https://themighty.com/2019/05/what-er-staff-should-know-about-chronic-pain/

I went to the ER once in 2008 for a 6 day migraine. I was vomiting and couldn’t break the cycle. I had almost none of the meds I have now for emergencies. I was treated very well and left with a pain level at 3.

I was becoming chronic in 2007/8. When I found both my feet in this strange alter-life by 2013/14, I knew I would never visit an ER for a pain flare again. I know how the majority of nurses and docs think – I’ve been on their side of the chart. And I know the prejudice they have at Chronic Pain patients. They don’t understand, and I cannot blame them. Chronic patients don’t fit pain models… square pegs in round holes. How does a Normal person really understand living in a constant state of pain – a “good day” is a level 3/4? A “good day” I can get out of bed before noon…

The article reminds me of a recent visit to a new primary doc.

Recently, I went in as my allergies had gotten so bad I could tell I was hours away from an infected ear or throat.

My last primary was great. I can’t go to her any longer because she changed her practice to a la cart and won’t take insurance. πŸ˜• I can no longer afford her. She’s like the 4th doc I’ve lost since moving to Texas in 2013. Healthcare is killing docs. It’s horrible.

Anyway, sitting on the exam table, waiting for the new primary: A. Pratt. I pulled in my feet to sit cross cross (always most comfy for my chronic back). I had my phone at the ready to discuss my lists of present illness symptoms and chronic conditions. I practiced breathing, looking around the office, curbing my anxieties. What would this chick be like? Would she be comfortable taking me on with all my chronic shit? Would she give me the cold shoulder and would I face the prejudices? And damn, my throat was hurting, I had complete laryngitis for almost a week, I could feel the clicking as my ears were filling with fluid and on the verge of infection, my migraine was chugging along (sick as a dog too) and making my eyes feel like open wounds. I wore my Axon Optics; the fluorescents in the exam room were bastards.

A. Pratt did not keep me waiting long. She was pleasant. Shook my hand (too hard… tip off: she isn’t practiced with RA patients). After a few pleasantries (me croaking out/whispering answers with my laryngitis), she sat down and said, “My! You’re on a lot of meds.”

😢 My reaction, my face.

And finally: “Oh yeah? Sorry about that. I don’t enjoy taking any of them.” Tip off: she doesn’t like that I take a “lot” of meds. Greeeeeat. Which should I discontinue? The Humira? The Synthroid?πŸ˜• I hastened to add: “I see specialists for almost ALL my medications, but I need a primary for when I’m sick… like NOW.” (It’s true: my primary ONLY prescribes allergy medicine and a tiny diuretic. That’s IT. Lol.

A. Pratt gave me a decent exam. A little whimpy… definitely not as thorough as my last great primary. She sat down again to discuss our plan. She would prescribe a Z pack because while I wasn’t truly infected yet, the concerning symptoms were lasting too long. Good answer, doc. Not that I’m judging. Yes, I’m judging. Your taking a test right now. And if I don’t think you’re good enough, you won’t get the privilege of knowing me.

She suggested a steroid pack for the allergies/cold too. Good call. I expected her to write for a steroid taper pack. INSTEAD, she instructed me to use my prn prednisone (prescribed for RA flares) as a “steroid pack.” Hello? That’s just LAZY doctoring. Tip off: as a physician, you realize a chronic patient’s meds are not interchangeable. That prednisone has a purpose that is NOT for this cold. Classic classic chronic prejudice from a doc.

Then, we talked more about my cough. Which especially SUCKED at night. Know what would be GREAT? A small script of cough medicine with codeine. That rocks for helping one stop the night coughing and go to sleep. A. Pratt thought about that, “Well you have other pain medications here. They should work for the cough.” Boom. Tip off: she just totally crossed an unbelievable boundary there. That pain medicine is prescribed for my S/I, RA and CM. This is very typical for chronic patients. Just because we may have some pain medications, it doesn’t mean we have enough for when we’re sick or have a short term problem arise! We ONLY HAVE ENOUGH TO LIVE WITH OUR CHRONIC CONDITIONS – and maybe not even enough for that! Totally unprofessional and total prejudice. Absolutely cruddy advice to give to a patient as well. You never instruct a patient to take their meds for other ailments. So prescription cough medicine wasn’t happening. Fine. Whatever.

While A. Pratt was kind and fine and will be a good primary for my husband… I may have to keep looking. She flagged a lot of basic issues with interacting with a patient with chronic illnesses. Which sucks and left me feeling judged and disappointed.

I did improve over the next week… the antibiotic fixed my ear fluid issue and throat in just a couple of days.

#ChronicPatients #ChronicIllness #InvisibleIllness #ChronicPain #WaitingRoomShoePic #ChronicMigraine #PatientsNotAddicts

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