I'm in PAIN!

The other day while browsing through a JEMS (Journal of Emergency Medical Service) article about "drug seekers" I found a very humorous list of symptoms/behaviors. Within the medical services, it is common for people to seek narcotics. Often it is because of drug addictions or occasionally, because they can sell the pills on the street for greatly inflated prices. Anyway, I was reading this list of behaviors that ran something like this:
- "I have pain that is a 30 on a scale of 1 to 10"
- "I am allergic to Tylenol, Ibuprofen, aspirin, etc" (all the common non-narcotic drugs)
- "Please give me some ________ (always a very specific narcotic drug)
- "I cannot get in touch with my regular doctor today (it is Saturday and they state the pain started two days ago)"

Not sure if that is a complete list, but you get the idea. Within the hour, we were dispatched to woman complaining of chronic 'hurts all over' pain. She was overly verbal, and spewed a plethora of symptoms, history, and complaints. I suddenly found myself having a hard time not laughing as I realized she was basically going down the list I had just read. As I moved outside to get the gurney I noticed her car as being perfectly capable of transporting her down to the ER for her pain medication. As I looked closer I saw what I thought was the typical white outlines of the family, kids, dogs, etc. but in this case it was the universal pain scale.


All I can say, this woman seemed to have taken the concept of pain and turned it into a lifestyle.

Grumbling

Sometimes it is a little hard not to grumble when we get dispatched to the Alzheimer's ward for the fourth time in a shift. Usually, the complaint is confusion or chest pain or back ache or something else that the patient, CNA, or other disinterested by-standers have a hard time describing. In most cases, we get called late at night for something that has been an on-going problem for several hours or even days.

So when we were dispatched once again to a chest pain call - I was grumbling. It was late in the evening, the location was the same old place we had been responding to all day. As we went en route, we got a bit more information - the patient was a 39 year-old female and had just walked in off the street, smelling of alcohol. This elicited and whole new line of grumbling and complaining as this was sorting out to be a transient who probably just wanted a warm place to sleep for the night.

Once we arrived, the grumbling stopped (at least the verbal part) even though one of the first things we discovered was that she had anxiety problems, for which she was taking medication. At least that made sense, because she did appear anxious.

But then, even though there was a bit of alcohol odor, she was not intoxicated, was clean, articulate, healthy, etc. About this time, I was thinking we might have miss-judged the situation. A quick EKG and it was confirmed. At a heart rate of over 180, she was quickly headed towards complete cardiac failure and death. The grumbling suddenly was ancient history as we started an IV, delivered Adenosine, momentarily freaked her out completely as the medication stopped her heart for about 2 or 3 seconds, and then we all (especially the patient) breathed a bit sigh of relief as her heart rate returned to normal and she was fine.