One of the most frustrating experiences I’ve had so far in residency is determining whether a particular patient had a true deficet or was seeking pain meds. The difficulty came when patient refused portions of the exam that I felt were critical for telling what was going on. It was worrisome because I hated to miss something that needed immediate management to prevent permanent problems but without having the full info I could get from a cooperative patient my abilitly to make decisions was severely limited.
I think that he should let his night nurse talk to this guy. In an earlier post, Qadgop related how some idjit had taken an intentional overdose of his roomie’s asthma inhaler, in a (failed) attempt to escape while being taken to a hospital. The night nurse had to monitor the inmate, and told him every hour what a total screwup and complete idiot he was. Apparently, she was administering therapy. 
I, personally, would have plastered a VERY concerned look on my face and started all sorts of very invasive tests on the patient, whether he wanted them done or not. A cystoscopy would have just been the beginning. However, Qadgop is a much nicer person than I am.
As for my doctors…when they hear hoofbeats and rule out horses, I want them to not only check for zebras, but for QUAGGAS, as well.
It’s simply a reference to the company QtM works for, the Sirius Cybernetics Corporation (warning: sound, 500 KB).
Dang! That does sound nasty!
Oh, and by the way, paging Dr. Qadqop! Sounds like you’ve already half-answered the question right here…
And folks, you just got a graphic demonstration of how Texas and Wisconsin are two different planets.
There are prison docs as good or better than me in Texas, and worse ones than me in Wisconsin. And we docs are pretty dependant on our nurses and other staff to keep us informed, thus making us able to act, when the situation arises too.
But thanks. 
Well, knowing where QtM works, in conjunction with the subject line, sort of gave me the entire gist of the thread
Two pathologists (there’s a woman whose name I can’t remember, plus yours truly).
As to the pain-on-a-scale-of-ten thing, I was in the ER a couple of weeks ago for something non-life-threatening, and one of the symptoms was an odd but low-level headache. It was a minor part of the complaint but the referral forms prominently list intensity of pain, so there I was going in to see the doc with big print on the chart announcing that I had pain of 1 on a scale of 1-10. I was just waiting for the look of derision from the ER doc, but didn’t get one, possibly because I wasn’t trying to scam Vicodin.
And let’s not forget Dr Paprika! I’d love to hear him weigh in on patients and ERs.
Ethilrist, this thread was sorta inspired by the one you linked to, but since I really don’t know how the hospital might have had the info in that case, I decided to keep out.
Ah yeah, Weeen! I love him. If I understood last time we spoke, he was taking the research route. He was growing things in petri dishes.
Good catch and thanks for the nod to your nurses
I work with a population vulnerable to all types of chronic pain and I am sure it would not surprise you how often we find them on scripts for acute pain instead of a more appropriate med/protocol, ususally because someone did not want to confront the real issue. What you did was time consuming and best for your patient…and probably a whole lot of fun, truth be known.
but I didn’t say that last part
QtM’s patient is the kind of junkie fucker that caused one of the most embarassing and painful experiences of my life. I really did have a kidney stone. My urine was full of crystals. Not to mention the blood. But the doctor flagged me as a junkie scammer because…hell, I don’t know why. I was a scruffy rocker at the time, but I really was sick. The doctor diagnosed me himself–HE was the one who said I had passed a stone and was probably going to pass another one pretty soon. I had no idea what was going on when I went to the doctor. And going to the doctor was a really big deal for me at the time because I was uninsured. I was in more pain than I had ever been in in my whole life and the doctor sent me away with a urine strainer, an antibiotic 'script, and a huge bill. I called back the next day saying I was in incredible pain and could I please have something for it. Nope, he said. Finally, my girlfriend convinced me to try again. I think it was the screaming that moved her to action. I ended up calling the doctor at home in tears and begging him for something. He said he wouldn’t do it over the phone, that he wouldn’t be in the office the next day, and that if I was still in pain tomorrow I should go see the other doctor in his office. The next day, the other doctor gave me some half-assed, non-opiate pain meds that didn’t relieve the pain but only made me stupid. I took them by the handful.
Wow vib, what a horrible experience.
What are the nasty effects of Soma? Since neither Qagdop nor DoctorJ prescribe it, I was just curious.
DSeid is, IIRC, a Pediatrician.
Enjoy,
Steven
:smack:
I knew that!
I’ve taken it and I didn’t think it really had any side effects. It’s just a muscle relaxer that makes you feel good. Docs don’t like to prescribe anything that’s going to make you feel good.
I guess it’s people like that guy who make it hard on those of us who really do have serious pain issues. I’ve been through four surgeries and am about to have another and doctors still hesitate to prescribe me what I need. It’s fucking ridiculous. Do they really think I’d go through all of that just to get a few pain pills?
I think adults should be able to purchase painkillers and muscle relaxers, etc. if they feel they need them. So many of us are in pain because doctors are terrified of getting in trouble for prescribing anything stronger than Naproxen. If that guy wants them so badly, he should be able to get them. After all, he’s an adult who can make his own decisions about what he wants to take.
But then, I’m one of those crazies who thinks all drugs should be legalized and regulated.
So, they’ve worn off, right?
d&r
While I agree with you in principal, remember that the patient is a prisoner receiving health care at taxpayer expense, looking for the taxpayer to buy him some painkillers. If it was his own money, I agree with your point of view, but I don’t think that it’s beneficial to society to provide prisoners with “all you can eat” dope.
-lv
errr…
ummmmm…
vibrotronica, that was just awful! I know all about the pain, I had my right kidney out in January, after fighting a nearly six-yr guerilla war with the stones. The stones won.
I’m so white bread looking, maybe it stood me in good stead. The night of the first attack, after taking all the blood and urine samples needed, and having an X-ray, I got a shot of Demerol. Ah, lovely, lovely narcotics. I’d never had it before, and haven’t since, but the relief will always be the benchmark by which I judge painkillers. Pain? What pain? I felt like I was floating an inch above the bed.
Later on I got hydrocodone. I’m glad I can tolerate, nay, enjoy the narcotic meds. It’s that feeling that causes me to use them sparingly.
So, what finally happened with your stones? Did you get further treatment, and did they ever return? Did you ever have a lithotripsy? There’s enough of us stone sufferers on the SDMB to form our own support group!