Sunday, March 27, 2011

The Return Of IronMan


Between Pysch Doc's hospital and mine, we are used to seeing IronMan frequently. (Click here for original Iron Man post if needed)

A month had gone by, and neither of us had seen him. I checked our electronic medical records, and it had been 5 weeks since he had been to any of the hospitals in my system. Had IronMan finally succeeded in offing himself!?!?

No it couldn't be. He is Iron Man. And although young, Iron Man is a GOMER, and GOMERs don't die.

Then 2 days ago he resurfaced in a triumphet return. He drank a bottle of rubbing alcohol and was vomiting everywhere. He said he did it b/c he was "frustrated" that he could only have his medicines as long acting shots instead of pills. The doctors had taken away all of his pill prescriptions due to his multiple ingestions.

Me: "Iron Man, where have you been? I haven't seen you in awhile"

Iron Man: "Hey ER Doc. I was at hospital-X for swallowing bleach. I'm not gonna swallow that stuff anymore. I went to hospital-Y for a week after swallowing a razor blade I put in a pill bottle. Then I went to hospital-Z for my normal Tylenol overdose. I really don't like hospital-Z. Can you send me back to hospital-A so I can see your friend Psych Doc. I like him."

Soo....I let time pass, treated his nausea, etc. He was cleared from a medical standpoint. And since he drank the rubbing alcohol b/c he was "frustrated" and not suicidal, I was going to be able to discharge him back to the group home instead of a psych hospital....a first.

But remember, Iron Man's goal is to live at a psych facility...not go back to a group home.

So he promptly made his way to the middle of the ER, fell on the floor and started shaking and screaming and acting like he was having a seizure. He kept screaming "THE VOICES ARE BACK THE VOICES ARE BACK." (He hears no voices but his own.)

So as everyone freaked out and went to get meds, I went to him and said quietly, "Iron Man, if I get you to a psych facility will you stop acting up and go back to your room?"

Amazingly the seizure stopped and the voices went away. He stood up and said, "OK, sounds good. I'll be sure to say I am suicidal this time. Oh yeah I ate plastic Chloraprep a few minutes ago too." I was pissed b/c the staff knows not to leave ANYTHING in his room.

So I called our psych liaisons, and of course their day was ruined. He was in the ER another 24 hours until a new facility accepted him.

This is the legend of Iron Man.

-ER Doc

11 comments:

Andrea said...

"...my normal Tylenol overdose..."?????

I have no words

Shash said...

He is truly Ironman. Amazing.

Webster said...

Goodness, you seem to show more compassion to Ironman than you do to anyone presenting with fibromyalgia. Interesting...

Wiggin said...

@Webster;

Ironman sounds like he's actually crazy, and wants to be treated for being crazy. Fibro patients are actually crazy, but want pain pills for their crazy. Big difference. One is asking for something with a chance of helping, one is asking for something that will only make the problem worse.

June Clever said...

"Fibro patients are actually crazy, but want pain pills for their crazy. Big difference. One is asking for something with a chance of helping, one is asking for something that will only make the problem worse."

It's my understanding that most fibro patients have been diagnosed by an MD as having fibro. For the average patient (ie. one who buys whatever the doctor is selling without researching on their own) how are they to discern that what they have may indeed be chronic depression rather than a pain disorder?

You go to the doctor with pain. The doctor says "Oh, you have generalized pain and are inactive due to the pain. Here, take these pain meds" Most patients are going to believe what the doctor is saying and not assume they have pain and inactivity due to depression and that the inactivity is, in fact, exacerbating the pain.

Their doctor has told them they have fibro. TV tells them they have fibro. Magazines tell them they have fibro. What would make them think that their doctor (whom they having a working relationship with, and trust), and TV and magazine ads are all wrong and what they actually have is depression?

I do not have fibro and have never had a doctor tell me that I do so that's not my motivation for asking. But, my point is, pain is pain. I'm guessing fibro patients actually do feel pain and no doctor that they trust has ever told them that what they have is anything besides fibro. It's not the patients fault that they are misdiagnosed, or mis-treated, by their doctor so why are some MDs so hostile to fibro patients who likely have no idea that they aren't being treated with anything that will actually help the underlying issue?

Anonymous said...

Ender is right, and so is Webster. SerenityNow disrespects people that have a psych issue that they don't know/don't want to accept is psych. It is a common practice amongst those in ERs b/c they cannot treat a Fibro/IBS patient in the ER - they just waste time. Frustration = disrespect. I think you'd feel similarly if you had someone come into your place of business and be unable to help them time and time again.

Don't get all upset about political non correctness, I'm sure they treat the patients just fine, they're allowed to rant on their own damn blogs. People are so touchy, damn. And for the record I have major depression and IBS, I'm suped on SSRIs all the time and don't feel particularly bad about it.

Melissa said...

I had a patient eat a hairbrush prior to admission once. Intact.

I so badly wanted to ask how they accomplished it, but professionalism won. I still regret that victory. Because seriously, how do you swallow a hairbrush whole? The world may never know...

Anonymous said...

re mellissa:

he/she was probably used to taking in large cocks

pay pal said...

Excellent article, thanks for the article, do not forget to visit my blog Indonesian people on a pay-pal-indonesia.blogspot.com

Mark p.s.2 said...

From the first IronMan post comments.
Me"There is no psychosis molecule for an anti-psychotic to effect."

You "True. But there is dopamine and serotonin." (in the brain)

Doctors do not test dopamine and serotonin levels in their patients, (as no such test exists for a living brain).

All you care about is an effect on the psychotic patient. Fine , that is reality.
But what is psychotic?

You (as a doctor) are forced to control an out of control person (psychotic).

What if you just put them to sleep, under anesthesia? That would solve the psychotic behavior problem.

Antipsychotic are a solution for you the doctor, not the patient.

Who pays the bill? The Government.
You are acting on behalf of the Government as a jailer. Stopping crime before it happens, because it would happen.

The drugs and labels you force on people stop them from learning from their mistakes. You trap them in the role of mental patient.
What other options does IronMan have?
Could he learn to live a different way with no one to teach him? Not likely.
But then he is supposed to be an adult. But he is a mental patient and not responsible for his actions, his mental illness is.
More antipsychotics for the mental illness.

ERP said...

I would love to see him be transferred to Nurse K's hospital and see what she blogs about him. He sounds legendary.