Absolutely Livid!

[UpInFlames]

My seventy-two year old best friend was admitted to the hospital with kidney stones and diverticulitis 3 days ago.

Due to 3 failed back surgeries and other chronic pain, she is under pain management. She has been on 10mg oxycodone APAP 3x daily, and 15mg IR morphine 3x daily for quite some time now.

Yesterday AM, she woke up violently ill, cramps, explosive diarrhea, bone pain, chills, sweats, RLS, etc. She was hauled from one place to another for tests, including a brain scan because she was having difficulty speaking coherently and a stroke was suspected.

You can probably guess, from her symptoms, what was wrong with her...turns out that the admitting physician DISAPPROVED of the pain medications prescribed to her by her pain medication doctor and didn't write for them when she was admitted.

My poor friend was in full-fledged withdrawal on top of her original illnesses. As of 11PM last night, her attending nurse was frantically, once informed of the fact that my friend was dependent upon these narcotics and under the care of a PM specialist, trying to reach a physician who could RX opiods for my friend.

The attending physician prescribed 1mg of lorazepam because my friend was agitated (who wouldn't be?) and being "unreasonable".

My friend's wife, once I told her that her wife was in withdrawal, ran home, grabbed B's pills, and had to be talked out of giving them because it was breaking her heart to see B suffering like she was.

B is 72. The admitting/attending physician wants her on suboxone to "get off the narcotics" and has referred her to a clinic when she is released.

B's wife went bananas and nearly got tossed out of the hospital.

B is dependent on opioids for pain control. She's been on them for many years under the care of a specialist whom she sees monthly. What right does some damned "hospitalist" seeing her for the first time, have to override patient care decisions made by a doctor who has been seeing and prescribing for a patient for years?

Do my friend and her wife have any legal recourse here? My friend has other complicating illnesses and is physically rather frail. I am concerned for both her physical and mental health as a result of this asshat cutting off her meds.

Also, if she got her meds yesterday night late, she would've been off the narcotics for 3 days. Is it safe for her to resume taking the meds at the old dose or would she have lost tolerance that quickly? Conversely, if it is safe for her to resume the meds at her old dose, would the old dose be enough to pull her out of withdrawal, or would she need a higher dose to do that?

I realize that compared to many recreational users, she was taking a small dose of the meds. She could actually use an increase for better pain control, but is concerned about falling if she increases her dosing.

I am going down to the hospital shortly when visiting hours start, as I have a bit more medical knowledge than B's wife does, and I'm also 20 years younger and (putting it politely) have no hangups about taking on doctors or other "authority figures".

I guess the moral of this story is that if a doctor decides you're a junkie, you're a junkie, and they have the right to cut you off, no matter how or why you are using drugs they disapprove of.

 

[placid space]

Yeah, this is typical for 90% of cops and doctors. I really despise them sometimes for the holier than thou attitude. A guy I know was arrested not so long ago and he had a monster tolerance. Benzos, opiates, alcohol, you name it. Had a few prescriptions, so it was in his chart also.
Cops didnt give a cr+p.
Doctors didnt give a cr+p.
Judge didnt give a cr+p (as in we'll figure it out later). At this point,he was in an extremely bad state already and felt unconscious directy before the judge.

Instead of helping they look down on addicts. And its not just that, in many the sadist in them comes out in a subtle way, they enjoy seeing one squirm because they define you as a bad guy, less of a person than them, a problem for society or whatever rationalization them find handy at the time.
Sometimes you wish they would be faced with their kids getting addicted so they would see addicts are people like them. Though honestly I wouldnt wish it on anyone. It just sucks sometimes how closeminded most people are.

 

[UpInFlames]

Well, as of a few minutes ago, my friend still hasn't gotten her pain medication, but has been put on Lyrica and Lorazepam, so is at least getting some meds to help with some of the discomfort she is experiencing from the WDs. Problem is, she is in a hellish amount of pain from her back problems and the kidney stone.

This asshat is definitely a sadist. Absent B's chronic pain issues, he's lefta patient to pass a kidney stone without pain medication.

He found it in him to order ibuprofen 600 mg every 6 hours. Isn't that just wonderful of him? B has a rod in her back that's shifted and isn't a surgical candidate due to severe osteoporosis.

At this rate, she'll be over the physical part of the WDs by the time she gets (if) her pain meds. She doesn't seem to be having cravings, she just HURTS real bad.

I am running down to pick up B's wife in about an hour. We will go over a list of issues to take up with the hospital ombudsman and director of nursing, and hopefully, with my help, B's wife will be able to light a few fires under a few asses.

The sad thing about B being treated like a "dirty addict" is that she's so careful with her damned meds that she sets an alarm to go off every 6 hours to make sure she doesn't take a pill too soon.

Meanwhile, since B's wife has her medical Power of Attorney, I told her to request a copy of B's medical records as I'm extremely concerned that there's an entry about drug seeking behavior in there as B's been asking for pain medication.

At least she's totally Benzo naive, so the 1mg of lorazepam is making her sleepy, which is good. The diarrhea seems to be easing off, which is a blessing as B needs help getting in and out of bed and help hasn't come in time several times, which is horribly humiliating for B.

It should be criminal to do to an elderly patient. hell, ANY patient, what they are doing to B.

 

[placid space]

Im not suggesting anything. But If it was me, I definitely would take her meds to her no matter what the doctor said. There is absolutely no need for her to be in pain. Unlesss of course there would be some problem in mixing it with some other drugs she is on. She has legitimate pain, she shouldve gotten her meds. Regarding the dosage. If she was on 10mg x3 plus morphine IR x3 per day, now after a couple of days her tolerance hasnt dropped significantly but nevertheless, Id start again with 10mg and go on from there depending on how she feels after an hour after ingesting it to be safe. 10mg is not a lot even for tolerance naive unless one has an extremely unusual low tolerance. And talking about going on subutex and doing it is something different. Until they intend to do it and tell her the plan she is just waiting in pain for no reason. But thats just my opinion.

 

[UpInFlames]

Well, as of now, the admitting physician is gone for a long weekend, and another doctor has taken over. The new doctor had a royal fit about the drug situation, prescribed the oxycodone APAP, and morphine.

She stood over B and a nurse while the nurse administered 15mg of morphine IV, which scared the crap out of B because of the rush. Once we all, including the doctor and nurse, assured B that she wasn't going to die and the doctor explained that she was doing it this way to make her feel better as quickly as possible, B basically sat back and enjoyed the ride. Future morphine doses will be administered orally.

An hour after she was given the morphine, she was lucid, albeit rather euphoric, and cooperative. She was given her dose of oxycodone once her vitals had been checked again.

When I left, she was sleeping comfortably which was a wonderful sight to see.

The new hospitalist asked B's wife to bring her meds from home in case she was cut off again by another physician. This doctor said she'd cover B and her wife, if B took meds from home if needed.

Now, this new doctor did schedule a psych consult, because she doesn't feel the unreasonable and oppositional behavior and cognitive issues were due entirely to withdrawal, and the neuro stuff was normal.

I don't know about that, but I do know that half an hour after that IV morphine, the old B was back in the house, lucid, and sharp as ever.

B's wife did talk to the pain mgmt doctor and he flipped about the suboxone issue, saying there was no reason for it, and besides, if B were to decide she wanted off the narcotics, it would be much easier to humanely withdraw her from the actual meds, than try to get her off of suboxone at a later date.

B's meds do not in any way impair her functioning. PAIN impairs her functioning and the meds make her more functional. Without them, she has very little quality of life.

As it turns out, the pain mgmt doc feels B is undertreated.He's wanted her on the patch with morphine for breakthrough pain, but for some reason B refuses that route. I think because her wife, who is in remission from bone cancer, uses the patch and B doesn't feel her pain is as bad as her wife's is.

Oh well, at least for the time being, her pain is being treated and she's out of withdrawal, though still very sore from the muscle spasms in her legs, back, and neck, and with very sore "parts" from the vomiting and diarrhea.

J and i did raise some serious hell with the droids in charge, and later this evening, I will be drafting a letter for J's approval, that will be sent to the management of the hospital and the Sister's of Mercy who actually run it. A letter will also be sent to the accredidation boards as soon as i find contacts for the state boards.

I also had J tell the doc to pull B off the damned benzos as she no longer is agitated and doesn't need them.

 

[SmokingAces]

Glad to hear at least she got given the necessary medication in the end. It amazes me hospitals choose to go against the of local doctors, it's like they think they know better, they should learn to respect others in their trade. This was clearly a very bad idea from the off how they failed to see it as supposedly qualified professionals is baffling.

 

[RedRum OG]

Doctors hate hate hate opiate addicts, whether they are using legally and prescribed or not

I can't count the endless, tortured hours inflicted on me by horrible, ignorant, clueless, and careless doctors. I don't hit up doctors for scripts, I never even ask them to give me my current script or methadone while in the hospital. Yet still, I am treated like I am robbing them if I ask a friend to bring me my methadone. And if I am in withdrawals "you deserve it" "here's some Tylenol"

No legal recourse, ever. We are the forgotten folks.

 

[Felonious Monk]

You should speak to the hospital administrator. Use words like emotional distress.

DO NOT believe that you have no recourse. The fact that the 2nd doctor came in and reversed orders immediately is excellent, shows he was concerned about the other doctor's treatment. Sending those letters is an excellent idea, especially to the licensing boards.

Getting that Doctor dismissed from the hospital or suing the hospital for monetary compensation of emotional distress and/or malpractice are not out of the question. Your friend being a 72yo nice old lady (I'm assuming about the nice part), gives you more recourse than the average patient.

I would almost encourage you, because she may have more luck than the average middle-aged person who may in fact not have much recourse. The fact that she has 2 doctors on her side makes me feel you have a case. I'd say definitely talk to the hospital administrator, and if you feel they do not address your concerns, call a lawyer.

 

[manboychef]

Yeah I would definitely sue. It isn't for the money, but to send a message. This type of treatment of people is not very progressive, and borderline sadistic.

 

[Formidable]

look at the original doc's credentials, if it says "DO" and not "MD" then i'm not surprised they took that course of action, DOs tend to take a more holistic approach to medicine. which PISSES me the fuck off, DOs should not be allowed to practice in an ER setting (IMO).