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Falling five storeys from a New York rooftop changed my life

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Re: Falling five storeys from a New York rooftop changed my life

#91

Post by astura »

a_t48 wrote: post #38
mattr47 wrote: post #24

Earlier quoted context omitted.

I've had both morphine via IV and fentanyl via a lollipop. Both were in Afghanistan and as far as pain relief goes the morphine was way better for me, because I got a large dose in my bloodstream. I totally understood at that point why people get addicted to that stuff. I did not care about anything at that point. The fentanyl just did not have a strong effect on me.

I had morphine for appendicitis. It didn't appear to do anything for me. :(

Any time I've had any sort of opioid the only thing it did for me is make me feel extremely sick.

Re: Falling five storeys from a New York rooftop changed my life

#93

Post by throwaway0a5e »

mncharity wrote: post #40
mpalmer wrote: post #2

The most pressing issue for the orthopaedic team was my left shoulder, which was visibly dislocated. Before attempting to reattach it, the doctor told me I would be given a dose of fentanyl: an opioid that is up to 100 times more potent than morphine. He went away, returned and started using a bed sheet to try to pop the shoulder back into the socket. Alarmed, I told him that I had not been given any pain medication.…

Doctors, surgeons in particular, are both project manager and individual contributor. At peak IC work load, the manager role gets starved for cycles. A failure to track "X was intended - did it actually happen?" is a typical of this. Having someone with you can help. "He's right, Doctor, the nurse hasn't yet ...". A role of maintaining a clear picture of project state, making sure everyone is on the same page, and mo…

They're also known for thinking their always right and not asking the team if the patient got their painkillers is exactly in character for that stereotype.

Re: Falling five storeys from a New York rooftop changed my life

#94

Post by Renaud »

nickjj wrote: post #31
WJW wrote: post #3

Earlier quoted context omitted.

Really seems like a "hey nurse did this patient have their fentanyl yet?" would have resolved this issue. Anyway if it's really 100x more potent than morphine you'd think any person that did have it in their bloodstream would not be all that capable of stating that they have not had their medication yet.

> Really seems like a "hey nurse did this patient have their fentanyl yet?" would have resolved this issue. You'd be surprised at how questionable hospital care is run in NY, even with $450 / month insurance with a high deductible. To protect the privacy of the person I know, here's a story from 2-5 months ago: - Person A goes into doctor's office for something pretty common - Doctor requests cat scan or MRI (I forgo…

I find it bonkers that the surgeon had no prior involvement in reviewing the case before the patient is brought into the operating room.

That's really scary.

Re: Falling five storeys from a New York rooftop changed my life

#95

Post by boomboomsubban »

Renaud wrote: post #94
nickjj wrote: post #31

Earlier quoted context omitted.

> Really seems like a "hey nurse did this patient have their fentanyl yet?" would have resolved this issue. You'd be surprised at how questionable hospital care is run in NY, even with $450 / month insurance with a high deductible. To protect the privacy of the person I know, here's a story from 2-5 months ago: - Person A goes into doctor's office for something pretty common - Doctor requests cat scan or MRI (I forgo…

I find it bonkers that the surgeon had no prior involvement in reviewing the case before the patient is brought into the operating room. That's really scary.

Requiring a surgeon's consultation before scheduling seems like it would be a huge hassle to arrange, and greatly reduce the amount of surgeries they could perform.

Beyond that, I'm not sure what benefit there would be to a surgeon independently reviewing the case early. Thinking about what they'll need you do in tomorrow's surgery would distract them during today's surgery.

Re: Falling five storeys from a New York rooftop changed my life

#96

Post by Reelin »

mikeyouse wrote: post #64
dkdk8283 wrote: post #39

Earlier quoted context omitted.

As someone who went through a IM nail procedure I couldn’t have done it without opiates. I didn’t get addicted either. It’s a valuable drug that was abused.

Yeah it’s absolutely indicated for some surgeries but unfortunately it’s “defaulted” for many as well, so people end up going home on prescriptions for it after cases where they didn’t really need it. The movement is to ID which cases don’t call for it and then use alternative anesthesia / analgesia to make the post op care consist of extra strength Motrin instead of opioids. The other part is to dramatically reduce…

> Small barriers to access have a huge impact on addiction.

At the expense of those who legitimately need it. Given how ridiculous the current climate has become, I would almost certainly preemptively purchase black market opiates prior to a procedure if the timing allowed for it. (At this point, I almost feel compelled to keep some on hand for family in general based on past experiences.)

Re: Falling five storeys from a New York rooftop changed my life

#97

Post by wl »

boomboomsubban wrote: post #95
Renaud wrote: post #94

Earlier quoted context omitted.

I find it bonkers that the surgeon had no prior involvement in reviewing the case before the patient is brought into the operating room. That's really scary.

Requiring a surgeon's consultation before scheduling seems like it would be a huge hassle to arrange, and greatly reduce the amount of surgeries they could perform. Beyond that, I'm not sure what benefit there would be to a surgeon independently reviewing the case early. Thinking about what they'll need you do in tomorrow's surgery would distract them during today's surgery.

At least with the surgeons I know in the United States, they have days devoted to clinic and days devoted to surgery. They meet with nearly all their patients beforehand to evaluate their conditions and discuss the options. The exceptions are emergent cases or if a surgeon (resident, fellow, or attending) is assisting on someone else's case that was seen in clinic by the primary surgeon.

Re: Falling five storeys from a New York rooftop changed my life

#98

Post by flemhans »

sjg007 wrote: post #84
admiral33 wrote: post #16

Earlier quoted context omitted.

There's a whole market for that. Roller coasters, haunted houses/corn maze etc. They get people as close to the edge of that feeling as possible. They won't get that full effect though because people know they are safe. If you wanted to get the full effect you need to break the illusion that customers signed up for midway through. Convince riders that the roller coaster is broken while they're still going full speed.…

Go parachuting. The split second before the chute catches is something else.. terrifying. Especially if you tandem jump. I imagine bungee jumping is similar.

I did a tandem in the Middle East and the instructor kept joking about how I wasn't Arab and didn't have faith and it would be so easy to clip me off the parachute :D

"Lol"

Re: Falling five storeys from a New York rooftop changed my life

#99

Post by [deleted] »

trhway wrote: post #83
WJW wrote: post #3

Earlier quoted context omitted.

Really seems like a "hey nurse did this patient have their fentanyl yet?" would have resolved this issue. Anyway if it's really 100x more potent than morphine you'd think any person that did have it in their bloodstream would not be all that capable of stating that they have not had their medication yet.

>Really seems like a "hey nurse did this patient have their fentanyl yet?" would have resolved this issue. i somehow think that a medical doctor should be able to tell whether a person has an opioid [at least in a pain relieving dose] in their system.

[deleted]

Re: Falling five storeys from a New York rooftop changed my life

#100

Post by dkdk8283 »

Reelin wrote: post #96
mikeyouse wrote: post #64

Earlier quoted context omitted.

Yeah it’s absolutely indicated for some surgeries but unfortunately it’s “defaulted” for many as well, so people end up going home on prescriptions for it after cases where they didn’t really need it. The movement is to ID which cases don’t call for it and then use alternative anesthesia / analgesia to make the post op care consist of extra strength Motrin instead of opioids. The other part is to dramatically reduce…

> Small barriers to access have a huge impact on addiction. At the expense of those who legitimately need it. Given how ridiculous the current climate has become, I would almost certainly preemptively purchase black market opiates prior to a procedure if the timing allowed for it. (At this point, I almost feel compelled to keep some on hand for family in general based on past experiences.)

I have a small bit left over from my surgery in my freezer in case of an emergency. It’s been a number of years but I’m planning to keep it around.
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