ER Experiences?

[mmglobal]

How many of you have been to the ER for uncontrolled pain related to your spine issues? Having dealt with about 1,000 clients, I've seen this process from afar from watching them. For the most part, the experiences are not good. The appearance to the ER staff often seems like someone coming in, looking for opiates. Drug seeker? Psych case? Some of the stories are pretty horrific.

I want to make clear that I'm not suggesting staying away from the ER. Symptoms from our spine problems will often mimic other health issues that must be ruled out. Obviously, if you are having symptoms like a heart attack, the fact that your spine problems often manifest themselves with similar symptoms DOES NOT mean that you are not having a heart attack. (This is my problem... the thoracic problems wrap around to the front so I'm experiencing crushing L chest pain and L arm pain. (And my dad's cardiovascular status would put me in a higher risk category.)

IF YOU ARE HAVING SYMPTOMS THAT MAY INDICATE A SERIOUS AND URGENT PROBELM, GO TO THE E.R. If you are unsure, go. If you are not going, call your doctor's office and let them know so they can decide if it's OK to ignore the symptoms.

Unfortunately, in the E.R., they don't have much to do for us except to rule out potential emergent problems, give us a shot which will likely control even the worst pain for some number of hours (or minutes.)

What are your experiences with going to the ER for pain?

Thanks in advance for the input. All the best,

Mark

[Maria]

Had back probs siince early 80's and never been to ER for back pain/probs. Working as an RN I knew how I'd be receieved and treated (at least in the 80s and 90's)...I probably had as severe pain as many here that would have and has sent many persons I know with back probs to the ER but for many years I would not use any drug stronger than an NSaid for back pain (till I couldn't use them anymore) and also I pretty much could determine whether I had an urgent or emergent problem not counting pain/spasms.

I do think what Mark stated is an important point about going to the ER if the pain is severe enough as it might very well be something of an emergent nature that presents with severe pain in the spine or radiating or referred to some area of the spine or some part of the body. One should not be afraid to go to the emergency room. One might want to call a telephone triage line if the insurance co. has one.

I've been to the ER since I started opioid pain meds in 2001 for other reasons like urinary, opthalmic, GI and everytime in initial intake when asked about medications and I state the pain med I'm on... there's a sudden shift to questiioning about use of medications/history of abuse/addiction etc. Some people are better prepared at hearing that one is on opioid medication for pain and some seem appalled. At first it really bothered me when I got the eye rolling by the intake person tho now 11 years later I could care less what someone else thinks of my need to utilize a prescribed medication for pain. I have gone to urgent care numerous times asking for a Toradol injection for lumbar or cervical spasms which doctors seem relieved to hear me ask for after telling them I take Methadone for chronic low back pain.

[karreymetris]

I've never been to an ER, I hurt my back really bad skiing but I never went to the hospital.... probably a bad idea. I was afraid of getting a surgery and how much money it would cost!

[chiku]

I have been to the ER twice in the past four years due to pain. The first time was after being in the car for 8 hours, driving to do tests in another city for workers comp, the second was after a PT session went very badly. I've been lucky, the ER staff treated me very well, both times I was in fairly fast, received morphine and Toradol, and felt much better. I've read a lot of peoples bad experiences at the ER which has made me extremely grateful for the good experiences I've had.

[doublehippy]

[i]'ve never been to the ER with my back pain, but my daughter has. She herniated a disc years ago and, on a Saturday evening, she asked that I take her to the hospital because she was in so much pain. The nurse there treated her like a drug addict....."yeah, we have a lot of sore backs in here tonight" and told her to see her primary care doc on the following Monday. No help at all. On the flip side, I went several years ago because of severe leg pain. I'd developed a DVT after hip replacement and was scared that I had another. No clot, but the PA happily handed me a script for Vicodin.....7 or 10 of them. Can't remember.

I can understand an ER doc being hesitant to prescribe narcotics, particularly to patients who are already taking them and are under the care of a surgeon or pain management doc. That said, if a patient presents with out of control pain and is desperate for help, something needs done! Most ER trips are made in the middle of the night or a weekend but most docs can be reached by phone 24/7 as well...and the patient's doc and ER doc should discuss the situation and best course of action for the patient? Chronic pain is so mis-understood by the medical community. I'll never forget asking my first hip surgeon for something a little stronger to take prior to my first replacement and he said..."no, I'm gonna fix you....keep taking your Aleve!"

Of course, further diagnostic testing should be done if a patient feels their pain could be something other than back pain. It gets to the point that we can't tell any more...is it my back? something more serious? should I hang in there and wait to see if this pain eases? Seems to me most of us know our bodies and pain tolerance better than anyone and, if we show up in an emergency room, it's an emergency to us! Help!

Mark....so sorry about your thoracic issues and the crushing pain in your arm and chest. Has to be so scary for you. Assuming you've have a complete cardiology work-up? Speaking of ER's, I headed there 2 years ago with chest pain. Lucky me....because of my age (arrgggghhhh), they admitted me and put me thru all the tests. My old ticker is fine.

I digress. Not sure I helped with your specific question about spine pain taking me to the ER. No, it has not (yet)...but I can only imagine the horror stories you've heard. Sad.....

Take good care, everyone!
Linda

[chiku]

Hi Linda,

I just wanted to say one quick thing, depending on where you live doctors are not always available 24/7 on the phone. I uterine cancer 10 years ago, and after the surgery my lymph nodes in my groin where swollen to about 2"-2.5". Of course it happened on the weekend so I went to the ER. The ER doctor said he could not call my Dr, sent me away and told me to call my Dr on Monday. When I called on Monday they had me n the Dr's office in 1 hour, admitted in the hospital in 2 and was there for over a week on I'VE antibiotics. I think that this type of situation was a combination of where I live, Canada, and an incompetent ER . The 2 other situations where I went to the ER in the past couple years I was lucky and had a good ER Dr, however they did not call my doctor before/during treating me. I had to inform my dr that I went, so I think that the availability of your Dr, and probably policy in contacting them, is dependant on where you live.

[teg]

I had a pretty responsive team work on me when ems bought me in to the er. I was home alone and my back locked up on me. I called ems and was given morphine during the 5-mile trip to the er. Upon my arrival, they gave me iv valium and dilaudid.

After this, I had 3-level rf ablation to address the severe spasms. Luckily, I have not had any repeat episodes. I am still experiencing some mechanical pain, which is addressed with Opana ER.

Thelma

[Maria]

Honestly I prefer going to Mexico and seeing a doctor there that will prescribe IM Toradol that I can give myself for my awful neck/back spasms. Works like a charm. I can't get any of my docs (not even PM) to prescribe the IM form here even tho I was an RN/NP for many years yet my friend from Oregon who also was an RN/NP can get her PM there to prescribe injectable Toradol for her.

As one doctor once told me about getting Soma in Mexico vs. him prescribing he said he'd rather prescribe it for me and at least have it documented on records and accounted for vs. having his patients go across the border and obtaining medications. He also said that often a patient wouldn't report what they may take that they obtain in this manner and not doing so could set someone up (doctor and patient) for an interaction with medications and possibly even a fatal interaction.

Re going to the ER for my back pain as I probably said earlier the other thing I'd do before going to an ER is go to Urgent Care. I get treated more quickly and the co pay is either that of an office visit or less than half of what my co pay is at the ER.

If I thought something was truly emergent I'd go to the ER but my stinkin' back flares are just a big ol' pain and nothing new to me "so far."