A trip to the ER...please help

[sghouston5]

First of all, hey everyone. I am new to bluelight. Just seeking some advice.

A bit of a background on *my friend*.....*my friend* has experiences with many different substances including but not limited to:

Benzos, opiates/oids(fentanyl, tabs, OC, dillies etc everything except heroin) , marijuana/hash, MDMA, psilocybe cubensis and cyanescens shrooms and...thats about it.

*My friend* went to the ER a few days ago. He took some pretty pure MDMA the saturday before and all week had been battling depression from serotonin depletion. So the week was okay minus the depression, but then friday rolls around. He takes an Opti-Men multi vitamin, then drinks a red bull. Takes a .5mg xanax and doesnt feel "good", a bit nauseated and panicked suprisingly. That subsides, then about four hours later, he pops two 50mg tapentadols. 10 minutes later....

He Noticed tingling sensation in face and extremeties, difficult breathing, surreal feeling, confusion, rapid heart rate, severe dry mouth, felt like he was about to seize or go into cardiac arrest.

Ambulance got there, took him to the hospital, after painfully struggling on the hospital bed for about two hours with this feeling, it subsided.

He was completely honest with the doctor when asked what happened, and then the doctor gives no explainaition and on the report basically rights him off with the title "Polysubstance abuse" which pretty much means, "Yeah you put yourself in here and are therefore a low life and do not deserve one bit of my REAL medical advice."

Ever since this happened, he went to bed that night and felt right to sleep. Woke up the next day and felt "okay" then he and his family went out for lunch somewhere. NOPE. Panic attack the whole ride in the car. Panic attack at restaurant. Overwhelming anxiety. This has been going on for two days. He is not sure what to do. Please help.

He thinks it was the combination of the NRI and Xanax that interacted negatively, because the prior night (thursday) to the ER visit, he took three tapentadols and everything was fine.

Any thoughts...or suggestions? I just want a better opinion than "You are a drug user and I will not help you". I just wanted to know what caused it..so that I know NOT to do it again. Its harm reduction right?

Anyways...PLEASE HELP!

 

[Bob Loblaw]

Maybe someone in OD knows more about a potential negative combination than I do.

 

[cj]

Sounds like the mdma brought out a panic disorder. I would seek mental health care options. Until then xanax will help.

 

[plmar]

Why are you trying to swim? You are not incriminating yourself or anything and it just makes it annoying and difficult to read for those who want to help you.

 

[Nicholai]

I don't think anyone could really tell you. I'd simply pin it on the redbull, meself.

It does sound like a panic attack, though.

 

[RTrain]

That is what emergency department doctors do, they make sure you are alright to live. If they come to that determination then they send you out the door with a referral to your primary care or a specialist(in this case a psychiatrist sounds apt). If not then you will be moved to another department, whether it be to surgery for a life saving procedure or just a medical floor for observation because they are not too sure of your condition/require further diagnostic testing.

 

[bluespeed]

That is what emergency department doctors do, they make sure you are alright to live. If they come to that determination then they send you out the door with a referral to your primary care or a specialist(in this case a psychiatrist sounds apt). If not then you will be moved to another department, whether it be to surgery for a life saving procedure or just a medical floor for observation because they are not too sure of your condition/require further diagnostic testing.

This. You can't expect doctors at ER when they see nothing too wrong with your body to sit next to your bed and talk for 3 hours about every possible interaction of all drugs you ever took with you, they are there for emergency conditions that require immediate intervention.
Random panic attack is not of those. Although I'm not trying to mock you for how you felt, I know personally (and so do a HUGE portion of bluelighters, I'm sure) how scary an actual panic attack, or more generally let's say a sudden crippling anxiety, feels, but it's not something they should or even COULD treat in ER, especially if there is connection with illegal drug use.
Your only bet is psychiatrist or MAYBE a very nice general practice doctor IF you have good relationship with him/her. Psychiatrist's job is to carefully listen to your every word and consider everything and they shouldn't look down at you for whatever drugs you did and should be able to help you understand and prevent similar situations.

 

[Dunno]

You have to remember that docs and nurses in Hospitals have to deal with drug patients all the time and from someone I know they come to work with another patient thinking "why do we bother" when we can be helping someone else who needs help who doesn't bring it upon themself.

 

[sghouston5]

Thanks everyone for the reply. For some reason its difficult to even get out of bed. I've been in bed 72 hours...I'm not sure what's happened to me ..

 

[cj]

You have to remember that docs and nurses in Hospitals have to deal with drug patients all the time and from someone I know they come to work with another patient thinking "why do we bother" when we can be helping someone else who needs help who doesn't bring it upon themself.

They should quit if that's how they feel.

 

[dopemaster]

My two cents here:

Your "friend" is you. We don't swim here.

If you want a doctor to take you seriously I wouldn't tell them you are a junkie. I think maybe you got a mental health thing going on, most likely panic and anxiety.

I guarantee you that if you tell them you take drugs they won't prescribe you benzos which usually help with anxiety.

So if it was me and I was having alot of anxiety I would lay off the drugs and see a doctor and not mention the drug use.

 

[RTrain]

They should quit if that's how they feel.

In that case we would be shit out of luck finding nurses to fill most the EDs in this country. I can't say the same about doctors, they typically conduct themselves more professionally (what they say and do behind closed doors might not be the same, also I don't interact nearly as much with them so its hard to say). But an ED dr is responsible for many patients, some who may be terminally ill and its the dr who has much weight on his shoulders to make the right decisions.

This is not a matter of the docs/nurses saying "screw this guy he brought it on himself", its a matter of there being more pressing matters and really nothing else they can do in the OP's situation. If a person came into the same ED in cardiac arrest from a drug overdose the doc/nurses would not treat the situation any less seriously than a non drug related cardiac arrest. I doesn't matter that the person who OD'd "brought it on themself". Similarly, if someone walks in that ED having a panic attack who has never touched a drug in their life, the hospital ED will assess, treat (if necessary), stabilize and release, just as they did in this situation.

 

[Dunno]

They should quit if that's how they feel.

She didn't mean it literally. It was a "drugs aren't that bad, they should have explained to me (even though I know) what caused it sort of me saying drugs are good if you know what you are doing"...and the other time a few years ago..I suppose with some drugs it's expected like a bad acid trip and someone who takes acid knows it can go wrong.. I am bad with explaining things. She loves her job and does everything she can for patients (so do the others)

 

[Dunno]

In that case we would be shit out of luck finding nurses to fill most the EDs in this country. I can't say the same about doctors, they typically conduct themselves more professionally (what they say and do behind closed doors might not be the same, also I don't interact nearly as much with them so its hard to say). But an ED dr is responsible for many patients, some who may be terminally ill and its the dr who has much weight on his shoulders to make the right decisions.

This is not a matter of the docs/nurses saying "screw this guy he brought it on himself", its a matter of there being more pressing matters and really nothing else they can do in the OP's situation. If a person came into the same ED in cardiac arrest from a drug overdose the doc/nurses would not treat the situation any less seriously than a non drug related cardiac arrest. I doesn't matter that the person who OD'd "brought it on themself". Similarly, if someone walks in that ED having a panic attack who has never touched a drug in their life, the hospital ED will assess, treat (if necessary), stabilize and release, just as they did in this situation.

Explained it better than me! Spot on!

 

[《Plasticity》]

I'm not too familiar with tapentadol but if it has any norephenepherine/SSRI effects like tramadol then I believe the combo of tapentadol and MDMA would be the main culprit. Tramadol is known as a big no-no when combined with MDMA, FWIW. Tramadol and MDMA puts you at risk for seizures and serotonin syndrome so if tapentadol is one of those 'dirty' opioids that hit a wide array of receptors I would be more careful when consuming it in poly-drug combos.

 

[missmeyet?]

In that case we would be shit out of luck finding nurses to fill most the EDs in this country. I can't say the same about doctors, they typically conduct themselves more professionally (what they say and do behind closed doors might not be the same, also I don't interact nearly as much with them so its hard to say). But an ED dr is responsible for many patients, some who may be terminally ill and its the dr who has much weight on his shoulders to make the right decisions.

This is not a matter of the docs/nurses saying "screw this guy he brought it on himself", its a matter of there being more pressing matters and really nothing else they can do in the OP's situation. If a person came into the same ED in cardiac arrest from a drug overdose the doc/nurses would not treat the situation any less seriously than a non drug related cardiac arrest. I doesn't matter that the person who OD'd "brought it on themself". Similarly, if someone walks in that ED having a panic attack who has never touched a drug in their life, the hospital ED will assess, treat (if necessary), stabilize and release, just as they did in this situation.

Don't always count on that (and that comes from 20 years in the medical profession).

 

[black53]

A lot of that comes from the fact that doctors/nurses simply don't know much about lots of drugs, especially about the rarer stuff (or rcs). They want to help you, but just don't know how. I have a few friends that are doctors and I had to explain to them how certain drugs work and what would be a good treatment for an od (not bragging at all, but ods, especially with some rarer drugs/rcs are, unless the doctor in question has a personal interest with the stuff, just aren't a good use of his/her time to learn about them). The fact that the blood tests they run don't aren't specific enough or miss some things (especially rcs) doesn't help either.

 

[RTrain]

Don't always count on that (and that comes from 20 years in the medical profession).

Which part? That workers in the ED will try just as hard to save a person who brought it upon themselves as someone who is an innocent victim? Let me tell you, I wouldn't count on anything, I would just hope that I get fair treatment if the need arises.

 

[Halif]

They should quit if that's how they feel.

It's probably not as black and white as that, but I am biased due to my awful experiences and thus I tend to agree. The impact that doctors and nurses have not only on their patients, but the members of that patient's family can cause an enormous amount of grief and bitterness which hangs around for years and years.

I saw too many doctors and nurses who were obviously burned out when I was in and out of the hospital when my father was dying of liver disease. There are so many stresses piled upon people working in a large busy hospital, and I'm always sympathetic to the challenges faced by people in high pressure jobs. However, the stress of watching my father die meant I was very emotionally vulnerable, and some of the words and actions of the doctors there were very poorly chosen, judgmental, and not kept out of ear-shot of my mother, my brother or myself.

I will never forget some of the harshness shown to the my mother and I during those times, and I can't help but feel that those experiences are stuck with me and have since (that was seven years ago now) meant that I avoid medical treatment and would, in all honestly, rather die alone than go to a place where the staff see the patients as "things" and are too tired, fed up, or simply worked into the ground to attempt even the most robotic pretense of caring or acknowledging the patients as people. Half-carrying my mother, who had been reduced to tears by the callous words of one nurse, out of the hospital in the days leading up to my father's death, I was filled with anger. Seven years later, and I can still feel that anger. I want to let go of it, because it's toxic, but as I said I was about as vulnerable as I've ever been at that time, and the total lack of empathy from two staff in particular made me lose faith in the medical system.

To the OP: Tapentadol is some pretty weird shit. MDMA, anti-depressants (if you're friend is taking them), and tapentadol is a combo that could cause strange things to happen, even quite a while after the substances were consumed. Does your friend take tapentadol regularly?

 

[omnipresenthuman]

My suggestion is to get a check up with your family doctor or a specialist and get an EKG test on your heart done, at the least.

A psychiatrist is a possibility I've seen mentioned by a number of people, but that's really up to you...mental health is your own business, only you know what's really going on in your head...however, your physical health can be monitored and, hopefully, fully restored, if possible.

I've done a lot of dumb shit with coke and amphetamines that I see no point in detailing again here but all I can say is that your heart should not be fucked around with, whether you're going through a panic attack or a full blown cardiac arrest.

My advice would be to lay off all drugs indefinitely...and at least for a half year to give you some peace of mind. Also, avoid alcohol, it won't help...other than that, yeah, I've never been, but, from what I know, ER/ED doctors and nurses are just there to make sure you're alive and that you can leave the premises in one piece. There is absolutely no sympathy there, and it shouldn't be expected, regardless of why you're there. It's easy to forget but normal, completely sober people have to deal with the exact same bullshit from health/safety personnel.

Also, yeah, in the OP's 2nd post on this thread, it's pretty clear that he and 'his friend' are the same person...but damn, staying in bed for 72 hours straight is not a good sign. You could legitimately have a real medical issue, probably with your heart, if I had to guess.