Today after I put in 36 hours of moving, we finally are settled into our new HUGE office. SO I was checking in a couple. The patient's husband had verbally harassed me about two months ago but really I do not even care anymore I acted pleasant towards them. Then I ended up triaging them. I continued to be nice and I could tell he wanted to get antsy but I thwarted his proposals for a fight. (Lmao is it completely ridiculous that people get so rude in the office because of pain medicine or what?)
Anyway he ended up telling me I was the sweetest girl in the office and that everyone else were b**ches, especially that one girl last time. That one girl was me. His wife knew it and put her head down.
I couldn't help but smile and told them that everyone has rough days.
And in my defense I was just being blunt with him last time cause he started to get rowdy that the doctor didn't give him medications...
Monday, November 4, 2013
Not even an E-Cig
Last week I had a patient light up an actual cigarette in the exam room. She said that it is so engrained in her daily routine she didn't realize what she was doing.
Monday, October 28, 2013
Never seen such disrespect in my life.
I wish people could see the things we see. You've never seen such a collaboration of helpless people. People stripped away of their entire lives and reason because of these pills. These people come in for at least one office visit, thinking they're going to get the medicine they want. When they find out they aren't getting their medicine they treat us horribly. They say the worst things you can imagine. They're the ones doing wrong yet they blame us? I hate the doctor's that became engulfed in their own greed to breed these people. These people are just so freaking horrible.
Today a patient came in with his wife and two kids. Slum of the earth I tell you. They ungratefully sat in the patient room. Complained because their wait was over thirty minutes. You know what, they aren't even paying for their office visit. You are paying for their office visit. Your tax dollars are going to the scum like this. I walk into the room with the doctor and the wife immediately becomes unsettled. Glaring at me and saying is this even authorized. Look lady I work here, and I need to be in here because God forbid you make up something about the doctor. Anyway the doctor tells her that she needs to get out of the room he wants to talk to the patient by himself without the children. She goes on a hissy fit. Then started complaining about the wait time and left. The husband was such an ass. About 35 years old. Tells us he's never taken pain medicine before in his life and this sob story. Then goes on to say hydrocodone and percocet do not work, he's a big guy and needs the strongest. Yeah, get the hell out of here. For back pain? Anyway he continues to make sly remarks to me. Belittling both of us. I won't even get into what him and his wife said while we were in the room. My boss told the patient we would call him with an opening. A breath of relief. But before they left his wife shoved disability papers through the window. She wanted, after treating us like shit, to fill out disability papers for her husband? He didn't even get medicine, so you think our boss thinks he is disabled? What a joke lady, get out of here and quit wasting the tax payers money. This isn't even the worst of it.
They waited in the parking lot...
One of the girls left from work early....
The husband goes up to her and grabs her arm. Calls her a bitch a slut and a whore nurse. Then said we were all whores. He complained about how he didn't get the medicine he wanted. He literally grabbed her and pulled her. All in front of his children.
This is my defining song of the day :
Today a patient came in with his wife and two kids. Slum of the earth I tell you. They ungratefully sat in the patient room. Complained because their wait was over thirty minutes. You know what, they aren't even paying for their office visit. You are paying for their office visit. Your tax dollars are going to the scum like this. I walk into the room with the doctor and the wife immediately becomes unsettled. Glaring at me and saying is this even authorized. Look lady I work here, and I need to be in here because God forbid you make up something about the doctor. Anyway the doctor tells her that she needs to get out of the room he wants to talk to the patient by himself without the children. She goes on a hissy fit. Then started complaining about the wait time and left. The husband was such an ass. About 35 years old. Tells us he's never taken pain medicine before in his life and this sob story. Then goes on to say hydrocodone and percocet do not work, he's a big guy and needs the strongest. Yeah, get the hell out of here. For back pain? Anyway he continues to make sly remarks to me. Belittling both of us. I won't even get into what him and his wife said while we were in the room. My boss told the patient we would call him with an opening. A breath of relief. But before they left his wife shoved disability papers through the window. She wanted, after treating us like shit, to fill out disability papers for her husband? He didn't even get medicine, so you think our boss thinks he is disabled? What a joke lady, get out of here and quit wasting the tax payers money. This isn't even the worst of it.
They waited in the parking lot...
One of the girls left from work early....
The husband goes up to her and grabs her arm. Calls her a bitch a slut and a whore nurse. Then said we were all whores. He complained about how he didn't get the medicine he wanted. He literally grabbed her and pulled her. All in front of his children.
This is my defining song of the day :
Saturday, October 26, 2013
Just take the flipping urine test
Top 10 excuses for why you can't take a urine test
(inspired by the crazy woman who comes in every month and harasses us. Yes I may be a smart ass, but no one likes you because you are SO DANG MEAN, for no reason)
1. You ran to the restroom before we called you in the room. Oh you can't pee? Here's some water. I only need a little ;)
2. You're on dialysis.
3. For some reason you can only pee once a day and on this particular day you already peed.
4. Your insurance company only lets you take one urine test a month. Conveniently your PCP already drug tested you. BTW to the woman who told me this, I called your insurance company and you lied. Plus with your medicare replacement plan I will never have to get urine test authorized. Who's the smart ass now?
5. You can't find your penis and you can't sit on the toilet
6. It's against your religion
6. It's against your religion
7. Your in so much pain you can't reach your arm down their to hold the cup, long enough or steady enough. But you can sure hold that cigarette to your mouth can't you?
8. You're on a regime of antibiotics that for some reason won't let you take a drug test.
9. Your special medicine makes you positive for all different types of street drugs. That dang diabetes medicine making you positive for cocaine again?
10. THE ACTUAL REASON: you took some drug, didn't take your actual prescription and you're afraid to be discharged.
Intoxicated before Noon
Lately when I have been running the urine test I've noticed a lot of our patients are positive for ethanol. Could it really be that I have a flock of drunk patients? Or maybe this was their first pee of the day after a long night of drinking.. Either way. Why?
About two weeks ago we had a patient frantically run into the office and had to use the restroom. Up front we have a patient restroom but it is currently out of order since we're too cheap to hire a plumber. There has been crap sitting in that toilet for about a month. She runs straight into that restroom, although there is a huge sign that says OUT OF ORDER. She actually used the restroom. When things like this happen, just let it happen.
Later that day she kept giving us a problem. Coming up to the desk asking when she's going to be seen numerous times. I noticed though as she talked to her us she seemed more than doped up. She was drunk. Slurring her words. Her face seemed half paralyzed. When she got into the room she started to get aggressive with the girls. Telling them that the doctor was going to pay her lawyer for her wait time in our office and all this nonsense. Before you could bat an eyelash she was out the front door wandering down the street. I figured she was never coming back.. I was wrong.
Three weeks later she makes an appearance, much uglier than before. This time she's really on a rant and lets everyone in the waiting room and the staff know how displeased she is with life. One of our patient's is a retired nurse and she had much input to say about this woman, confirming my suspicions of the ladies intoxication.
Well she must have been going on about how she used to go to this 'pill mill' and they would see thirty patients at a time. They would also serve them BBQ as they waited in line. Now I believe a lot of patients in pain management are addicts but some patients are not. Talk like this must embarrass them, disturb them, offend them because I believe a lot of our patients truly are in pain. They come into the office and have one on one interaction with our doctor. They accept alternative treatment (most of the time) and can be very receptive and sweet. They were really upset with this woman today. If it weren't so busy we probably would have heard her in the lobby. But the patient's said she was going on and on about pain medicine and this and that and this doctor gave her this blah blah blah - lady we have a sign that says SHUT THE HELL UP ABOUT MEDICINE IN THIS OFFICE. They said she kept dozing off, then becoming belligerent.
Luckily for me I triaged this patient. When I came back in she didn't even recognize me. I asked her who gave her all her bruises and she began to cry. Saying she was an alcoholic and a drug addict and blah blah blah. I felt bad but the doctor was not so empathetic. At this point he was irritated with the scene she caused in the lobby and was hell bent on discharging her. Sorry, don't talk badly about the doctor and don't talk about medicine in the lobby, hell don't talk at all.
Well when he came in, she started to flip out. This gave him all he needed to discharge her. But he sat quietly didn't really respond to her rants, just went on about the office visit. She first states she wants her 'oxy's' and doesn't know why he wont give them to her. She's yelling and drunk so you can only imagine this woman. Her hair is frizzy, pretty young, eyes closing and pasty skin. Then she goes on saying how he owns a blue ferrari and why the hell not write her the medicine. BTW my boss does not have a ferrari... Then she starts cussing at him, F this F that F YOU. Asks him if he knows a neurologist. He starts to mess around and is like, no I don't associate with them. And shes like HE"S TRAINED EVERY DOCTOR IN THE USA AND HE HITS ON ME. Great... just great.
My boss gave her a script for Mobic (lol Lol LOL) and gives it to her and she takes one look at it and flips out. She runs out of the office again, like the last time before we told her she could not come back. I guess I'll just wait till her next phone call to advise her. Until next time she'll probably be waiting in line at that one pain management clinic behind the gas station with the BBQ stand.
About two weeks ago we had a patient frantically run into the office and had to use the restroom. Up front we have a patient restroom but it is currently out of order since we're too cheap to hire a plumber. There has been crap sitting in that toilet for about a month. She runs straight into that restroom, although there is a huge sign that says OUT OF ORDER. She actually used the restroom. When things like this happen, just let it happen.
Later that day she kept giving us a problem. Coming up to the desk asking when she's going to be seen numerous times. I noticed though as she talked to her us she seemed more than doped up. She was drunk. Slurring her words. Her face seemed half paralyzed. When she got into the room she started to get aggressive with the girls. Telling them that the doctor was going to pay her lawyer for her wait time in our office and all this nonsense. Before you could bat an eyelash she was out the front door wandering down the street. I figured she was never coming back.. I was wrong.
Three weeks later she makes an appearance, much uglier than before. This time she's really on a rant and lets everyone in the waiting room and the staff know how displeased she is with life. One of our patient's is a retired nurse and she had much input to say about this woman, confirming my suspicions of the ladies intoxication.
Well she must have been going on about how she used to go to this 'pill mill' and they would see thirty patients at a time. They would also serve them BBQ as they waited in line. Now I believe a lot of patients in pain management are addicts but some patients are not. Talk like this must embarrass them, disturb them, offend them because I believe a lot of our patients truly are in pain. They come into the office and have one on one interaction with our doctor. They accept alternative treatment (most of the time) and can be very receptive and sweet. They were really upset with this woman today. If it weren't so busy we probably would have heard her in the lobby. But the patient's said she was going on and on about pain medicine and this and that and this doctor gave her this blah blah blah - lady we have a sign that says SHUT THE HELL UP ABOUT MEDICINE IN THIS OFFICE. They said she kept dozing off, then becoming belligerent.
Luckily for me I triaged this patient. When I came back in she didn't even recognize me. I asked her who gave her all her bruises and she began to cry. Saying she was an alcoholic and a drug addict and blah blah blah. I felt bad but the doctor was not so empathetic. At this point he was irritated with the scene she caused in the lobby and was hell bent on discharging her. Sorry, don't talk badly about the doctor and don't talk about medicine in the lobby, hell don't talk at all.
Well when he came in, she started to flip out. This gave him all he needed to discharge her. But he sat quietly didn't really respond to her rants, just went on about the office visit. She first states she wants her 'oxy's' and doesn't know why he wont give them to her. She's yelling and drunk so you can only imagine this woman. Her hair is frizzy, pretty young, eyes closing and pasty skin. Then she goes on saying how he owns a blue ferrari and why the hell not write her the medicine. BTW my boss does not have a ferrari... Then she starts cussing at him, F this F that F YOU. Asks him if he knows a neurologist. He starts to mess around and is like, no I don't associate with them. And shes like HE"S TRAINED EVERY DOCTOR IN THE USA AND HE HITS ON ME. Great... just great.
My boss gave her a script for Mobic (lol Lol LOL) and gives it to her and she takes one look at it and flips out. She runs out of the office again, like the last time before we told her she could not come back. I guess I'll just wait till her next phone call to advise her. Until next time she'll probably be waiting in line at that one pain management clinic behind the gas station with the BBQ stand.
Monday, October 14, 2013
Tips on being the best chronic pain patient you can be
Foremost, I'm not going to blab how to convince your doctor to write you the pain medication you want. I'm probably a pro after the thousands of addicts I've seen run through, but I'll keep my secrets to myself. In any event if this is what you are trying to achieve, please go see a primary care doctor who actually isn't a pain physician and pay them a boat load of money.
Anyway if you're trying to not be such a jerk when you come in for your follow up here are some tips:
1. You really do not know which medication is best for you. If you've already tried these medications maybe you should check yourself into a rehab.
2. If you haven't had your pain longer than three months, it is not considered chronic and you have no business making an appointment at a pain management office. You just had a tooth pulled? Follow up with your dentist. You just had a surgery about three days ago? Follow up with your surgeon. None of these instances are considered chronic.
3. This is not walmart. This is not burgerking you can't always have it your way.
3. This is not walmart. This is not burgerking you can't always have it your way.
4. I have yet to meet anyone that is actually allergic to aspirin, Tylenol and anything that isn't dilaudid. Just because the tylenol makes you "sick", it does not mean you are allergic to it. The doctor is NOT going to write you the hydromorphone or 'oxys' you prefer, that you said you've been taking for YEARS. If this is the case, go back to your old doctor. Oh wait? He's in jail?
5. There is a slim chance that the reason you are positive for meth/cocaine/marijuana is because someone put it in your food or drink. If you are taking these drugs you shouldn't be in a pain management clinic. End of story. Maybe your long history of addiction is causing your body to shut down and now you really are in pain, but congratulations your reputation has caused everyone doubt what you say.
6. If you can sit with the doctor and argue with him, argue with me, and slam doors and basically act like a two year old, you've lost all credibility regarding your "chronic pain". Please get out.
7. Pay your flipping copay. Medicaid only has a two dollar copay. If you can't afford two dollars, you better go elsewhere.
8. Fibromyalgia does not warrant a script for oxycodone. If your primary care doctor told you you had fibromyalgia, chances are he just wanted you to get out of the office. It isn't real. Get up off the couch. Stop feeling bad for yourself. Narcotics aren't going to solve your problems. Anyways do a little research for yourself, neuropathic pain doesn't even respond to opioid medications.
9. If you're in SOOO MUCH PAIN and the doctor suggest different types of treatments aside from pain medications, take it into consideration. Upping your dose of narcotics is stupid, and unlikely to happen in our office.
10. Do not talk about your medications with other patients. I'm listening. If I hear it I will tell the doctor. You will be discharged.
11. It's probably time you've sought out a psychiatrist or therapist.
11. It's probably time you've sought out a psychiatrist or therapist.
12. Above all, please treat the staff with respect. We understand you are either agitated because of your withdrawals and your previous pain management doctor just left the state or you really are in pain but treat the staff with respect. It is discouraging on a daily basis to meet such miserable people who are ALL CONCERNED WITH MEDICATIONS. EVERY SINGLE ONE OF YOU, IN LEGITIMATE PAIN OR NOT. If you consistently treat us like crap, we do tell the doctor, and you'll be discharged. But I doubt our time with you will even get that far as you have already moved on to the next doctor who will write you your script of dilaudid. Good luck trying to get that filled.
Sometimes honesty is the best policy
I mean are there people out their who feign their own illnesses and disabilities to get free things in return? Not in our office! We like to be as honest and upfront as possible...
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