Patients, Doctors, and Patience

[Soumis]

What happens if they request a second opinion from a different staff member? Do you get the shotgun then?

I would worry if someone makes decisions about care and medication immediately without getting different opinions first.

EDIT:
I know that my wife would act this way, too, most likely. But this would have nothing to do at all with our BDSM relationship or that I wouldn't grant her her own opinion and decision. She asks for advice or opinions in dozen areas, then why should she completely disregard it in the medical field, where it actually is really important?

I'm not sure that I'm articulating well the most common situation that I see. Generally what happens is I go in asking an obviously hurting Mom how much she is hurting and would she like an pain medication or an epidural. Mom looks at husband who says no. Mom tells me no. It makes me angry to see a spouse making decisions on pain control when they are not the ones in pain. I've told patients that they can blame me if they'd like. Tell their spouses I was pushing for pain control if they want. Because I'm a firm believer that a patient should go through labor with the level of pain they are prepared to handle. Whether that's all natural, or epidural from the start.

And of course I don't get a shot gun out when they want a second opinion. Granted, I rarely have someone ask for one, because when someone is in labor, we all know how the party is going to end, but a patient is always welcome to seek medical treatment elsewhere.

 

[Soumis]

I'm seeing it differetnly than a lot of you might be...when the OP is asking about pain leve, for example, I wouldn't look at someone else for the answer. If the dr was asking about any meds I took, I can see checking with him "Hey, did I take the iron supplement last night, I can't remember?" and he might say "no, your stomache was hurting too much, remember?" ect.

Sometimes the PYL/pyl needs to be there.. when my husband had a kidney stone he was incapable of speech, and they had to ask me about when he last ate, etc. But his pain level was pretty obvious from the "FUCK FUCK FUCK THIS FUCKING HURTS GIVE ME SOMETHING" shouts.

This is completely how I see it. The patient, the person in pain, should be able to talk to me about their pain. I'm not asking how much pain does the person watching think you are in. I'm asking the patient. Pain is subjective and is whatever the patient says it is.

I guess you could say I just think the family member/what have you should stay in a supportive role, provided the patient is capable.

 

[Primalex]

It makes me angry to see a spouse making decisions on pain control when they are not the ones in pain.

Interesting point of view around here.

 

[graceanne]

Just a side note, I HATE it when I'm asked to rate my pain on a scale. Annoys the snot out of me.

 

[Soumis]

first, although i may have a general idea on what my Master would and would not want for me, having to make very specific decisions, unexpectedly and on the spot is something very different. if my Master is not already right there by my side (many doctors will not allow anyone else in the examination room itself), then i refrain from making any decisions and usually say "i have to think about it." this takes the pressure off and gives me the time to consult my Master so he can then make the decision he feel is best.

secondly, we have never and would never broadcast our M/s relationship in a medical situation...we are not the flag-flying sort by any means. if it's a really hairy situation, like a medical emergency and decisions are expected to be made on the fly, my Master reveals his legal guardian status. but thus far that has only happened once, that's not something we really want to shout from the rooftops either.

"I have to think about it," is always a great way to go. There are exceptions to the rule of course because sometimes it is a life and death emergency, but generally we're not stopping to ask for signatures at that time.

Is it state by state? I'm just asking - I have *never* had anyone refuse to let the person I want in with me in and I can't imagine the level of hissy I'd have if that happened.

I mean the pt IS the consumer in this situation.

There's a big difference in my brain, between denying access to the patient in a hospital and check up setting. There are times when when we've called security because a family member could absolutely not be at the bedside like they wanted to be. Granted, I work at a public facility that very antiquated, and literally does not have the means at time to deal with a family member whether in terms of supply or staffing.

The hardest limit we have is absolutely no family during a stat c/s. This is a time for running down the halls, patient's put under general, 5 minutes or less from c/s decision, to get to the OR, cut, and baby. I don't care what kind of scene a family member was making, they don't go back in that situation period. We don't have time to hold anyone's hand, we are making sure your baby doesn't die before we deliver them. I've had patient's say after the fact, "I wish I hadn't needed a c/s," but no one ever says, "I wish you'd let my baby die."

 

[graceanne]

"I have to think about it," is always a great way to go. There are exceptions to the rule of course because sometimes it is a life and death emergency, but generally we're not stopping to ask for signatures at that time.



There's a big difference in my brain, between denying access to the patient in a hospital and check up setting. There are times when when we've called security because a family member could absolutely not be at the bedside like they wanted to be. Granted, I work at a public facility that very antiquated, and literally does not have the means at time to deal with a family member whether in terms of supply or staffing.

The hardest limit we have is absolutely no family during a stat c/s. This is a time for running down the halls, patient's put under general, 5 minutes or less from c/s decision, to get to the OR, cut, and baby. I don't care what kind of scene a family member was making, they don't go back in that situation period. We don't have time to hold anyone's hand, we are making sure your baby doesn't die before we deliver them. I've had patient's say after the fact, "I wish I hadn't needed a c/s," but no one ever says, "I wish you'd let my baby die."

As someone who's had a . . . well, it wasn't a total emergency cesarean, but it wasn't planned, I have to say that if you are having so many problems with labor that you need an emergency cesarean, by then you're so out of it that won't notice if your SO is there with you. By then you're exhausted and not all there.

 

[Soumis]

As someone who's had a . . . well, it wasn't a total emergency cesarean, but it wasn't planned, I have to say that if you are having so many problems with labor that you need an emergency cesarean, by then you're so out of it that won't notice if your SO is there with you. By then you're exhausted and not all there.

Most of the time it goes like you said, because most complications arise in the later stages of labor. I've had mom's think we're crazy though when we tell them they're having an emergency c/s while they are talking on the phone or watching tv. Baby is not always fine, even if mom is. I had to pull a cell phone out of patient's hand once on the OR table because she would not stop talking. She just didn't seem to understand or want to understand the gravity of the situation.

 

[graceanne]

Most of the time it goes like you said, because most complications arise in the later stages of labor. I've had mom's think we're crazy though when we tell them they're having an emergency c/s while they are talking on the phone or watching tv. Baby is not always fine, even if mom is. I had to pull a cell phone out of patient's hand once on the OR table because she would not stop talking. She just didn't seem to understand or want to understand the gravity of the situation.

With mine I had toxemia, I'm tiny, and my daughter was huge. I was induced at 6 am, and 16 hours later I hadn't dilated AT ALL, and my blood pressure was getting scary high. When my doctor told me she wanted to do a cesarean I didn't understand, I couldn't concentrate on what she was saying or even understand what she was saying. She had to repeat everything she said several times for me to get a basic grasp of what was going on, and I'm still didn't completely understand when I signed permission. Luckily, I kinda suspected I'd end up with a cesarian and K and I'd already discussed it as a possible option. Not everyone in this world was meant to give birth vaginally.

 

[Soumis]

and you shouldn't have to. if everyone conducts themselves properly, it never has to be known that someone else is truly making the decisions. i agree with Netz in that it should appear to any questioning outsiders that the Dominant party is only going along with the personal desire of the submissive party.


then you would absolutely hate me as a patient. and if a medical professional were to force me to answer such questions all alone, again i would just refrain from making any decisions. i think all of my regular doctors/nurses read me as intelligent, well-informed, inquisitive (because i ask many questions so my Master can make the best choices), thoughtful and somewhat reserved. definitely not abused or frightened, so they are not made to feel uncomfortable or ethically obliged to intervene.

Then we wouldn't have a problem. I just can't be given any reason to think the patient isn't acting of their own free will. Patients sometimes forget their baby is my patient too. I think there's abuse I have to follow up, same as if I suspected outright child abuse. Statistically, pregnancy is often a time when domestic violence will escalate.

 

[graceanne]

Statistically, pregnancy is often a time when domestic violence will escalate.

Yeah, I had a friend who's hubby beat her into convulsions when she was pregnant with his twins. The twins had to be taken emergency cesarean and she died three weeks later.

 

[Keroin]

L had a gag go wrong once and ended up with a 2nd degree burn on half his face and parts of his hands. I went to meet him at the hospital and I knew he was in a shit load of pain but he's Mr Tough Guy so he's playing it cool. He's even relatively brave when he finds out he needs a tetanus shot, (L is very scared of needles). Then the nurse sticks herself with the tetanus needle so he has to get his blood taken so she can have some peace of mind, (re: aids, Hep, etc). He's not so cool anymore.

So, a great deal of fuss is being made over him by the nurses, as he's finally given the green light to leave. L being the consummate comedian, and quite tall, pretends to smack his head on the exit sign on the way out.

The poor nurses came running to help him. I quickly filled them in.

My husband.

 

[Soumis]

With mine I had toxemia, I'm tiny, and my daughter was huge. I was induced at 6 am, and 16 hours later I hadn't dilated AT ALL, and my blood pressure was getting scary high. When my doctor told me she wanted to do a cesarean I didn't understand, I couldn't concentrate on what she was saying or even understand what she was saying. She had to repeat everything she said several times for me to get a basic grasp of what was going on, and I'm still didn't completely understand when I signed permission. Luckily, I kinda suspected I'd end up with a cesarian and K and I'd already discussed it as a possible option. Not everyone in this world was meant to give birth vaginally.

My hospital gets doesn't get permission for a c/s separately. When you sign paperwork for a vaginal delivery there is a part that says in an emergency you've given us permission for a c/s. We prefer our patient's to be as cognizant as possible when they are signing things.

It sounds like they did what they could to help you deliver vaginally, until it because unsafe for you and your daughter. I hope everything went well.

 

[Soumis]

L had a gag go wrong once and ended up with a 2nd degree burn on half his face and parts of his hands. I went to meet him at the hospital and I knew he was in a shit load of pain but he's Mr Tough Guy so he's playing it cool. He's even relatively brave when he finds out he needs a tetanus shot, (L is very scared of needles). Then the nurse sticks herself with the tetanus needle so he has to get his blood taken so she can have some peace of mind, (re: aids, Hep, etc). He's not so cool anymore.

So, a great deal of fuss is being made over him by the nurses, as he's finally given the green light to leave. L being the consummate comedian, and quite tall, pretends to smack his head on the exit sign on the way out.

The poor nurses came running to help him. I quickly filled them in.

My husband.

LOL! I would have been panicked too!

 

[Soumis]

Yeah, I had a friend who's hubby beat her into convulsions when she was pregnant with his twins. The twins had to be taken emergency cesarean and she died three weeks later.

Sorry to hear that. This is why I have to be a stick in the mud sometimes. It's not as uncommon as people think.

 

[ownedsubgal]

This is completely how I see it. The patient, the person in pain, should be able to talk to me about their pain. I'm not asking how much pain does the person watching think you are in. I'm asking the patient. Pain is subjective and is whatever the patient says it is.

I guess you could say I just think the family member/what have you should stay in a supportive role, provided the patient is capable.

how much pain i'm in, what symptoms i'm having...as these things are happening within my own body, i can relay this information just fine. but what to DO about those symptoms is another matter. i.e. my pain level could be "10," and i may WANT the highest non-lethal dosage of the world's most powerful painkiller, but i would not accept so much as a tylenol from a medical professional without my Master's say so.

 

[ownedsubgal]

Statistically, pregnancy is often a time when domestic violence will escalate.

increased pressure, increased stress, the financial strain, etc...that makes sense.

 

[graceanne]

My hospital gets doesn't get permission for a c/s separately. When you sign paperwork for a vaginal delivery there is a part that says in an emergency you've given us permission for a c/s. We prefer our patient's to be as cognizant as possible when they are signing things.

It sounds like they did what they could to help you deliver vaginally, until it because unsafe for you and your daughter. I hope everything went well.

Yes. She's 11 and top of her class. I had planned cesareans after that, though. I didn't mind giving birth vaginally if it was guaranteed, but the recovery of 16 hours labor AND a cesarean is a bitch. Honestly, all my kids had 15 cm heads. I'm only a little over 5' tall, and I have a narrow pelvis. Thank God for modern medicine, or I probably wouldn't have made it through having her.

Sorry to hear that. This is why I have to be a stick in the mud sometimes. It's not as uncommon as people think.

I know. It's actually very common when an SO becomes disabled. People who won't abuse normally will when they're constantly taking care of an SO, and a heavily pregnant woman has a lot in common with a disabled person. They're irritable, it's hard for them to move, they're often sick . . . you get the point. In my friends case she had only one working kidney and being preggers made her very very sick. He decided she was faking it and beat her for it.

 

[Soumis]

Yes. She's 11 and top of her class. I had planned cesareans after that, though. I didn't mind giving birth vaginally if it was guaranteed, but the recovery of 16 hours labor AND a cesarean is a bitch. Honestly, all my kids had 15 cm heads. I'm only a little over 5' tall, and I have a narrow pelvis. Thank God for modern medicine, or I probably wouldn't have made it through having her.

I always feel worse for the people who labor and then have c/s. Sometimes we have moms in the delivery room pushing when they decide they need a c/s. Twins trump it all though: we have a lot of patients have one vaginally and then have to have a c/s for the second. Ugh! To have to recover from both!

 

[graceanne]

I always feel worse for the people who labor and then have c/s. Sometimes we have moms in the delivery room pushing when they decide they need a c/s. Twins trump it all though: we have a lot of patients have one vaginally and then have to have a c/s for the second. Ugh! To have to recover from both!

Yeah, that would seriously SUCK.

 

[sb2009]

not regarding labor, but when I worked at a rape crisis center one of my main jobs at the ER was the keep family/so's/etc informed and not freaking out while the victim was having the personal evidence recovery kit exam.

Many times I had hysterical moms scratching my arms, punches thrown at me, drinks thrown at me, etc BUT it was better me, the victim advocate who was there for them, rather than the nurses who would call the cops when being treated like that. (which they should, they dont' need to be assualted at work doing thier job).

I also a few times had a spouse who ended up being the rapist try to get me to let them in the exam room, while the cops were taking the statement from thier spouse. It was a dicey job. I'm really glad I don't do it anymore, but I"m glad there are people who do.

 

[sb2009]

and both my c-sections, I did this wierd thing that happens to me before surgury - I nearly lose my power of speech. It's so odd, I just totally feel like I'm under water and just can't move or talk. The first time it happend I was having a baby alone and while the nurses were all "oh, look, she is so calm" I was terrified inside, nearly comatose with fear.

Thankfully the second time my husband was there and he knew what was happening and was able to keep talking to me and letting me know it was going to be ok. The second one was scheduled so he could be in the room with me, thankfully.

 

[Soumis]

and both my c-sections, I did this wierd thing that happens to me before surgury - I nearly lose my power of speech. It's so odd, I just totally feel like I'm under water and just can't move or talk. The first time it happend I was having a baby alone and while the nurses were all "oh, look, she is so calm" I was terrified inside, nearly comatose with fear.

Thankfully the second time my husband was there and he knew what was happening and was able to keep talking to me and letting me know it was going to be ok. The second one was scheduled so he could be in the room with me, thankfully.

You think it was the meds? I heard of people having that sensation due to the drugs.

We actually use a lot less drugs now than we used to. If the patient has an epidural or spinal anesthesia they can be completely awake for their section. Most anesthesiologists won't give the sleepy meds until after mom has seen the baby.

I'm actually not a fan of this trend. Last thing I want when I'm having a c/s is to be 100% cognizant of what's going on. Course, since I know the people who will have their hands in me it could just be the weirdness talking.

Me: "Oh really why do you need another pennington? Am I bleeding? Did you fuck something up? Jessica pull yourself together you're a surgeon!"

Anesthesia: "Okay, I think it's time we took a little nap, so the surgeons can do their jobs without you yelling at them."

 

[sb2009]

it might have been. Whatever it was, it happend when I had my boob reduction too. I"m not complaining, I have two healthy girls and smaller boobs, I'll deal with some anxiety during surgury LOL

 

[graceanne]

You think it was the meds? I heard of people having that sensation due to the drugs.

We actually use a lot less drugs now than we used to. If the patient has an epidural or spinal anesthesia they can be completely awake for their section. Most anesthesiologists won't give the sleepy meds until after mom has seen the baby.

I'm actually not a fan of this trend. Last thing I want when I'm having a c/s is to be 100% cognizant of what's going on. Course, since I know the people who will have their hands in me it could just be the weirdness talking.

Me: "Oh really why do you need another pennington? Am I bleeding? Did you fuck something up? Jessica pull yourself together you're a surgeon!"

Anesthesia: "Okay, I think it's time we took a little nap, so the surgeons can do their jobs without you yelling at them."

ROFL!! Doctors/nurses are the worst patients.

I had an epidural and a local with my oldest girl. The epidural numbed everything but a half dollar size spot right where they were going to be cutting. After she was born they just put me under. With my younger girl I had an epidural that didn't work. I climbed onto the surgery table for them and could move my legs and wiggle my toes. My doctor refused to do anything until i was numb, so they ended up putting me under. With my son I had a spinal tap which made me HURL.

it might have been. Whatever it was, it happend when I had my boob reduction too. I"m not complaining, I have two healthy girls and smaller boobs, I'll deal with some anxiety during surgury LOL

I didn't talk much with mine, but that's cause talking took my concentration off my breathing and made the pain so much worse. I didn't want to be talked to, touched, or distracted in any way. Me and the nurses went at it, at one point, because they wanted to move me onto my side (cause of my blood pressure), but that gave me back labor, so I wouldn't. We finally compromised with putting pillows on that side of me, to tilt me a bit.

 

[Soumis]

Anesthesia is a funny business. No denying some people are flat out better at administering it than others.

And most people labor better on their side, and babies tolerate it better on the side, but pillows are generally enough to shift weight.