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I recently Had a fall in my bathroom that caused a great deal of pain in my mid back, my doc was on vacation so her nurse advised urgent care as it was late in the day. I went to urgent only to have the doctor refuse to give me any thing for pain and do a simple x-ray that showed nothing. I have a history of Spinal fractures and they do not show up on x-rays. I also have generalized anxiety disorder that makes it incredibly difficult for me to be in situations like the ER.
Backround might help you understand-I have early onset Osteoporosis and have had 5 MRI's this year alone. I have been on a regime of Vicodin 3x per day (a pretty low dose that keeps the edge off from the pain due to collapsed discs and small fractures in my lower spine). Due to the ongoing narcotic I have a contract with her (doc) that states she is to be made aware of all medications I am prescribed which is pretty standard.
So the Doc at Urgent Care assumed the contract was to prevent any pain medication to be prescribed (they don't read them they just assume). He suggested I go to the ER and they could do more for me.
My pain level was so high and anxiety through the roof instead I went home and took a sleeping pill that helped me dose slightly, very slightly. Within 24 hours I was in the ER. I could not walk! every step felt like I was being crushed any movement was severely compromised like I was being squeezed at the same time-pain scale of 1-10 definite 9!
The ER was a nightmare, the doctor refused to do anything until she spoke with my clinic I have never heard of such a thing! Then she wanted to do a chest x ray (obviously I am an idiot and don't have a clue as what is going on with my own body)and gave me a Tylenol-it took all my strength not to throw it at her (not really but talk about condescending). I refused the chest x ray I needed a MRI! I needed pain relief! I explained my history, needing a bone growth machine etc but She refused any treatment and gave me 6 Vicodin (yes I already had some!)and sent me home. to continue to suffer until my doctor was in the office 3 days later! I had now suffered for 7 days. My doc gave me pain meds and muscle relaxers and I had to set up both an MRI and CT. After 24 hours it was obvious that any amount of pain medication was not going to work-it barely too the edge off and lying on my side was my only relief.
The thing most people don't get is a person with an anxiety disorder like mine hides from these things! I had the gumpsion and was ready at the ER but by this time with the pain not subsiding I stayed in bed for the next 10 days! The chances of my ever going to the ER or Urgent Care again are slim to none!
Finally got MRI and CT scan done with doses of "mothers little helper" the doc gave me I got through it-although my body spasmed on its own. I got home an layed down and with 3 hours the doctor that read the MRI called and told me I had to be seen by neuro surgeon within the next 24 hours!
I had multiple disc fractures-one that had split in half and was 1/18 of an inch from my spinal cord! THERE is NO medication that can relieve that pain!
I share this story because it has to stop-Doctors are afraid to give medication or do testing! This could easily have left me paralyzed for life!
IT IS BS to think that you can actually have control of your health care-not when doctors have constant suspicion's and don't listen to their patients!
The fact is that less than 3% of all ER patients are drug seeking and because I have a contract they assumed!
Well this post is going to get moved but here is my take. I see three problems here.
1. A lack of knowledge of how to interact with the health care system.(i.e. Who does what and what biases they may have.)
2. The Anxiety disorder.
3. A lack of knowledge of the dangers/issues with narcotics(beyond addiction).
The Hippocratic Oath is "Do no Harm" which is what the doctors were trying to do.
The first problem was ER vs. Urgent care and this one is something you might not know. With a fall and a great deal of pain you should have opted for the ER. Urgent care is cheaper than the ER, but should your needs go beyond what they can do they will just send you to the ER. The Nurse is working for the insurance company and baring something so obvious(like symptoms of an heart attack) will direct you to Urgent care hoping that that is all that is needed because the insurance company will save money. What makes urgent care a bad idea in this situation is that a fall could cause serious injuries. Urgent care is an good idea when the problem is something minor and you need to see a doctor today. (I have the flu and want some Tamiflu).Even if your doctor had not been on vacation, he still might not have been able to take you. It is a bad idea when more may be needed(ER's are attached to hospitals and can hospitalise you or have surgery done if needed). Also to protect themselves you may wind up getting the same tests again in the ER that you had in Urgent care.
The second problem was not going to the ER when Urgent care told you to. You should not have gone home and that sleeping pill complicated things.
As for the Vicodin as well as the sleeping pill. Narcotics have strong effects. An overdose can cause you to stop breathing. So they have to fear overdose(when was the last time you took it?) as well as addiction(is he lying?). In addition if you abuse the narcotic it will take more and more of it to get high and it will also loose it's pain killing power as you develop tolerance to the narcotic but it will still have the power to stop your breathing and/or heart. They have to be careful administering more in this situation.
The nurse at the ER was a Triage nurse. Her job was to dived the people into categories. Back pain for the most part is not fatal so you would not have been in the highest category for care. The reason for the chest X-ray was to determine if there is more going on. The ER can't assume that there is one problem or that the fall is the cause and not the effect. A chest X ray could reveal enlarged heart(Congestive heart failure) or problem in the lungs which would have a big impact on how you get treated. Chest X-rays are cheap(relatively) and painless there was no reason to refuse it. The other thing that might have happened is an EKG to make sure that the back pain is not an heart attack(rarely heart attacks cause other types of pain). The reason why they wanted to contact the clinic was because they wanted as much information as possible(like did they give you anything for pain?) before acting. In addition painkillers can mask symptoms.You feel better but can't tell the doctor what hurts and thus something is missed so they are not going to give them until they have a clearer picture of what is going on.
You may have needed an MRI, but that is something for the doctor to decide not you. The six Vicodin may have been at an different strength or frequency than what you had at home(Which in that case you really need a new prescription). If you had gone through with the X-ray, she might have decided to do the MRI next. She also might have needed to call in an specialist. .
And finally the anxiety problem just made things worse.
The stop-doctors were not afraid to give medication or testing(the chest X ray is an test) They just didn't want to overdose you or get rid of symptoms(which are a clue as to what could be going on) until they had a clear picture. For instance you stated there is no medication that could relive that pain, well in that case anything admisted in the ER would have been pointless. And yes doctors have suspicion because it is their license that is at risk. They do listen, but they also have to protect themselves which is what that chest X ray was about. If they had overdosed you or missed other problems(like Congestive heart failure), it could turn into an lawsuit.
My wife woke up one day with terrible back pain I took her to the ER they did a CT scan and saw bulging disc gave her shot of demerol, and script for vicodin. Took about 6 hours in the ER from when we got there till we left. She went to spine doctor recommend pain block shots and PT for now. I never had any problems with ER doctors except for taking a long time but have always had good experience. I think in your case the urgent care was a waste of time they are good for minor stuff like chest cold. Maybe next time go to a different ER hospital if you had bad experience with the one you are talking about.
I have to wonder when people seem to think they know more than doctors know. Post #2 by Chirack is right on the money, especially in pointing out that ignorning the advice on the part of urgent care to go to the ER was a dangerous and foolish thing. That refusal to go to the ER except after a long delay is what could have caused the original poster to be paralyzed for life. But no, everything is the doctors' fault and nothing is the know-it-all patient's fault!
She should have gone to the ER as advised. I don't think that was the complaint. It isn't the doctors fault that she has the condition that she has. She isn't blaming them for that.
She is blaming them for not treating her pain. That is the issue.
This is a big problem and it isn't right. The laws make it hard for the Doctors to do the right thing by their patients.
Maybe the Dr.s didn't assume anything, but were following protocol. It still isn't right.
Gee whiz, how bad would it be if she was adequately treated for her pain? They can't fix her.
She should have gone to the ER as advised. I don't think that was the complaint. It isn't the doctors fault that she has the condition that she has. She isn't blaming them for that.
She is blaming them for not treating her pain. That is the issue.
This is a big problem and it isn't right. The laws make it hard for the Doctors to do the right thing by their patients.
Maybe the Dr.s didn't assume anything, but were following protocol. It still isn't right.
Gee whiz, how bad would it be if she was adequately treated for her pain? They can't fix her.
Seems to be something left out because typically ER docs will give a small amount of pain meds even if they suspect drug addiction what they won't do is give a script for refills or more then a few pills to get you by until you see your regular doctor. Most of the time they just send you home with a bottle 4-6 pills depends on what the problem is. Wife got 30 pills for her back she only took 1/2 of them her regular doctor refilled it. They could clearly see the bulging disc she wasn't faking anything. I think I would have left out any facts about anxiety when dealing with ER doctors.
I have to wonder when people seem to think they know more than doctors know. Post #2 by Chirack is right on the money, especially in pointing out that ignorning the advice on the part of urgent care to go to the ER was a dangerous and foolish thing. That refusal to go to the ER except after a long delay is what could have caused the original poster to be paralyzed for life. But no, everything is the doctors' fault and nothing is the know-it-all patient's fault!
you are describing my brother exactly: he knows it all and expects doctors to give him pain meds at his request because he knows when he needs them: just ask him. If they don't treat him as he thinks they should, he says they are not fit to be in the medical field. Of course he is also one who will spend a couple of days in bed if he has cold.
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