A friend is coming in to town, and he just starting his residency in the ER. I figure if Timaca can pass on some Lyme advice to her friends who are docs, so can I.

I know many of us have had horrendous experiences in the ER. There are probably way too many stories to pass on. But what are the real basic common things you wish all ER docs know when it came to Lyme?

I asked my father in law this very question last week, for he was an ER doc for 30+ years. I asked him..."do you think the ER docs would have figured out that I was having a herx reaction when I was in so much pain a year ago?"

He said "that is unlikely". Most ER docs are trying to save (1) a life or (2) a limb. If it looks like you're not going to die, or not going to lose a limb, then they will make sure you're stabilized and wait until the specialty docs (neuros, etc) are available to exam you.

In my case, with all the pain I was in with my herx reaction (and not knowing at the time what it was)...it would have taken a very special doc to have figured it out.

The docs probably would have made sure my vitals were stabilized...maybe admitted me for observation, but that would be about it.

My father in law did say that our local ER had one good doc that could spot the "zebra among the horses"....He MIGHT have figured it out, had he been on duty. But, there is so much going on in the ER, that their main business is usually saving the life or the limb.

If someone presents with an obvious rash, take in photos and articles, and ask to be started on antibiotics...at least enough until the PCP can come on the scene to follow up.

Tina

1) If a patient comes in & says:

"I have Lyme disease & I can NOT have STEROIDS".......

THEN DON'T SEND A PATIENT HOME WITH AN RX FOR A STEROID (ESPECIALLY without telling them it's a @#$% steroid!!!!)

2) LISTEN & don't be condescending - as the patient may actually have a general idea as to what might be wrong...

3) NEVER ASSUME the patient is just having an anxiety attack if SHE happens to break into tears (because she is completely frustrated with the medical system & her symptoms!)

I could make up some doctor 'rules' all night long....but I'll not waste my time & just leave you with my top 3.

Thanks for the opportunity!

quote:

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Originally posted by imanurse:

My advice to physicians is, "Listen to the patient long enough and they will tell you the diagnosis."

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DITTO!!!

and ditto to this too!

"Any time a patient is describing fatigue, neuro related symptoms, pain, or using the word "weird or bizarre", THINK Lyme!! In my experience, nurses and doctors are not doing thorough enough neuro examinations and are missing a lot."

nurses thought my halucin...opening my eyes and seeing a hosrses hove (sp?) - and yes it is sort of downright funny.

quote:

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Originally posted by timaca:
My father in law did say that our local ER had one good doc that could spot the "zebra among the horses"

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This makes me realize what I want say to ER docs, and all other docs and medical personnel: Lyme disease is not a zebra! It's a horse! And not just in the northeastern US, either.

There is now at least 1 ER doctor who knows that

(1) if a person comes in with a red circular rash then that person very likely has Lyme and needs antibiotics immediately, and

(2) if a patient says they have Lyme under no circumstances should that patient be given steroids.

I'll keep adding to his knowledge base each time I see him

Grrr.... WHat's really scary is that some people might believe these drs. who say this..... If I would have believed them I will be disabled for the rest of my life.....

Instead ... I'm disabled right now but I know one day I will get my life back.

That's great if a er dr is willing to listen to try not to make mistakes regarding lyme disease.