My first visit to an Emergency Room in over 15 years was December 19th, 2014, and it went badly. I found little has changed in how pain patients are treated in those 15 years.
I have chronic pain from a failed lumbar back surgery in the 80's. It left me with low back pain, muscle atrophy and neuropathy in my legs and feet. For those who don't know, neuropathy is nerve pain. It can be different for each person, but for me it's a burning feeling, with electrical shooting pain, like someone hitting the edge of my right foot with 110 volts at random times all day.
But this was something new, I hurt something in my mid back bending over hooking up some wires in our home. It's like there's a knife to the left side of T-10, the pain radiates around my ribs, sometimes it feels like it goes straight through me . My low back is one thing, I can usually find a position of comfort, but this is different. It's always there, it ranges from feeling like a knife in my back, to someone pushing very hard with their thumb in that one spot.
I had taken my usual dose of pain meds, after an hour there was no relief, it was so bad, I took a second dose. Another hour went by, and the pain was still bad, so I woke my wife up about 1:00 AM. When I told her I needed to go to the ER, she got pretty worried. We've been together 10 years, I don't complain about my pain, and I've never gone to the emergency room since we've been together. Thats the one thing they did drill into us at the pain clinic I went to, no one want's to hear that you hurt, they've heard it, they know, shut up.
When drove the 40 miles or so to the Kingman Regional Medical Center Emergency Room in Kingman. They were nice enough, I told them I had chronic pain, I took opioid pain medications, and had a high tolerance. They could see I was hurting, my blood pressure was the 180/104 range, so they gave me 4 mg's of morphine. They did all kinds of blood work, urine tests, and a CAT scan of my abdomen. Remember my complaint is mid back, and rib pain.
The nurse said I had to wait an hour to see if the morphine was going to work. As a paramedic I have given iv morphine to patients many times, and it works in minutes, not an hour. The nurse stopped by about 30 minutes later, I told her there was no relief, and when she checked my BP was still very high. The tests and CAT scan showed no problems, so they didn't know what to do.The nurse could see I was still in pain, so the doctor ordered 1 mg of dilaudid IV.
In about half hour, they repeated the dose. Then one of the doctor's said they had given me as much of the most powerful drug they have, so I need to follow up with my pain doctor. As a paramedic I was trained you titrate the dose of pain medications until you receive the desired pain relief.
My blood pressure was still in the 175/100 range, by the time we got home, my BP was over 180/100.
As a paramedic I would have been taking the patient to the emergency room, not discharging them with a BP that high. I was trained that a hypertensive crisis "was a severe increase in blood pressure that can lead to a stroke. It's a systolic pressure (top number) of 180 mm Hg or higher, or a diastolic pressure (bottom number) of 120 mm Hg or higher, and can damage blood vessels causing strokes, and other bleeding conditions.
I was very disappointed in the treatment I received at Kingman Regional. I saw my pain doctor earlier in the week, he saw how much pain I was in, and increased my pain meds. He also gave me three shots of lidocaine in my back in hope of getting it to settle down, but the shots only lasted a couple hours.
Second Visit to KRMC ER
On January 5th, the pain was getting unbearable, so I went to see my primary care physician. She was worried about my level of pain, and my blood pressure was still too high. I told her on my last visit to KRMC ER, they did little to control my pain, and sent me home with a BP of 168/102. She didn't say anything, but cringed as she made notes in the chart.
Around 10:00 AM she sent me to KRMC ER to get some help with the pain. I told her last time the ER didn't take my pain seriously, and asked if she could call the ER and let them know I was coming. She said she would call the ER annd let them know about my back pain. We drove the 10 miles or so into Kingman and KRMC ER.
At intake they asked what medications I take, and explained how the pain radiates from my back, around my ribs, and it had been going on for several weeks, and was made better for a day or so after the chiropractor adjusted it. For some reason they assumed it was cardiac related, started two IV's, and gave me aspirin to chew. I kept telling them I had back pain, not chest pain, and I was not short of breath.
It was busy around me, when an older doctor came by and said, "you have chest pain", I said no, he said, "you're short of breath", and again, I said no.
He wasn't listening to me. He wasn't asking if I had chest pain, or if I was SOB, but telling me I had chest pain and SOB. We tried telling them it's my back, not my heart. I told the doctor I didn't want to go to the cardiac catheterization, unless it was absolutely necessary. He just ignored me.
Next thing I knew I was given a paper to sign, and I was in the cardiac catheterization lab. I also see in the medical record the doctor said he had, "explained procedure alternatives possible benefits and possible complications were all thoroughly explained to the patient, who understood and agreed". That's not true....
After telling me I had chest pain, and SOB, he handed me a paper, and said if it was necessary to put in a stent, or something else, I forget the name, was necessary, they would wake me up, and discuss it. At no time did my wife, or I understand I was on my way to the Cardiac Cath Lab right then. I was sitting in the hall when someone came out and told me my heart was normal, and I could leave.
I asked about my back pain, the reason my primary care physician had sent me to the ER was to control my back pain, not chest pain. The cardiac doctor told me the ER had discharged me, and sent me to him, if I wanted something for my back pain, I would have to get dressed, go back to the ER desk, and start all over again. At this point I wanted nothing to do with Kingman hospital.
I've filed complaints against the physicians involved with the Arizona Medical Board, the Board of Osteopathic Examiners, and the Joint Commission on Health Care Accreditation.
Until patients start filing complaints against physicians, hospitals, and pharmacies who fail to take pain seriously, nothing will change. Please if you feel your pain wasn't properly treated by your physician, or if you're treated like a drug addict for trying to fill a prescription for legal pain medications, prescribed by a licensed physician, please file a complaint.
Write to your legislators, tell them about how you are treated by physicians, and pharmacists, simply for suffering from chronic pain.
Update
The cost for my second visit was a little ove $47,000
