The opposite of "emergency"

[Estrace]

And to be honest, I'm not looking for sympathy. When I left the ER on Monday, I summed up the whole experience as just one bad ER experience. I was on Facebook and this celebrity was going off about her experience at a CVS pharmacy two days ago. I read through the comment section and a lot of people were agreeing with her while I didn't see anything wrong with what the pharmacist did. So I decided to educate myself a little bit my coming on the ER subforum. It is always easy for us to get offended when we are at the receiving end.

---

Members don't see this ad.

 

[Birdstrike]

You seem to be the only one that understands my issue with this doctor. Yes, the NPO order wouldn't have been an issue if he actually show any concerned or even took more than 2 minutes to listen. I actually didn't feel like I was being punished until the evening shift nurse came in (almost 10hrs into the whole ordeal). The first thing the doctor asked me when he came in was what brought me in that day? I felt like I needed to give him some back history so that my compliants that day will make a little sense to him but he wouldn't let me. He cuts me off and proceeded to ask me to tell him why I came in that day? So I told him the issues I was having that day.
The first time I went to the ER for this issue, the doctor that saw me was very patient. I showed her some pics on my phone , gave her history of my battle with this illness, told her what I thought it was and why no doctor will give me a diagnosis. She listened, helped me the best she could, and gave me name of a rheumatologist to see. Even went as far as calling them the next day for me to make sure I get seen immediately.
I have seen eight specialists (4 rheumatologists )in the past six months and only my hematologist agreed with me that I have some type of connective tissue disease. I have all the symptoms (some are just presented differently) but all my lab results comes back clean except for a positive ANA test. I get flare up every couple of weeks and they differ in severity. Sometimes, it can be excessive dryness (dry eyes, dry mouth, dry skin) and I deal with those. Other times, it's massive inflammation (I can feel my organs swollen), my voice will change and I will turn pale. I have only gone to the emergency department for this because it scares me.
I understand that this disorder is very hard to diagnose because it's several things presented together but I can't help it when I get those scary systemic inflammation. I wish more doctors know how to handle cases that don't fall within the standard guideline . I will never go to an ER to look for an answer for this type of illness because I know they are not equipped to provide me with an answer. This is also all new to me as well and sometimes, I get symptoms that will scare me enough to head straight to the ER.

It sounds like, in addition to your likely real underlying Rheumatologic condition, the primary thing that caused you to go to the ER at this given time, was not your disease particularly, but your anxiety surrounding your condition. Am I correct?

 

[MSUSpartan642]

Mobile version posted in wrong thread.

 

[MSUSpartan642]

Delete

 

[Birdstrike]

Many times an emergency physician is under tremendous stress and time pressure. This should be obvious, but to many it's not. Life and death decisions and events are the norm. The hours are stressful sometimes being upside down nights, holidays and everything in between. You may walk out of a room having pronounced a baby dead, or told a 29 year old new mother her scan shows cancer, all the while realizing the waiting room just filled full of twice as many patients as you can possibly see and in the morning your boss is going to insist there should have been a way you could have done the impossible by seeing them all in a pizza-delivery 30 min or less with a smile. You know the monday morning quarterbacks and specialists will always say they would done it better, more perfectly, once you have sorted the facts out of the chaotic fog of the unknown, and lined the facts up neatly for their well rested Monday morning brains.

So you gather yourself together, you try to turn your stomach right side up and forget the dead two year old in the other room whose parents don't know it yet, who you're going to have to tell when they get here. And you try to forget the ambulance radio just chirped out "rollover motor vehicle accident 10 minutes out can't get an airway!" And you try to see just one more patient so the place doesn't blow up, while trying to forget your body just isn't made to be awake a 4 am, even though you know you're kidding yourself that it's even possible to stem the tide of chaos. The nurse comes and says, "This should be quick, see this one."

And you walk into the room and what you find is a person having what they feel is the worst day of their life, with concerns that are incredibly anxiety provoking to them, with a problem that very well may be real. But you know they're not dying. You know they have no life or limb threat. Your thousand of hours of training have taught you how to be able to do this almost automatically, quicker than anyone else possibly can. You try to smile. You try to do the best you can to ease their concerns and meet their perceived needs. And then you think about the dead kid in the other room and if the parents are almost here yet. And you wonder why no one has grabbed you and pulled you to the trauma bay yet, for the trauma that's not breathing who they can't get an airway on that you're going to have to find a way to do, and you wonder how many more have piled into the waiting room while you're thinking this.

And you try to smile. But it's not always easy. Sometimes it's very hard. But none of the others waiting know about the dead kid tearing your heart out, or the impending trauma fueling your own streak of anxiety and they certainly aren't concerned with the others before them or after them in the waiting room. After all it's not their problem. It's yours.

You try to smile, knowing it's likely never to be good enough, touchy-feely enough or Disney-like enough, even though the memo from the hospital CEO to your boss says that's how it must be. But all the while you know you've done what you thought you were there for, to save those dying or losing limbs, and to make sure the others weren't losing life or limb. But to some it will never, ever be good enough.

You try to smile.

 

[Estrace]

It sounds like, in addition to your likely real underlying Rheumatologic condition, the primary thing that caused you to go to the ER at this given time, was not your disease particularly, but your anxiety surrounding your condition. Am I correct?

No, that's not correct. I just explained above that I get flare up in form of systemic inflammation (similar to severe lupus flare up)

 

[MSUSpartan642]

I have seen eight specialists (4 rheumatologists )in the past six months and only my hematologist agreed with me that I have some type of connective tissue disease.

This difficult for me to talk with patients like this because I feel like they don't understand specialization. You have seen 8 SPECIALISTS and only one of them possibly agree that you might have this disease process. What makes you think an ED physician is going to give you answers that your looking for. Are you in the ED for empathy?

If you think you have some kind of GI disease process would you give up after seeing 8 specialists and just say "ah screw it I'll see a cardiologist. They have an opening today for them to see me." No that sounds crazy. ED physicians are trained for many specific tasks but one of those is not immediate diagnosis and treatment of complex diseases.

 

[GeneralVeers]

No, that's not correct. I just explained above that I get flare up in form of systemic inflammation (similar to severe lupus flare up)

Why would you think this was an emergency? You had already seen specialists, and had some general diagnosis for it. Knowing that it's a (non-emergent) "lupus-like-flare", what was your expectation about what the ED physician could do to fix it?

 

[WilcoWorld]

Many times an emergency physician is under tremendous stress and time pressure. This should be obvious, but to many it's not. Life and death decisions and events are the norm. The hours are stressful sometimes being upside down nights, holidays and everything in between. You may walk out of a room having pronounced a baby dead, or told a 29 year old new mother her scan shows cancer, all the while realizing the waiting room just filled full of twice as many patients as you can possibly see and in the morning your boss is going to insist there should have been a way you could have done the impossible by seeing them all in a pizza-delivery 30 min or less with a smile. You know the monday morning quarterbacks and specialists will always say they would done it better, more perfectly, once you have sorted the facts out of the chaotic fog of the unknown, and lined the facts up neatly for their well rested Monday morning brains.

So you gather yourself together, you try to turn your stomach right side up and forget the dead two year old in the other room whose parents don't know it yet, who you're going to have to tell when they get here. And you try to forget the ambulance radio just chirped out "rollover motor vehicle accident 10 minutes out can't get an airway!" And you try to see just one more patient so the place doesn't blow up, while trying to forget your body just isn't made to be awake a 4 am, even though you know you're kidding yourself that it's even possible to stem the tide of chaos. The nurse comes and says, "This should be quick, see this one."

And you walk into the room and what you find is a person having what they feel is the worst day of their life, with concerns that are incredibly anxiety provoking to them, with a problem that very well may be real. But you know they're not dying. You know they have no life or limb threat. Your thousand of hours of training have taught you how to be able to do this almost automatically, quicker than anyone else possibly can. You try to smile. You try to do the best you can to ease their concerns and meet their perceived needs. And then you think about the dead kid in the other room and if the parents are almost here yet. And you wonder why no one has grabbed you and pulled you to the trauma bay yet, for the trauma that's not breathing who they can't get an airway on that you're going to have to find a way to do, and you wonder how many more have piled into the waiting room while you're thinking this.

And you try to smile. But it's not always easy. Sometimes it's very hard. But none of the others waiting know about the dead kid tearing your heart out, or the impending trauma fueling your own streak of anxiety and they certainly aren't concerned with the others before them or after them in the waiting room. After all it's not their problem. It's yours.

You try to smile, knowing it's likely never to be good enough, touchy-feely enough or Disney-like enough, even though the memo from the hospital CEO to your boss says that's how it must be. But all the while you know you've done what you thought you were there for, to save those dying or losing limbs, and to make sure the others weren't losing life or limb. But to some it will never, ever be good enough.

You try to smile.

No, that's not correct. I just explained above that I get flare up in form of systemic inflammation (similar to severe lupus flare up)

You tell him! Birdstrike foolishly tried to use thoughtfulness and empathy to frame an alternate, more charitable interpretation of your experience.

Clearly he doesn't understand what an emergency is.

 

[Psai]

You seem to be the only one that understands my issue with this doctor. Yes, the NPO order wouldn't have been an issue if he actually show any concerned or even took more than 2 minutes to listen. I actually didn't feel like I was being punished until the evening shift nurse came in (almost 10hrs into the whole ordeal). The first thing the doctor asked me when he came in was what brought me in that day? I felt like I needed to give him some back history so that my compliants that day will make a little sense to him but he wouldn't let me. He cuts me off and proceeded to ask me to tell him why I came in that day? So I told him the issues I was having that day.
The first time I went to the ER for this issue, the doctor that saw me was very patient. I showed her some pics on my phone , gave her history of my battle with this illness, told her what I thought it was and why no doctor will give me a diagnosis. She listened, helped me the best she could, and gave me name of a rheumatologist to see. Even went as far as calling them the next day for me to make sure I get seen immediately.
I have seen eight specialists (4 rheumatologists )in the past six months and only my hematologist agreed with me that I have some type of connective tissue disease. I have all the symptoms (some are just presented differently) but all my lab results comes back clean except for a positive ANA test. I get flare up every couple of weeks and they differ in severity. Sometimes, it can be excessive dryness (dry eyes, dry mouth, dry skin) and I deal with those. Other times, it's massive inflammation (I can feel my organs swollen), my voice will change and I will turn pale. I have only gone to the emergency department for this because it scares me.
I understand that this disorder is very hard to diagnose because it's several things presented together but I can't help it when I get those scary systemic inflammation. I wish more doctors know how to handle cases that don't fall within the standard guideline . I will never go to an ER to look for an answer for this type of illness because I know they are not equipped to provide me with an answer. This is also all new to me as well and sometimes, I get symptoms that will scare me enough to head straight to the ER.

Basically you need a therapist. There's no time for empathy in today's corporatized medicine

 

[Apollyon]

You tell him! Birdstrike foolishly tried to use thoughtfulness and empathy to frame an alternate, more charitable interpretation of your experience.

Clearly he doesn't understand what an emergency is.

Well, to be just, (s)he (as I am guessing female, but not sure) DID "like" that post from Birdstrike that you quote.

 

[WilcoWorld]

Well, to be just, (s)he (as I am guessing female, but not sure) DID "like" that post from Birdstrike that you quote.

Hmm, I missed that.

I was initially inclined to write a post similar to the "liked" post, but Birdstrike beat me. Then I read was seemed like a dismissal of said post and got a bit snarky. My bad.

That being said, the fact remains that (s)he is, at base, complaining about spending hours without eating in the ED. This happened after the EM doc initially tried to discharge (s)him. (S)he insists that the doctor didn't listen, but the initial plan was actually correct - this (patient-driven) extended work up only ended up making the patient's life worse.

This all serves to demonstrate the point of this (and other) threads. The ED should not function like Burger King. When it does, it is ultimately the patient that suffers.

 

[Birdstrike]

You tell him! Birdstrike foolishly tried to use thoughtfulness and empathy ...

I know, right? What was I thinking?

 

[Birdstrike]

Hmm, I missed that.

I was initially inclined to write a post similar to the "liked" post, but Birdstrike beat me. Then I read was seemed like a dismissal of said post and got a bit snarky. My bad.

I thought it was one of my better all time posts, but...hey, what do I know? You can't please 'em all. Lol