So I have a patient yesterday call us for severe hip and joint pain which has been lasting all week. So long that he's been unable to eat and he's taking 4 Alieve every 4 hours on an empty stomach and he's now peeing, crapping and throwing up a little blood.
(lots of painkillers + empty stomach = destroyed stomach/intestinal lining) Always eat something when you take pain meds even over the counter meds (OTC).
Anyhow...So at first I'm thinking what's with this guy calling 911 friggin call your doctor, get an appt like the rest of us shmooes and move on with your life. Turns out he did see his doctor, he did go to his appt and was told he had elevated uric acid and was prescribed Voltarin pain gel which is friggin EXPENSIVE because it's new AND it's ----
Important Safety Information
*Voltaren® Gel is indicated for the relief of the pain of osteoarthritis of joints amenable to topical treatment, such as the knees and those of the hands. Voltaren Gel has not been evaluated for use on the spine, hip, or shoulder.
It's specifically made to treat osteoarthritis not GOUT (or hip pain duh!) which btw is caused by elevated uric acid.
This patient wasn't told by his doctor that he was diagnosed with Gout, no no, he was told he had elevated uric acid. That's friggin gout moron! Gout will cause similar joint pain like OA but it won't be relieved by the same meds because it's a completely different disease process. HELLO!
You should take pain relievers with Gout but you also have to treat the Gout with medications such as allopurinol and corticosteroids and change your diet, lose weight and exercise. This poor guy wasn't on any Gout medication and was 400 lbs and wasn't doing anything else to treat his Gout. (of course he should be taking some responsibility himself as well like EAT LESS!) But by this time he was in so much that pain lifestyle change was out the window.So my main grip was with the friggin doctor! This guys insurance wouldn't cover the Voltaren cause it's like $100 a tube!!!!!! AHHHH!!! And the other meds are generic. So I have to ask myself-is this doctor insanely incompetent (which he very well may be) or----------
is he something much worse? Is he deliberately mis-prescribing meds to this guy to get some sort of kick back (like it doesn't happen!) , withholding information that a first year med student would know (gout goes with increased uric acid like peanut butter goes with jelly) and thereby indirectly setting this guy up for more injury by him accidentally injuring himself by taking OTC meds incorrectly out of desperation.
Now this guy should be taking more personal responsibility, absolutely! You are your own best advocate in this mess up system. However, hearing about how totally incompetent and/or unethical this dr is really burned me. Makes me what to march to his office and head butt him, then kick him a few times while he's down just for good measure.
Remember asshole...First do no harm!