Comments on: Inconsolable http://nursesean.com/musings/inconsolable.htm The Ups and Downs of My First Year in the ICU Wed, 08 Oct 2008 02:18:39 +0000 http://wordpress.org/?v=2.3.1 By: Leah http://nursesean.com/musings/inconsolable.htm#comment-21970 Leah Sun, 06 Apr 2008 11:07:40 +0000 http://nursesean.com/musings/inconsolable.htm#comment-21970 I have been getting pins and needles pain through out the upper body mostly. starts with the arms then expands towards chest. sometimes it flows towards legs. but this only occurs when my its time for bed, or to take a nap. or just when body is idling. do you have any suggestions? I have been getting pins and needles pain through out the upper body mostly. starts with the arms then expands towards chest. sometimes it flows towards legs. but this only occurs when my its time for bed, or to take a nap. or just when body is idling. do you have any suggestions?

]]> By: Sean http://nursesean.com/musings/inconsolable.htm#comment-19530 Sean Tue, 12 Feb 2008 15:45:30 +0000 http://nursesean.com/musings/inconsolable.htm#comment-19530 Anon: His nutrition was being followed very closely by a dietician and had been an ongoing problem. Hy was VERY dysphagic and had a peg tube in which we administered feeds. His had daily bloodwork that would have shown deficiencies. Anon: His nutrition was being followed very closely by a dietician and had been an ongoing problem. Hy was VERY dysphagic and had a peg tube in which we administered feeds. His had daily bloodwork that would have shown deficiencies.

]]> By: anon http://nursesean.com/musings/inconsolable.htm#comment-19511 anon Tue, 12 Feb 2008 08:20:59 +0000 http://nursesean.com/musings/inconsolable.htm#comment-19511 Has anyone thought that this patient might have nutritional deficiencies that don't show up in blood tests (CBC, CMP)? I know that I had some routine blood work done last year that found that everything (H&H) was WNL except my hemoglobin was slightly low (12.3). I was having these strange spasms occasionally when I swallowed pills, which was not typical for me, since I could take four 200mg ibuprofen all at once (or the large 800mg) and I've been like that since I was a kid. Started reading up on nutrition one day and lo and behold, I read that iron deficiency can cause dysphagia. Started taking iron supplements in addition to my once a day multivitamin and voila -- in a month, no more spasms when swallowing and they haven't returned. When my mom was bothered by restless legs syndrome, I looked that up and it can be caused by magnesium deficiencies. Got her some Mg supplements. When she takes them regularly (after a few weeks), no more restless legs. When she forgets or slacks off, the restless legs come back. Not everything has to be -- or can be -- solved by pharmaceuticals. Sometimes the body just needs what it needs, and since every body is different, maybe this man's body needs more. Or perhaps he takes meds that imbalance his magnesium, calcium, or potassium -- all deficiencies that can cause muscle cramps and twitching. Just a thought. Has anyone thought that this patient might have nutritional deficiencies that don’t show up in blood tests (CBC, CMP)? I know that I had some routine blood work done last year that found that everything (H&H) was WNL except my hemoglobin was slightly low (12.3). I was having these strange spasms occasionally when I swallowed pills, which was not typical for me, since I could take four 200mg ibuprofen all at once (or the large 800mg) and I’ve been like that since I was a kid. Started reading up on nutrition one day and lo and behold, I read that iron deficiency can cause dysphagia. Started taking iron supplements in addition to my once a day multivitamin and voila — in a month, no more spasms when swallowing and they haven’t returned.

When my mom was bothered by restless legs syndrome, I looked that up and it can be caused by magnesium deficiencies. Got her some Mg supplements. When she takes them regularly (after a few weeks), no more restless legs. When she forgets or slacks off, the restless legs come back.

Not everything has to be — or can be — solved by pharmaceuticals. Sometimes the body just needs what it needs, and since every body is different, maybe this man’s body needs more. Or perhaps he takes meds that imbalance his magnesium, calcium, or potassium — all deficiencies that can cause muscle cramps and twitching.

Just a thought.

]]> By: Nickie http://nursesean.com/musings/inconsolable.htm#comment-18857 Nickie Fri, 01 Feb 2008 03:54:11 +0000 http://nursesean.com/musings/inconsolable.htm#comment-18857 I'm a person with chronic pain because of Reflex Sympathetic Dystrophy. I can relate to this patient's struggles, and wanted to say that the fact that you care makes a huge huge difference. Sometimes, just knowing that the people around me will keep trying, and that they believe me is what matters. Conversely, those who don't believe me cause a lot of pain emotionally, too, which can increase the physical pain. Thank you for caring about your patient. He may not be able to say it, because of the problems he's going through, so I wanted to say it. I’m a person with chronic pain because of Reflex Sympathetic Dystrophy. I can relate to this patient’s struggles, and wanted to say that the fact that you care makes a huge huge difference. Sometimes, just knowing that the people around me will keep trying, and that they believe me is what matters. Conversely, those who don’t believe me cause a lot of pain emotionally, too, which can increase the physical pain. Thank you for caring about your patient. He may not be able to say it, because of the problems he’s going through, so I wanted to say it.

]]> By: Barbara K. http://nursesean.com/musings/inconsolable.htm#comment-18730 Barbara K. Tue, 29 Jan 2008 23:17:37 +0000 http://nursesean.com/musings/inconsolable.htm#comment-18730 What a dreadful situation for you and the patient. I am sorry you (and he) had to go through this. I too have suffered with unreachable physical pain. I think it's so important for health care professionals to know that even when they can't make the physical pain go away, they can help to lessen the suffering. How? With attentiveness, with gestures, with words. Patients in pain fear not only endless pain, but also abandonment. It does make a difference to have the medical person respond to your calls, touch your shoulder, and say something like - "I can see how awful this is for you, and I am sorry I can't make it stop right away. I won't forget you, I'll check in on you in an hour, and we'll keep trying." Your expressed compassion may soothe the heart even if it can't eliminate the pain. And when the heart is calmer, the patient may have more resources available to try to manage the pain. This may not have worked for this particular patient, but I know my doctors' and nurses' outreach and caring helped me get through many pain spikes that pills couldn't touch. What a dreadful situation for you and the patient. I am sorry you (and he) had to go through this.

I too have suffered with unreachable physical pain. I think it’s so important for health care professionals to know that even when they can’t make the physical pain go away, they can help to lessen the suffering. How? With attentiveness, with gestures, with words. Patients in pain fear not only endless pain, but also abandonment.

It does make a difference to have the medical person respond to your calls, touch your shoulder, and say something like - “I can see how awful this is for you, and I am sorry I can’t make it stop right away. I won’t forget you, I’ll check in on you in an hour, and we’ll keep trying.”

Your expressed compassion may soothe the heart even if it can’t eliminate the pain. And when the heart is calmer, the patient may have more resources available to try to manage the pain.

This may not have worked for this particular patient, but I know my doctors’ and nurses’ outreach and caring helped me get through many pain spikes that pills couldn’t touch.

]]> By: GM http://nursesean.com/musings/inconsolable.htm#comment-18716 GM Tue, 29 Jan 2008 18:09:47 +0000 http://nursesean.com/musings/inconsolable.htm#comment-18716 Can you get a massage therapist in to massage his legs? Can you get a massage therapist in to massage his legs?

]]> By: Sean http://nursesean.com/musings/inconsolable.htm#comment-18683 Sean Tue, 29 Jan 2008 04:51:09 +0000 http://nursesean.com/musings/inconsolable.htm#comment-18683 Ivory: an epidural is a great idea and probably would have worked great. However, he's well enough to go home (minus this issue), so finding a strategy that would work at home long-term. He was in for a colectomy and VAC dressing, not specifically for the restless legs. Ivory: an epidural is a great idea and probably would have worked great. However, he’s well enough to go home (minus this issue), so finding a strategy that would work at home long-term.

He was in for a colectomy and VAC dressing, not specifically for the restless legs.

]]> By: Grand Rounds: Volume 4, No. 19 // Emergiblog http://nursesean.com/musings/inconsolable.htm#comment-18681 Grand Rounds: Volume 4, No. 19 // Emergiblog Tue, 29 Jan 2008 04:33:48 +0000 http://nursesean.com/musings/inconsolable.htm#comment-18681 [...] Nurse Sean describes the emotional pain of watching a patient suffer and being unable to help in Inconsolable. [...] […] Nurse Sean describes the emotional pain of watching a patient suffer and being unable to help in Inconsolable. […]

]]> By: Ivory http://nursesean.com/musings/inconsolable.htm#comment-18676 Ivory Tue, 29 Jan 2008 03:09:15 +0000 http://nursesean.com/musings/inconsolable.htm#comment-18676 What about an epidural? What about an epidural?

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