Re: Jan G from W/pcp

[Guest guest]

Jan G,

thanks for your post. My mother and I discussed my pcp's recent about face in

regard to my care and we feel sure that it has something to do with this total

jerk of a doctor that is the main ER doctor at the small hospital in my town.

In the past, my pcp has argued with this ER doctor and has even had me admitted

to the floor before the ER even got my labs back because this jerk doctor

refuses to give me any pain medicine unless my panc enzymes are elevated.

However, on the Wednesday prior to my being admitted to the hospital last

Saturday, I went to the local ER thinking that maybe just IV fluids and a round

of IV meds would settle things down and I could avoid being admitted. I had

been battling the attack for several days. When I first got to the ER another

doc was there and he immediately had them give me IV fluids, demerol, and

phenergan. However, by the time the labs came back shifts had changed and the

jerk ER doc was there. He had not even seen me but sent the nurse in to tell

me they were going to give me a shot of bentyl and then I could go. I told the

nurse that even though the demerol/phenergan had helped for a couple of hours,

the pain and nausea was back at full strength. I also asked to see my labs and

sure enough, even though the panc enzymes were normal, my liver enzymes were

elevated. I told the nurse I wanted the jerk doc to call my pcp. I dared to

question the jerk doc's authority so I was in deep trouble. He called my pcp

and I couldn't hear everything he said but some of what he said was that there

was nothing wrong with me, all my labs were normal, the other ER doc

had 'graciously' given me 50 mg of demerol, and it was obvious that I was not

in pain and had no reason to be at the ER. The jerk doc comes in the treatment

room to tell me that my pcp agrees totally with his recommendation and that

there is no reason to give me more pain med or to admit me. I thought that was

odd because my pcp had never refused to admit me when I felt I needed to be

admitted. In fact, it was just in June that I asked my pcp to take back over

as my primary doc since my internal med doc had moved to another state. My pcp

and I discussed the fact that because I have cp, my panc enzymes rarely elevate

and my GI has said we have to go by the symptoms, not the labs. If I am

throwing up to the point of dehydration and/or my oral meds are not controlling

the pain, then I most likely need to admitted for at least a couple of days

of 'gut rest' - NPO for a day or so and then slowly advance my diet. My pcp

assured me that he totally agreed with my GI doc and had no problem managing my

care. He said he would consult with my GI if he felt he was over his head. My

pcp knew then that I was under the care of a pain mgmt doc and that I take Oxy-

IR 5 mg for pain at home. I have been under the care of my pain doc since Nov

02 and my pcp NEVER mentioned that he was against narcotics being prescribed to

treat chronic pain until AFTER my last run-in with the jerk ER doc.

I guess it really doesn't matter what changed my pcp's mind on my treatment.

However, that means that from now on whether I am going to the ER or being

admitted, I have no choice but to go to the hospital in Huntsville which is

about an hour away. Thankfully, I still have my wonderful GI and I don't think

he is going to do an about-face on me - at least I hope not! I will ask my GI

for recommendations on a new internal med doc in Huntsville and when I find one

I feel I can trust I will just go back to having an internist as my pcp and end

my relationship with my current general practice/pcp in Athens. I do hate it

because he has been my doctor for over 15 years and he has always been kind and

caring.

I really don't think having my GI or pain doc talk to him would change

anything. Besides, I really don't want a doctor taking care of me in a manner

he is not comfortable with. There is a reason for everything and I feel sure

that God will once again lead me to the doctor that I am supposed to be with.

W