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Patient Perfects ‘Sliding Scale Dilaudid’ Regimen at Home

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MONROE, NC – A North Carolina woman has invented a new pain management protocol for herself, and she has experienced incredible success with controlling her debilitating pain.  Anne Erskell hails from a Charlotte suburb and has accrued at least four different pain syndromes over twelve years, though she has yet to show any significant laboratory or imaging abnormality.

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“This PCA works soo much better without a time restrainttttt…ahhh”

Thanks to multiple primary MDs, PAs and NPs who prescribe narcotics liberally, for years Ms. Erskell has been blessed with a dizzying surplus of narcotics with which to experiment at home.

Erskell, 43, was hospitalized last week and reached by GomerBlog for comments.  “Sorry it took me a while to get back to you, but I have been in a ‘fibro fog’ for a couple of weeks.  I had to double up on my fentanyl patches, and I ramped up the Soma from thrice daily to four times.  My sliding scale basically goes like this: when my pain flares up, I count on my Dilaudid tabs.  My doctors knows me well; they are the best doctors in the world, I’m sure of it.”

“They make sure that I have plenty of both 2 mg and 4 mg Dilaudid on hand.  I mentally rate my own pain, then take the appropriate Dilaudid dose.  If my pain is a 1-4, I take 2 mg and reassess.  If it is a 5-7, I take a 4 mg tab.  If it is 8-9, I take a 4 mg and a 2 mg, which totals 6 mg.  If it is a 10, which it frequently is, I take two of the 4 mg tabs, or 8 mg total.  I reassess after 20 mins and repeat the process.  If it is still a 10 or even 10+ at that point, I call 911 and get to the ER to have my port accessed and get a PCA for a few days.”

“It is elegant simplicity in action.  It just dawned on me one day that diabetics dose their insulin based on what their blood sugar value is, so why shouldn’t chronic pain patients use the same method?  Pain is the 5th vital sign, for heaven’s sake!!  It is much more important than a blood sugar value.  I hope and pray that all patients suffering with chronic pain will embrace my method for a happy, healthy life.”

Erskell then drifted off into a “fibro fog” that happened to coincidentally closely follow her jack-hammering of the PCA button, which she was able to reprogram without a bolus time restriction.

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  • Jake Ho

    After 10 years spent fighting the unwinnable war that is Emergency Medicine in America, an "ER doctor" left medicine altogether and joined a Buddhist temple in Tibet, changing his name to "Jake Ho." He found the peaceful solitude he achieved to be the antithesis of years spent dealing with unreasonable requests and reprimands from patients, families, hospital administrators, and consultants. The vows of celibacy and silence he took are largely mitigated by the blogging and internet porn made possible thanks to the temple's excellent Wi-Fi connection.

  • Show Comments

  • Avatar
    Malcolm McKenzie

    I would love to RT this but I daren’t.
    “have my port accessed”
    Genuine lol
    Thank you.

  • Avatar
    June Dcruz

    Whoa !! Really ??

  • Avatar
    Melissa Jean

    Mary Boyd lmao

  • Avatar
    Melissa Jean

    Mary Boyd lmao

  • Avatar
    Andrea Stevenson Eskridge

    good – maybe they can figure out how to use that aweful Braun pump too

  • Avatar
    Kelly Healy

    Barry Johns

  • Avatar
    Monica McKnight

    lol

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    Doras Trussell

    Okay, this may be extreme, however it does make a good point. Here in the midwest, I would challenge you to get a prescription for anything stronger than tramadol. Our doc’s are so afraid to rx pain meds that their patients are severely undertreated. Forget addiction, treat the immediate problem.

  • Avatar
    Cary Lincycomb York

    Sliding Scale Dilaudid!!!

  • Avatar
    Cary Lincycomb York

    Sliding Scale Dilaudid!!!

  • Avatar
    Casey Roberson Shaver

    Myra Congioloso sliding scale dilaudid. Hahaha. I know a few that invented this at home. I love this page!

  • Avatar
    Casey Roberson Shaver

    Myra Congioloso sliding scale dilaudid. Hahaha. I know a few that invented this at home. I love this page!

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    Jeff Yu

    This is a very elegant regime that I will ask to be implemented into our EMR as an order set. I am quite concerned however regarding the absence of dosing for 11-20 out of 10 pain. This is a serious oversight that will decrease patient satisfaction scores.

  • Avatar
    Stephen Bailey

    Gee there was no real info for the 10 to 20 range on the pain scale other than just a 10+, I’m a little sceptical of the value of this scale to be truthful.

  • Avatar
    Lena Taylor

    Susan Michelle Linnen..lol

  • Avatar
    Karin Cartwright

    I’m amazed she can still do the math after a few hours? :)

  • Avatar
    Kerin Mora

    Lol

  • Avatar
    Tommie Cox Blue

    Amy Craven Geurts what do you think? Lol

  • Avatar
    Lisa Keith

    And I guarantee I don’t even know the names or dosages of my “blood pressure” or “heart” pills

  • Avatar
    Barbara Bialack Mazzarella

    Brillant!

  • Avatar
    Karen Townley

    you can’t make this up

  • Avatar
    Kathy Graf

    True

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