The Medical Thread

[barcode120x]

Originally Posted by GenjiChan

Then if placebo did work, is it still wrong? We are preventing an obvious dependence on pain medications that's why we are sometimes informed by the physician to be sure that the patient is really in pain before giving the said medication. We do observation and using the 0-10 pain scale most of the time....

Imo it's wrong in the sense that the patient has the right to know what kind of drug they're taking. I know that defeats the purpose of a placebo, but going through a whole lecture and exam on legality/ethics/morality of nursing, there's a lot of "rights" that are involved with patients and the "right to know" is a biggy. That's my main concern both as a nursing student and if I was a patient.

[NoemiChan]

Originally Posted by barcode120x

Imo it's wrong in the sense that the patient has the right to know what kind of drug they're taking. I know that defeats the purpose of a placebo, but going through a whole lecture and exam on legality/ethics/morality of nursing, there's a lot of "rights" that are involved with patients and the "right to know" is a biggy. That's my main concern both as a nursing student and if I was a patient.

YEah.... but if successive doses of different medications has been give and yet the pain scale is still high (as alleged by the patient) but his facial expression says other wise ( hear him laughing with his friends before you enter his room).. I think another request of dose won't be making him good but worst mentally speaking... Yeah, we have ethics but RL experience will often shock you....

[Ledgem]

Originally Posted by GenjiChan

Then if placebo did work, is it still wrong? We are preventing an obvious dependence on pain medications that's why we are sometimes informed by the physician to be sure that the patient is really in pain before giving the said medication. We do observation and using the 0-10 pain scale most of the time....

What do you mean by "dependence on pain medications"? Are you afraid of getting patients addicted to the medications? That's the common fear among patients and medical professionals alike. Two points worth noting:

1) If a patient has a chronic pain condition then it's expected that they'll become dependent on the pain medication. And why shouldn't it be given in that scenario?

2) Studies indicate that addiction from opioid pain medications among the general population is only around 2-3%. In other words it happens, but at an incredibly low rate that does not justify the concerns that are expressed about it.

If you ever have the chance to work with a pain specialist who knows what they're doing with pain medications and pain management I can highly recommend working with them. The number of misconceptions that I learned in medical school are staggering, and not surprisingly it results in many physicians (and other medical professionals) doing things that don't make much sense with those medications.

The ethical question of "if the placebo worked, is it wrong" is an interesting one, though. Medical professionals care for the patient, but the patient retains ownership of their body at all times. While the system used to operate under the notion that the doctor knew best and directed everything (patriarchal medicine), the more modern expectation is that of patient autonomy. The patient ultimately calls the shots on treatment, and the doctor acts as something of a guide and consultant, laying out the options and explaining them to the point that the patient can make an informed decision. Under the former model of medicine, placebos would be a valid option. It should be clear that placebos are not compatible with the new model.

It's important to note that the patient's right to know is also a right to not know, however. The legality of this may be sketchy but in theory the patient could very well agree and consent to being switched to a placebo without knowing, as long as the doctor explains what's being done and what the potential benefits are to the patient.

Originally Posted by GenjiChan

YEah.... but if successive doses of different medications has been give and yet the pain scale is still high (as alleged by the patient) but his facial expression says other wise ( hear him laughing with his friends before you enter his room).. I think another request of dose won't be making him good but worst mentally speaking... Yeah, we have ethics but RL experience will often shock you....

You've never seen someone in severe pain laugh or smile?

As I said before, this requires some of your discretion as a medical professional to determine whether or not someone is faking symptoms. It is my personal belief that we should always err on the side of caution, though. If a person is truly in pain then you are doing them a tremendous service, doubly so because many members of the medical system are cynical about claims of pain with no obvious source. A drug addict will continue to be a drug addict regardless of whether their next hit comes from you or from someone else.

To be clear, I am not saying that we should give pain medications to everyone who asks for them. I am saying that the amount of evidence we need to declare someone a drug-seeker should be greater than what it is. Is overhearing someone laughing with his friends good enough evidence to declare that he is faking symptoms? Maybe it was: you were there to experience everything first-hand and have a lot more information on the situation than that, some of which can't be conveyed through text. Yet maybe it wasn't, and we are being too quick to declare people fakers. In the process of doing so we would rightly turn away many drug-seekers, but we would also be doing a terrible disservice by turning away people with legitimate pain who needed our help.

[GDB]

Originally Posted by Ledgem

I've had it twice in my life, and both times were during periods of high stress and lack of sleep. I would suggest attempting to find ways to de-stress as much as possible and to get onto a healthier sleep schedule. Even if those don't fix your spasms they're healthy changes to your life that will benefit you regardless. I don't know what the official data says (if there is any) but even after fixing my sleep schedule it took at least a few days, perhaps up to two weeks, for the spasms to go away.

Originally Posted by barcode120x

I actually had this EXACT issue mid last year when I started working graveyard shift (11:30pm-8am). I too didn't know what it was, but I did notice I was getting bags under my eyes and my eyes were always drying out and blood shot (I wear both glasses and contacts). I worked gy shift on the weekends then during the weekdays I would be back to regular sleeping schedule + school. I don't think it was stress (but I do think that it could be a contributing factor) since school wasn't too bad for me. This all lead me to believe that it was the lack of sleep that was causing these eye twitches.

I don't know exactly when it went away, but I just stopped having it. Most likely since I got used to working gy shifts and I do tend to take a lot of naps a week + I always make sure I get at least 6 hours of sleep a day. I'd say get as much sleep as you can and find things to de-stress, exercise, gaming, anime, etc x)

Thanks both of you. My stress has gotten worse due to work (though at least the stress from worrying about my eye went away), but after getting on to a better sleep schedule my eye stopped twitching. One load off my mind.

[SummeryDreams]

Originally Posted by GenjiChan

Then if placebo did work, is it still wrong? We are preventing an obvious dependence on pain medications that's why we are sometimes informed by the physician to be sure that the patient is really in pain before giving the said medication. We do observation and using the 0-10 pain scale most of the time....

If pseudoaddiction is the case, placebos wont give that much of a relief as the problem is sensitivity in the drug rather than fighting of intervals. if a dosage of morphine wont give relief but a higher dose will do, placebo weren't be effective as we are now dealing with how MUCH is needed rather than WHEN it is needed.

[SaintessHeart]

Originally Posted by GDB

Thanks both of you. My stress has gotten worse due to work (though at least the stress from worrying about my eye went away), but after getting on to a better sleep schedule my eye stopped twitching. One load off my mind.

Mix :

1 glass of milk.
2 tablespoons of blueberries
50ml of yoghurt

into a blender. Put it in a bottle and label it "For my lovely onii-chan" and let it refrigerate overnight.

Pretend that it is from your favourite loli when open the fridge during breakfast.

[SummeryDreams]

Originally Posted by GenjiChan

YEah.... but if successive doses of different medications has been give and yet the pain scale is still high (as alleged by the patient) but his facial expression says other wise ( hear him laughing with his friends before you enter his room).. I think another request of dose won't be making him good but worst mentally speaking... Yeah, we have ethics but RL experience will often shock you....

If you're very observant, even a layman could tell if someone is faking their pains. And just so you know, the best fakers of pain are children; not psychotics. xD

[barcode120x]

Originally Posted by SummeryDreams

If you're very observant, even a layman could tell if someone is faking their pains. And just so you know, the best fakers of pain are children; not psychotics. xD

Or prisoners xD

[VGAddict]

I had to have an appendectomy in my junior year of high school.

[SummeryDreams]

Originally Posted by barcode120x

Or prisoners xD

Nope, prisoners are easy to read whether they are faking pain. xD I don't know, but I guess we've developed some kind of instinct over how to tell if someone is faking any. Though children are really difficult to assess as they are fakers of pain because of fear to come in the hospital, psychotics are next though. A schizo who has a somatoform disorder had trolled me one time, and my instructors was like - you believe in his fakes then you're a fake nurse as well - ouch that hurts. xD

[SummeryDreams]

Originally Posted by VGAddict

I had to have an appendectomy in my junior year of high school.

This is one of the easiest operation ever.. it got about 90% success rate. Even interns are permitted (though not advised) to do appendectomy here in our place. xD I haven't heard someone died of an appendectomy.

[Kerspunkle]

Is it cause for concern if you scream and you get a sharp pain at the base of the skull and after a few minutes the sharp pain goes away and you develop tension (like if you're looking up at a movie screen for a really long time and you're in the front row) in that same area, then get a headache directly above the temples and in the forehead?

[Ledgem]

Originally Posted by Kerspunkle

Is it cause for concern if you scream and you get a sharp pain at the base of the skull and after a few minutes the sharp pain goes away and you develop tension (like if you're looking up at a movie screen for a really long time and you're in the front row) in that same area, then get a headache directly above the temples and in the forehead?

Sounds like it's just muscle spasm. How many times has it happened?

[Kerspunkle]

Originally Posted by Ledgem

Sounds like it's just muscle spasm. How many times has it happened?

Just once.

[NoemiChan]

Originally Posted by SummeryDreams

If you're very observant, even a layman could tell if someone is faking their pains. And just so you know, the best fakers of pain are children; not psychotics. xD

Hahah... Some relatives are foolish even if it's pretty obvious..... 8/10 are so foolish.... Kids... don't make me remember... 8/10 are actually faking it... but after seeing the syringe... the pain goes away... instantly... hahaha

You've never seen someone in severe pain laugh or smile?

An old women with hepatitis and cholelithiasis... such a sweet women.... we talk a lot while she's in pain... she understands why I can't just give pain meds in an instant.... She follows my advice truthfully....

[SummeryDreams]

Originally Posted by Kerspunkle

Is it cause for concern if you scream and you get a sharp pain at the base of the skull and after a few minutes the sharp pain goes away and you develop tension (like if you're looking up at a movie screen for a really long time and you're in the front row) in that same area, then get a headache directly above the temples and in the forehead?

I've tried this. Nothing serious about it. There is an increase pressure in the brain caused by screaming. This happens to me everytime as I sing and scream a lot. I just take some rest whenever this happens to me.

[SummeryDreams]

Originally Posted by GenjiChan

Hahah... Some relatives are foolish even if it's pretty obvious..... 8/10 are so foolish.... Kids... don't make me remember... 8/10 are actually faking it... but after seeing the syringe... the pain goes away... instantly... hahaha



An old women with hepatitis and cholelithiasis... such a sweet women.... we talk a lot while she's in pain... she understands why I can't just give pain meds in an instant.... She follows my advice truthfully....

There are clients who usually tolerates pain really good. Pain is subjective in nature though, what painful for others may not be that painful for some. My clinical instructor got an accident and it tears her achilles tendon. He was rush to the ER, and the ER ran out of Anesthesia. The doctor sew her achilles tendon without anesthesia. That hurts, ouch!

[AnimeFan188]

The promises and pitfalls of a magic exercise pill:

"Researchers have discovered a special protein that mimics the physiological effects
of a tough workout

The pipe dream of a do-it-all exercise pill isn't a new idea. Imagine the promise! No
more gym locker rooms that smell like moist socks; no more fruitless five-mile runs,
especially on hot summer days (looking at you, New York); no more obnoxious
trainers hovering over you, twisting you into weird knots while asking you to lift a
kettle bell.

Instead, your entire workout would consist of popping a pill and chasing it with a
gulp of water."

See:

http://news.yahoo.com/promises-pitfa...160500824.html

[SummeryDreams]

This is still understudy, so we can't get a brief and detailed explanation of its chemical components. At the very least, I won't use any supplemental drug not unless I will know its pharmaceutical background. If I take supplemental drugs by the way just like before, I don't follow the instructions in the administration of the drug. I usually do some detailed research and will anaylze its composition and will generate a program over that supplement. Will give me better results. xD

[NoemiChan]

Originally Posted by AnimeFan188

The promises and pitfalls of a magic exercise pill:

"Researchers have discovered a special protein that mimics the physiological effects
of a tough workout

The pipe dream of a do-it-all exercise pill isn't a new idea. Imagine the promise! No
more gym locker rooms that smell like moist socks; no more fruitless five-mile runs,
especially on hot summer days (looking at you, New York); no more obnoxious
trainers hovering over you, twisting you into weird knots while asking you to lift a
kettle bell.

Instead, your entire workout would consist of popping a pill and chasing it with a
gulp of water."

See:

http://news.yahoo.com/promises-pitfa...160500824.html

I better take a walk..... People today are becoming too lazy....