34 Comments

I was in the ER recently for severe abdominal pain and was given morphine. I did not like it at all: it gave me dry mouth, a headache, made me feel drunk and I still felt the pain. It was awful.

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Oh goodness, was wondering why I am not seeing any post. I hope you're feeling better? Thank you for sharing your experiences.

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Gabapentin is used heavily in addiction for both acute alcohol detox and long-term cravings control. We were even pitched on a non-benzodiazepine protocol using gabapentin and other adjuncts by one of the national organizations, which I haven't actually done.

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It turns out Gabapentin is a wonder drug.

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So glad you have healed well. Thinking of the insight about how much luck plays a part in our health. I guess if one is Christian, it might be referred to as grace. Why was I spared from a bad outcome that others were not? It’s a mystery. And that is why acknowledging this can lead to gratitude and empathy. Our sense of control is an illusion.

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My conclusion was the opposite of yours when I heard that your patients said, "Never mind," when offered another doctor in your place: to me it means they preferred to wait and speak to you, because they trust their relationship with you more than a Cifu substitute. You ARE that important.

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My 2yo cat tore his CCL (I forget the first C but it’s more fun to call it his Cat Cruciate Ligament ) and he needed a month of crate rest. They gave me gabapentin for him. It calmed him and he slept most of the time. Without it, he howled. My sister has 3 competition dogs and has had it Rx’ed for their various injuries. The vets say it numbs pain but mostly is used to calm them for rest. At least you didn’t require crate rest!

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Interesting the ER gave you narcotics instead of toradol when you complained of pain. Do you think they would have offered a non physician narcs or a NSAID first?

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Really good to hear a different type of story about doctors as patients. Glad to hear that you managed your way through it well and you're feeling better.

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number one lesson: don't race your kids after they turn 5

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Except on skis. 😄

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The greatest gift we can have - and thanks for the reminder - is that we are not that important. Life became much easier as “just Jim” and not “Jim, messenger to save lives” after being done with that part of life. The realization that the world goes on fine without me is liberating! It allowed me to filter what’s important and what’s not.

I’m glad you are feeling better and I’m glad I’m sober so I wouldn’t try to figure out where you got all those great opioids! 🤣

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author

Ha ha...

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Sep 8, 2023Liked by Adam Cifu, MD

Our surgery chief had a similar accident. For about three months after his recovery he spoke to his residents as if they were worthy of respect. The humbling effect wore off and he began once again to yell,make faces, belittle and cause grown people to cry.

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author

Uggh. I hope you chimed in with the occasional, "I remember that brief and fleeting moment when you were pleasant to work with..."

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Glad you're on the mend. (Also yes, gabapentin really can work sometimes, it's wild!)

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Sep 8, 2023Liked by Adam Cifu, MD

Wow AC I am so sorry to hear this but so glad you are recovering well. Sounds to me like you are not only an amazing doctor but an amazing patient!!

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Sep 8, 2023Liked by Adam Cifu, MD

HTG, great that you;re on the mend, dr C...BUT, this ol'mechanic is in a state of shock, all this from a bicycle toss & a soft grass landing?...clavicle broken ribs! ...FYI having had 12 m/cycle [racing & road] & too many to recall, car vs bicycle,car vs car crashes, roofing& extension ladder falls...not one broken bone & Never ever ingesting any systemic poison painkillers, just hom.Arnica et al... The 'biggie' was being t-boned by a cab going thru the red light at 50mph...landing 100ft away from the yamaha & resulting in total amnesia for the 3yrs at university..... ol'M Rx = apples [malic acid], transdermal Mg, alkaline diet ...meat/dairy is acidic&body leaches Ca out of the bones to buffer theacidic blood pH...just my 2cents et xrays to prove it. cheers

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Sep 8, 2023Liked by Adam Cifu, MD

Here are a few lessons I got out of it, not that I didn't know them already, but reminders are always good: Bikes are not toys and can be as dangerous as any vehicle; intensity of pain perception is like a quarterback's role in winning - people get too much credit when they have a high threshold, and too much blame when they have a low threshold; problems often resolve themselves without intervention; gratitude is ALWAYS the best response to any situation; and last but not least: individuals are unique and have different responses to the same stimulus (including interventions), which is why clinical trials often have a huge within groups standard deviation, which is why being a doctor is as much art as science! Thanks for sharing.

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author

Great thoughts. Thanks.

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Sep 8, 2023Liked by Adam Cifu, MD

I love this essay. So honest! Especially about the needless mychart messages. We start epic in three weeks- can’t wait!

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author

Best of luck with Epic!

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