Mrsa

[oscardeuce]

Originally Posted by Tizzo
http:///forum/post/2482254
Oscardeuce, I have a question for you...
The public has been taught since elementary school that there is no cure for the common cold. And I understand that antibiotics will not work on viral. That being said, when I took my daughter in, I also checked in. Lemme explain why and you can explain why they did what they did... I figure I had a common cold, so I didn't want antibiotics, but my eyes were swollen, burning, and extremely itchy and running enough to make it look like I was crying. My head was hurting and they told me I has a sinus infection as well as an ear infection. So of course they gave me the antibiotics.
But I was "treating the symptoms" at home with tylenol, nyquil, and ibuprofen and nothing relieved the discomfort in my head and eyes. I WANTED pain killers or something of the like. Why wouldn't they prescribe 3 or 4 days of something to remove the obvious discomfort? My hubby had Panadeine in his travel bag, thank goodness, but why wouldn't the docs give me something to treat the symptoms more aggressively.
And just to avoid the obvious topic, I used to work in a hospital and I realize there are drug seekers, but you could tell by looking at me that my symptoms were real.
I can't say why as every physician is different. I usually prescribe pain

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for ear infections as they can be quite painful. Some are more liberal prescribing than others.

 

[al mc]

Originally Posted by oscardeuce
http:///forum/post/2482718
I can't say why as every physician is different. I usually prescribe pain

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for ear infections as they can be quite painful. Some are more liberal prescribing than others.
Goes back to the legal ramafications again. The MD prescribes you pain killers. You get sick because of them..he/she may get sued. You become addicted to them..he/she gets sued....You child gets into them becomes/ill/tries to sell them at school..MD gets sued.
This is a world of defensive medicine. Why does NJ have to pay doctors to practice obstetrics...you guessd it.....they are tired of paying 3-4 hundred K per year in malpractice insurance, if they can even get it.

 

[tizzo]

Originally Posted by Al Mc
http:///forum/post/2482782
Goes back to the legal ramafications again. The MD prescribes you pain killers. You get sick because of them..he/she may get sued. You become addicted to them..he/she gets sued....You child gets into them becomes/ill/tries to sell them at school..MD gets sued.
I hardly think 3 days worth would get me addicted. If my kid gets into them, well, depending on the state, in NC if it's 1% my fault because I didn't lock the cabinet or whatever, then they pay nothing. They have to be 100% responsible. Not sure about here though. And if I get sick that should fall back on the little questionaire I filled out.
BUt in a sense your right and it's sad.
Oh but oscardeuse, thanks for the reply.

 

[bigarn]

Men are from Mrsa .... women are from Venus. Hope this helps.

 

[oscardeuce]

3 years ago my group's malpractice insurance went from $60,000/yr to $400,500/ yr. WITHOUT a claim against us. That's about $35/patient just to pay the insurance. Needless to say we did not do too well that year.
We need a better union!

 

[janastasio]

I have a sister who used to get pain meds for small things like strep, ear infections, ect. Then after she had kids by Caesarian section she was also put on pain meds. She now has an addiction problem, and has had to be in 2 rehab programs, and I still believe she has her addiction problem. People dont plan on becoming addicts, but it does happen if you end up needing pain medicines for minor ailments. Please dont think I'm being insensative to your pain, I just have seen many years of a sister who feels she should not have to deal with pain and abuses medicines to deal with it. Now she is unable to tolerate anything. Life is full of pain, and unfortunately maybe pain medicine would help this time, but the next time maybe it would take more to relieve pain and so on and so on. I think practitioners tend to worry about these things.

 

[elfdoctors]

I am a family physician myself. I am glad that oscardeuce has been piping in here as I've tended to become a lurker on these boards.
However, I wanted to put a historical spin on this. Back before antibiotics and antiseptic technique, practically every surgical wound became infected. Doctors would keep close tabs on the type of discharge from the wounds. If the wound became foul-smelling, it was often a sign of gas gangrene - these people usually died (from clostridial perfringens infections). If the area surrounding the wound became bright red and the patients developed a fever, these people also usually died (from overwhelming streptococcal infections). However, if "laudatory pus" formed (indicative of a staph infection), these people usually survived.
The first two infections are usually easily treated with antibiotics. Our treatment for staph infections will likely be returning to the way that staph infections were treated before antibiotics. Often, the best treatment for staph infections is a surgical treatment (by a simple lancing).
I agree that the fear over MRSA has become far too overblown. I also completely agree that antibiotics are overprescribed. I have always been conservative with antibiotics (but I have the luxury of practicing in an medically under-served area and I have more patients that I want - so I don't care if people want to drive half an hour away to get the antibiotics or pain

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they think they need). People should really be worrying about things that are much more important (such as banning smoking or helping with obesity problems). These problems contribute to FAR more preventable deaths than all infections put together (even including ALL influenza, AIDS and the exceedingly rare deaths from staph infections).
Related to the issue of pain medications, I am liberal with them for appropriate indications. Narcotics are best used for nocioceptive type pains, i.e. when definite tissue damage has occurred (e.g. broken bones). They are quite ineffective for the more common type of pain which people have today - neuropathic pains (often caused by having nerves with low pain thresholds). My rule of thumb is to practically never use narcotics for non-cancer pains which have lasted more than 30 days. In the ER setting, I have been amazed at how often the same people keep returning to the ER for a different pain related concern often seeking narcotics for conditions that could easily have waited until normal clinic hours. There is good evidence to show that when narcotics are taken for over 1 month that people tend to have 1) MORE pain than people who are not on narcotics, 2) LOWER quality of life, 3) LOWER likelihood of being able to get back to their jobs and normal life activities. People seem to have forgotten why heroin became a banned substance. I also tend to be much more conservative with prescribing to people who are already addicted to another substance (e.g. tobacco).

 

[tizzo]

Thanks Elfdoc, and welcome back! Nope, haven't seen to much of you lately.
WEll, thanks for all your info, but a little off topic issue you pointed out reminded me of something.
About 4 years ago, i was...how you say in english, VERY overweight. I actually went to Jenny Craig, and they told me I needed a doctors note before they'd help me. I remember leaving there kinda mad. I didn't need a doctors note to GAIN all that weight (which I did rather quickly. I was pregnant and me and Hershey's developed an intimate relationship), anyway I was so mad. I had to pay a dostor 80 bucks just for the visit for that note. So, of course I didn't use JC, but I thought it was ironic that you need permission to lose, but it's OK to put the candy bars on every isle, desserts are advertised everywhere in a restaraunt before you even eat your meal and heck now a days the meals themselves are desserts!! IHOP is a great example.
Anyway, I have since lost every pound and got down to a size 4 on my own. (I was squeezing into an 18 before).
But it's still nauseating to see how sugar is "pushed", and obesity IS the #1 problem.
and I don't smoke

Used to, but quit that about 8 years ago.