Chronic Pain And The ER

I’ve been in pain management for over four years and I have been on the same (low) dose of narcotic and non-narcotic pain medications for that period. Although I don’t intend to be on them forever, these medications currently allow me to work and live a somewhat normal life.

This is the story of my experience in the ER as a chronic pain patient. This is a story of how discrimination against me as a chronic pain patient could have led to a stomach bleed or me becoming septic.

The Emergency

I am fortunate in that I have not been to the emergency room in over six years. Not only do I avoid it like the plague (as most chronic pain patients are aware, the ER is a bastion of judgement and doubt), I haven’t had a reason to go.

Sunday December 30th broke my no-ER streak. The day before was a normal day. I woke up, went to work and came home at about 7:30 pm. I then started my routine of getting into pajamas and falling into my “happy place” (my couch with a PS4 controller in my hands to play Red Dead Redemption 2).

Suddenly, out of nowhere, I was struck with the most intense, agonizing pain I have ever felt in my life. I’ve had multiple surgeries and broken bones, but I’ve never experienced anything like this. It felt as though someone had shoved a burning hot poker right under my right rib cage.

I immediately curled up into the bed and prayed that it would stop soon. Along with that, my thoughts went to “This is forever.” Because when you have chronic pain it’s hard to think of pain as temporary anymore.

After a while the pain subsided enough that I could breathe again. My husband went to the store and bought some stomach medications, as we thought maybe it was just digestive-related (turns out it was, just not in the way we thought). He also grabbed a movie from Red Box for us to watch to hopefully help distract me from the pain. I took the medications and settled in to watch the movie.

As I laid there, the pain was at the surface threatening to break through. Once the movie was over I had to lay down, as I could feel it coming back.

I was able to fall asleep somehow, but I was awoken at 2 am to another bout of agony. The pain hadn’t moved, so I knew that it wasn’t trapped gas. However, in my desperate desire to avoid the ER, I tried to go back to sleep.

At 4 am I woke up drenched in sweat and in so much pain that I couldn’t breathe properly. I was involuntarily moaning with every ragged breath and I couldn’t even cry. That was when I knew I had to do it: I had to go the ER.

I woke my husband up and we went.

The Discrimination

We arrived at about 4:30 and I stumbled in, unable to breathe enough to get full sentences out. The woman at the desk was nice enough, but the rest of them weren’t quite as kind. I knew immediately that half of the staff thought I was overreacting.

And so it began.

They take me back to the room and I get in the bed. The pain forces me to lay on my left side in the fetal position. To lay flat is to be in agony, and I’m unable to lay on my right side due to my shoulder. The night-shift doctor comes in and asks me what’s going on. I inform her of my symptoms and I let her know right off the bat that I am on pain medications. She is pretty nice about it, but her shift was almost over.

About 15 minutes later the new doctor comes in and asks the same questions. Although he wasn’t rude, his tone and demeanor told me what I needed to know: He had been informed of my medication regimen.

Here I am, a 29 year old who is in pain management coming to the ER complaining of pain. I tick off many of the “drug-seeker” boxes, except the ones where I hadn’t been to the ER in six years and wasn’t asking for pain medication, but, you know…

Without doing a physical exam, he orders an ultrasound to check my gallbladder. Okay, fine, please. I just want to know what’s wrong.

The ultrasound technician comes in and she obviously doesn’t want to be there. (Soon after the test my husband saw her leaving — I must have been her last patient.) She tells me that I’m going to have to lay on my back for this test. I know it will be terrible, but I also know it has to happen, so I do it.

My (wonderful, amazing, kind, beautiful, etc.) husband holds my hand as I cry out with every breath. I can practically feel the tech roll her eyes. No compassion whatsoever. As the test is happening a student nurse comes in with a cup of water and gives me a sympathetic look. She was the only one who seemed to care or believe me.

After the test I’m asked to give a urine sample. I waddle to the bathroom and do what I need to do and then collapse back into the bed, praying for relief. About 20 minutes later the doctor walks back into the room.

“The ultrasound came back normal. There’s nothing wrong so we’re going to discharge you.” He says flatly.

“But something is wrong. What can I do? Should I try ice or heat?” I ask in desperation. He actually smirks at me.

“I mean, I don’t know…” He says as he reluctantly walks to my side to finally do a physical exam.

“She can’t even lay flat. There’s nothing else that this could be?” My husband asks, frustrated. That seemed to do the trick.

“Well, we can do a CT scan,” the doctor replied, dejected, “but I don’t know if it will show anything. I’ll order one.” He walks out of the room as if he’s lost a war.

The CT technician eventually comes in to get me and wheels me to the machine. When I had to transfer from my bed to the machine the pain came back full force. I had to repeatedly apologize for how many times I said the F word. Every breath was another stab. And then it got worse.

During the CT scan I have to lay flat with my arms above my head. This was bad enough — I hyperventilated the entire time — but then he injected the dye and the fire in my ribs roared. I lay there shivering and let the scan continue because I know that I have to. The technician is compassionate and continuously apologizes to me.

I return to the ER and wait. Finally, the doctor steps into the doorway to quickly say:

“You do have a reason to be in pain, you have a perforated ulcer. I’m admitting you and contacting the surgeon right now. You’ll be having surgery as soon as possible.” And without waiting for us to ask any questions, he’s gone.

Final Thoughts

Unfortunately my experiences didn’t get much better, but that’s a story for another time.

I’m now sitting in my recliner, in pain, with a drain coming out of my stomach and a massive bandage over the incision after a week of agony.

However, had we not protested I would’ve gone home and writhed in agony as my stomach lining opened and its contents spilled out, causing me to become septic.

There is no reason for that ER doctor to do only one test, no physical exam and then send me away. I have insurance, so it’s not like they were worried they wouldn’t get paid for any tests they did. The only logical explanation for his negligence is because I take pain medications, so he assumed I was faking it and almost sent me home to my death.

I understand the problem with opioids, I do. I work in a hospital and I have seen my fair share of drug seekers. I understand that it’s frustrating and that it happens a lot, but writing someone off solely because they take pain medications or you think they’re a drug seeker is not only wrong, it can be extremely dangerous.

I am not a drug seeker. I do not like having to take the medications I currently take. I don’t enjoy being treated like a common criminal. But they help me, I take them as directed and without them I’d be home bound. We have to stop assuming everyone on pain medications is an addict because it’s not true. The majority of us are just trying to live.

3 thoughts on “Chronic Pain And The ER

  1. I’m glad it’s getting better. Working in neurosurgery I see the need. Having a chronic back issue I understand. Sometimes people need a little extra help. I’m sorry you had to go through this. The opioid crisis is real, but it sucks for those that aren’t addicts and just want to live as normal as a life as possible.
    Thanks for writing this Hil. Love you girl❤️

    • Thanks Joy-Beth! I hesitated writing it because I know how people feel about these medications but I thought it was important. I don’t intend to be on these meds forever but for now they’re helping me be “normal”.

      I’m sorry about your back, I can’t imagine nursing with a bad back. You’re tough and resilient to do it! Love you too! ❤️

  2. Pingback: Listen To Your Body | hillaryrobyn

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