his life. There’s always someone worse off than you, and nothing brings that to life more clearly than a short stay in a crowded ward. I’m at home now still on the antibiotics, and quite chastened to know how seriously ill I could get in a day and a half without knowing it.
ETA: Hi, casdave, should have thought to mention your name earlier.
Holy crap!
Although my uncle had this, and he was fine. I mean, he’s dead and everything, but before that he was A-OK.
I kid, I kid. He had it when he was about my age (54) and lived to his eighties, so fear not. Glad you are doing better.
Be well.
Regards,
Shodan
Sorry to hear about the cellulitis, Malacandra. I had a bout with it about five years ago and spent a good week and a half in the hospital for it. Nasty infection, and painful.
Well, from the absolute social destruction I’ve heard addicts leave in their wake (there’s a thread on the board that tells of a daughter selling her parents’ wedding bands to get a fix) it sounds about typical.
Eh, I guess intellectually it was nothing new to me - just came as a shock to see his lordship trying to gouge morphine out of the doctors with a combination of bad acting and blackmail (making 30 invalids’ lives a misery until he got his own way). Ah well. Overhearing the prison officers’ conversation, at least it was doing somebody some good by way of the overtime, though I don’t suppose they enjoyed the spectacle any more than I did.
In other news, the doctor today told me to clear off for a couple of weeks, and then they’ll see if I’m on the mend enough to return to work. :smack:
Just curious- do you ever do this despite the patients’ wishes? I know several recovering addicts who have asked for/specified non-narcotic/opiate painkillers for surgery, ER visit, etc. only to wake up either already attached to a drip or having been administered a drug they did not want.
I’m just wondering, in your experience of the medical field in general, if these requests are taken seriously or if these stories are just isolated incidents. Is it even possible to have such a request permanently attached to your medical record, so that if you are unconscious they avoid such drugs as seriously as they would for an allergy?
I am not a doctor and I can’t speak for pendgwen. But my understanding is that it would be a serious case of medical misconduct to give a patient any form of treatment that they had explicitly refused.
pantheon- the thing about non opiate pain relief is…it isn’t very good when it comes to major pain.
You can use it in ways that are less likley to cause addiction- nurse controlled analgesic pumps, epidurals etc.
For someone with major trauma NOT giving them pain relief because of the possibility (and it is only a possibility- not every substance misuser who is prescribed pain relief will go back to full-on junkiedom) it may cause them future dependency when they are currently in agonising pain…it is a no brainer. You sort out the acute problem and worry about the long term problem later.
Opiates are often used as part of the sedation process for ventilation in ICU- if you are truly unconscious you’re probably going to be ventilated, and unless you actually have a life threatening allergy the safest way involves opiates. Again- opting for a riskier treatment in case of theoretically causing addiction, in someone who require life saving treatment NOW… no brainer.
Competent people can refuse pain relief (or any medication or surgery)- how competent you are when you are in extreme pain is not exactly cut and dried. Advance directives must be folowed if they are directly applicable to the clinical situation- if staff feel that the situation isn’t covered by the advance directive, it doesn’t have to be followed.
I had a dose of cellulitis earlier this year. Evidently it was much milder than yours - no hospital stay was necessary. So you have my sympathies.
Sorry- edit timed out.
Having said that- if someone competent refuses opiates, then yes- administering them would be a crime and serious malpractice.
To be competent you have to be able to rundrstand, believe, retain and weigh up information- and that might be the bit where judement is needed. You may not be able to weigh up much of anything with several bullet holes in your chest or after being involved in a major pile-up.
What? I have wished AIDS on people for cutting me off in traffic. Seriously.*
Are you really so afraid of people thinking you’re a bigot, that this disclaimer was necessary?
Holy fuck! Well aren’t you glad you decided to go to the hospital when you did? I sure am. Be well.
*Not seriously.