A&E not handing out "the hard stuff" anymore

Richard Dower

i was in A&E last weekend for a recurrance of renal cholic/kidney stones....so i wait four hours because in triage terms i wasn't in any imminent danger, then this poxy first year kid doctor with floopy hair rolls around and asks the usual, i know the routine.......

.....then he says we'll give you something for pain, two paracetamol and Difene 75........:eek:

Are they fu*kking kidding me?????? :mad: , i'm an old skooler to pain and A&E with Crohn's and what not, i was insulted by what he constituted as "pain relief", back in the good old days they have the old hardcore injections on tap...no questions.

But now, ooh you're a junkie!...you'll get addicted, MF please! :rolleyes:
I get they have to be careful but with someone like me with practically my own bed and nameplate on the door you'd think they'd listen to you, but no.

Gone to the dogs, pain management is a joke in Ireland.

pragmatic1

Free drugs is the only good thing about hospital. That sucks OP.

Taco Chips

Obviously with your extensive knowledge of pharmacology and biochemistry you know waaaay more than some eejit with a medical degree. Tis a disgrace Joe...

Biggins

pragmatic1 wrote: »

Free drugs is the only good thing about hospital...

What about the nice female nurses?

pragmatic1

Biggins wrote: »

What about the nice female nurses?

Depends. If you're in for a circumcision that could be a gift and a curse.

cocoshovel

only 4 hours in A&E :eek:? Lucky you.

smk89

He's just following the rules. You start with the non opioid a first. You may be an expert at pain management but he's an expert at being a doctor

Richard Dower

Taco Chips wrote: »

Obviously with your extensive knowledge of pharmacology and biochemistry you know waaaay more than some eejit with a medical degree. Tis a disgrace Joe...

Most of these junior doctors are clueless, they revert to the nurses alot of time to OK what they've prescribed, and yeah....i used to wow the medical teams with my knowledge of Crohn's.....hell they used to send teams down to me to quiz me.

Jaxxy

Taco Chips wrote: »

Obviously with your extensive knowledge of pharmacology and biochemistry you know waaaay more than some eejit with a medical degree. Tis a disgrace Joe...

Oh come off it. Since when is giving someone in pain with kidney stones a couple of paracetamol actually going to be effective? Bloody nanny state-ism Joe, tis a disgrace indeed.

January

In the throes of labour and asked for some pain relief... she handed me two paracetemol... heh, love, you're going to have to break out the stronger stuff, come on now!

Richard Dower

smk89 wrote: »

He's just following the rules. You start with the non opioid a first. You may be an expert at pain management but he's an expert at being a doctor

The thing is, it's about fear....they don't want to make the decision themselves, so they up it to the HSO or registrar...who i prefer dealing with, those guys listen to me for five mins and know i'm savvy and OK things right away.

Biggins

pragmatic1 wrote: »

Depends. If you're in for a circumcision that could be a gift and a curse.

There's no pleasure without pain!

Richard Hillman

You should have attemped to walk out and say you will go get heroin off a dealer instead. The doctor would have given you what you want.

Eviledna

January wrote: »

In the throes of labour and asked for some pain relief... she handed me two paracetemol... heh, love, you're going to have to break out the stronger stuff, come on now!

Would anything stronger not have harmed the baby?

Kevin Duffy

Richard Dower wrote: »

Are they fu*kking kidding me?????? :mad: , i'm an old skooler to pain and A&E with Crohn's and what not, i was insulted by what he constituted as "pain relief", back in the good old days they have the old hardcore injections on tap...no questions.

But now, ooh you're a junkie!...you'll get addicted, MF please! :rolleyes:
I get they have to be careful but with someone like me with practically my own bed and nameplate on the door you'd think they'd listen to you, but no.

Hmm.....maybe he had a point....

January

Eviledna wrote: »

Would anything stronger not have harmed the baby?

Pethidine can transfer over to the baby and make it drowsy, but Gas & Air is ok... Epidural can have some side effects too.

Richard Dower

Eviledna wrote: »

Would anything stronger not have harmed the baby?

Depends on the dosage, they usuallly only give you a small dosage.

byhookorbycrook

Just out of hospital. Asked for a script for the zydol I had been on that morning and was told if I needed that,they shouldn't be letting me out?!!

Biggins

byhookorbycrook wrote: »

Just out of hospital. Asked for a script for the zydol I had been on that morning and was told if I needed that,they shouldn't be letting me out?!!

Thats puzzling!
Is zydol that dangerous that you have to be bedridden for taking it?

Richard Dower

Kevin Duffy wrote: »

Hmm.....maybe he had a point....

:rolleyes: did you not read the Crohn's part + the renal cholic is related to the surgeries i've had, i don't absored oxilates like normal folk due to the sections of intenstine they removed.

Temptamperu

Getting awfull upset over your fix there OP

byhookorbycrook

Biggins wrote: »

Thats puzzling!
Is zydol that dangerous that you have to be bedridden for taking it?

ooooohhhhhh...you might, I dunno, go on a drug crazed rampage!!

Richard Dower

Biggins wrote: »

Thats puzzling!
Is zydol that dangerous that you have to be bedridden for taking it?

Bizarre...they're usually gagging to free up a bed. Zydol makes you a bit drowzy at high dosage, but nothing that would zombiefy you.

Kiera

Biggins wrote: »

Thats puzzling!
Is zydol that dangerous that you have to be bedridden for taking it?

Nope its not. I get monthly scripts for it. Its only a med painkiller.

Richard Dower

Temptamperu wrote: »

Getting awfull upset over your fix there OP

I'm just ranting, if i was an addict there would be alot of ways to get my "fix".

Son Of A Vidic

Biggins wrote: »

What about the nice female nurses?

Biggins, I'm surprised at you. One of my best mates is a male nurse, married with three kids and a psycho job on the rugby pitch.

Biggins

Kiera wrote: »

Nope its not. I get monthly scripts for it. Its only a med painkiller.

Thats mad then! Daft people!

Temptamperu

Richard Dower wrote: »

I'm just ranting, if i was an addict there would be alot of ways to get my "fix".

Im just fcking with you dude

arybvtcw0eolkf

Biggins wrote: »

Thats puzzling!
Is zydol that dangerous that you have to be bedridden for taking it?

Whenever I've used it its been pretty good at knocking me out and me sleeping for hours. At 50mg it wasn't too bad, but I went up to 150 at one stage and I was wiped out for close on a week - great so it t'was :pac:

Better in my opinion than DF118's - anyone who's been through pain management might know the DF's.

byhookorbycrook

Had it on my lti book for a while,didn't murder anyone.
I have come to the conclusion that hospitals are no place for the sick. I always ask what I am being given,why and what dosage-twice this year they gave me stuff that I had already been given or should NOT be given.

I lost faith in the place early this year. Arrived with something that screamed "appendix" to me,only for the dr. to say,as he reviewed my notes: "Well sure it's not your appendix anyway, we took that out 3 years ago."...funny thing was, they hadn't...

Jess16

I wonder what treatment the boys in green in New Zealand are getting, they seem to be experiencing a bit of Kidney failure right now too

Biggins

Corvus Maximus wrote: »

Biggins, I'm surprised at you. One of my best mates is a male nurse, married with three kids and a psycho job on the rugby pitch.

Why?

I'm a bloke. I appreciate a good female nurse!
(Given the chance if the wife would let me!)

Jaxxy

byhookorbycrook wrote: »

Had it on my lti book for a while,didn't murder anyone.
I have come to the conclusion that hospitals are no place for the sick. I always ask what I am being given,why and what dosage-twice this year they gave me stuff that I had already been given or should NOT be given.

I lost faith in the place early this year. Arrived with something that screamed "appendix" to me,only for the dr. to say,as he reviewed my notes: "Well sure it's not your appendix anyway, we took that out 3 years ago."...funny thing was, they hadn't...

:eek:

What the..!

Richard Dower

JaxxYChicK wrote: »

:eek:

What the..!

Jaxxy...i've heard that and worse!, mistakes get made everyday.

volvoman480

Biggins wrote: »

Why?

I'm a bloke. I appreciate a good female nurse!
(Given the chance if the wife would let me!)

My wife is a nurse!!:D
A psychiatric nurse, no uniform unfortunately.....:(

Biggins

volvoman480 wrote: »

My wife is a nurse!!:D
A psychiatric nurse, no uniform unfortunately.....:(

She can borrow my wifes one - and she's not a nurse - at least not to others!
Lucky me!

take everything

Jess16 wrote: »

I wonder what treatment the boys in green in New Zealand are getting, they seem to be experiencing a bit of Kidney failure right now too

Ba dum tshhh!!!

Aishae

Zydol completely zombiefies me. So I wouldn't touch it with a bargepole.

Had surgery on my face there 2/3 years ago - tumours- cheeky feckers gave me paracetamol when I woke up

After surgery on my hand they also gave me paracetamol - i was in bits. are you having a laugh sunshine?!

On the other hand I had back surgery twice in the last 2 years and they didn't have to be asked for stronger than paracetamol. Though I've noticed that they've really scaled back on what mess they will dish out from the evening trolly. Thought it was cutbacks to be honest!

byhookorbycrook

JaxxYChicK wrote: »

:eek:

What the..!

Not quite what I thought...by the time they found I was having a heart attack (really),the appendix had burst. Difene 75 only good for muscle pain, I find.

Richard Dower

Difene is shiite all round, has zero effect on me. They seem to hand out the same crap in Irish hospitals.

fearcruach

Richard Dower wrote: »

i was in A&E last weekend for a recurrance of renal cholic/kidney stones....so i wait four hours because in triage terms i wasn't in any imminent danger, then this poxy first year kid doctor with floopy hair rolls around and asks the usual, i know the routine.......

.....then he says we'll give you something for pain, two paracetamol and Difene 75........:eek:

Are they fu*kking kidding me?????? :mad: , i'm an old skooler to pain and A&E with Crohn's and what not, i was insulted by what he constituted as "pain relief", back in the good old days they have the old hardcore injections on tap...no questions.

But now, ooh you're a junkie!...you'll get addicted, MF please! :rolleyes:
I get they have to be careful but with someone like me with practically my own bed and nameplate on the door you'd think they'd listen to you, but no.

Gone to the dogs, pain management is a joke in Ireland.

TBH i'd be much more worried about being prescribed Difene when you have Crohns disease. That will massively aggravate the symptoms of Crohns.

Richard Dower

fearcruach wrote: »

TBH i'd be much more worried about being prescribed Difene when you have Crohns disease. That will massively aggravate the symptoms of Crohns.

They say the same about opiates, masking effect etc. - but i'm in remission so Difene has zero effect.

Jess16

take everything wrote: »

Ba dum tshhh!!!

There was a serious element to that comment too, believe it or not

Aishae

difene is very hard on the lining of the stomach

Richard Dower

Aishae wrote: »

difene is very hard on the lining of the stomach

I have ulcers as well.....im fecked

tightropetom

Richard Dower wrote: »

Difene is shiite all round, has zero effect on me. They seem to hand out the same crap in Irish hospitals.

They do similar here in the UK, OP.

A systematic review in 2004 by Holdgate, Pollock et al. concerning the use of nonsteroidal anti-inflammatory drugs (NSAIDs) versus opioids for renal colic concluded that:

• NSAIDs and opioids can both provide effective analgesia in acute renal colic
• opioids are associated with a higher incidence of adverse events, particularly vomiting

hence, many docs work their way up the analgesic ladder. Many pts improve with Difene, Paracetamol and Codeine.

Just out of interest though, you mention a poxy first year kid doctor with floopy hair rolling around and asking the usual, ([you] know the routine) - were you that condescending to him at the time, or did you calmly and politely explain your previous experiences?

IrishEyes19

Richard Dower wrote: »

i was in A&E last weekend for a recurrance of renal cholic/kidney stones....so i wait four hours because in triage terms i wasn't in any imminent danger, then this poxy first year kid doctor with floopy hair rolls around and asks the usual, i know the routine.......

.....then he says we'll give you something for pain, two paracetamol and Difene 75........:eek:

Are they fu*kking kidding me?????? :mad: , i'm an old skooler to pain and A&E with Crohn's and what not, i was insulted by what he constituted as "pain relief", back in the good old days they have the old hardcore injections on tap...no questions.

But now, ooh you're a junkie!...you'll get addicted, MF please! :rolleyes:
I get they have to be careful but with someone like me with practically my own bed and nameplate on the door you'd think they'd listen to you, but no.

Gone to the dogs, pain management is a joke in Ireland.

I get it, that you've been through the system before and know what you need, but on the other hand, if someone came in who had gotten addicted to something a doctor perscribed and didnt run through the measures or else reacted badly to some form of medication, there would be all out war and the HSE would get another bashing already. There's no winning really.

Richard Dower

tightropetom wrote: »

They do similar here in the UK, OP.

A systematic review in 2004 by Holdgate, Pollock et al. concerning the use of nonsteroidal anti-inflammatory drugs (NSAIDs) versus opioids for renal colic concluded that:

• NSAIDs and opioids can both provide effective analgesia in acute renal colic
• opioids are associated with a higher incidence of adverse events, particularly vomiting

hence, many docs work their way up the analgesic ladder. Many pts improve with Difene, Paracetamol and Codeine.

Just out of interest though, you mention a poxy first year kid doctor with floopy hair rolling around and asking the usual, ([you] know the routine) - were you that condescending to him at the time, or did you calmly and politely explain your previous experiences?

They don't tolerate any BS from people in recent years, for any staff...especially nurses, so they boot you out. To answer, no....i know how to communicate with doctors through 18 years of repeat visits, i get the grading scale and how it works, but....when you have a patient with a long history of renal cholic, someone who knows what works and what dosen't the doctors should listen to the patient, i get he's never met me before etc. but a patient who is clearly in alot of visible pain should not be handed two paracetamol.

bnt

The problem with Zydol (a.k.a. Tramadol) is that it's an opiate; not only is it addictive, like most opiates it's specifically contraindicated in renal cases. The kidneys have to work to excrete it, and you don't want your kidneys working harder if one is struggling to squeeze out a lump of rock ..! :eek:

edit: It's not a case of "never", but (as tightropetom says) it's definitely not the first choice.

Richard Dower

IrishEyes19 wrote: »

I get it, that you've been through the system before and know what you need, but on the other hand, if someone came in who had gotten addicted to something a doctor perscribed and didnt run through the measures or else reacted badly to some form of medication, there would be all out war and the HSE would get another bashing already. There's no winning really.

I get what you're saying 100%, a registrar once told me they have a policy of "CYA"...Cover Your Ass, meaning they are always protecting themselves, my point is renal colic is one of the most painful pains, you can't fake that crap....your vitals, your face will tell the tale.

YoureSoVain

Richard Dower......The thing is, it's about fear....they don't want to make the decision themselves, so they up it to the HSO or registrar...who i prefer dealing with, those guys listen to me for five mins and know i'm savvy and OK things right away.


Whats a HSO? Anything like an SHO.....:D You being savvy and everything