Comments on: Glenn Beck http://www.kevinmd.com/blog/2008/01/glenn-beck.html medical blog Sun, 22 Nov 2009 19:59:44 -0500 http://wordpress.org/?v=2.8.4 hourly 1 By: Anonymous http://www.kevinmd.com/blog/2008/01/glenn-beck.html/comment-page-1#comment-83057 Anonymous Fri, 25 Jan 2008 19:20:00 +0000 http://clients.emmense.com/kevinmd/2008/01/glenn-beck.html#comment-83057 As a patient, it is really hard to judge whether what is happening to you in the ER is what should be happening. A while ago, my daugther started to limp and her doc said she probably had a viral infection of the hip and should go home and rest but if she started running a fever or stopped walking entirely I should go to the emergency room immediately becausee it may have become a bacterial infection of the hip. That weekend both of these things happened and I took her to the ER. The intake person listened impassively to my story and sent me to a long line for the triage nurse. Sometime later the nurse called us and took her temp and blood pressure; then we waited and waited and waiited. About 3 hours later, I could tell that my daughter's fever was getting worse and still we hadn't been called. I thought, "well, there must be more urgent cases ahead of me" but finally I asked a rather harried looking staff member to please check for me and he did. Right after that a nurse burst through the ER door and said, "Is this the chld with the bacterial infection of the hip? We've been looking all over for you!" I can't imagine where they were looking as we were exactly where we had been told to wait -in the ER waiting room. Anyhow, later I wondered if I should have made a fuss or something earlier. It seemed to me that perhaps some sort of "communication error" had occured. I don't know how "urgent" our case was compared to the other people there-I have no way of judging that. It might have been helpful if the staff gave people some guidance about what they should expect when they are triaged-something like please come back and let us know if you aren't called in 20 minutes or something like that. In the absence of some system like that, I think that staff should be understanding of patients who question wait time, etc.., just like the staff member was who went back iinto the ER to check on the situation for me. As it turned out, my daughter did not have a bacterial infection, she had a tumor that had caused a pathological fracture of her femur. As a patient, it is really hard to judge whether what is happening to you in the ER is what should be happening. A while ago, my daugther started to limp and her doc said she probably had a viral infection of the hip and should go home and rest but if she started running a fever or stopped walking entirely I should go to the emergency room immediately becausee it may have become a bacterial infection of the hip. That weekend both of these things happened and I took her to the ER. The intake person listened impassively to my story and sent me to a long line for the triage nurse. Sometime later the nurse called us and took her temp and blood pressure; then we waited and waited and waiited. About 3 hours later, I could tell that my daughter’s fever was getting worse and still we hadn’t been called. I thought, “well, there must be more urgent cases ahead of me” but finally I asked a rather harried looking staff member to please check for me and he did. Right after that a nurse burst through the ER door and said, “Is this the chld with the bacterial infection of the hip? We’ve been looking all over for you!” I can’t imagine where they were looking as we were exactly where we had been told to wait -in the ER waiting room. Anyhow, later I wondered if I should have made a fuss or something earlier. It seemed to me that perhaps some sort of “communication error” had occured. I don’t know how “urgent” our case was compared to the other people there-I have no way of judging that. It might have been helpful if the staff gave people some guidance about what they should expect when they are triaged-something like please come back and let us know if you aren’t called in 20 minutes or something like that. In the absence of some system like that, I think that staff should be understanding of patients who question wait time, etc.., just like the staff member was who went back iinto the ER to check on the situation for me. As it turned out, my daughter did not have a bacterial infection, she had a tumor that had caused a pathological fracture of her femur.

]]> By: Zagreus Ammon http://www.kevinmd.com/blog/2008/01/glenn-beck.html/comment-page-1#comment-82629 Zagreus Ammon Thu, 10 Jan 2008 07:15:00 +0000 http://clients.emmense.com/kevinmd/2008/01/glenn-beck.html#comment-82629 It is just too funny, to think about such a horse's ass having a problem with his own. I always thought his personality was a little constipated. Of course his pain meds were ineffective. That implies a lot to any physician who has dealt with people of his ilk. After all, who is the idiot who believes surgery is painless? Pain is to be controlled, not eliminated. <br/><br/>Sorry but I'm going to say it:<br/><br/><br/><br/>crybaby It is just too funny, to think about such a horse’s ass having a problem with his own. I always thought his personality was a little constipated. Of course his pain meds were ineffective. That implies a lot to any physician who has dealt with people of his ilk. After all, who is the idiot who believes surgery is painless? Pain is to be controlled, not eliminated.

Sorry but I’m going to say it:

crybaby

]]> By: dreaming78 http://www.kevinmd.com/blog/2008/01/glenn-beck.html/comment-page-1#comment-82623 dreaming78 Wed, 09 Jan 2008 22:34:00 +0000 http://clients.emmense.com/kevinmd/2008/01/glenn-beck.html#comment-82623 I suffer from chronic back pain, and my pain level is lessened but not completely resolved by the fentanyl patch (basically, I live at a four instead of the 6-8 I'd be at without them). I'm not anywhere near death (I hope!). Morphine does nothing for me, as a combination of long-term opiod use and inherited drug tolerance means that I am one of those people that, when in pain spike, only Dilaudid has any kind of effect on me. I'm far more familiar with these drugs than I want to be.<br/><br/>The boxes for the patches very clearly state that they're not for post-operative or acute usage. I'm baffled as to why they'd be prescribed. As for the side effect of breathing problems, I was under the impression that was the case for most heavy-duty painkillers.<br/><br/>And this guy DID leave the hospital AMA, paperwork or not. I'm sorry, but if I woke up during surgery, and then was at a high pain level afterward, I would not leave until my pain was under control. I don't quite understand how leaving the hospital after surgery, when it was suggested that he stay, is any fault of the hospital or the staff caring for him.<br/><br/>I'm sorry he had a bad experience, but it really does seem like he had more than a small part in creating his own misery. If he was too weak or in too much pain to advocate for himself, then it was his wife's job to advocate for him. Also, I very much doubt that that the orderly/nurse/whoever that met them in the waiting room REFUSED to help him. That would be grounds for disciplinary action at every hospital I've ever been too. Take some responsibility, Mr. Beck. If you'd just stayed the hospital for observation and pain management, oh. Wait. You wouldn't have a way to be an attention whore. Think I hit it, there? I suffer from chronic back pain, and my pain level is lessened but not completely resolved by the fentanyl patch (basically, I live at a four instead of the 6-8 I’d be at without them). I’m not anywhere near death (I hope!). Morphine does nothing for me, as a combination of long-term opiod use and inherited drug tolerance means that I am one of those people that, when in pain spike, only Dilaudid has any kind of effect on me. I’m far more familiar with these drugs than I want to be.

The boxes for the patches very clearly state that they’re not for post-operative or acute usage. I’m baffled as to why they’d be prescribed. As for the side effect of breathing problems, I was under the impression that was the case for most heavy-duty painkillers.

And this guy DID leave the hospital AMA, paperwork or not. I’m sorry, but if I woke up during surgery, and then was at a high pain level afterward, I would not leave until my pain was under control. I don’t quite understand how leaving the hospital after surgery, when it was suggested that he stay, is any fault of the hospital or the staff caring for him.

I’m sorry he had a bad experience, but it really does seem like he had more than a small part in creating his own misery. If he was too weak or in too much pain to advocate for himself, then it was his wife’s job to advocate for him. Also, I very much doubt that that the orderly/nurse/whoever that met them in the waiting room REFUSED to help him. That would be grounds for disciplinary action at every hospital I’ve ever been too. Take some responsibility, Mr. Beck. If you’d just stayed the hospital for observation and pain management, oh. Wait. You wouldn’t have a way to be an attention whore. Think I hit it, there?

]]> By: Anonymous http://www.kevinmd.com/blog/2008/01/glenn-beck.html/comment-page-1#comment-82619 Anonymous Wed, 09 Jan 2008 18:53:00 +0000 http://clients.emmense.com/kevinmd/2008/01/glenn-beck.html#comment-82619 <i>This patient, I'll wager, was not a pharmacologic virgin.</i><br/><br/>Good call--he's not. He was once a drug addict.<br/><br/>Someone asked what the surgery was for; it was for hemorrhoids. <br/><br/>Yes, hemorrhoids. And he thinks he "almost died." <br/><br/>I wanted to scream when I saw his ridiculous hysteria. And WTH, he was back at work in days--how bad could it <i>really</i> have been? I think the staff he said was BSing deserves his complaint--unless he hallucinated the whole thing--and he was obviously given an absurd amount of painkillers. (Of course, maybe they just wanted him to STFU.)<br/><br/>My sympathies to this obnoxious jerk's wife. Can you imagine living with someone like this? Ugh!<br/><br/>Honestly, I think this whole drama is just being milked for ratings. It's notable that he keeps mentioning how his YouTube video was "most watched" and stuff like that. I mean, does anyone even watch Glenn Beck on CNN-HN? I don't, but I (stupidly) did on Monday when he returned. Yeah, his little stunt worked. <br/><br/>God help him, his wife, and the medical profession should GB ever get a <i>serious</i> illness or injury. Sheesh. This patient, I’ll wager, was not a pharmacologic virgin.

Good call–he’s not. He was once a drug addict.

Someone asked what the surgery was for; it was for hemorrhoids.

Yes, hemorrhoids. And he thinks he “almost died.”

I wanted to scream when I saw his ridiculous hysteria. And WTH, he was back at work in days–how bad could it really have been? I think the staff he said was BSing deserves his complaint–unless he hallucinated the whole thing–and he was obviously given an absurd amount of painkillers. (Of course, maybe they just wanted him to STFU.)

My sympathies to this obnoxious jerk’s wife. Can you imagine living with someone like this? Ugh!

Honestly, I think this whole drama is just being milked for ratings. It’s notable that he keeps mentioning how his YouTube video was “most watched” and stuff like that. I mean, does anyone even watch Glenn Beck on CNN-HN? I don’t, but I (stupidly) did on Monday when he returned. Yeah, his little stunt worked.

God help him, his wife, and the medical profession should GB ever get a serious illness or injury. Sheesh.

]]> By: Anonymous http://www.kevinmd.com/blog/2008/01/glenn-beck.html/comment-page-1#comment-82617 Anonymous Wed, 09 Jan 2008 17:24:00 +0000 http://clients.emmense.com/kevinmd/2008/01/glenn-beck.html#comment-82617 Anybody know what the surgery was? Sure seems to me like a chronic back pain surgical intervention. A few things amaze me... he instantly woke up and described pain to the anesthetist, asked for something and cannot remember it. Here in the ER we call that the 10+ reflex ... 10+/10 pain and disoriented to TPP but still asking! The reply to the government mandated question "wake up and tell me on a scale of 1 to..." "20" syndrome.<br/><br/>Second .. the patient wakes up instantly and needs "three hours to stabilize me on pain" -- whatever that was. Did this not set the alarm bells off ... they actually let him go home. What the hell were the anesthetists and surgeons thinking!? If this guy wanted to go home so bad, they Docs needed an AMA.<br/><br/>Third ... Did anybody do a drug/alcohol/substance abuse screen before surgery? This patient either has no opioid pain receptors in his brain, or a liver that can metabolize narcotics (the proper term!). This patient, I'll wager, was not a pharmacologic virgin.<br/><br/>Fourth... yes heavy narcotic use can lead to urinary retention. And that is why they leave the catheter in for a few days, because with the potent narcotics they were using the patient will stay in urinary retention.<br/><br/>Fifth... I hope this patient doesn't get cancer or some other painful disease, because the cupboard is bare for controlling his pain with narcotics. The Sched 1 drugs may work, but you will not find any ER Docs that can prescribe heroin. <br/><br/>Finally, this represents the surgical trifecta. The surgeons get a procedure (on a questionably suitable candidate), raise the expectations of the patient that the red carpet will be rolled out for him by the ER (so the anger is directed at the ER and not the surgeon), and end up ultimately dumping him on some poor hospitalist and seeing him in consult. A potentially chronic surgical complication offloaded on the ER/Hospitalist, with and patient worships the surgeon.<br/><br/>Nice.<br/><br/>iDoc Anybody know what the surgery was? Sure seems to me like a chronic back pain surgical intervention. A few things amaze me… he instantly woke up and described pain to the anesthetist, asked for something and cannot remember it. Here in the ER we call that the 10+ reflex … 10+/10 pain and disoriented to TPP but still asking! The reply to the government mandated question “wake up and tell me on a scale of 1 to…” “20″ syndrome.

Second .. the patient wakes up instantly and needs “three hours to stabilize me on pain” — whatever that was. Did this not set the alarm bells off … they actually let him go home. What the hell were the anesthetists and surgeons thinking!? If this guy wanted to go home so bad, they Docs needed an AMA.

Third … Did anybody do a drug/alcohol/substance abuse screen before surgery? This patient either has no opioid pain receptors in his brain, or a liver that can metabolize narcotics (the proper term!). This patient, I’ll wager, was not a pharmacologic virgin.

Fourth… yes heavy narcotic use can lead to urinary retention. And that is why they leave the catheter in for a few days, because with the potent narcotics they were using the patient will stay in urinary retention.

Fifth… I hope this patient doesn’t get cancer or some other painful disease, because the cupboard is bare for controlling his pain with narcotics. The Sched 1 drugs may work, but you will not find any ER Docs that can prescribe heroin.

Finally, this represents the surgical trifecta. The surgeons get a procedure (on a questionably suitable candidate), raise the expectations of the patient that the red carpet will be rolled out for him by the ER (so the anger is directed at the ER and not the surgeon), and end up ultimately dumping him on some poor hospitalist and seeing him in consult. A potentially chronic surgical complication offloaded on the ER/Hospitalist, with and patient worships the surgeon.

Nice.

iDoc

]]> By: Anonymous http://www.kevinmd.com/blog/2008/01/glenn-beck.html/comment-page-1#comment-82612 Anonymous Wed, 09 Jan 2008 08:16:00 +0000 http://clients.emmense.com/kevinmd/2008/01/glenn-beck.html#comment-82612 I am an ER doc and completely sympathize with mr Beck. Everybody seems to be missiing the main thing the guy is cribbing about-lack of empathy! I have seen that in my ER before and it makes me crazy when the nurses are chit chatting and some family member has an agonizing look on their face is standing at the nursing station trying to get an answer. <br/>Of course his doctor dumped on the ER. That happens everyday. But the ERs job is to releive pain-who gives a rats ass whether his doctor callled ahead. The guys is here, he is agonizing pain-take care of him! I am an ER doc and completely sympathize with mr Beck. Everybody seems to be missiing the main thing the guy is cribbing about-lack of empathy! I have seen that in my ER before and it makes me crazy when the nurses are chit chatting and some family member has an agonizing look on their face is standing at the nursing station trying to get an answer.
Of course his doctor dumped on the ER. That happens everyday. But the ERs job is to releive pain-who gives a rats ass whether his doctor callled ahead. The guys is here, he is agonizing pain-take care of him!

]]> By: The Happy Hospitalist http://www.kevinmd.com/blog/2008/01/glenn-beck.html/comment-page-1#comment-82610 The Happy Hospitalist Wed, 09 Jan 2008 04:33:00 +0000 http://clients.emmense.com/kevinmd/2008/01/glenn-beck.html#comment-82610 This narrative sounds like a conversation I may have with one of my out of control alcoholic, entitled antisocial chronic pain seeking unemployeed, disabled freeloaders who refuses to LEAVE the hospital.<br/><br/>Is it politically incorrect to say that?<br/><br/>Honestly, I feel bad for the people he came in contact with, based purely on the words he has written.<br/><br/>And nothing else. This narrative sounds like a conversation I may have with one of my out of control alcoholic, entitled antisocial chronic pain seeking unemployeed, disabled freeloaders who refuses to LEAVE the hospital.

Is it politically incorrect to say that?

Honestly, I feel bad for the people he came in contact with, based purely on the words he has written.

And nothing else.

]]> By: Christian Sinclair, MD http://www.kevinmd.com/blog/2008/01/glenn-beck.html/comment-page-1#comment-82608 Christian Sinclair, MD Wed, 09 Jan 2008 03:46:00 +0000 http://clients.emmense.com/kevinmd/2008/01/glenn-beck.html#comment-82608 Thanks for highlighting this story and all the other stories you bring. Just a tip, opioids is probably a much better/preferred term as opposed to narcotics. Narcotics just emphasizes the stigma of opioids since it is primarily used as a law enforcement term. A lot of medical providers still use the term narcotics, but for those who work closely with these medications, it is perceived as inaccurate and outdated.<br/><br/>Another great point this story brings up is that just because medicines like fentanyl and morphine are used at the end of life, does not make them inappropriate for other medical situations. Although using fentanyl patches in the opioid naive should be done with caution. Thanks for highlighting this story and all the other stories you bring. Just a tip, opioids is probably a much better/preferred term as opposed to narcotics. Narcotics just emphasizes the stigma of opioids since it is primarily used as a law enforcement term. A lot of medical providers still use the term narcotics, but for those who work closely with these medications, it is perceived as inaccurate and outdated.

Another great point this story brings up is that just because medicines like fentanyl and morphine are used at the end of life, does not make them inappropriate for other medical situations. Although using fentanyl patches in the opioid naive should be done with caution.

]]> By: Goatwhacker http://www.kevinmd.com/blog/2008/01/glenn-beck.html/comment-page-1#comment-82606 Goatwhacker Wed, 09 Jan 2008 02:17:00 +0000 http://clients.emmense.com/kevinmd/2008/01/glenn-beck.html#comment-82606 My first reaction is how over dramatic Beck is being here, but I guess I'll give him the benefit of the doubt. I've never seen anybody as worried about respiratory depression as this guy, where the heck is that coming from? All it would have taken is a couple of minutes to explain pain control and Beck could have used his PCA pump and got some rest.<br/><br/>The "wonderful" surgeon dumped big time on the ER here. I'm not sure the non-medical readers are getting this aspect. My first reaction is how over dramatic Beck is being here, but I guess I’ll give him the benefit of the doubt. I’ve never seen anybody as worried about respiratory depression as this guy, where the heck is that coming from? All it would have taken is a couple of minutes to explain pain control and Beck could have used his PCA pump and got some rest.

The “wonderful” surgeon dumped big time on the ER here. I’m not sure the non-medical readers are getting this aspect.

]]> By: Anonymous http://www.kevinmd.com/blog/2008/01/glenn-beck.html/comment-page-1#comment-82604 Anonymous Wed, 09 Jan 2008 01:22:00 +0000 http://clients.emmense.com/kevinmd/2008/01/glenn-beck.html#comment-82604 everybody should go to fda.gov (http://www.fda.gov/consumer/updates/fentanylpatch122107.html) and search fentanyl. should NEVER have been given patches. straight from fda's second warning on these patches:DURAGESIC(fentanyl) is only for patients with chronic (around the clock) pain that is moderate to severe and EXPECTED TO LAST FOR WEEKS OR LONGER.You should ONLY use fentanyl if you have been taking at least 60milligrams (mg) of oral morphine daily, or at least 30 mg of oral oxycodone daily, or at least 8 mg of oral hydromorphone daily, or an equally strong dose of another opioid for A WEEK OR LONGER before starting fentanyl. doctors can ignore 2 fda warnings? time to start sendind docs to defensive doctoring classes. everybody should go to fda.gov (http://www.fda.gov/consumer/updates/fentanylpatch122107.html) and search fentanyl. should NEVER have been given patches. straight from fda’s second warning on these patches:DURAGESIC(fentanyl) is only for patients with chronic (around the clock) pain that is moderate to severe and EXPECTED TO LAST FOR WEEKS OR LONGER.You should ONLY use fentanyl if you have been taking at least 60milligrams (mg) of oral morphine daily, or at least 30 mg of oral oxycodone daily, or at least 8 mg of oral hydromorphone daily, or an equally strong dose of another opioid for A WEEK OR LONGER before starting fentanyl. doctors can ignore 2 fda warnings? time to start sendind docs to defensive doctoring classes.

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