The reason I hate hospitals and don't trust doctors, part I

[Sapphire Silk]

Turn off my painkilling and mood stabilisation and you'll get an upset person too.

Absolutely! We're careful about the use of Narcan in the ER regardless of why or how the person overdosed. Whether it's turning off a high, or turning off therapeutic effects, it's bad, bad, bad for the patient and the staff who feel their rightful wrath.

My students often don't understand why we give morphine rather than Narcan to newborns born with heroin addictions until I explain that we don't want to send them into instant withdrawal.

[Seshat]

Romazecon or Narcan . . . give it to someone used to taking benzos or opiates, and be prepared for a very upset person . . . esp if they're abusing it. You've just turned off their high

Turn off my painkilling and mood stabilisation and you'll get an upset person too.

[Sapphire Silk]

It's not easy to OD on benzodiazepines, though. For one thing, their therapeutic window (i.e. the difference between the minimum effective dose and the toxic dose) is incredibly wide, in contrast with the barbiturates they replaced in the early 60s. And even if you do manage to ingest a frankly toxic dose, there's a specific BZD-receptor antagonist (Romazecon) which can reverse the effects pretty quickly. (Obviously whatever you took it for will come back with a vengeance, so it's not a real good idea to give it to someone who's taking BZDs for seizure prevention.

Yeah, I always keep a vial on hand when I am doing moderate (formerly conscious) sedation . . . that and Narcan. I've had to use it once I think, when the doc ordered too much Versed.

Romazecon or Narcan . . . give it to someone used to taking benzos or opiates, and be prepared for a very upset person . . . esp if they're abusing it. You've just turned off their high

[Seshat]

Mogadon (nitrazepam) is not available in the USA, so I've never seen it used and can't comment from experience; the chart says it has a very fast onset, but being fat-soluble, I'd expect that in heavier persons you'd need more of it for the same effect.

By BMI, I'm on the 'overweight' side of the 'overweight/obese' border. Probably a bit less now.

By waist/hip ratio, I was at the time just a bit over the 'healthy' point. I'm now below that mark, though not in the 'ideal' range.

I have more fat tissue than I want, but I also have a lot of muscle tissue. I can move large pieces of furniture on my own: and I mean fridges, or large-screen CRT TVs.

In the time when I took the mogadon, I used to max out the leg press machine at our old gym, and was working my way to doing the same with leg adduction/abduction and the lat pulldown.
Of course, I was also doing my fibromyalgia no good at all by doing so: I was throwing myself into pain crashes all the time. But it gives you an idea of how 'wrong' the BMI was as an indicator of fat level.

[Shalom]

I want to say it was mogadon, but I don't remember precisely. Both he and the pharmacist told me to take it and go straight to bed - to expect to be out like a light.

I'd take the Cymbalta first thing in the morning. Take the Mogadon just before bed. And even then, it would be most of an hour before I was asleep!

Mogadon (nitrazepam) is not available in the USA, so I've never seen it used and can't comment from experience; the chart says it has a very fast onset, but being fat-soluble, I'd expect that in heavier persons you'd need more of it for the same effect.

My eyebrows would be going up, too. That's a lot of Valium.

Well, yeah, it is. I also didn't mention in my post that over the next hour or so I took another two of them. It usually takes about 30mg to make me hold still for a venipuncture. 35mg is a bit high even for me, though if I'd had another hour or so to wait, perhaps I could have gotten away with "only" 30. For an IM injection, 20 to 25 mg might be enough; for SQ, probably wouldn't need more than 15.

(For purposes of comparison, for the non-medical readers, the usual anxiolytic dose is 2 to 5 mg for mild anxiety, 10mg for more severe anxiety. Don't assume that just because I'm a pharmacist and taking that much, that this is a safe dose for everyone else.)

It's not easy to OD on benzodiazepines, though. For one thing, their therapeutic window (i.e. the difference between the minimum effective dose and the toxic dose) is incredibly wide, in contrast with the barbiturates they replaced in the early 60s. And even if you do manage to ingest a frankly toxic dose, there's a specific BZD-receptor antagonist (Romazecon) which can reverse the effects pretty quickly. (Obviously whatever you took it for will come back with a vengeance, so it's not a real good idea to give it to someone who's taking BZDs for seizure prevention.)

Also, diazepam partitions into fat tissue, like Mogadon referred to above, and thus heavy people like me (BMI=32) might be able to tolerate larger doses. The stuff doesn't even put me to sleep, even at the massive dose I took: just makes me kind of limp and floppy, a bit uncoordinated, and maybe a little more peaceful than usual. It's true that my name means Peace, but I've always had trouble living up to that. Especially when confronted with needles... when I was a kid, I couldn't even take a splinter out with one. I've mellowed a bit since then.

(Although sleepy or not, I wasn't stupid enough to try and drive home after that, I took a cab and went back for the car a couple days later.)

Then again, some people build tolerance pretty quickly.

True, but I don't take it often enough to build up a tolerance to it. Besides prophylaxis for blood tests, which don't happen very often, maybe two or three times a year I need to take 5mg for a particularly bad muscle spasm, and that's about all.

[Seshat]

I'm surprisingly tolerant to the diazepam family. When I was adapting to Cymbalta, my adaption side-effect was an inability to sleep.

At that point, I'd taken diazepams once, for a short period of time, as an attempt at sleeping pills. Maybe a week of mild diazepams. (They didn't work.)

Anyway, my doctor listened to that, and put me on a more serious one. I want to say it was mogadon, but I don't remember precisely. Both he and the pharmacist told me to take it and go straight to bed - to expect to be out like a light.

I'd take the Cymbalta first thing in the morning. Take the Mogadon just before bed. And even then, it would be most of an hour before I was asleep!

[Sapphire Silk]

Several times my father tried to flag a nurse and ask for pain meds, but was flatly told that only a doctor could issue medication, but so far we'd not seen hide or hair of a doctor.

Over one hour of writhing in the worst pain of my life, someone steps into the room and gets a look on their face like they were shocked that anyone was in the room.

5 minutes later I was in CAT scan, 15 minutes after that I was in surgery to have my appendix removed.


Found out later the hospital had just recently installed a new monitoring system (As seen with the giant monitors on the walls of the triage center), and it still had some bugs, in that I had been assigned to one of two doctors, but the one I was assigned to was told my room was assigned to the other doctor. So, for a full hour, I was lost in the system.


Happily, my request for financial assistance (since I was unemployed at the time), yielded a 100% write-off of my bill.

As well they should. There really is no excuse for that, and it's a miracle your appendix didn't burst while you were waiting.

He asked me how many I'd taken, so he could document it in the chart; when I told him five 5mg tabs to start with, his eyebrows reached his hairline...

My eyebrows would be going up, too. That's a lot of Valium.

Then again, some people build tolerance pretty quickly.

[Shalom]

* if necessary, dose myself with valium or ativan. (NOTE NOTE NOTE: this is with my GP and psychiatrists' permission. And I ask if that's okay for this particular set of tests FIRST.)

This. I will not allow anyone to stick a needle in me without pretreatment with Valium. Lots and lots of Valium. Like, six to seven times the normal dosage of Valium. And I couldn't care less if it interferes with whatever test they're doing; that's their problem to deal with however they want.

Went in for a CAT scan a couple years ago to r/o possible appendicitis. (Wasn't. Nor was it diverticulitis. They never did find out what the hell was hurting me, but it stopped after a couple days.) I asked them whether I'd need an IV; when they said I would, I said Excuse me, I need to take some diazepam, and swallowed some. He asked me how many I'd taken, so he could document it in the chart; when I told him five 5mg tabs to start with, his eyebrows reached his hairline...

[Pojodan]

Time to chime in with my own ER fail story!

Long story short, my dad took me to the ER after writhing in pain all morning with what seemed like really bad gas, but which reached the point of direness while we were in the car to a local clinic.

I arrived, pointed at 9 on the scale of 1 to 10 pain meter since, having been riped through a blackberry bramble in my youth, I had experienced worse pain than this, but that would soon change.

Arrived at my waiting room... and waited... and waited... The tiny TV screen was showing Judge Judy. I quietly wondered what I'd done to deserve this punishment.

Several times my father tried to flag a nurse and ask for pain meds, but was flatly told that only a doctor could issue medication, but so far we'd not seen hide or hair of a doctor.

Over one hour of writhing in the worst pain of my life, someone steps into the room and gets a look on their face like they were shocked that anyone was in the room.

5 minutes later I was in CAT scan, 15 minutes after that I was in surgery to have my appendix removed.


Found out later the hospital had just recently installed a new monitoring system (As seen with the giant monitors on the walls of the triage center), and it still had some bugs, in that I had been assigned to one of two doctors, but the one I was assigned to was told my room was assigned to the other doctor. So, for a full hour, I was lost in the system.


Happily, my request for financial assistance (since I was unemployed at the time), yielded a 100% write-off of my bill.

[AccountingDrone]

My lack of medical body modesty seems to bother some medical people.

I have normal body modesty in other settings, but if it's medical I'm fine to strip down without a curtain and a paper 'gown'. Why not - it's not like I've got anything the doctor/nurse/physiotherapist/whatever hasn't seen before.

Or if I DO, it means they REALLY should see it!

Heh, I have spent so much time hospitalized in my life I also don't have any left ... I have a friend from Norfolk VA who said [when he came home after boot camp] that he was so used to the gang bathrooms they had in boot that he felt uncomfortable alone in the bathroom and had the urge to take a bucket out onto the patio so he could have some company

I do know that I can sleep anywhere in pretty much any situation now - I used to travel a lot, and would use a small sea bag as a pillow with a small blanket by wrapping my arm through the strap so nobody could snatch and run with the bag and roll next to the wall or behind a row of seats in the waiting area nearest my plane. I could fall asleep in a crowd, in silence, in dark, in light - just doesn't matter as long as I have a scrap of blanket. I need to have something covering me.

[Andara Bledin]

Why not - it's not like I've got anything the doctor/nurse/physiotherapist/whatever hasn't seen before.

Or if I DO, it means they REALLY should see it!

This is pretty much how I've always thought about it. I mean, I may not strip down for people all of the time, but they do what they do for most of their careers, so by the time they leave for the day, they will barely have any memory of me.

^-.-^

[Seshat]

My lack of medical body modesty seems to bother some medical people.

I have normal body modesty in other settings, but if it's medical I'm fine to strip down without a curtain and a paper 'gown'. Why not - it's not like I've got anything the doctor/nurse/physiotherapist/whatever hasn't seen before.

Or if I DO, it means they REALLY should see it!

[Fire_on_High]

I think I must be weird...on blood draws, I tend to reflexively jerk if I'm NOT watching from the contact and pain, but it doesn't bother me in the least if I'm watching...doesn't matter if it's a child sized butterfly or a huge honking blood donation needle. I've had to convince a few nurses of that one...

Same thing with gynos...I'm not even slightly bothered by the idea, the thought, or anything other than the need to cold turkey caffeine 2 days before to bullshit my BP/heart rate down to acceptable and the actual few seconds of pain as they wrench things around. Tends to freak nurses out just a bit, tho not nearly as much as the first.

Maybe I just came defective directly from the factory?

[Andara Bledin]

And this lady was so awesome - her and the other techs caught me when I blacked out and fell forward out of the chair; this is why I do not donate blood. I faint after about 1/8 of a pint comes out. And she loaded me to my eyeballs with juice and cookies, she let my boyfriend at the time come into the test area and see me when I woke up and she gave him junk food too.

How well had you eaten before the time you passed out?

I give blood fairly regularly - I have good veins and a moderately high demand blood type. The first time I gave blood was on an empty stomach, and as a result, I pretty much missed the entire rest of the school day recovering. After that, however, I made a point to have a somewhat high carb meal about an hour or so before donating, and it's been peaches every time since.

I make a point of concentrating on the silly posters they have when they're about to stick me and also try to go as limp as possible. Next time I'm going to see about getting a hand warmer, too, to help open up the blood vessels before it's time to get stuck, because I know how it feels when I stick my hands under warm water when the office is chilly.

As for the girly-bits exam, my first one was at 21 or 22 when I wanted to get on the pill. I've never been particularly shy around doctors even though I can feel my blood pressure rise if they have to do anything more complicated than checking my pressure or temperature. The guy who did my first one was pretty blase, matter of fact, and was willing to talk to me.

I hate having medical pros who won't freaking talk to me. My last dentist was one of those... I had to pry what he was doing out of him with a crowbar. Needless to say, I never went back to him.

^-.-^

[Eisa]

Holy shit, that ER was beyond awful.

The last time I went to the ER, the doctor was really...cold. And kind of acted like I was a nuisance. And with the blood...oh dear. I'm also a hard stick. On top of that, I was dehydrated--I ended up getting a bag of fluid in an IV. That was fun, too. She put the IV in my hand and said if I'd moved at ALL when she was putting it in, it wouldn't have worked. Then she tried a few times to get blood, didn't work...had someone else try, didn't work [I think?], and then someone from the lab came down, and went "no wonder it's so hard to get blood from you right now, you're freezing!" and used an infant foot warmer to warm up my arms. That was awesome.

And with the gyn...I didn't go until I was...21, I believe? I finally had to force myself to go because I was having a lot of problems and kind of freaking out about the possibility of an STD from a douchebag ex. >.> My gyn was lovely. Listened to me tell her the reason behind my PTSD, told me everything she was doing, moved slowly , used the smallest instruments...and it's ridiculous 'cause even with the smallest instruments, I still end up bleeding afterward.