Reasonable Rascal
Has No Life - Lives on TB
A PILL IN TIME
You never know when having a couple bottles of the right medication on hand might be your salvation. And no, this is not a diatribe on why to self-medicate. But it is an observation on why making simple preparations can prove useful at times, or even a lifesaver.
I've made it a personal policy to keep on hand what I can legitimately acquire in the way of various medications, never tossing out a partial prescription when the doc changes one for another or the need for the medication ceases to be - an example of which would be left over oral narcotics such as Vicodin or Darvocet prescribed for an injury or dental procedure. Over the years they occasionally come in handy, as when a dental abscess strikes during the night on a weekend. I know the drill well by now; manage the pain with the least analgesic that will provide relief – starting with Ibuprofen and working up only if necessary – and start taking one of 2 or 3 appropriate antibiotics I keep on hand. I won’t bore you with details but that often means 500 mg of something like Penicillin or Ampicillin 4 times a day until I can see the dentist for further work. In other words it may take more than a bare handful of pills, never mind knowing what is likely to work versus what is a wasted effort.
Having access to the Mexican farmacias on occasion I tend to keep the medicine chest better stocked than in years past. The lovely bride keeps a several month stock of thyroid medication on hand rather than run to the local pharmacy every 30 days for a new (and much more expensive) supply.
Likewise I have kept around Albuterol inhalers and nebulizer dose units against a rainy day. Some of you may know that such a rainy day struck last December, and again just last month in April. Simple things can be a lifesaver.
More recently it was the phone call in the middle of the night. Okay, so it was before 1 AM. I was in bed already and trying to sleep so that should count for something.
One of my co-workers called about a patient I had admitted the night before when I last worked. As soon as I hear the words out of her mouth I’m thinking uh oh, what’d I miss on the paperwork that has someone riled up? And I had even stayed over an extra hour to complete it so that Day Shift nurse wouldn’t have to.
No, it wasn’t anything like that. The patient had been transferred from our floor Medical-Surgical (also sometimes called Acute Care) to the Telemetry floor. There the nurse to patient ratio is higher and all patients have their heart monitored via a wireless sending device.
By the time of the call though the patient was no longer on the Telemetry floor but rather now they were in Intensive Care. Rut row, Raggy (pop culture reference). That’s why my friend was calling.
The patient had been diagnosed now with bacterial meningitis. That explained the altered mental status that had been reported for a couple days prior to his admission. The admitting diagnosis was “fever.” That’s all, just fever. And not too high, maybe 102 degrees on the Fahrenheit scale. By the time the patient reached me a single dose of Acetaminophen had dropped it down to normal range. The admitting doc had called for no infectious disease precautions and there was nothing in his presentation that indicated such was necessary. Urinary and related infections are very common reasons for admission and altered mental status (i.e. “confusion”) is very often the reason help was sought to begin with. Often that is the only sign that anything is wrong with the patient; even fever does not always accompany the infection.
So, to get to the point of this missive I was told that all staff that had been in contact with the patient was recommended to have a prophylactic (preventative) dose of antibiotic within 24 hours of initial exposure. Rocephin was the drug of choice but the routes there are either IV or IM injection. Rocephin I do keep on hand in limited quantity but the thought of trying to twist around in order to poke myself in the derriere, or to have my untrained (insofar as using that particular site, i.e. the gluteus maximus ouchus) lovely bride perform the deed for me was rather unappealing.
The alternative medication of choice was Ciprofloxacin 500 mg by mouth taken as a one-time dose. Said medication I also happen to keep a bottle of in the medicine cabinet, fresh, in date and unopened, just in case.
Or, assuming I had neither medication already stashed away just drive out to the local ER.
So there you have it. I had 3 choices in all.
1) Dig around until I can find my very modest stash of injectable Rocephin and play the part of a martyr (there is a reason they mix that stuff with Lidocaine - it HURTS),
2) Take the blue and white capsule
3) Or get myself dressed and drive 8 miles to the hospital, get them to jump me ahead of the line at the ER waiting room and to issue me the required medication so I could have it within the 24 hour exposure window. And in the latter instance you know darn well some malicious ER doc or PA-C would go with the first drug of choice and cause me to limp out of there.
Yeah, I’m with you. I took the fresh, sealed, well within date bottle of blue and white capsules out of the cabinet, opened it and took the called for dose. Now that the seal has been broken it will greatly shorten the remaining shelf life of the other 99 capsules left behind, and ultimately cost me about $25 but such is life. It beats the other alternatives, especially the one not heretofore mentioned – my exposure goes untreated, I develop bacterial meningitis, expose my lovely bride and we both end up playing the A. recover, B. recover but end up gorked in the head, C. or just outright die roulette game.
Yeah verily, sometimes a dollar or two spent ahead of time can pay out huge dividends in ways that you least expect. And here I thought I was just putting that bottle away in case of a stubborn urinary tract infection sometime in the future.
RR
You never know when having a couple bottles of the right medication on hand might be your salvation. And no, this is not a diatribe on why to self-medicate. But it is an observation on why making simple preparations can prove useful at times, or even a lifesaver.
I've made it a personal policy to keep on hand what I can legitimately acquire in the way of various medications, never tossing out a partial prescription when the doc changes one for another or the need for the medication ceases to be - an example of which would be left over oral narcotics such as Vicodin or Darvocet prescribed for an injury or dental procedure. Over the years they occasionally come in handy, as when a dental abscess strikes during the night on a weekend. I know the drill well by now; manage the pain with the least analgesic that will provide relief – starting with Ibuprofen and working up only if necessary – and start taking one of 2 or 3 appropriate antibiotics I keep on hand. I won’t bore you with details but that often means 500 mg of something like Penicillin or Ampicillin 4 times a day until I can see the dentist for further work. In other words it may take more than a bare handful of pills, never mind knowing what is likely to work versus what is a wasted effort.
Having access to the Mexican farmacias on occasion I tend to keep the medicine chest better stocked than in years past. The lovely bride keeps a several month stock of thyroid medication on hand rather than run to the local pharmacy every 30 days for a new (and much more expensive) supply.
Likewise I have kept around Albuterol inhalers and nebulizer dose units against a rainy day. Some of you may know that such a rainy day struck last December, and again just last month in April. Simple things can be a lifesaver.
More recently it was the phone call in the middle of the night. Okay, so it was before 1 AM. I was in bed already and trying to sleep so that should count for something.
One of my co-workers called about a patient I had admitted the night before when I last worked. As soon as I hear the words out of her mouth I’m thinking uh oh, what’d I miss on the paperwork that has someone riled up? And I had even stayed over an extra hour to complete it so that Day Shift nurse wouldn’t have to.
No, it wasn’t anything like that. The patient had been transferred from our floor Medical-Surgical (also sometimes called Acute Care) to the Telemetry floor. There the nurse to patient ratio is higher and all patients have their heart monitored via a wireless sending device.
By the time of the call though the patient was no longer on the Telemetry floor but rather now they were in Intensive Care. Rut row, Raggy (pop culture reference). That’s why my friend was calling.
The patient had been diagnosed now with bacterial meningitis. That explained the altered mental status that had been reported for a couple days prior to his admission. The admitting diagnosis was “fever.” That’s all, just fever. And not too high, maybe 102 degrees on the Fahrenheit scale. By the time the patient reached me a single dose of Acetaminophen had dropped it down to normal range. The admitting doc had called for no infectious disease precautions and there was nothing in his presentation that indicated such was necessary. Urinary and related infections are very common reasons for admission and altered mental status (i.e. “confusion”) is very often the reason help was sought to begin with. Often that is the only sign that anything is wrong with the patient; even fever does not always accompany the infection.
So, to get to the point of this missive I was told that all staff that had been in contact with the patient was recommended to have a prophylactic (preventative) dose of antibiotic within 24 hours of initial exposure. Rocephin was the drug of choice but the routes there are either IV or IM injection. Rocephin I do keep on hand in limited quantity but the thought of trying to twist around in order to poke myself in the derriere, or to have my untrained (insofar as using that particular site, i.e. the gluteus maximus ouchus) lovely bride perform the deed for me was rather unappealing.
The alternative medication of choice was Ciprofloxacin 500 mg by mouth taken as a one-time dose. Said medication I also happen to keep a bottle of in the medicine cabinet, fresh, in date and unopened, just in case.
Or, assuming I had neither medication already stashed away just drive out to the local ER.
So there you have it. I had 3 choices in all.
1) Dig around until I can find my very modest stash of injectable Rocephin and play the part of a martyr (there is a reason they mix that stuff with Lidocaine - it HURTS),
2) Take the blue and white capsule
3) Or get myself dressed and drive 8 miles to the hospital, get them to jump me ahead of the line at the ER waiting room and to issue me the required medication so I could have it within the 24 hour exposure window. And in the latter instance you know darn well some malicious ER doc or PA-C would go with the first drug of choice and cause me to limp out of there.
Yeah, I’m with you. I took the fresh, sealed, well within date bottle of blue and white capsules out of the cabinet, opened it and took the called for dose. Now that the seal has been broken it will greatly shorten the remaining shelf life of the other 99 capsules left behind, and ultimately cost me about $25 but such is life. It beats the other alternatives, especially the one not heretofore mentioned – my exposure goes untreated, I develop bacterial meningitis, expose my lovely bride and we both end up playing the A. recover, B. recover but end up gorked in the head, C. or just outright die roulette game.
Yeah verily, sometimes a dollar or two spent ahead of time can pay out huge dividends in ways that you least expect. And here I thought I was just putting that bottle away in case of a stubborn urinary tract infection sometime in the future.
RR
