When you have a chronic medical condition sometimes you have chronic pain that is not easy to handle without medications. Due to strict laws through out the U.S., most of the time your general practitioner cannot provide you with the medication that you need, so they refer you to a pain management doctor. Most of the time, these doctors are trained in anesthesiologist who have concentrated their studies in pain management.
I have had the pleasure of dealing with PM doctors over about the last 10 or so years. Some of them were amazing and knew what they were doing, how to treat the pain appropriately and understood how having chronic pain affects your daily activities and your life. There have been many evenings I have been in so much pain, that medications did not touch, that unfortunately I ended up in the ER.
Treatments in the ER range the same way depending on the doctor. You could have amazing care or you can have a doctor tell you they cannot treat you. Break through pain happens! If you are in a contract with a pain management doctor, those contracts apply to prescriptions, meaning you cannot have another doctor write you a prescription for pain management (ex: narcotics, muscle relaxers, ect). However, this contract does not apply to break through pain that your medications are not controlling, which then leads you to the ER. They can treat you for that particular episode, but not write a prescription.
My recommendation for those who have a severe break through of pain that is not able to be controlled by your regular medication, to call your PM doctor before heading to the ER. Always maintain a honest, opened relationship with your PM, so that there is trust between the doctor and patient. This also helps you when you go to the ER, because your doctor can always call ahead and let them know the best way to treat your pain during your visit. Also, remember a follow up with your PM is very necessary.
I can tell you that certain ER doctors will not treat the break through pain, either because they do not understand chronic pain or because they absolutely refuse. Due to the influx of people seeking out pain medications some doctors are very hesitant to treat these conditions in the ER. Many people whom have chronic pain are viewed as drug seekers to the medical communities. It is very important not to hop around to different ERs to treat your break through pain. This will alert every hospital in your area, which in return they will see you in a negative light.
Also when or if you have to go to the ER, have your medical history typed or written out to give to the triage nurse. This way they are aware of every condition you have been diagnosed with, your surgical information, your allergies, and list of all the physicians that are currently treating you for all your health conditions. (See my post on traveling with medical conditions.) This information can help the medical staff at the ER treat you efficiently and with the care and consideration you deserve!!!
Understand that every condition and person will be treated differently, due to medical background and history. Also note that the ERs first step is triage to access you and the your needs for treatment. Depending on the ER, you may have to wait longer than others depending on their conditions and the level of medical treatment they require.
However if you feel that you have not been treated adequately or have any other issues, you have the right to a patient advocate. This may help your process and provide constructive feedback for the hospital when dealing with patients who have chronic pain.
I hope this gives you some insight and helps your battle with chronic pain. Please note that all states are different and have to follow policies and procedures laid out by the hospital and state laws. Look for future posts regarding pain management!
Shuffle on my friends!!!!
Written 29th January 2015