Question
Subject   Problems in the Emergency Room
Question   My name is Joe Baker. I am an emt/
Firefighter in Anderson, Indiana. Since last July, I
have been having chronic health problems. I have had
several surgeries for Vericoceles, Kidney Stones, and
nerve blocks as it is thought that a nerve may have
been knicked during one of the Vericocele surgeries. I
have had Kidney Stones since the age of 12. Today, I
had an appointment with a doctor at the Indiana Kidney
Stone Institute to go over some lab work. I was told
that I have Renal Tubular Acidosis, and this is in
part what my chronic pain is due to. I have been going
to the ER thinking I was trying to pass kidney stones
when it was really this problem. When stones showed up
on the CT, I was told that yes I do have kidney stones
but none are where they should be causing pain. Know I
know why I am having this pain, but I have been labled
as a drug seeker at the only hospital I am able to go
to. I know this because I requested a copy of all my
records, and it is noted in the doctors narrative as
drug seeking behavior. It has taken as long as one and
a half hours to get the first shot of pain medicine,
and every time I go (which is not all that often, just
when it get's really bad) the wait gets longer and
longer. I have pain and anti nausea medicine at home
to take, and I tell them this every time. It's just
that when I start to hurt really bad and start
vommitting, I can't keep the pain medicine down. I
even have anti nausea suppositories that some times
won't stay in due to diarrhea. This last visit, I had
been vommiting most of the day prior with diarrhea and
vommitting turning into dry heaves the night I went to
the ER. No fluids were started, just an IV lock. I was
forced to try to urinate in front of a nurse, but as I
told them, I am dehydrated and probably won't be able
to urinate. I finally did urinate about 2 cc's of
urine. Because no blood was preasent they treated me
like trash the rest of the time I was there. What do I
do? I AM NOT A DRUG SEEKER!! All I want is to be able
to go to the ER when needed for pain management and go
home. The thought of being labled as a drug seeker
makes me sick and embaressed. I am really at the end
of my rope here, and I don't know what to do to
convince these people that I have a problem. How do I
get them to realise I am not a drug seeker? I
understand that my health problems are cronic and that
the ER is not the place to treat chronic illnesses.
But once in a while, a chronic illness does make one
go to the ER for tempoary help. What do I do? If you
don't know, please ask around for me. Thanks.  

Answer
Joe,

Wow. This is a big one. Thanks for being so detailed. You really do have a problem here, and the additude you're recieving from supposed medical professionals doesn't help at all. You might be surprised to know that many if not most people with chronic pain resulting from chronic health problems recieve this type of treatment. Most of my family lives in Anderson, and I'm familiar with their medical facilities, since I had some difficulties last time I was up there. They aren't, if I may say so, top notch. It is not good if that truly is the only hospital you have access to. I realize that in an emergency, it is. But otherwise, I'd do whatever I could to find a hospital elsewhere, maybe go into Indianapolis.
To address the drug seeking behaviour bit. That enrages me. I have seen so many chronic pain sufferers labeled in that manner, and I myself have been called it to my face since I've been all over the country looking for answers. The sad truth is, most doctors don't understand chronic pain. All they see is a person complaining often about vague pain that they can't find a reason for, and they think they're just looking for drugs. I know that's not your case; the terrible physical manifestations (the vomiting, diarrhea, ect) is proof enough. However, there really is nothing you can do to change the doctor's minds. I've had to switch doctors before, and make sure that my previous records weren't transferred so that their diagnosis might remain objective and not become tainted by the previous doctor's opinions. I still get it a lot. The key is to find a doctor who understands chronic pain, one that will take the time. This is a very difficult task, but worth it. It'll take time, and a lot of repeating your life history, but with your pain on the level it's on and with the type of job you have, I don't see how you can't seek to actively treat this.
I am unfamiliar with the condition you described, and I had no idea Indiana had a kidney stone institute. I'll not protest to being a urinary expert either, because most of my urinary problems and thus contact with urologists has been light. However, I do know that there is no way they can just assign a name to your pain, tell you the kidney stones aren't bothering anything, and turn you out. Did they even explain your diagnosis to you, suggest treatment or therapy? Also, if I were you, I would consider asking to have the stones removed, if only to see if it'd help. Don't let these guys tell you a handful of things and suggest nothing to help it. You have to be proactive in your medical care, and assertive. Of course, too much assertiveness will only make them think you are a 'seeker', so you have to know where to draw the line.
This chronic illness is affecting your life drastically. These doctors can't deny that you can't successfully carry out your job when you're throwing up and doubled over in pain. Pain blocks are good things; I've had several myself. But I just can't understand how you can be that sick and there be nothing wrong. I would seriously consider looking elsewhere, finding a facility that specializes or deals with this disease (seperate from the one you've been to, of course), and also checking in with a chronic pain center. These places focus completely on relieving and dealing with chronic pain, and mostly treat people with illnesses that either cannot be properly diagnosed (like mine) or people with diagnoses that are not able to get other methods of treatment. Don't stop looking for ways to help yourself, and don't rely soley on the pain killers. I know they're all that's getting you through right now, but trust me, if you rely too much on them or you them too long, it'll be much worse in the long run.
I really don't know what to tell you about the ER. If it's the only one you can reach, there really isn't a lot you can do, that I can think of. I was thinking, if you're an EMT, is there no one you know in the hospital that could vouch for you, up your credibility enough that the ER docs will treat you better? If you have any connections that might help you, don't hesitate to use them. It's important also to remember to explain your problems in detail, which you're great at, from the look of your email. That way, people can develop a sympathy for you, and those who feel for you are more likely to attempt to help. Don't give them any reason to think you're a drug seeker, because they'll assume that enough on their own^^
I hate it, but there isn't much more I can tell you. I don't know anything about this illness. It would be wise for you to do all the research you can on it, read up to see what you're facing and if you agree with the diagnosis. Know your enemy, they say^^ This isn't going to be easy, as you've already found out. Do what you must to get through each day until you can find a better way, even if that means taking pain meds (in moderation of course), though I'm not sure how you can do that and have the response necessary for firefighting and EMT. You'll probably face more disbelief and ignorance. I've been told I was a drug seeker, hypochondriac, recluse, and lazy, all due to my chronic illness. There's alot of prejudice out there, and you have to be strong and assertive as to your treatment, while being inoffensive too. Don't give up, just keep on going^^ There will be help out there somewhere. I know it's incredibly frustrating to go from one person to another, looking for answers, only to be told over and over that there's nothing there when obviously there must be or you wouldn't be sick. And I know I'm not helping that a lot. Advice and encouragement are all I can give at this point. Find that strength in God and in yourself, and keep on, even if it's only from day to day, until you find something that helps you. If you have any more questions or just need support, feel free to ask; I'll always do my best to answer. I wish you the best of luck, and will keep you in my prayers. God bless.

Sincerely,

Celeste