Form that may help when seeking ER help for severe pain

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straydog
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Date Joined Feb 2003
Total Posts : 13466
   Posted 1/10/2010 2:34 PM (GMT -7)   
Hi,
 
I meant to put this in BlueJets post and totally forgot, imagine that. She was telling me that in the "migraine forum" a member by the name of "tysmaboo" has a form attached to her signature that her dr signed that she shows to ER drs when going to ER for severe pain. She says this has helped her many times and some drs comment was they wished more patients had the form when coming to ER for care. The form states the person is a patient of dr A and has a condition and is on certain meds for said condition, but at times the pain becomes severe and is in need of extra pain control. The form clearly states the person is not a drug seeker. Now I have looked at this form and as BlueJet said she changed the form up to fit her condition and her PM dr had no problem signing the form.  She tells me that this has helped her many times when going to ER. I wanted to put this out here for everyone because as a rule we get no care when going to ER and most of us avoid th ER for this very reason.
 
Give it a look and see if this form may help you out.
 

crohns disease dx 2002 & small bowel resection, still looking for remission whatever that is, chronic pain 22 yrs, added ulcerative colitis 6-05 to the mix, high blood pressure 28 yrs, aortic heart valve insuffiency, depression, osteoarthritis, osteoporosis lumbar spine, scoliosis lumbar spine, peripheral neuropathy hands & feet, COPD & on oxygen therapy, lupus & psoriasis and psoratic arthritis. Several other health issues just not enough room to list it all. Too many surgeries to list and too many medications to list. Currently on 17 different daily medications. Intrathecal pain pump implanted June 05.


White Beard
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Date Joined Feb 2009
Total Posts : 3611
   Posted 1/10/2010 2:56 PM (GMT -7)   
straydog

Ummm uh??? Where is the form we are suppose to look at???

White Beard

Jim1969
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Date Joined Jul 2009
Total Posts : 2042
   Posted 1/10/2010 3:42 PM (GMT -7)   
http://www.healingwell.com/community/default.aspx?f=31&m=1503516

Follow that link and then click on ER Treatment Form found in the signature line of tysmyboo.
2 confirmed herniated lumbar discs. Spinal Arthritis. Spinal Stenosis, diabetic peripheral nueropathy.


Screaming Eagle
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Date Joined Sep 2009
Total Posts : 5005
   Posted 1/10/2010 3:54 PM (GMT -7)   
Thanks for the information, I appreciate it, and sure many more will too.

Jim1969
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Date Joined Jul 2009
Total Posts : 2042
   Posted 1/10/2010 4:09 PM (GMT -7)   
I agree, such a form can be a great thing to have and if you take the time to write one up for yourself then take the time to write up a "medical" history page as well.

Things to include:

All current conditions.
All current doctors with their addresses and phone numbers.
All current and recent (last 30 days) medications. Be sure to include doses and reason prescribed.
All surgeries and non surgical medical procedures with dates performed.
Allergies and medications that you can not tolerate.
Optional but worth considering is placing your name and an emergency contact or two on this as well.

I know for some of us that can take a while and end up being quite a list, but it can save a lot of time and possible confusion when doing admits to the hospital, going to the ER, seeing new doctors, etc.

I keep one copy in my wallet and another in a folder that I take anytime I am not seeing a current doctor. I started doing this after going to the ER once extremely ill and couldn't recall 3/4 of my medical history. Fortunately it was a hospital that I had been too many other times for various reasons so all but my current medications were on file.
2 confirmed herniated lumbar discs. Spinal Arthritis. Spinal Stenosis, diabetic peripheral nueropathy.


Tirzah
Veteran Member


Date Joined Jul 2008
Total Posts : 2281
   Posted 1/10/2010 4:22 PM (GMT -7)   
Great post, Susie!

Too bad my insurance company has a new rule that they will only cover ER visits if there is a danger of loss of life or limb. So even if I'm to the point that I'm blacking out for periods of time from the pain, the ER will contact my PM for orders to treat, but I'm 100% responsible for the bill. Fortunately, my PM has helped me out by writing me for the same emergency meds that the ER gives to keep at home only for cases where I am completely bedridden (plus, I've been doing better with the pain lately -- now I get to go 2 months in between visits :)

Just wanted to warn people to check their insurance benefits to make sure that the ER visits are covered. Sadly, a note saying the patient is being managed by a pain clinic does nothing to convince the insurance companies that benefits should be paid.

take care & stay warm, all,
frances :)

Mevans27
Regular Member


Date Joined Dec 2009
Total Posts : 33
   Posted 1/10/2010 4:27 PM (GMT -7)   
That is a very good idea. I have seen the ER on a couple of occasions mainly because of the timing I could not get into my dr. And I know from my experience it was hard and very very time consuming going through my entire medical history to get the right treatment.
Neurofibromatosis Type 1, PVNS left hip, Arthiritis Left Hip/Knee
 


straydog
Forum Moderator


Date Joined Feb 2003
Total Posts : 13466
   Posted 1/10/2010 4:28 PM (GMT -7)   
Sorry WB its the migraine forum here @HW.
 

crohns disease dx 2002 & small bowel resection, still looking for remission whatever that is, chronic pain 22 yrs, added ulcerative colitis 6-05 to the mix, high blood pressure 28 yrs, aortic heart valve insuffiency, depression, osteoarthritis, osteoporosis lumbar spine, scoliosis lumbar spine, peripheral neuropathy hands & feet, COPD & on oxygen therapy, lupus & psoriasis and psoratic arthritis. Several other health issues just not enough room to list it all. Too many surgeries to list and too many medications to list. Currently on 17 different daily medications. Intrathecal pain pump implanted June 05.


straydog
Forum Moderator


Date Joined Feb 2003
Total Posts : 13466
   Posted 1/10/2010 4:32 PM (GMT -7)   
Most drs are treating a person with a dx when treating CP. Just putting chronic pain would not be a good idea in my opinion, rather list what has caused the CP. Matter of fact I am not going to be putting CP on my sheet, instead I will put my dx there. The fact that I may have an episode of severe pain is how I plan to state my form. To each their own tho.lol
 

crohns disease dx 2002 & small bowel resection, still looking for remission whatever that is, chronic pain 22 yrs, added ulcerative colitis 6-05 to the mix, high blood pressure 28 yrs, aortic heart valve insuffiency, depression, osteoarthritis, osteoporosis lumbar spine, scoliosis lumbar spine, peripheral neuropathy hands & feet, COPD & on oxygen therapy, lupus & psoriasis and psoratic arthritis. Several other health issues just not enough room to list it all. Too many surgeries to list and too many medications to list. Currently on 17 different daily medications. Intrathecal pain pump implanted June 05.


Scarred_for_life
Veteran Member


Date Joined Jul 2008
Total Posts : 1559
   Posted 1/10/2010 6:17 PM (GMT -7)   
As you all know I recently had knee surgery. Now even though my surgery was what most would consider small and for all intensive purposes I really was not in a whole lot of pain. My new ortho was about to send me home with a script for loratabs 7.5 even though I am taking percocet 10s and Kadian for my back.

Now being as though I knew that my current meds would be able to control what little pain the three holes in my knee would give me, I knew better then to fill this script as it would probably have violated my pain contract and given me a huge problem to boot. So I refused the script and was sent home to resume my reg medications.

Now I know that each of us have come across many problems with ERs and have felt like smacking a wall just to get the attention we need to control the pain, but I think that doctors don't speak with one another regarding our current treatments.

Maybe this was a test?


Hugssss

Scarred
What doesn't kill us only makes us fight back harder! :P
 
Two level fusion on S1- L4 in 2000. One level fusion on L3-L4 in 2003 and revision on L3-L4 6 months later.  This led to a diagnose of failed back syndrome, nerve pain and Chronic Pain. Two bi-lateral patellar realignments on both knees last one in 1988.  Overall...I'm in great health. 


prepackey
Regular Member


Date Joined Oct 2004
Total Posts : 183
   Posted 1/10/2010 6:41 PM (GMT -7)   
Scarred, i really like what you said (what doesn kills us only makes us fight back harder) that is so true. iam still fighting have been in pain 13yrs and have been tested and tested and still no diagose. and a judge even said i was suppose to get my pain meds. and i still have to pay for them. my husband is disable a vet and i'am disable so we do not have alot of money left over after bills. i can not understand i thought when a judge said i could get them and something over powers that. this happen a year ago and i'am still pissed. i thought a judges word would be higher then any thing else! prepackey

skeye
Veteran Member


Date Joined Mar 2008
Total Posts : 2976
   Posted 1/10/2010 6:45 PM (GMT -7)   
Thanks Susie! Maybe we can add it to the sticky of CP resources (with ty's permission of course).

Skeye

White Beard
Forum Moderator


Date Joined Feb 2009
Total Posts : 3611
   Posted 1/10/2010 10:11 PM (GMT -7)   
straydog

Thanks for posting this, This is an excellent form it could easily be modified to accomidate a host of different medical problems that cause you to be treated by a Pain Management Specialist With the proper changes and and then have your PM Doc sign off on it! This form could prove to be a great help in getting proper and adquate pain treatment in an ER!!!

White Beard




P.S. Thanks Screaming Eagle for the link,....Staydog after thinking about it I suppose I could of just looked up "tysmaboo" and found it, I guess I was brain dead on that one blush

straydog
Forum Moderator


Date Joined Feb 2003
Total Posts : 13466
   Posted 1/11/2010 11:23 AM (GMT -7)   
Hey WhiteBeard I will move over a seat so you can join me in the brain dead room. One chair left up for grabs.
 

crohns disease dx 2002 & small bowel resection, still looking for remission whatever that is, chronic pain 22 yrs, added ulcerative colitis 6-05 to the mix, high blood pressure 28 yrs, aortic heart valve insuffiency, depression, osteoarthritis, osteoporosis lumbar spine, scoliosis lumbar spine, peripheral neuropathy hands & feet, COPD & on oxygen therapy, lupus & psoriasis and psoratic arthritis. Several other health issues just not enough room to list it all. Too many surgeries to list and too many medications to list. Currently on 17 different daily medications. Intrathecal pain pump implanted June 05.

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