Monday, January 18, 2010

Bucket O' Meds

I love these patients! I see them a few times a week. They come with severe pain (usually all over their body), and they hurt everywhere you touch them.

When they DO bring their meds, it usually looks like this guy's mini-pharmacy.

Invariably, they are allergic to Ibuprofen, Toradol, and Tramadol as well as anything else that they don't want.

This guy's basket was very typical and included 5 different narcotics, 4 different "nerve pills" (benzodiazepines), and few non-addictive medications as well. Of course, these Rx's were from 4 different physicians, but amazingly in this case were all filled through the VA (great job of oversight by the Government system).

This particular patient was barely responsive from taking handfuls of this stuff, but when he awakened, he demanded shots of Demerol!

These folks are always lots of "fun" because when you refuse to give them any meds, they become quite belligerent and threaten to call their lawyer and sue. (So far, not one has actually HAD a lawyer).

Once this guy woke up, he was writhing about, and pressing the call button every few minutes asking for a shot for pain. When I told him that he wasn't getting anything, his pain seemingly disappeared magically and he grabbed the basket and stormed out, calling me names that I won't repeat here!

I love my job!


  1. Better Watch Yo' Back...these guys always claim to be former SEALs/Specil Forces/CIA Assassins with piles of Medals that they'd tell you about if they werent still classified Top Secret and they'd have to kill you after for telling you...


  2. i wonder where those baskets come from because i see them all the time... are they official VA issue?

    that got me wondering about the plastics manufacturer that has the contract for these baskets. wow.

    that would be almost as good as the metal/sign manufacturing company that got the US govt contract to place mile markers every 2/10 of a mile along every US interstate. i mean, the mile marker wasn't good enough? are they expecting a proliferation of blizzards? global cooling? you don't believe me? next time you are on the interstate look... mile markers every 2/10 of a mile... probably money from the bail out. great.

  3. I've never seen such markers along I-5 in Oregon or Washington.

    The internet suggests they're not Federal; Mass. installed them as a State decision.

  4. (Also, New York does every tenth of a mile, and various other states do as well, or random fractional ones when they feel like it...

    No mandate for 1/5 mile signs, though I suspect they'll become more popular as a way to spend stimulus money - and they do have useful features if you break down.)

  5. Oh how I'm never surprised by people anymore. The other night, I swear I saw the patient that inspired the making of 911DOC's seizure patient video. She commenced to blink extremely fast and try to convience me that she was having a seizure in her freaking eye. Then shortly after having the best laugh I have had in a long with Ms. Blinksalot, this guy gets rolled in by wheelchair makeing all kinds of grunting noises and hyperventilating. Well I thought ok let's see whats up. Chief complaint sever abdominal pain that the VA was worked him up numerous times over. Well once this character realizes that I'm not very successful with pain management, he jumps out of the bed and stomps to the lobby very briskly stating "I guess I will just go die at home." Well my friend may the force be with you.

  6. In Texas, the markers are also every 1/10 mile. I've seen them in on every Interstate I've ever driven, but I've never driven in Oregon or Washington, only flown there and never saw any in the air.

    My favorite, signs are the ones that say: "Guard Rail Damage Ahead". These are always set in concrete along the side of the road (not temporary markers). Wouldn't it be more cost effective to just fix the guard rail?

    Besides, I do not usually rely on the guard rail to keep my car on the road!

  7. And for extra entertainment you have patients like my Mom, who secrets a stash of narcotics from home in her bag for use after surgery. She ended up in a nursing home because no one could figure out why she was so comatose. Now I warn her doctors and rifle her bags!

  8. Dev,

    I always appreciate family members like you. Unfortunately there aren't too many of them as most seem to be "enablers". They seem to be convinced that despite the bucket o' meds that there is some magical medication that everyone is withholding from the patient's phantom pain and that the ER Doc is going to pull it out of his derriere.

  9. ER-SCUT, aren't we supposed to want to die at home, surrounded by a loving extended family rather than an antiseptic Hospice or worse yet, ICU bed???
    Only Relation of mine who's died at home was Uncle Roscoe, and thats stretcin it a bit, although the "Georgia Diagnostic and Classification Center" was his actual home...


    PS: its a Prison

  10. I've never driven in Oregon or Washington

    You really should treat yourself to this experience ;) My father-in-law swears we have the worst drivers in the country. I like to blame Canada.

  11. Frank,

    I completely agree with someone wanting to die at home but my point was that there was nothing medically wrong with that patient. He was drug seeking.