Before I was diagnosed I went to the ER for pain and swelling. The doctor gave me a cortisone shot in my hand which was welcomed by me. He presumed I had something called Trigger Finger which I likely did but it was likely caused by the PsA which I still didn't even know that I had. It was in the finger where the PsA started of course.
I agree with you. My dr. gave me a prescription for Prednisone in case of a bad flare. It has helped me so far.
GrumpyCat said:
I think everyone needs an emergency plan in place for flares. 3 days worth of steroids, toradol, and a pain med with instructions on how an when to use the meds. It's one of the first things a rheum should give and tell a patient how to use it, why they are getting it. If I had known how to treat myself or even had the meds to do so, I don't think I would have relied on the hospital at all (except for that severe flare where they did admit me. I just wasnt capable of coping at that time).
I wouldn't say that everyone who goes to the ER for PsA is "drug seeking". Technically, this is true (semantics). When I go I want some IV steroids and IV or at least IM Toradol, so technically, I am seeking drugs. However, the term "drug seeking" has such a negative meaning in the hospital. It's a label that a patient never wants to be given, and one that I will no longer put on a patient. A lot of times, people are ashamed enough with PsA, and inaccurate labels don't help. Maybe I'm too much of a softie now, but I can't even bring myself to use it when dealing with addiction cases.
I agree that if you feel bad enough to have a trip to the hospital cross your mind, then your doc needs to know. They may be able to help you avoid the trip. There are meds that can be called in, or they can even refer you to a good urgent care clinic that they work with routinely. You can get medications and treatment without the expense or time investment that the ER requires. Also, if you're really sick, the doc who knows you best should be in the loop.
tntlamb said:Chest Pain is something they can do something about IF its not PsA. Beyond that the ER can't do a thing for PsA (or any chronic condition) beyond giving pain meds. If they could every Rheumy in the country would be out of business. So the bottom line is pretty simple Unless you have an emergency that is not PsA related you are drug seeking no matter what else you call it, you are drug seeking. Now I'm not saying that there aren't times when that isn't appropriate but you don't just show up. A referral from your PCP or rheumy is helpful or even standing orders. (I have a tordol script on demand) Chances of them actually medicating you at all are becoming slim and none especially if you have scripts for pain meds already. In most states all narcos are on an accessible data base. they will not give you more with out the prescribing Docs orders.
They are not going to insert themselves in the middle of a treatment protocol already in place.
Now there are of course exceptions like a loss of neurolgical function etc. But again a call to your doc before presenting yourself in the ER is helpful.
If you in any way shape or form bitch about your doc not taking care of you, not taking care of pain etc etc., or ask for a referral to a different doc who will take better care of you etc etc. they will throw you out.
Debee, my Rheumy says that the meds for PsA have the amount of pain medication I need. If the pain is under control, it is the correct medication. If not, we need to notify the Rheumy.
Seenie said:
Debee, you're not alone at all, as you can see. Your question about pain relief medications that people use is a good one, but at the moment, it's buried in the ER thread. If you start a new thread (top of this panel, +Add) it will stand out and you may get more responses.
Debee said:It is a good feelibg being on this site. I dont feel so alone with this crap. My sister has Lupus and CREST and I always say people looking at her yeh right and now she is addicted to pain meds because 10 years ago when she first got sick that was handed out like candy. Now when I go to the Dr for something that is less knoen about they look at me like here comes another one... I am a mother of two. I dont like taking pain meds. I only take whrn I have to. I usually can keep a RX for about 6 mths. I cant not take tramadol it makes my heart race. I cant take tylonal because the meds I am on bother my liver and tylonal can make it worse and Ibriprophen messes with the effects of my methotrexate and enbral. Any suggestionson what to talk to Dr about when I go in 2 weeks?