Surgeon denied me FM meds in hospital! (Major vent)

Discussion in 'Fibromyalgia Main Forum' started by justjanelle, Jan 11, 2006.

  1. justjanelle

    justjanelle New Member

    OK, I could tell the surgeon didn't "believe" in FM by the smirk he gave when reading my health history. I gave him my rheumatologist's card and asked him to call him to discuss it, as there might be some special issues with the FM with surgery. Although he didn't throw it away in front of me,I could tell he wasn't going to bother to call.

    But I'd been referred to him as The Best Orthopedic Surgeon Around to deal with pinning together my badly broken foot.

    He did take down all the information about my current meds, and at the pre-registration at the hospital they told me to leave my current medicines at home because everything I needed would come from the hospital pharmacy. I followed their instruction.

    So the surgery went well (and I'll only need 1 or 2 more to get the foot back in reasonable working condition). I'm in the hospital bed dealing with a moderate amount of post-operative pain and I start getting muscle spasms in the foot.

    I call for the nurse and ask for my Zanaflex, which I was due to take about then anyway. No, she says, the Dr. hasn't authorized that. Oh. What about the Amitryptaline? Nope. Not that either. Want some more pain meds?

    I wait a couple hours to the shift change, and the spasms are getting worse. It was just like someone running by every 30 seconds or so and stabbing me with a knitting needle. And of course it was mostly in that foot. I'm starting to wonder if this is going to pull some stitches or something.

    New nurse, same message. The dr. didn't authorize the meds, so they can't give them to me. No, they don't have another dr. around until morning who might be able to authorize them. No, I really can't have DH bring me meds from home that the dr. hasn't authorized. Do I want some more pain medicine?

    Then the good news that I'm "doing so well" in my recovery (and there are 13 really sick patients stacked up in ER waiting for beds) that I can check myself out and go home "if I want".

    Do I want?!! You bet! I call my husband to come get me, and to bring my medicines with him so I can finally get some relief.

    I increased my Zanaflex dose to about double normal and called my rheumatologist's number on the weekend to let him know (after the fact) what I'd had to do. And why. He OK'd it.

    It took 4 days to get the muscle spasms under control and me back to my normal dosage.

    I suppose I was lucky the surgeon at least authorized pain medicine, as he told me before the surgery that people with Ehlers-Danlos Syndrom (like me) don't feel pain "like normal people do" -- HUH?

    This is getting really long and I apologize for that.

    But here's my dilemma: I need at least one more operation to fix the foot. This guy may be a major jerk about the FM (and the EDS as well) but he's supposed to be the best for feet. And he's already done the first part of it.

    I'm going in soon to get my stitches out and a new cast on. I'm supposed to have the next operation in a few weeks.

    So what do I do now? I know I need to explain the muscle spasms and the real need for my FM medicines. Do I stay with this guy and (a)just take my own meds to the hospital and use them as needed or (b)tough it out in the hospital and do what I can about it when I get home? Or should I try to switch to a different surgeon in mid-stream? Or maybe there's some other solution I can't see right now?

    Help, please?

    Janelle
  2. tedybear

    tedybear New Member

    I would take all my meds with me to the hospital and keep them out of sight in a cosmetic bag that you can get to. That's what I always do. It will make life easier and comfortable for you during your stay. You know what you need. I would stay with the good surgeon. They are hard to find.

    Hope this helps.
  3. Geechie

    Geechie New Member

    I would get your hubby to bring you the meds. The staff will have forgotten about it by the time yo go back.

    My mom was an RN and she was in the hospital for 16 weeks due to a wreck. If my dad had not helped her with pain meds, I don't think she would have made it. They were her own pain meds, too, and not that old.

    Last time I was in, for back surgery, I didn't get my blood presure med for two days. Just a plain old oversight. I got Mike to bring me one the day he picked me up, since going home involved riding over some monster bridges that I hate.

    Notice next time you are in the hospital, do they check your bracelet? Do they call you by your name? (ok, mrs snigglepop, it's time for your (whatever) Just enough to give you a chance to say 'I'm not mrs. Snigglepop, i'm Jane Smith". Silly, but even if they just left the room, they are supposed to do that. Also they are supposed to watch you swallow the pill.

    I used to give meds in a hospital and it can really be a mess. The head nurse of the floor should have called the dr's service and told him you needed your FM meds. They do it all the time, with all kinds of meds. It is not one doc's place to take you off another doc's rx's. It might not even be legal.

    i'm sure sorry you had to go through that, as well as your foot hurting. No excuse for it!
  4. ksp56

    ksp56 Member

    When I had surgery, I brought my own. I would highly suggest you do so also. Like someone suggested, put them in something the staff cannot see.

    It is such a hassle to wait for them, and if they call your doctor to see if it's okay, it takes even longer.

    I've come to the conclusion after several surgeries, cancer, etc., that it basically up to me to provide for my own needs! LOL

    How much longer do you have to deal with this moron? If it isn't long, and he is the best, I'd stick with him, but not be friendly...at all! Answer questions only. Maybe change if it is a long term process with him.

    Doctor's the great healers, Right......

    Kim

    P.S. I wonder if your rhuemy would prescribe when you are in hospital? It's normal to have several doctors checking up on you. I don't believe the surgeon can tell him no. Still take your own until you know for sure!




    [This Message was Edited on 01/11/2006]
  5. Bambi

    Bambi New Member

    different opinion. I don't know how large an area you live in, but if it's a city or suburb there are usually a lot of surgeons. He "may" be the best or he may just be in the opinion of whomever you talked with.

    I personally would not hire a surgeon that would not work with ALL my health issues AND my prescribing doctor.

    It "could" effect your insurance companies willingness to pay for the whole thing if they found out that you were going against the doctor's orders. I don't know that but I do know they can refuse to pay if you sign yourelf out.

    Most of the medications we take have serious side effects to being stopped suddenly, I don't know about the ones you take, but most of mine say don't just suddenly stop them. I know my pain doctor wouldn't be pleased to know that his orders were being over ridden. However if he is not affiliated with the hospital in question he might not have the right to step in on your behalf. You never know when an infection of something else might lengthen your stay unexpectedly also.

    I personally would look and ask around about another surgeon that both "believed" in FM and would go along with my doctor's qualified opinion about what medications I need.
  6. justjanelle

    justjanelle New Member

    for more insight.

    Thanks!

    Janelle
  7. sues1

    sues1 New Member

    I would ask my rheumy of he would call your Dr. that is doing the operating. This second Dr. might look at all differently if your rheumy talked to him about it. Also ask him to stress that you are on certain meds that you can not go without.......Blessings
  8. sues1

    sues1 New Member

    HUH? I put Ehlers-Danlos Syndrome in a search engine.......Wow......I can not pull my skin out and be elastic like.......

    Would be interesting to ask Dr. why he called it that?


    Description:
    An inherited disorder of the elastic connective tissue characterised by hyperelasticity of the skin, hypermobility of the joints due to extremely lax ligaments and tendons, and poor wound healing.

    The skin bruises easily. There are subcutaneous tumours, visceral malformations atrophic scars, and calcified subcutaneous cysts.

    Mitral valve prolapse is usual and congenital cardiac defects, e.g. atrial septal defect, are common. Described primarily in people of European ancestry. Both sexes affected (some authors report male prevalence); recognized from birth. Exists in 7 forms.

    Prematurity due to early rupture of fetal membranes is common. Inheritance corresponds to various pathochemical mechanisms in the disturbed collagen synthesis. The disorder is very heterogenous, most forms have an autosomal dominant inheritance but some are autosomal recessive or X-linked. It is believed to affect 1 in 5,000 people.

    A syndrome with a history
    As early as 400 BC Hippocrates noted that Nomads and Scythians were lax of joint and had multiple scars.

    The syndrome can also be diagnosed in the Spanish sailor George Albes who was infamous for being able to stretch the skin on his chest out to arm's length. Albes was presented by the Dutch surgeon, van Meekeren, to a group of senior physicians at the Academy of Leiden in 1657.

    The first complete description of this condition was given by A. N. Chernogubow in 1892 when he presented two patients at the Moscow Dermatological and Venereologic Society.

    One of them was a seventeen years old boy who suffered from recurrent joint dislocations and cutaneous nodules, his skin was hyperextensible and fragile and he had multiple scars resulting from minor injuries.

    Chernogubov accurately diagnosed that the clinical manifestations were caused by an abnormality of the connective tissues. However, the article written by Chernogubov did not come to the notice of Western Europe at that time. The disorder still carries his eponym in Russia.

    In 1899 Edvard Ehlers spoke at a clinical meeting of the Paris Society of Syphilology and Dermatology. The patient he presented was a 21 years old law student from the Island of Bornholm in the Gulf of Bosnia.

    This patient gave a history of late walking and frequent subluxations the knees. He had suffered many haematomata on minor trauma, with the formation of discoloured lesions on the elbows, knees, and knuckles. In addition, he had extensible skin and lax digits.

    In 1908 Henri-Alexandre Danlos gave a presentation to the same Society. This boy had lesions on his elbows and knees and had been presented to the same Society 18 months previously by Danlos colleagues, François Henri Hallopeau (1842-1919) and Macé de Lépinay, with the diagnosis of juvenile pseudodiabetic xanthomata.

    At the presentation, Danlos disagreed with the original diagnosis and drew attention to extensibility and fragility of the patient's skin. He stated that the lesions over the bony prominences where posttraumatic 'pseudo tumors' in a patient with an inherent defect which he termed 'cutis laxa'.

    In 1936, Frederick Parkes-Weber suggested that the disturbance should bed named Ehlers–Danlos syndrome.
    FROM:
    http://www.whonamedit.com/synd.cfm/2017.html
  9. justjanelle

    justjanelle New Member

    Yeah, the Ehlers-Danloss Syndrome is basically an inherited condition where the collagen is extra-stretchy. Collagen makes up the main "connecting" tissues in the body.

    Since a whole lot of "connecting" tissue is in the body (including ligaments and the stuff that connects the skin to the muscle underneath) you end up with a person who can do weird stretchy stuff with their joints and skin. Very entertaining in elementary school.

    You do end up with a lot of sprains and dislocations though, just doing normal activities, because the joints kind of float around instead of seating firmly in one place. Also leads to arthritis later.

    That's the most common type (called Benign Hypermobility Type). That's what I have. It's very prevalent in my Mom's family line -- going at least as far back as my Great-Great-Grandparents. My Grandma had cousins who were circus contortionists!

    There are several other types including a Vascular type that are pretty scary -- they can rupture blood vessles and stuff without warning. Really glad I don't have that!

    Actually, the EDS is the reason my foot got so badly broken up in the first place. I twisted it and broke one bone. Given the EDS my primary dr. apparently should have put it in a cast but did not -- then the other bones started sliding out of place and breaking over the course of a few weeks in a sort of domino-effect. Made a real mess of it, I'm afraid.

    Best wishes,
    Janelle

    [This Message was Edited on 01/12/2006]
    [This Message was Edited on 01/12/2006]
  10. tdavis1

    tdavis1 New Member

    I would take your own meds with you.
  11. JLH

    JLH New Member

    First of all, I would suggest that you STAY with your current orthopedic surgeon for the duration of your foot surgeries. He did the first one and knows what needs to be done next -- and he was supposed to be the best. You can just be prepared with your meds in your purse and take them on the way home--if you are having same-day surgery.

    Also, before this next surgery, explain to the doc that you have bad muscle spasms all of the time, and you really need to have your Zanaflex ordered to take immediately after the surgery along with your pain meds.

    If you were having same-day surgery,the doctors/surgeons normally only order what they consider essential during your short stay until you are released--like a pain medication--then you are expected to take the rest of your daily meds when you are released.

    Sometimes pain, or other problems you experience in the hospital will alert your doctor to important matters regarding your illness or problems that you might not be aware of. If you bring you own meds to the hospital and slip and take them, they may mask an important problem that the doc needs to know about.

    The hospitals advise not to take home meds while in the hospital because they may react with the anesthesia, other injections given for tests (like iodine, nuclear materials, etc.).

    I know an awful lot of people take their meds to the hospital, and I have too when I've been admitted for days, but we really should not--they have their rules for a reason--and whether we realize it or not, they are for our own best interests.


    P.S. Good luck with your surgery. I broke my foot a couple years ago and it took it nearly a year to heal. I went through many procedures and various hard casts, soft casts, "moon" boot, orthopedic shoe, and you name it!!

    Hugs,
    Janet



    [This Message was Edited on 01/12/2006]
  12. justjanelle

    justjanelle New Member

    Dianna, I think that really says it all! Thank you!

    Best wishes,
    Janelle
  13. TXFMmom

    TXFMmom New Member

    HOney, been there, had that happen.

    I was an RN, an Advanced Nurse Practitoner, and a Certified Registered Nurse Anesthetist for many years before this DD got me and disabled me.

    I had to have an emergency hysterectomy, and they almost permitted me to bleed to death in the hospital before I got to the OR. NURSE ANESTHETISTS COMPUTE THE BLOOD LOSS FOR OPERATIONS AND I KNEW HOW BAD I WAS GETTING AND THE NURSES WERE FRANTIC, BUT THE HOSPITAL HAD MADE A "MISTAKE" AND MISPLACED ME IN THE ER, TOLD THE DOC ON CALL, WHO WAS NOT MINE BUT ONE IN HIS GROUP COVERING, THAT I HADN'T SHOWED, AND THEN HE REFUSED TO COME IN FOR OVER 14 HOURS.

    It was AWFUL.

    Then, he and MY DOC, decided that since I was in CRITICAL CONDITION IN THE ICU, THAT I JUST COULDN'T TAKE ALL THOSE MEDS I WAS ON.

    HUH?

    I went into terrible muscle spasms, myoclonic twitching, which we don't need with an abdominal incision, and WORST OF ALL EFFEXOR WITHDRAWAL.

    I BEGGED THE NURSES TO CALL AND GET THE OK FOR IT. I WAS SWEATING, HAD TACHYCARDIA, PALPITATIONS, AND WAS SHAKING AND RETCHING AND THEY JUST STOOD THERE.

    That is when I told the RN THAT I WAS AN RN, A CRNA, AN ARNP, AND THAT I HAD CALLED MY HUSBAND AND TOLD THEM I WAS DYING BECAUSE OF THEM WITHOLDING THE MEDS AND THAT HE SHOULD SUE HER.

    Then, I told her that she should call the PHARMACIST AND LOOK UNDER THE FDA BULLETIN FOR APRIL 2001 and LOOK AT THE SIDE EFFECTS OF EFFEXOR WITHDRAWAL AND THAT THE FDA SAID THAT IT COULD RESULT IN DEATH. SHE SMIRKED AND I TOLD HER THAT I WAS GOING TO GET UP AND GO TO THE DOOR, IF I COULD, AND START SCREAMING THAT THEY WERE KILLING ME.

    She left, and TEN MINUTES LATER, I HEARD HER RUNNING DOWN THE HALL TO MY ROOM WITH THE EFFEXOR. After taking it, I asked her WHAT THE PHARMACIST HAD SAID, AND SHE JUST SAID THAT I WAS RIGHT AND THAT SHE HAD CONVEYED THAT TO THE DR. ON CALL. MY GUESS IS THAT THE PHARMACIST RAN THE STUFF TO HER AND DID NOT WAIT FOR THE ORDER.

    I had been without the stuff for almost 72 hours.

    From now on, I am going to take my meds, in a small container and HIDE THEM, if I have to go to the hospital. If they think you may have the stuff stashed, they may search your room. I know that I searched a patient's room who was a known "former" addict, after he went WILD WHEN AWAKENING AND HURT SEVERAL INDIVIDUALS IN THE OR AND THE RR.

    WE found morphine, heroine, and downers in his case, hidden behind the lining.

  14. ulala

    ulala New Member

    I concur with the majority here! I always take all of my meds with me for surgery. I have had several and have learned, like many here, that you have to take care of yourself. This way you cut out alot of the stress and eliminate a lot of the unknown. Keep on good terms with your orthopedic doc., no need to mesh the FM with the ortho if he doesn't understand. Your goal is to get your foot fixed and be comfortable while doing so. So many of these guys have tunnel vision.

    We'll have to coin "bring your own meds" BYOM, it used to be Bring your own Booze.

    Best wishes for a full recovery for your foot and a comfortable stress free journey getting there!
  15. lease79

    lease79 New Member

    I am extremely thankful that with the local hospital here that they have either A: Held my meds & subsitituted with their own & then always released my meds to me when I've left the hospital or B: Have let me self medicate.
    I can't imagine what it would be like to have vital medication withheld from you :(
  16. sofy

    sofy New Member

    but I doubt if you are going to do anything to change this arrogant docs mind.

    If you really have it in you to try and educate him go ahead and try and take him on before your next surgery but you have to do so knowing that he MIGHT refuse to do the next operation.

    Then too your rheumy. might not want to be all that involved in trying to educate him when this is someone they have to live with in the medical community.

    Perhaps being pragmatic and just having your hubby, as suggested in above posts, bring in what you need and not inform him at all is the best solution.

    Whatever you decide I wish you the best of luck and hope you will be taking a nice enjoyable stroll soon.
  17. elsa

    elsa New Member

    He is your foot specialist that is repairing bad breaks. He did not move to the top of your treating physician list.

    This is what I do .... Find out exactly what will be used to knock you out and any other medications during the proceedure and immediately following it.

    Take the list to the doctor who is at the top of your treating list. Go over what will be used during surgery and after, with your big boy doc and make sure that what you are on daily mixes well with what they plan to give you. If it doesn't find out what will.

    Make a plan with the main doc. Present plan to surgeon .... Say I want this, this and this. Tell them per your treating physician you are not going to abruptly stop medications indefinately but resume them at such and such time.

    Direct them to refer to your main treatment doc if unforeseen problems arise and plan needs adjustment.

    Surgeon, etc will not like this one bit. Too bad ... You are the client and it is your pocket book. That gives you a big say in what happens ... besides the fact that it's your body.

    Bring a trusted person close to you to these pre-surgery meetings with main treatment doc so they will know exactly what is supposed to happen and can speak for you if you cannot. Try to make one of the nurse's aquaitance ... they are the ones that know from hour to hour how you are doing.

    Unfortunately for many specialized medical professionals, the days of being the unchallenged authority are long gone.
    Too many options for the client to spend their dollars elsewhere. As in a private specialty hospitals.

    Elsa