so we get this lady from the ED. she's a bad COPDer with a crap ton of heath problems who was found down at home barely breathing and for some reason rushed to the ED. they can do basically nothing for her because she is a DNR/DNI. well, nothing except for bipap. and by golly!! it worked!!
unfortunately.
this woman was so crazy, that i wanted to hurt myself. that's right, not hurt her, but myself. self-destruct mode. three gallons of crazy in a two gallon bucket. cray.
it all started with her "running leg syndrome". ok, first of all ma'am, if you're planning on faking a disease, take the time to get the name right. now i'm not going to say that i don't believe in RLS. maybe i do, maybe i don't. but i know for a fact that restless leg does not make you buck around in bed to the point where i have to put seizure padding on your siderails. restless LEG. legs. not arms flailing and head twitching and an occasional seizure-like spasm for good measure.
also, your RLS becomes less credible when you tell me that ativan and oxycodone are the only things that can help you. the drug seeking seems obvious, yet i find these things on your home med list in obscene doses.
ooooooooohhhh, so your dealer...excuse me, your doctor, prescribes them for you. how thoughtful.
so she got half her home dose of meds for the RLS show: 1mg of ativan and 15(yes, she takes 30 at home) of oxycodone.
and oh, the sweet silence that ensued. until she became unresponsive. rock solid vitals, eyes open and looking around, but no one was home upstairs.
narcaning her was a crime against myself.
to make a long story short(er), she required 4 vials of narcan, 3 sets of STAT ABGs, and someone to hold her down so she didn't rip off her Bipap. and this is on half of the home dose.
so in the morning, when she sobered up, the true story came out. the patient couldn't sleep because of her restless legs, so she decided to take triple the amount of medication she was prescribed, a whopping 6 mg of ativan and 90 of oxycodone.
ninety milligrams of oxycodone. NINETY MILLIGRAMS OF OXYCODONE, to a woman who is approximately 115 pounds and can't breathe at baseline.
it makes me want to bang my head against the wall and not stop. self. destruct.
yes, people are that stupid. and yet somehow this stupidity is rewarded, and she gets to continue breathing even though she very well should have died because she was so stupid.
once again, if you have no regard for your own life, please do not come to the hospital and make your problems my problems. if you want to take enough drugs to kill yourself over a disease that is ALL IN YOUR HEAD, stay home and die.
yes, that's a horrible thought. it's cold and uncaring and mean and i should be ashamed of myself. but isn't it the truth?
is it so much to ask that fully functioning adults take some responsibility for their health? that they don't do blatantly stupid things like triple dose themselves on narcs and benzos?
i don't think so . do you?
Thanks for posting. I work ED in the suburbs. No one - and I mean NOBODY - would believe the crap we see on a daily basis. This a fine, shining example. And your post helps me realize I'm not losing my mind, they really are that irrational.
ReplyDeleteThese people could survive a nuclear apocalypse.
ReplyDeleteHowever, I had a 52 year old woman as a patient last week who had lost her husband to a massive heart attack last year and now has metastatic colon cancer.
She's got an 10 year old son and is a school teacher.
There is no justice it seems.
that's the hard thing, the sweetest, nicest, most productive members of society always have the worst diagnoses, and those are the patients that just break your heart.
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