NationStates Jolt Archive

This past Friday I began having some abdominal pain that I couldn't quite explain. Soon accompanied by low back pain. It eased by afternoon, so I just kind of blew it off. Saturday it returned. Multiplied tenfold. Late saturday night my roomie insisted I go to the emergency room. To me this seemed like a fine idea. They'd find out what it was, and hopefully give me something for the pain.

After spending a mere four hours in the emergency room, during which time they drew blood and the Doc spent approximately 60 seconds poking my abdomen, I got my diagnosis. Irritable bowel syndrome, gallstone and low potassium. An Rx that should help my stomach cramps in a few days. And a recommendation that I stick to a diet of clear liquids until I could see my doctor on tuesday.

Now, if I was carrying on with all that crying and cussing while in the ER, I was either a determined drug addict or really in pain. When told that the Doc would not give or prescribe any pain meds I jumped up and grabbed the clipboard from the nurse, screaming at her. Not my finest moment. I was told in no uncertain terms to leave immediately or be arrested.

So I have a few questions to ask all you wise and otherwise NSers. Did the docs refusal to give pain meds have anything to do the fact that I have a mental illness? If he asks for a list of my medications, there's no hiding the fact that I'm bipolar. What the hell else do you take lithium for?

Does it have anything to do that my insurance is through Medicare and Medicaid? Proves to the Doc that I'm poor and "on the dole." Must be a loser and drug addict I suppose.

Until I was on disability, no doctor ever abosolutely refused to give me pain meds, ER or regular office visits. Since then it's happened three times.

And as a post-script- Can he really tell it's IBS and gallstones with just a bloodtest? I don't believe so. I think he's full of shit and was just trying to get rid of me. And I've never heard of IBS being this painful.

when I had gallstones they wouldn't give me pain meds either, apparently they just won't help.

I waited a year to get my gallbladder out, by the time I got in for surgery it was just not working anymore and was about to rupture.

I think it had everything to do with the fact that I didn't have health insurance at the time. I totally was going to pay my bills, but without insurance to write down they treat you like you won't.

That was an unfair assumption for him to make just because you were on disability, and given the level of pain you were in. The doctor should have known better than to not give you pain meds. If he was worth his salt, he would have made his prescense justified by at leasting monitoring you for a while after giving you some pain meds.

Watching "House" only confirmed my belief that modern medicine is a joke.

Watching "House" only confirmed my belief that modern medicine is a joke.

Judging modern medicine by what happens in a TV show probably isn't a great idea.

I absolutely love it when people are quick to blame not getting what they want on discrimination.

Usually pain meds aren't used to ease the pain of such a condition.

But, screaming and swearing certainly aren't the best way to get an effective and clear explanation for a doctors decision.

Judging modern medicine by what happens in a TV show probably isn't a great idea.

tss tss tss, you should know better.

tss tss tss, you should know better.

Lies, nobody expects me to know anything.

If thats the case I'm glad I live somewhere where there is Universal Healthcare. If you do have any evidence that this doctor was discriminatory towards you in any way then act against it. Who knows how many other patients he may do this to.

EDIT: I didn't add that sad face at the top of this post....The smileys are becoming sentient!

When told that the Doc would not give or prescribe any pain meds I jumped up and grabbed the clipboard from the nurse, screaming at her. this was your mistake. not that you were screaming in pain, but the fact that you did this.

everything else... talk to your doctor and more importantly, get a second opinion. it may be IBS, it may be gallstone, or it may be Divers.

oh and please refrain from attacking the nurses. :p

I know you didn't, and pain can drive someone to do something rash...

This past Friday I began having some abdominal pain that I couldn't quite explain. Soon accompanied by low back pain. It eased by afternoon, so I just kind of blew it off. Saturday it returned. Multiplied tenfold. Late saturday night my roomie insisted I go to the emergency room. To me this seemed like a fine idea. They'd find out what it was, and hopefully give me something for the pain.

After spending a mere four hours in the emergency room, during which time they drew blood and the Doc spent approximately 60 seconds poking my abdomen, I got my diagnosis. Irritable bowel syndrome, gallstone and low potassium. An Rx that should help my stomach cramps in a few days. And a recommendation that I stick to a diet of clear liquids until I could see my doctor on tuesday.

Now, if I was carrying on with all that crying and cussing while in the ER, I was either a determined drug addict or really in pain. When told that the Doc would not give or prescribe any pain meds I jumped up and grabbed the clipboard from the nurse, screaming at her. Not my finest moment. I was told in no uncertain terms to leave immediately or be arrested.

So I have a few questions to ask all you wise and otherwise NSers. Did the docs refusal to give pain meds have anything to do the fact that I have a mental illness? If he asks for a list of my medications, there's no hiding the fact that I'm bipolar. What the hell else do you take lithium for?

Does it have anything to do that my insurance is through Medicare and Medicaid? Proves to the Doc that I'm poor and "on the dole." Must be a loser and drug addict I suppose.

Until I was on disability, no doctor ever abosolutely refused to give me pain meds, ER or regular office visits. Since then it's happened three times.

And as a post-script- Can he really tell it's IBS and gallstones with just a bloodtest? I don't believe so. I think he's full of shit and was just trying to get rid of me. And I've never heard of IBS being this painful.
And people suggest that the Canadian health care system sucks compared to the US.

1. It appears that you have made some assumptions regarding the diagnosis and not giving you pain pills because you are on Medicare/Medicaid?

2. Get a 2nd opinion.

when I had gallstones they wouldn't give me pain meds either, apparently they just won't help.

I waited a year to get my gallbladder out, by the time I got in for surgery it was just not working anymore and was about to rupture.

I think it had everything to do with the fact that I didn't have health insurance at the time. I totally was going to pay my bills, but without insurance to write down they treat you like you won't.
Once again:

And people suggest that the Canadian health care system sucks compared to the US.

I think most general painkillers are inflammatory. Hence if you have IBS then doctor probably didn't want to make it worse, and probably didn't want to give your specialised painkillers until your GP could could give you a more accurate diagnosis. Apparently IBS is hard to diagnose though- most often other potential causes are eliminated first.

The NHS says gallstones are commonly detected through blood tests, cholesterol tests, ultrasound scans, or occasionally x-rays. So he's probably right about gallstones.

I just checked some warning labels for Ibuprofen. It says talk to your doctor before taking if you take Lithium. Perhaps the ER doctor is deferring to your GP who probably knows more about your treatment.

I wouldn't be too hard on the ER doctor.

I was diagnosed with IBS only after a barium enema and a scope of the large intestine to rule out any other possibilities. Maybe the doc was wrong, maybe not, but s/he probably could've explained things a bit better.

Having been admitted via ambulance and casualty for gall stones - here's what happen in the UK 20+ years ago.

I was in so much pain i thought i was going to die.

I couldn't move because f the pain, I had to be carried to the ambulance.

I did not get any painkillers until after various tests and then I was given IV painkillers.

I was not allowed any fluid by mouth for 6 days - was on a drip - then clear fluids.

I think you were not given pain meds because you were not in enough pain - you could possibly have bought painkillers strong enough over the counter - i'm guessing i don't know what you can buy where you are.

So i think you were treated the way you were ecause you were percieved (rightly or wrongly) as not being an 'emergency'

tss tss tss, you should know better.

Yeah. Everyone knows House is a bastion of moral fortitude and apothecarian delight.

House is God.

House is God.

Kinda like the Old Testament god, 'cept there's more lasciviousness involved. And frankly, House is smarter.
*nods*

You might not ever catch House doing this ...
Malachi 2

2:1 And now, O ye priests, this commandment is for you.
2:2 If ye will not hear, and if ye will not lay it to heart, to give glory unto my name, saith the LORD of hosts, I will even send a curse upon you, and I will curse your blessings: yea, I have cursed them already, because ye do not lay it to heart. Give glory to God or he will curse you.
2:3 Behold, I will corrupt your seed, and spread dung upon your faces, even the dung of your solemn feasts; and one shall take you away with it.

Well, then again, it's hard to top himself at this point. Maybe it will happen this season.

So I have a few questions to ask all you wise and otherwise NSers. Did the docs refusal to give pain meds have anything to do the fact that I have a mental illness? If he asks for a list of my medications, there's no hiding the fact that I'm bipolar. What the hell else do you take lithium for?


I think it may be because it is unwise to give painkillers to someone who already takes other nerve- and brain-targeting medicinals, like lithium. Usually, the less medicinals you take, the less they can mix with bad side effects.
Then again, I'm no pharmacologist.


And as a post-script- Can he really tell it's IBS and gallstones with just a bloodtest? I don't believe so. I think he's full of shit and was just trying to get rid of me. And I've never heard of IBS being this painful.

By checking liver markers in blood (trans-ammynases, I think), yes, you can tell it's gallstones. IBS, I don't know.

Anyway, I have IBS, and I can tell you it can be quite painful. I've had some attacks that made me bend over and scream with pain, and I have a high pain threshold (I've been able, after crashing with a moped, to use a knife to extract glass splinters and gravel from a couple of wounds I had got in my hand, and I didn't scream or weep).

If it be pain relief that you desire I suggest a cocaine solution like the one Dr. Bill Halsted used as the first local anesthetic. Sure he started shooting it into his blood and was an addict for years but he founded the John Hopkins Hospital and is the father of modern surgery.

Well, then again, it's hard to top himself at this point. Maybe it will happen this season.


House started to jump the shark rather early. Bats, extreme fever, and general crazy behavior (http://en.wikipedia.org/wiki/Histories_%28House_episode%29) and they're still standing around with their thumbs up their butts like they don't know what it could possibly be (my screaming the answer at the television not helping for some reason). The bats could be the only symptom and it would still be totally obvious.

I quit watching when frying a guy's brain became a treatment for his inability to talk to girls (http://en.wikipedia.org/wiki/Words_and_Deeds). For Jebus' sake...

I hate disabled people.

Fixed.

I'm pretty sure diagnosing IBS on the basis of a quick exam and a blood test is, if not impossible, bad medical practice. There's a few more important disease that you'd want to rule out first with an endoscopy or such.

I'd ask for another opinion, or something.

By checking liver markers in blood (trans-ammynases, I think), yes, you can tell it's gallstones. IBS, I don't know.


Markers for liver malfunctions:
Alanin-transaminase (ALT)
Alkalin-phosphatase (ALP)
Gamma glutamyl-transferase (GGT)
Aspartate transaminase (AST)

If it be pain relief that you desire I suggest a cocaine solution like the one Dr. Bill Halsted used as the first local anesthetic. Sure he started shooting it into his blood and was an addict for years but he founded the John Hopkins Hospital and is the father of modern surgery.
I don't think it is advisable to prescribe anything if you are not a doctor.

I also don't think it is advisable for anyone on NSG to accept medical advice from the posters.

Fixed.
Some friendly advice.....fixing posters' quotes to something other then what they said can get you an unwanted holiday from posting.

Once again:

And people suggest that the Canadian health care system sucks compared to the US.

I was told that cholecystectomy was an elective surgery, and that's why it took me so long to get in, lots of people with emergency type surgeries ahead of me.

I know a friend who has insurance and still had to wait a while for an elective surgery, we treat the sickest first. If you need emergency surgery there isn't anyone who is going to turn you away.

I have heard stories of people having to wait in Canada for emergency surgery.

To the OP: Has it ever occurred to you that perhaps the doctor knows more about medicine than you do?

To the OP: Has it ever occurred to you that perhaps the doctor knows more about medicine than you do?

Seems to me that the doc did his job, whereas even if they were wary of you due to your medical history, you only justified their suspicions with your behavior. He fulfilled his end in a tricky situation, ie treating a possibly erratic and unpredictable patient, whereas you acted like an ass, ie throwing a hissy fit.

Fixed.

Putting words into other people's mouths =/= intelligent debate or discussion.

Judging modern medicine by what happens in a TV show probably isn't a great idea.

its actually the best idea in the world.

Seems to me that the doc did his job, whereas even if they were wary of you due to your medical history, you only justified their suspicions with your behavior. He fulfilled his end in a tricky situation, ie treating a possibly erratic and unpredictable patient, whereas you acted like an ass, ie throwing a hissy fit.I can hardly deny my behavior at the end was considerably less than stellar. I'm not claiming otherwise. But do keep a couple of things in mind.

1) In the weeks prior to my ER visit I had a pretty constant case of diarrhea. Probably due to IBS. This totally screwed up my lithium level. Making me perhaps a little less rational than I might otherwise be.

2) Pain might also make me a little less rational than I might otherwise be.

3) I was actually fairly calm until he told me "no" on the pain meds. I was cussing, but not at people.

He's an ER doctor. Surely he's seen patients who aren't as rational as they may be in everyday life. My apology was rejected. If he can't handle me grabbing a clipboard and raising my voice without calling the cops, he may be in the wrong line of work. Just me, but in his position I would have tried to calm the patient and explain my reasoning. Not throw them out with the threat of arrest.

Fixed.

Altering quotes to make other people look bad is flamebaiting. Let's not do that again.

NationStates Forum Moderator
HotRodia

Anyway, I have IBS, and I can tell you it can be quite painful. I've had some attacks that made me bend over and scream with pain, and I have a high pain threshold (I've been able, after crashing with a moped, to use a knife to extract glass splinters and gravel from a couple of wounds I had got in my hand, and I didn't scream or weep).

Oddly, I'm so very happy to hear this. I felt like such a huge wimp. And embarrassed to death by my wimpiness and lack of calm.

But still, I can get a little pissy when I think someone is being unfair. Especially if this someone has some sort of power over me.

He's an ER doctor. Surely he's seen patients who aren't as rational as they may be in everyday life. My apology was rejected. If he can't handle me grabbing a clipboard and raising my voice without calling the cops, he may be in the wrong line of work. Just me, but in his position I would have tried to calm the patient and explain my reasoning. Not throw them out with the threat of arrest.

I think a lot of the threads I've seen around here regarding ER treatment really come down to a problem with bedside manner. If painkillers would not have been helpful or if the doc was worried about them reacting with your other meds or any of the other explanations, he should have made that clear to you from the start. I recognize that ER docs are under a great deal of stress and something that doesn't appear to be life-threatening probably isn't going to be high up on their list of priorities. However, they also need to recognize that any patient who comes in there with a legitimate illness is looking for someone to help them, and that the doc needs to explain if he can't/won't give the kind of help they were looking for.

And as a post-script- Can he really tell it's IBS and gallstones with just a bloodtest? I don't believe so. I think he's full of shit and was just trying to get rid of me. And I've never heard of IBS being this painful.

IBS, hell no! IBS is an exclusionary diagnosis that should not (and I would claim cannot be) made on a single appointment - usually you have to follow the patient for a while and as I mentioned exclude other causes, and then couple this with a thorough medical history of symptoms consistent with IBS. An acute development, as you describe, is not consistent with IBS and the ER really isn't the place to make an IBS diagnosis. You can suspect it, but without a work-up that isn't really suited for the ER you cannot make it.

Gall stones? Sort of. Signs pointing to a post-hepatic biliary tract obstruction (billirubin, ALP, AST/ALT, pancreatic amylase disturbances for instance) can be found through a blood test, but a diagnosis should be confirmed with an ultrasound or other radiological method.

It is strange, to say the least, that you were not properly medicated for your pain. If he had confirmed his gall stone diagnosis, he should have given you something like diclofenac, as it's usually very effective. If counter-indicated, then you could have gotten a dilaudid-atropine injection. If he was sending you home, he should have given you diclofenac suppositories or something that's called "Spasmofen" in these parts (a mixture of codein, morphine, papaverine... and I can't remember the rest at the moment) if diclofenac was counter-indicated.

Well, something like that, at least. What you describe, if one may take its verisimilitude for granted, makes it sound like you did not get adequate care. Far from it, I would say.

SNIP OP for longiness

I don't know whether the docs were being funny because of your disability or because you were being awkward.

I had to go to hospital a few months ago, long story short, I was referred from my GPs surgery to the Medical Assessment Unit at the local so I was taken in as an emergency but due to a massive fear of needles I wouldn't let them take blood or do a lumbar puncture. After a discussion at my bedside involving my doctor and a consultant during which they never spoke to me once, I was sent home and told to go back to my GP, the guy who couldn't diagnose the problem in the first place.

Altering quotes to make other people look bad is flamebaiting. Let's not do that again.

NationStates Forum Moderator
HotRodia

not the first time NT's done it. He's been reported before.

not the first time NT's done it. He's been reported before.

Links?

Edit: Nevermind, I saw it. I see no reason to change my action.

IBS, hell no! IBS is an exclusionary diagnosis that should not (and I would claim cannot be) made on a single appointment - usually you have to follow the patient for a while and as I mentioned exclude other causes, and then couple this with a thorough medical history of symptoms consistent with IBS. An acute development, as you describe, is not consistent with IBS and the ER really isn't the place to make an IBS diagnosis. You can suspect it, but without a work-up that isn't really suited for the ER you cannot make it.
my husband says that IBS is what they tell you when they can't figure out why you are sick or worse, when they just don't care to find out.

I don't know if he is right or not, but many people I know who have IBS have had no medical tests of any kind and are still sick, what if they have crohn's or something? nobody knows. In the US if you have digestive issues it's assumed that it's IBS or "anxiety" unless you almost die. :mad:

Links?

Edit: Nevermind, I saw it. I see no reason to change my action.

Sorry, I put a link in the mod thread.

and it's more of an FYI.


oh btw... Bitchkitten, what was the diagnosis?

my husband says that IBS is what they tell you when they can't figure out why you are sick or worse, when they just don't care to find out.

To make a diagnosis of IBS, one has to exclude other things that can cause the symptoms. So, in that sense it is "what they tell you when they can't figure it out", but since the causes of IBS are not known, that's not too surprising.

I don't know if he is right or not, but many people I know who have IBS have had no medical tests of any kind and are still sick, what if they have crohn's or something? nobody knows. In the US if you have digestive issues it's assumed that it's IBS or "anxiety" unless you almost die. :mad:

There are certain symptoms (and, sadly, kinds of patients) which are somewhat typical for IBS, but it sounds flat out ludicrous to me to make the diagnosis without a work-up that excludes other causes, including such minor things as fecal testing, to coloscopies.

i don't know, but the last time i was in hospital i was quite clearly stoned out of my mind and complained of a (genuine) pain in my knee - they gave me opiates.

Still in moderate pain. Follow up to specialist. EGD and colonoscopy as well as ultrasound. EGD and colonoscopy show nothing. Ultrasound shows gallstones. Diagnosis still IBS and gallstones.

Had the preceding procedures done at a different hospital. 40 miles away but preferable to dealing with the locals. They were very nice. I behaved well too.:D

This past Friday I began having some abdominal pain that I couldn't quite explain. Soon accompanied by low back pain. It eased by afternoon, so I just kind of blew it off. Saturday it returned. Multiplied tenfold. Late saturday night my roomie insisted I go to the emergency room. To me this seemed like a fine idea. They'd find out what it was, and hopefully give me something for the pain.

After spending a mere four hours in the emergency room, during which time they drew blood and the Doc spent approximately 60 seconds poking my abdomen, I got my diagnosis. Irritable bowel syndrome, gallstone and low potassium. An Rx that should help my stomach cramps in a few days. And a recommendation that I stick to a diet of clear liquids until I could see my doctor on tuesday.

Now, if I was carrying on with all that crying and cussing while in the ER, I was either a determined drug addict or really in pain. When told that the Doc would not give or prescribe any pain meds I jumped up and grabbed the clipboard from the nurse, screaming at her. Not my finest moment. I was told in no uncertain terms to leave immediately or be arrested.

So I have a few questions to ask all you wise and otherwise NSers. Did the docs refusal to give pain meds have anything to do the fact that I have a mental illness? If he asks for a list of my medications, there's no hiding the fact that I'm bipolar. What the hell else do you take lithium for?

Does it have anything to do that my insurance is through Medicare and Medicaid? Proves to the Doc that I'm poor and "on the dole." Must be a loser and drug addict I suppose.

Until I was on disability, no doctor ever abosolutely refused to give me pain meds, ER or regular office visits. Since then it's happened three times.

And as a post-script- Can he really tell it's IBS and gallstones with just a bloodtest? I don't believe so. I think he's full of shit and was just trying to get rid of me. And I've never heard of IBS being this painful.

That's unusual.. When I was diagnosed with gallstones (which were immensely painful), the doctor gave me a bottle of pain meds. He said they might not help as much as I like, but it was better than nothing, and I agreed; thankfully, a couple months later the cursed organ was out of my body anyway.

Maybe lithium reduced your potassium?