Yesterday, almost immediately after I finished my blog post, I took my smaller kid to my bigger kid’s school where the nanny met us. I promptly ditched the kids and skipped happily towards my car, which I piloted to the Emergency Room at Weiss Hospital, which is, for those of you not familiar with Chicago’s north side, located in one of the last outposts of true Cubsland weirdness, Uptown. As I pulled my car into the parking lot I realized that the self park lot for the ER was hosting a farmers market, which, as an injured party trying to get as close as possible to the hospital, I found to be a little shortsighted. I flipped around and managed to snag some street parking less than a block away and then made my way through the farmers market to the doors of the ER. On my way, I bought a bear full of local honey, the consumption of which is apparently the best way to combat seasonal allergies. I gave the guy a fifty. He bitched about it. I told him that ‘fuck it, man. I don’t need the honey I guess. I’m really just here because I’ve got a broken rib and this shit’s between my car and the hospital.’ His wife overheard this and bitched him out like only the wife of a beekeeper can. The phrase “he’s got a busted rib for chrissakes” was even bandied about a bit. I got the honey and a mumbled apology.
The reception area was empty except for a pretty, young Latina receptionist and an Asian guy in a long white coat (not sure what that implies) buying a Sierra Mist from the vending machine. I approached and gave my information (“Hey, I was up in the middle of the night to pee, I tripped on a misplaced footstool and fell on a chair and now my rib is broken. Here’s my insurance card”). She seemed very concerned and had me go sit in the waiting zone.
The triage nurse, who was an Egyptian looking, large, pretty woman wearing a headscarf that looked too whimsical to be religious but too big and all over the place to be appropriate if it wasn’t religious brought me in and asked me a few questions, like if I was on drugs or if I had ever had a heart attack. She was extremely nice and had very kind eyes, which I decided was a great quality to have if you’re a nurse. She seemed to sympathize with my pain and ushered me back into the real ER zone where I was immediately confronted with an unshaven bald, hairy man in a robe splayed out eating some kind of brown goo/rice combination off of a molded green tray. The nurse in the headscarf took me to a small waiting area, which could be made private by pulling a shower curtain across it. She had me sit in the chair and then pulled the curtain leaving me somewhat isolated. Almost immediately I noticed that my little spot had some thick fumes in the air. It smelled like nail polish and was getting progressively stronger as I sat there. I had to pull back the curtain eventually because I was getting dizzy.
The first receptionist came by and asked me if I was doing okay. I assured her that so far, everything was cool. I sat there for about forty five minutes or so before the doctor, a young blonde woman who was either gorgeous or weird looking (I couldn’t quite decide) came by and kind of smirked at me. “So, broken rib, eh? What happened?” I told her the story and she had me unbutton my shirt. She traced my ribs with her finger super lightly and asked me to tell her where the pain was. The thing is, her touch was so light I couldn’t even feel her fingers at all, so I took my finger and pointed to where it hurt. She smirked again and said “well, I don’t think it’s broken, but we’ll do an X-ray just to be sure. Most likely we’re gonna tell you to take ibuprofen and get on your way.”
At this point, I’m sitting in the ER, looking at this doctor and I say “Oh, so you think I’m just some pussy making a big deal out of nothing? I can’t fucking breathe over here. You know what? Now I hope my rib IS broken just to kind of stuff it up your smug, naysaying ass. How about that?”
Actually, I said “Yeah, sure. I’m just here because the pain keeps getting worse every day. Thank you.” After the doctor left, I sat there stewing for about another 40 minutes before burly dude that looked like he’d be right at home wearing a leather apron and fighting for his life in a dusty pit under the name “The Butcher” came and brought me to the X ray area. Once there, he opened a folding chair right in the hallway and indicated that I should sit there. I thought maybe I was getting the old “this asshole isn’t really hurt, let’s stick him in a hallway and see if he bails” treatment, until they wheeled in an old guy with tubes in his dick and nose and left him beside me to die (I’m just guessing about the dick tubes, if we’re being honest). In an attempt to ignore the morbidity that was suddenly so prevalent in the hall, I pulled out my computer and did a little hospital websurfing for a while until the Butcher came back and brought me to a locker room where I changed into a gown. Next, the Butcher and I went into the X-ray room where we took pictures of my ribs. The Butcher, it turns out, is one of the most remarkably sweet and gentle people on the earth. He put the lead screen up and said “It’s to protect your…erm…you know…You’re a young guy…” and blushed. I said, “ah, dude. I’ve got plenty of kids. I don’t need any more.” Later, when placing the lead screen up after I’d struck a different pose he said, “I know you said you don’t need any more kids, but just the same, to be safe….” Almost apologetically. He was really truly a nice dude, to the point where it was almost kind of sad for a reason I can’t put my finger on. I guess maybe it’s that the world is just so ugly that nice people seem more doomed and fucked than the rest of us assholes.
Anyway, we went through a few rolls of film and a whole smattering of sexy poses before I was led back to the locker room where I changed back into my clothes. I was led back to the tiny little nail polish remover zone where I’d sit for another 30 minutes before the young, blond, smug doctor came back. By this time I’d determined that she was, in fact, really good looking, and that she resembled that one art history major that I went on a few dates with about fifteen or so years ago…you remember her? We went back to her place and I thought FOR SURE that we were gonna bone and then she said something that implied that she was incredibly racist and so I made some excuse and left her house and haven’t seen her since. Maybe she’s a doctor now….Hmmmmm.
Anyway, the doctor came back and said “so, turns out your rib IS broken. I’m gonna give you Norco and send over the discharge papers.” She walked away and I sat there, not at all satisfied by these results. Sure, it was sweet to be vindicated for my pain and trouble, but having a broken rib means that this shitty pain is gonna keep on keeping on for a long fucking time, which blows. Also, there’s the Norco. Norco is cool. When I broke my knee I took Norco. The thing is though, it contains Tylenol which is real bad for your liver.
Now, I know what you’re thinking: So’s booze. Well, yeah. That’s true. The thing about booze though, is that it’s supposed to be bad for you. I understand that relationship. I don’t want medicine that hurts my liver. My vices are already doing a fine job. Plus, I’ve talked to a few EMT and doctor friends and they all say the same thing about acetaminophen/tylenol: “That shit is bad. Seeing what that does to people’s bodies is some of the darkest shit ever.” You get the idea. I don’t want to take acetaminophen. I know some people who have suffered liver failure at the hands of acetaminophen, and I’m not interested in that. SO, when the discharge guy came back, I asked if I could have some medicine that doesn’t have any acetaminophen. He asked if I had anything in mind and I said no. I’ve never been a ‘get high on pills’ kind of guy. I don’t understand pills, and the few times I’ve taken them recreationally, they’ve either upset my stomach or generally just been a bummer. So I wasn’t interested in getting pills that got me high. I just wanted something that will make my rib feel less shitty and that won’t eat away at my organs too terribly.
He went away and came back with a scrip for something called altram, which sounded fine. I skipped out and went to get some lunch over at Tweet, which is a great place to get breakfast or lunch in uptown. While there I got on my computer and checked out Altram, which I discovered was the generic term for Tramadol. Fuck. This was bad news.
I’ve had Tramadol in the past and it makes me sick. Like, it makes me nauseous and spinny and green. I needed to manage my very real rib pain, but in trying to theoretically save my liver, I wound up with a prescription for something that I knew I’d never take. I finished my breakfast and went back to the ER.
The triage nurse in the headscarf listened to my dilemma patiently. I said “look, I’d rather have the Norco than this. I really can’t deal with how this stuff makes me feel.” She went back to talk to the racist art history doctor and finally came back with “she says to just take over the counter ibuprofen. You’ll be fine.”
I said, “oh, great. Cool. That’s what I’ve been doing and it’s not doing shit. I have a broken rib. I KNOW there’s no physical treatment for it. I came here to get some medicine that will give me some relief.” She told me to wait and went back again. When she returned, she had a prescription for Vicoprofen, which sounds completely made up to me. It’s apparently hydrocodone paired with motrin (ibuprofen) instead of Tylenol (Acetaminophen). I thanked her profusely and apologized for being such a pain in the dick (a phrase that she seemed to enjoy) and went on my way.
So here I am. I have a broken rib and a bottle with NINE pills in it. If I began taking them according to the directions, I would be out of them by tomorrow at this time.
Now, I’m not one to sit here and complain, but….no. I am. That’s what this blog is for. Nice fucking pain management, ER. I don’t think my rib is gonna be healed by next month, much less tomorrow morning. Dumb bullshit. Sigh.
guy. dad. husband. uncle. dog master. brother. son. uh...bad sleeper. some farts.
This echoes my 6 hour experience at UIC’s ER so much that my kidney is twitching just thinking about it.
I’m sorry, man, but thanks for the drug education. My dad broke his rib on Jurassic Park the Ride at Universal Studios because they let kids on the ride that were definitely too small and everyone shared a lap bar, so when the sudden drop occurs as you’re being frightened by the T-Rex all of his weight came down on the restraint. He was miserable for a couple months and sore for one more. I think he is probably the first and only person in the history of California to not sue someone over an honest mistake. How does Illinois do with footstool liability? Heal quickly.
Dude, hope you heal uber fast.
I just had to say, I love your descriptive writing and this one line, man, you nailed it. Much obliged.
…I guess maybe it’s that the world is just so ugly that nice people seem more doomed and fucked than the rest of us assholes.
lol i recently had a very similar experience. fucking nine pills
: ..( Friggin’ Six weeks to heal- You need to call back there or ask your doctor for at least one week of meds.(id ask for two, lol) Bcuz if it hurts too much to breathe in, you could get pneumonia.
I so sorry for you. Be well.
I got knocked over by a dog at work and managed to land two herniated discs in my back. The first doctor I saw told me I was fine. Then the next doctor looked at the same results and was just like “So, you’ve got two herniated discs.” then sent me off to physical therapy.
After a month, it was just getting worse and I told the doctor (who’s a shitty workers comp doctor) and he told me my pain didn’t make sense and wrote me back on full duty for work.
So, I tried to go back to work. I’m a dog groomer, so my job involves a lot of lifting and pulling of dogs that don’t want to be pulled and lifted. By the end of the day, I ended up back in the ER because my legs and arms were numb and my left arm starting twitching uncontrollably.
Mother fuckers just sent me home with Vicodin, and treated me like some dumb bitch trying to get painkillers. I followed up with a nuerologist a few days ago, turns out I’ve got some pretty gnarly spinal neurological problems. I’ve been working for a month now and making it worse.
I hate doctors. Most of them are fucking awful.
They certainly are. Most are incredibly ignorant as well. I mean, dump a goody bag of regular assholes off the street into any med school program, eschewing the typical GPA requirements and yada yada, and witness a whole lot of highly motivated, highly average and otherwise ignorant motherfuckers suddenly making the grade in order to make big money. On a more shallow note, I imagine they tend to have shitty taste in just about everything for more often than not. Oh shutup Big Titty C
Sucks big time that it’s broken for really real. Get better soon.
That said, this post made me laugh a ton. I love to read your writing. Anything ever happen with that novel of yours? And what’s up with Buzzard Country? The world needs more BK in all media.
(Also, just to reiterate… anytime your wife gets sick of your broken body, healthcare’s free up here.)
My fiancé got into a car accident that has resulted in permanent damage to her neck and spine. The curve in her neck has been completely reversed from the whiplash. The quacks who handled her case told her she was fine and that it was probably a per-existing condition. Fuck American medicine.
Dildos, man. Dumb fucking dildos.
seems like you knew you had a broken rib, and that they werent going to do much about it. you shoulda just made yer own prescription and bought it from the streets.
Have a nice and a speedy-as-a possible recovery.
And get your gear and bring the Larry Arms to come play Rio de Janeiro.
Y all can crash at my house.
Peace,
Gabriel Neiva.
Is shit there really as scary as in those Elite Squad flicks? Brrrr!
No, it´s not.
Probably not worse than Boston or something like that.
And it´s as much as “realism” is put on those movies, it´s a fiction piece.
Or did you really like think Mean Streets, NY was as tough as Scorcese pictured.
Come on, BK.
Ironically my suspicion that these two overrated flicks employ typical dramatic license and that RDJ’s “danger factor” had been comically trumped up is what led me to ask. For my uncertainty, you can blame the extensive touting of those two flicks’ supposed “realism”, including non-stop claims by your fellow RDJ inhabitants “Fiiinally! A movie that tells it like it is in la slums of la Rio de Janeiro!” for my uncertainty. Stop by literally any internet discussion thread for these movies on for confirmation.
Re: Mean Streets, to New Yorkers’ credit I don’t see them going around the internet praising MS for its “realism”. So uh.
And I’m not BK. Ugh
I’m an ER doctor. The problem is that opiate addicts ruin everything for people with legitimate pain. I see so many people that try to manipulate me for drugs that I tend to assume that most people are drug-seeking until proven otherwise. Also, I have to say that having any aversion to Tylenol, for whatever reason, sounds like a big red flag to me, that’s what people who want oxy’s say. Also, going back to the ER to ask for something besides tramadol is a huge red flag, opiate addicts do this kind of shit all the time. So, you inadvertently made yourself look like an addict/drug seeker. That’s why you got 9 pills. If your rib wasn’t broken, you wouldn’t have gotten anything. Also, when opiate addicts break a rib or sprain their ankle or hurt themselves in any way that is legitimate, they go to multiple ER’s to get multiple prescriptions because they have a real reason to get pain meds. So, like I said before opiate addicts ruin it for everyone.
I dunno, it’s miiighty convenient most of the “red flags” correspond with (potentially) sensible, legitimate scenarios. Reeks of cheapjack policy justification to me. I mean, I would think a five second visual assessment would clarify who’s who in the overwhelming majority of cases. I mean I guess then there’s a real risk of unfairly denying meds to the folk who come by their quasi-translucent skin/oozing sores/90 lb frames honestly and whatnot
(Hushed, anxious whispers) “pss pssh…tattoooos…weathered, stinky fedora….two kiiiids…he says……musicia–…” SIR? SIR. DENIED. SIR. SIR IM SORRY BUT. SIRWEVE CONCLUDED. Sir, we’re fucking idiots, I apologize
You have no idea Iittle bob. This is a classic drug seeking pattern that I see every day. No one gives a shit what he looks like or what he does for a living, he inadvertently made himself look like a drug seeker. Also, you can’t tell a drug seeker by looking at them, that’s an asinine suggestion.
Well, what I’m obviously getting at is my cynical side can’t shake the suspicion that the fact lil’ ‘Smokey Bones’ does sometimes seek hospital drugs under false pretenses serves mostly as a convenient reality for said establishments to hide behind in cutting costs, the result being “Everyone gets 7-8 pills, including the nun and that innocuous elderly gent over there (i.e. people who CLEARLY aren’t looking to score from the ER), cuz, ya know, drug seekers!” I’m speaking more of fascist facility policy with which doctors must comply, rather than individual discretion. Am I really supposed to believe the seekers are an “epidemic” that outnumber or even come close to rivaling the legit in number? Give me a fucking break.
As for visually identifying HABITUAL users of the sort of goodies an ER stocks, yeah, ya often sort of can. Not definitively, but, ya know, “red flags” (!) Emaciated…pale…..generally unhealthy…notably jittery or unnaturally “perky”…don’t be an asshole. Clearly that doesnt account for college kids scoring painkillers on a friday night, but I’m not talking garden variety pot/cokeheads/functioning members of society who dont need to feign boo-boos and bellyaches to procure their shit from the ER either.
Also, when you cats are running your “druggie likelihood diagnostics” or whatever, do you stop to account for coincidence, e.g. “Well perhaps this gentleman isn’t an oxy freak, but merely a decently-informed person that googled Tylenol/paracetamol and is apprehensive of what a terrible fucking concoction it is. Compounded with his appearing to be a functional human being and not a Trioxin zombie (ROTLD holla~!), I think we’ll give him the stamp of approval”.
Again, lil bob, you have no idea. Not everyone gets 7-8 pills, and this has fuck all to do with “cutting costs.” Trust me, in the ER, no one is in the business of trying to save money, and none of this is policy. It’s 100% case by case judgement call. Some people get 40+ tabs of dilaudid or oxy, some people get shit. If you sell me some bullshit on being afraid of tylenol and not liking tramadol or being allergic to a host of non narcotic meds, then the likelihood that you’ll get shit just went up a thousand fold. This ain’t policy, it’s just how it is. And drug seekers don’t outnumber legitimate patients, but they constitute at least 20% in some places. That is too significant a number to ignore
Oh I dunno, I think I may have kinda sorta an idea. Like the idea a facility as astronomically expensive to run as an inner city hospital cutting a few corners, even (gasp) at the potential expense of some patients’ utmost well-being, is not an unreasonable suspicion. Or that your knee-jerk assumption about those seeking Tylenol alternatives is almost too stupid for words (That they’re “full of shit”, seemingly implying that you, as a fucking DOCTOR, are somehow unaware of what “questionable” stuff Tramadol has been revealed to be, and thus why anyone would POSSIBLY have legit concerns that don’t align with a desire to score shitty Rx drugs from your little fortress). Or that your flagrant use of “you have no idea” and “red flag” is, uh, a real red flag. Stuff like that hehe~
Next time come to Northwestern. we love pain management! also, weiss is a shithole. if you must go to uptown, at least go to thorek. they’re legit.
You’re officially retarded little bob. You’re not even close to making sense in the context of real world medicine. Pain meds are cheap, so witholding them would be a shit way to cut costs. They also don’t cost me or any other ER doc anything, so I guarantee you that cost has no bearing on anything in an Emergency room. I don’t care what anything costs if I feel that it’s an appropriate test or drug because, like I said before, it doesn’t cost the doctor a dime, so I never consider it. Also, opiate addicts don’t like drugs with tylenol in them because you can’t inject them. They want straight oxy’s or dilaudid because these are easily injected. Also, the toxic dose of Tylenol is 150 mg/kg. so it would take 30 lortabs/Vicodin/norco/Percocet taken acutely to make a toxic dose to a 150 lb person. So, In the context of acute pain management, it IS unreasonable to be worried about the toxicity of Tylenol, unless you already have cirrhosis or considerable liver injury. Just stop talking Lil bob, it’s getting harder to argue with you’re asinine bullshit.
Wouldn’t it be sort of expected for me to…NOT have an in-depth understanding of the complicated sphere that is “real world medicine”? Not my line of work, you fucking idiot. You already clarified both that 1) cost is (supposedly) not a consideration/concern in making the decision of who walks out with what (fair enough) and 2)med allotment is entirely left to personal discretion (read: the whims of egotistical, power-drunk assholes like yourself desperately asserting a degree of control over their little speck of the world – fair enough!) ; I was clarifying in my last comment that, from an outside, non-enlightened perspective, the cost matter is a pretty reasonable notion. Bonus trivia to that end – nowhere did I suggest the ER doc PERSONALLY foots the bill (wow!), and ’7-8 pills’ wasn’t a literal figure but an implication of “less than optimal”. Christ.
Still, that doesn’t account for your sweeping assessment of patient apprehension over Tylenol as “bullshit”. Perhaps it’s a simple matter of you lazily failing to articulate what the fuck you actually mean. Obviously, there’s ample conjecture out there over previously unsung dangers/possible long-term effects of Tramadol–which go beyond high dose toxicity in the context of acute pain treatment btw. Thus, it seems slightly insane that someone in your profession wouldn’t at least be aware of such and thus reasonably expect possible concerns that aren’t a front for copping some oxys or whatnot. This obviously transcends your personal thoughts on the legitimacy of said claims, so even if you earnestly felt in your scholarly knowledge (lulz) such conjecture to be laughable, you couldn’t expect common folk off the street to have reached that enlightened conclusion. Likewise, if you’ve consciously decided the best course of action is to take your chances and treat every Tylenol-weary person as a potential druggie, at the risk of dismissing some “innocents”, fine, that’s a sound albeit imperfect solution. But in that case, actually say that so that you don’t sound like a fucking ignorant assclown that somehow scammed their way through med school.
“Officially retarded”? How high-minded and altruistic of you, Doc! A sterling candidate for the profession if ever there was one.
Cwweaaaarly weeeeetahds are as well-spoken as meeeee, doc! A weeeal weeeeeeeeeeeetaaaaaaaaaaaaaaaaaaaaaaaaa
BTW – in my internet questing I somehow walked away with the conception ‘Tramadol’ is another name for acetaminophen/paracetamol, the arguably bad ingredient in Tylenol. It’s not…something completely different. Substitute accordingly; everything else stands
This entire thing is awesome. Thank you both for your arguments. It’s more entertaining than anything I’ve put up here in years. I actually didn’t attempt to get any more drugs because the Vicoprofen was making me feel kind of sluggish and I just decided to bear with the pain. That said, I gotta agree with our non-doctor friend. you, doctor, are at best just kind of a dick, and at worst, throwing weird accusations at me. Just so we know what kind of drug seeker you’re dealing with, seven years ago I snapped my patella. I was prescribed Oxys and norcos for pain that was so severe that immediately following the surgery, when my wife sat down on a couch across the room from me, the vibrations through the floor were enough trauma to make me spontaneously barf on myself. I threw all the norcos and oxys away (into the garbage!) after the first week because they made it tough to shit and made me a slug. I hate that stuff.
I also have 2 friends that died from liver failure that was in part helped along by Tylenol. That’s not speculation. That’s what the doctors said. I like drinking booze. I do enough damage to my liver without getting medicine that my friends, specifically a EMT and a Hematologist (who let his prescription abilities lapse, or we wouldn’t even be having this awesome conversation) have told me, in no uncertain terms, is fucking terrible for my liver. I have also had legit shitty reactions to tramadol. It makes me dizzy and it has made me barf on two occasions. I think that my entire behavior at the ER was completely reasonable and to be frank I’m offended that you’d suggest otherwise. I mean, I get it, the world is full of shitheads, but that doesn’t mean that you should be dismissive of everyone. I don’t like being talked to like I’m 6 and I don’t give a fuck if your job is a big fucking boner because of drugged up assholes. My job is ALSO a boner because of drugged up assholes. Look at the fucking dude you’re arguing with, for fucks sake. That’s the job. Sorry. You work in an ER. It’s gonna be full of fuckups of all flavors, from the drug seekers to the marginally informed douchebags who just act like drug seekers. I had legit concerns, and to be demoted to ‘drug seeker’ because I don’t want to take certain drugs is lazy, rude and ultimately unhelpful and un Hippocratical (how about that shit?) In conclusion, uh…I don’t know. Sunday morning. God, I’m hungover. Nice one, liver.
Brendan. Don’t think you’re a drug seeker. Just saying you inadvertently made yourself look like one. This is Tre, by the way. Love the blog. Read it all the time.
Holy shit!!!!! Tre!!! I love you and I guess we’re both right, because you’re a total dick. Ah, you can call me a drug seeking asshole any time. I hereby rescind all previous comments. This doctor fetus happens to be one of the best persons out there. Fucking retards. Heh. Come bring your kids up by my kids and lets party, eh? Xoxoxo
Whoa. BK actually acknowledging comments/commenting himself. This shit hasn’t happened in far too long.
Always nice to argue anonymously with folks on the internet. Also, not giving opiates ain’t “Un hippocratical” you drug seeking asshole. Hippocratic oath is “do no harm”. Cant do harm by doing nothing unless its gross negligence, and last time i checked pain never killed anybody. Just kidding about the drug seeking asshole part. We miss you guys and would love to see y’all again and meet your kids. From what i’ve read and heard, they sound pretty dope.
Brendan, Next time you guys are in florida, y’all are welcomed to come stay in our huge sprawling doctor mansion that we built with all the money i saved the hospital by withholding drugs. Seriously though, you’re Welcomed anytime.
Well this has taken a surreal turn for the obnoxious. BTW, this tidbit – “My job is ALSO a boner because of drugged up assholes. Look at the fucking dude you’re arguing with, for fucks sake”.
Yeah, not a druggie. At all. Asshole? Well…no more so than you and, dare I day, considerably less than your pen pal Dr. Assbag here. Anyhow, I get it. Doogie’s got shit down pat. He’s got da forumlas all scribbled on scraps o paper in his pockets n shit, all over da employee locker room n shit, theres not a potential danger or adverse side effect of a single substance he administer wif glee any given week to which he not privy, he packs a healthy azz lunch every goddamn day, he got a dog named ‘JD’ off Scruuubs n if some FOOL come at him with some SHIT bout bein scared o Tylenol, he gonna say “HALT. THAT IS A RED FLAG SIR”, blow his punishment whistle, give em three pills an make em march up out the ER with thay pants pulled down around thay ankles (Ha-haa day look so stoOpid~)! Well, ta-ta for now
That sounds about right
Seconds to go. Backed into a corner. Made to look like an overall asshole/frightening disgrace to his profession–boom! Dr. Cuntius Mcgew plays the ace in his hole and evokes the “appeal to acquaintanceship”, referencing the fact he and grand highmaster have apparently smoked shitty pot together/sucked each others’ dicks off, or something! …SUCCESS! All wrongs exonerated. ALL HAIL DR TRE (Tre!? lulz) Well played, Dr Tre. Well played. Have an ice cold BUD LIGHT on me! Afterward, treat yourself to a black cobra dick throat cleansing. You surly orangutan
hardly backed into a corner. I’m the only one in this discussion that has a clue what he’s talking about. I see over 5000 patients a year, most of them quite sick, dying, or nearly dead, so you’ll have to pardon me that I don’t think fondly of manipulative pricks who waste my time.
Right, topical mastery + credentials; we’ve got that. Let’s touch on wasted time a moment. So, you popped in of your own accord…made at least one questionable statement that (perhaps inadvertently) made you sound disturbingly unempathetic at best and comically ignorant-within-your-own-sphere at worst…were called out on such in fairly effective–and admirably restrained–fashion (when lesser minds may have just stooped to calling you Dr. Faggot ad nauseam) by another party–to which you never actually offered up an effective rebuttal btw; opting instead for a lame, pussified evasion tactic/disarming hat trick (Urrr, it’s ME Beeex) that, still more obnoxiously, actually worked–and somehow others have wasted your time. Right, totally. I like the way you think, sir.
I’m at a loss on the manipulative bit as well, but uh, suredude! (does little play fist pat on your shoulder)
does this mean I’m cool, again?
Not referring to you wasting my time, my friend, I’m referring to all the manipulative opiate addicts wasting my time. I’d hardly call this little arguement wasted time.
Gotcha. My bad.
So the Tylenol bit is getting a bit old. Look, I am painfully aware that Tylenol in considerably supratherapeutic doses is toxic to the liver, I’ve treated plenty of patients with liver failure secondary to tylenol overdose, the key word here is OVERDOSE (almost always intentional) not therapeutic Tylenol use. It’s not nearly as dangerous as you seem to think. Also, you might be interested to know that even massive Tylenol overdoses are fairly simple to treat if the antidote, n-acetylcysteine, is started early enough.
I’m not even sure what we’re arguing about anymore.
I think the issues it’s the toxicity of Tylenol alone, but the taxing it puts on an already admittedly overworked, abused liver.
And I’m with BK on the hating the feeling of narcotics. I’d rather be in pain than wasted on a couch trying not to vom everywhere.
I like knowing that both medical doctors and total burnouts and everyone of us in between likes to read Badsandwich whilst taking a dump.
Ok, I’ll give this one more go. Doc, you’ve said a lot of sensible/informative stuff – e.g. non-factor of cost in prescribing whatever to whomever; comparatively cheap cost of pain meds…all good. And you’ve made clear what you know–or at least think you know, if I may be so bold–about Tylenol based on your med school/ER ‘playbook’, for lack of a better term. All fine and dandy. You say the Tylenol thing is getting old, but that’s been the whole crux of my last couple posts. To be clear, this isn’t about me saying “OMG Tylenol is evil, and you clearly don’t know that!”–I’m nowhere close to sufficiently informed to make that kind of statement. No, I just took umbrage over your earlier phrasing re: patient Tylenol concerns (bullshit) because it came off as ignorant/lazily dismissive/a combo thereof. Look, feeling that the scary conjecture on Tylenol (some of which perhaps clashes with your playbook) that is afoot is mostly hot air is one thing. Lacking basic awareness such conjecture exists–and by extension why not everyone expressing concern is necessarily “selling you a line”–is another. Disturbingly, I felt your phrasing suggested the former. Hopefully, it’s not the case. Regardless–and it’s not as though I’d expect you to own up to it here on the off chance you WERE in fact previously unaware scary shit is being said about Tylenol that some (non-druggies) are inevitably going to read and be thusly freaked out by–you now know, and well, that’s it. All I wanted you to walk away with. Something to consider next time you’re sizing someone up I guess.
No! Backwards! I felt your phrasing suggested the LATTER. Crucial difference there yall. K cheerio
Good talk.
Look, I know some people, for whatever reason are afraid of different medications, I see them all the time, but I also know that every single night I see at least 2 people who tell me they have anaphylaxis(severe/potentially deadly allergic reaction) when they take Tylenol and then,in the same breath,they tell me they can take Percocet or lortab/Vicodin/Norco, all of which are an opiate mixed with Tylenol. I’m not sure you understand the scope of this Rx drug problem. In Florida alone, there are over 3000 opiate (excluding heroin) deaths a year, that’s an incredible number. I’ve even treated a few patients in respiratory arrest secondary to overdosing on opiates that i had prescribed to them. It’s a huge problem, so you’ll have to pardon me for making an effort to prescribe opiates appropriately and judiciously. Sometimes, I may get it wrong, but it’s always in the interest of doing no harm, and that’s pretty goddamned “hippocratical” of me if I do say so myself
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