Friday, July 6, 2007

Just for the record....

If you have had recent hip replacement surgery,

and your hip becomes dislocated when you bend over to pick something up,

and EMS had to give you narcotics just to load you on their stretcher,

and you are lying on my gurney in a horribly contorted position with silent tears coursing down your face,

and you rate your pain as 10/10,

there are two things that you must know.

1. I believe you.

2. You don't need to apologize for being a wimp.

"Hip dislocation" is now located directly below "femur fracture" on my "List of things that I don't ever want to happen to me."

9 comments:

Bubblewench said...

From the laypersons side, I don't understand why this happens: I broke my hand, I (6 weeks later) am still in quite a bit of pain. Pain to the point I'm illegeally treating it with a friends prescription, one pill about every 5 or 6 days when I just can't take the pain any more. NO DOCTOR will give me anything. Not even ibuprofin. They tell me to take tylenol. 6 tylenol does nothing, not even take the edge off the pain.

I understand the worry of a patient being becoming addicted, yet even before this experience, I have never been treated (in my mind) adequately for pain. And it seems to be the norm around here.

Why is that? Any insight?

I sure as hell wouldn't want to dislocate my hip either.

Natalie Heitz said...

Bubbles,

It is a true statement that we (meaning physicians, but can apply to the entire health care community) undertreat real pain. I would say it is a backlash to our OVERtreatment of non-real pain. We see so many addicted/dependent/whatever you want to call it patients that we undertreat most people.

As for your hand still hurting...has it been re-xrayed? Was it properly fixed the first time? Did they splint or cast it? Persistent pain for this long can be a sign of either a worse or different injury than previously thought, improper immobilization during healing (and now improper healing), or a long-term effect of the injury itself.

Another thing to consider is something called RSD, reflex sympathetic dystrophy. It's a pain syndrome that more or less randomly develops in anything from minor injuries upward. The nerves keep sending pain signals, for unknown reasons. Can be extremely difficult to treat, sometimes requiring nerve blocks.

Good luck...I hope you feel better!

(PS: some advice...don't show up in an ER several times in a row for your pain and never following their instructions to see a specialist...that's always my first question to repeat pain visits. "Have you seen the orthopedist we referred you to?")

Anonymous said...

Dude, impaction is still number one on my list because narcs just don't work for the pain. And digging out mounds of crusty, dried out shit from your bowel can be a long, tedious process.

Ambulance Driver said...

""Hip dislocation" is now located directly below "femur fracture" on my "List of things that I don't ever want to happen to me.""

Yup, and when you have either one and I'm your medic, you can call me your knight in shining armor, Sir Fentanyl the IV (that's Eye Vee).

I'll dope those poor people to the eyeballs before I even get them off the floor.

Anonymous said...

Oi! Makes my hips ache just reading about it and I'm still a young'un. Hmmmm....so Shakira was right? Hips don't lie! ;)

Blame AD for me finding you. That's not 100% true, but I like blaming him anyway. It's fun to watch him protest his innocence. (yeah right!) heh..heh..!

mielikki said...

Ouch. Hip problems are not for sissies, thats for sure. My patients who suffer it are always well medicated as well.

GuitarGirlRN said...

Uh--person with the hand pain: sorry about your pain but are you taking six tylenol a day or six tylenol AT A TIME?

If you value your liver you will stop doing that. Seriously.

Anonymous said...

I dislocated my hip when I was 16 when my horse fell on me. I remember them telling my friend that I couldn't have dislocated it because I would be screaming. Truthfully, I don't remember it being too painful (I told them a 2/10 on the ride over). However, I wouldn't let my Mom touch my hand when she got to the hospital, because it made my hip hurt too much. Dr. later said it was the worst dislocation he had ever seen.

ERnursey said...

funny how those people who really have 10 out of 10 pain don't arrive with the posse, talking on their cell phone and snapping their gum.