Rheumatic

From pljera, Pete from Baltimore
You show up in the ER because you try to do too much. Of course,
what is too much varies with the PA ups and downs.
You asked what they did for me in the Er. Depends on who saw me. I
am sort of lucky since I often work at hospitals and know the
routines and a few docs and RNs and RTs. Usually I presented in Er
with inability to walk or sit up to drive home. Three (or 4?) times
it was an ambulance ride, at least 3 times I was working at that
hospital and was found on the floor. First, the ER treats the basic,
airway, breathing, and circulation. When I tighten up my back, I use
those muscles to crush a disc or two into the spinal column. Somehow
this translates into lower respirations and heart rate and low
oxygen in my blood. If I am concious, I tell them what's wrong and I
am sometimes right. I have difficulty staying awake when my o2 sats
drop into the 70s, so on a few occasions I was tested and treated
for overdose, since that was a good guess, (not supported by blood
test results later). Usually I get xrays, physical exam, blood
screening, initial monitoring, and eventually CAT or MRI.
The drugs given have been morphine, percocet, other pain
injectables, soma or other muscle relaxers, and bedrest which I
refuse as soon as possible. The docs often add a course of steroids
to reduce inflamation and swelling. Once I can move, I have a bed at
home, and a bathtub. I take home pain meds, and muscle relaxants,
and rest. The longest I stayed in bed was 2 weeks, but I often
return to work part-time after that.
My ER diagnosis is compounded by my previous PA therapy which was
aspirin to near toxic levels. In hindsight, that and antibiotics led
to some major ulcers and significant internal bleeding on a few ER
occations. GI problems are way too common with PA people for several
reasons. Some is the meds, some is not enough of the right meds,
including meds to keep your mind from short circuiting your body. I
still think Valium gets a bad rap. It really helped ease things in
the 1970s in small irregular doses. Of course a steady diet of
valium needs close monitoring. Its a shame you can't take valium,
percocet and steroids all the time. You can't. Withdrawal from heavy
pain meds is not much fun either, but it helps you lose weight.
Your Er visit, hopefully NEVER, depends on whats wrong. Don't follow
my old example, get treated by a rheumy and stay out of the ER.
Enbrel costs more than aspirin, but it isn't associated with
bleeding to death. Methotrexate and Enbrel have been lifesavers for
me. Aspirin may be the most useful and dangerous legal pill
available.
When things are realy bad, keep a log of medications you take and
when. An alternative is to ration pills in those day/nite weekly
plastic divider pill boxes, if you can keep the days straight. It is
easy to overdose when the pain or meds cause the dreaded "brain
fog". If you feel bad ,it is good to check what was prescribed. With
10-20 prescriptions a month and similar looking generics, I have
gotten the wrong stuff or wrong dosage prescibed several times.
I have been off full-time work since November, but will restart
full-time in two weeks.
Pete from Baltimore (not the other Pete)