About last week

Monday's migraine stayed all day, and worsened towards the evening. I couldn't see any way of making it disappear with what I had to hand, so ER it was.

In many ways the visit was crazy and confusing, but I'd say the most basic problem was that when I woke up there around 3 in the morning, still in pain, I wasn't able to get more pain medication for two or three hours. Report is that I metabolise this stuff very quickly, so the more space inbetween doses, the less efficaceous it is.

I'm not going to harsh on the ER in question for that delay--there had been a fight involving staff and a patient, and my nurse needed medical attention himself. It was just unfortunate all round.

At about 7 they asked the fish-or-cut-bait question, and I decided to fish, to get admitted so they could administer more pain medication and monitor my vitals.

Oy.

Each ER visit costs me $75. Not inconsiderable. Any given admission means the ER cost is waived, but then it'll cost $250.

For a long time Tuesday morning I regarded my breakfast as the most expensive ever, because no one came to see me.

They sent in nurses, to take readings. I complained to them that if I wasn't going to get medication, they should just let me go home.

They sent in a psychiatrist, because they saw anti-depressants on my chart. We chatted, and I finished by telling him that I didn't currently have a drug or alcohol problem, but was considering developing one since I couldn't get painkillers.

That brought Patient Relations in, and my answer to "What can we do for you?" was still the same "Get me a doctor, or get me discharged."

Eventually a doctor came in, examined me, and decided they'd do PCA (Patient Controlled Analgesia). Except he wouldn't write the orders, the pain specialist was.

Great. Another wait. Pretty sure they didn't get going until the afternoon. If not for the free internet access, I would probably have just started walking home. Not only could I take better-than-nothing painkillers there, the food was palatable. This hospital said they served Wolfgang Puck food, but it was pretty disgusting.

For PCA they give a breakthrough dose of 4mg of Dilaudid (I'd had 6 the previous night in the ER), and then the patient is allowed to administer 1mg at a time, no more often than once every fifteen minutes.

Should there be a big gap in there, they start again with the breakthough.

Needless to say, I had a big gap--the IV slipped out of place and blood and saline were being squirted everywhere. Took me forever to get a nurse in (don't have anything happen around shift change), and he made it sound like I'd purposefully removed the needle.

Yeah, sure. That makes sense.

Also during my stay I had a neurologist come in and suggest changing my anti-depressant medication and dosage. He was also very negative about the idea of me actually using the PCA. Unfortunately I'm hella suggestible that way, and did back off it until the pain guy came in again and made me feel silly.

I ended up leaving Wednesday afternoon, still in pain, but a little less. In fact, I felt pretty good until getting out of the car, at which point everything crashed in on me. Taken upstairs, put to bed, waking up a few more times in a lot of pain, but it ended up ebbing to about a 5 by the time I went to sleep.

Hmmpf. Having been admitted to both UCLA Westwood and Century City Doctor's Hospital I really REALLY really don't want to be admitted again.

But mostly I don't want to feel like hospital is the only reasonable option, ER or no.