Community Chat

[pitdakota]

---

@raven-blackbird wrote:

---

@151949 wrote:

@Trinity11 Didn't you say they gave me morphine even when I didn't need it -- the only reason you didn't need it would be if you weren't having pain. It was a perfectly reasonable assumption. 

Also - yes - many people have myocardial infarctions and don't have pain . They have arrythmias and that is how their MI is detected. Some people have routine EKGs and old MIs are detected that they were not even aware ever happened. 

Just because you were a patient in a hospital does not qualify you as an expert.

---

@151949

@Trinity11

the fact her doctor had her on a pain medication, rather she needed it or not, falls under pain management......also, nurses can't order medication, they can only follow doctors orders.....the idea of managing the pain before it gets to a point where all the pain medication in the world can't manage it, is prudent actions by her doctor/nurses...........it will also, like aspirin, thin the blood which is extremely helpful on someone having cardio problems..........which is also another reason why they would want her on the medication rather she felt she needed it or not.


now the fact SHE HAS PERSONALLY faced this issue...........makes her more of an expert then someone who has not.........even doctors learn from their patients...............................................raven

---

___________________________________________________

I haven't read the entire thread so I am not sure how having an MI with or without pain discussion evolved, but as a critical care nurse for more years than I will admit, it is like nails on a chalkboard when I read things such as @raven-blackbird posted.  And the nurse in me, must correct misinformation.  Sorry.

Morphine sulfate is not a blood thinner in any way, shape, form, or fashion.  Any nurse knows that.  It is used to manage many different types of acute pain, myocardial infarction included.   However, the first treatment of choice for eligible patients would be TPA which would then negate any need for pain medications.  

But morphine sulfate is the drug of choice to manage pain in MI because is also decreases systemic vascular resistance and therefore decreases preload and afterload, to get technical.  But it is not a blood thinner. 

And yes there are individuals that have a heart attack with no pain at all.  These are called silent MIs.  Took care of many of those patients along the way as well. 

Protocol for nurses treating pain is to assess pain level and have the patient rate the pain on a scale of 0-10; 0 being no pain, 10 being unbearable.  If a patient reports a score of 0, no pain med should be administered.  For the majority of situation involving pain, any nurse administering a pain med for someone reporting a pain score of 0 would be having to answer to someone and could face questioning.  They most certainly would be liable in a potential lawsuit and could face discipline from their state board of nursing, depending.  The patient must report at least some level of discomfort in order for the nurse to administer a pain med to be within the scope of practice.

This is standard protocol and standard of practice for pain managment with the exception of pain in someone that is terminal.  The above does not pertain to that situation.

[Trinity11]

---

@mstyrion 1 wrote:

---

@Trinity11 wrote:

---

@mstyrion 1 wrote:

Thanks, Noel!

I haven't mentioned it before now either.

I'm doing exceptionally well.  Back to full activity and feeling wonderful.

I knew enough about women's heart symptoms to get to the ER very early on.  I sustained no damage to my heart .

I probably did not have true pain because I caught it so early.  Immediately after the stent placement, I felt fine.  The most annoying thing about the whole ordeal was the massive bruise in my groin area!  

---

You are truly blessed. I sustained a lot of damage to the muscle and was in heart failure immediately after. 

I really wish more was known about women and heart disease. We are given the same meds that research on men is approved but our arteries are much smaller...

---

------------------------------------------------------------------------------------------------

I'm sorry you're going through so much, Trinity.

I am very lucky to have been treated so quickly and so thoroughly. The time from getting into the ER to getting the stent placed was all of 45 minutes. I lucked out with a great Cardiologist who is young and totally up to date on the latest info available.

Much luck to you. Hang in there. The human body does amazing things to restore itself.  

---

Thanks....I truly believe in my heart that because the hospital I was in had no Cath lab, the delay of more than 36 hours was the cause of all the damage. 

Glad to read you had quick action. I changed myself to a young doctor recently who was so much more upbeat. He said I am out of heart failure and thinks I just need time to heal.

[pitdakota]

---

@Trinity11 wrote:

---

@mstyrion 1 wrote:

---

---

------------------------------------------------------------------------------------------------

I'm sorry you're going through so much, Trinity.

I am very lucky to have been treated so quickly and so thoroughly. The time from getting into the ER to getting the stent placed was all of 45 minutes. I lucked out with a great Cardiologist who is young and totally up to date on the latest info available.

Much luck to you. Hang in there. The human body does amazing things to restore itself.  

---

Thanks....I truly believe in my heart that because the hospital I was in had no Cath lab, the delay of more than 36 hours was the cause of all the damage. 

Glad to read you had quick action. I changed myself to a young doctor recently who was so much more upbeat. He said I am out of heart failure and thinks I just need time to heal.

---

---

@Trinity11 wrote:

---

@mstyrion 1 wrote:

---

@Trinity11 wrote:

---

@mstyrion 1 wrote:

Thanks, Noel!

I haven't mentioned it before now either.

I'm doing exceptionally well.  Back to full activity and feeling wonderful.

I knew enough about women's heart symptoms to get to the ER very early on.  I sustained no damage to my heart .

I probably did not have true pain because I caught it so early.  Immediately after the stent placement, I felt fine.  The most annoying thing about the whole ordeal was the massive bruise in my groin area!  

---

You are truly blessed. I sustained a lot of damage to the muscle and was in heart failure immediately after. 

I really wish more was known about women and heart disease. We are given the same meds that research on men is approved but our arteries are much smaller...

---

------------------------------------------------------------------------------------------------

I'm sorry you're going through so much, Trinity.

I am very lucky to have been treated so quickly and so thoroughly. The time from getting into the ER to getting the stent placed was all of 45 minutes. I lucked out with a great Cardiologist who is young and totally up to date on the latest info available.

Much luck to you. Hang in there. The human body does amazing things to restore itself.  

---

Thanks....I truly believe in my heart that because the hospital I was in had no Cath lab, the delay of more than 36 hours was the cause of all the damage. 

Glad to read you had quick action. I changed myself to a young doctor recently who was so much more upbeat. He said I am out of heart failure and thinks I just need time to heal.

---

_____________________________________________

O/T  @Trinity11, glad to hear you are not in heart failure any more!   When you had the heart attack, did they evaluate you for TPA since they could not get you to a cath lab quickly?

@mstyrion 1, glad to hear you are doing okay as well. 

[Trinity11]

---

@Noel7 wrote:

---

@Trinity11 wrote:

---

---

Noel, costochondritis is a lot like a heart attack. I have had it through the years and sometimes it is hard to differentiate the pain from heart disease. 

I didn't realize you had a heart attack last June. Please know I am praying for both yourself and Mystrion that you both get through all of this. There are days it is all I can do to just get through the day without angina. I thought 3 stents and a balloon would "fix" it all but it hasn't. I wish more research was done on women and heart disease...

---

*****************************

@Trinity11

I didn't say anything about the heart attack until now this time, just the pericarditis and water in the heart/lungs issue.  It just seemed like so much.

I've had costo so may times, I can't count.  I'd never heard of a MI where it was just your ribs.  Don't worry, I've learned my lesson. 

Two stents this time.  Lupus directly deposits plaque in the heart.

I hope the medicine is helping you and I hope you feel stronger, Trinity.

---

Noel, thankfully you didn't sustain damage to the heart muscle. It's so hard sometimes not to be an alarmist after a heart attack. I had chest pain on Thursday the entire morning but didn't know if it was just indigestion from all the meds. I would be living in the ER with all the scares I have had. So it is understandable that you wanted to be sure.... 

[Trinity11]

---

@pitdakota wrote:

---

@Trinity11 wrote:

---

@mstyrion 1 wrote:

---

---

------------------------------------------------------------------------------------------------

I'm sorry you're going through so much, Trinity.

I am very lucky to have been treated so quickly and so thoroughly. The time from getting into the ER to getting the stent placed was all of 45 minutes. I lucked out with a great Cardiologist who is young and totally up to date on the latest info available.

Much luck to you. Hang in there. The human body does amazing things to restore itself.  

---

Thanks....I truly believe in my heart that because the hospital I was in had no Cath lab, the delay of more than 36 hours was the cause of all the damage. 

Glad to read you had quick action. I changed myself to a young doctor recently who was so much more upbeat. He said I am out of heart failure and thinks I just need time to heal.

---

---

@Trinity11 wrote:

---

@mstyrion 1 wrote:

---

@Trinity11 wrote:

---

@mstyrion 1 wrote:

Thanks, Noel!

I haven't mentioned it before now either.

I'm doing exceptionally well.  Back to full activity and feeling wonderful.

I knew enough about women's heart symptoms to get to the ER very early on.  I sustained no damage to my heart .

I probably did not have true pain because I caught it so early.  Immediately after the stent placement, I felt fine.  The most annoying thing about the whole ordeal was the massive bruise in my groin area!  

---

You are truly blessed. I sustained a lot of damage to the muscle and was in heart failure immediately after. 

I really wish more was known about women and heart disease. We are given the same meds that research on men is approved but our arteries are much smaller...

---

------------------------------------------------------------------------------------------------

I'm sorry you're going through so much, Trinity.

I am very lucky to have been treated so quickly and so thoroughly. The time from getting into the ER to getting the stent placed was all of 45 minutes. I lucked out with a great Cardiologist who is young and totally up to date on the latest info available.

Much luck to you. Hang in there. The human body does amazing things to restore itself.  

---

Thanks....I truly believe in my heart that because the hospital I was in had no Cath lab, the delay of more than 36 hours was the cause of all the damage. 

Glad to read you had quick action. I changed myself to a young doctor recently who was so much more upbeat. He said I am out of heart failure and thinks I just need time to heal.

---

_____________________________________________

O/T  @Trinity11, glad to hear you are not in heart failure any more!   When you had the heart attack, did they evaluate you for TPA since they could not get you to a cath lab quickly?

@mstyrion 1, glad to hear you are doing okay as well. 

Do you mean cardiac enzymes? I had massive amounts of them in the blood work they performed. The new cardiologist said I should have been transferred. I was surprised he was that frank...

---

[pitdakota]

---

@Trinity11 wrote:

---

@pitdakota wrote:

---

---

---

@Trinity11 wrote:

---

---

_____________________________________________

O/T  @Trinity11, glad to hear you are not in heart failure any more!   When you had the heart attack, did they evaluate you for TPA since they could not get you to a cath lab quickly?

@mstyrion 1, glad to hear you are doing okay as well. 

Do you mean cardiac enzymes? I had massive amounts of them in the blood work they performed. The new cardiologist said I should have been transferred. I was surprised he was that frank...

---

-------------------------------------------------------------------------------

Hi @Trinity11, no TPA is Tissue plasminogen activase or commonly called activase.  It is a powerful "clot busting" medication they will use when someone is having a myocardial infarction  to perserve myocardial function,.

There are certain factors that have to be present in order to be a candidate to receive it.  It does have to be administered within so many hours of the onset of the pain or discomfort, can't have any significant risk factors for bleeding, etc. 

You don't have to post that information, I was just curious if they evaluated you to receive the TPA.  If they had given it to you, you would have known it.....long list of questions, explanation about what it is, the risk factors, etc. 

Still, good news that you aren't in heart failure now!

---

[raven-blackbird]

---

@pitdakota wrote:

---

@raven-blackbird wrote:

---

@151949 wrote:

@Trinity11 Didn't you say they gave me morphine even when I didn't need it -- the only reason you didn't need it would be if you weren't having pain. It was a perfectly reasonable assumption. 

Also - yes - many people have myocardial infarctions and don't have pain . They have arrythmias and that is how their MI is detected. Some people have routine EKGs and old MIs are detected that they were not even aware ever happened. 

Just because you were a patient in a hospital does not qualify you as an expert.

---

@151949

@Trinity11

the fact her doctor had her on a pain medication, rather she needed it or not, falls under pain management......also, nurses can't order medication, they can only follow doctors orders.....the idea of managing the pain before it gets to a point where all the pain medication in the world can't manage it, is prudent actions by her doctor/nurses...........it will also, like aspirin, thin the blood which is extremely helpful on someone having cardio problems..........which is also another reason why they would want her on the medication rather she felt she needed it or not.


now the fact SHE HAS PERSONALLY faced this issue...........makes her more of an expert then someone who has not.........even doctors learn from their patients...............................................raven

---

___________________________________________________

I haven't read the entire thread so I am not sure how having an MI with or without pain discussion evolved, but as a critical care nurse for more years than I will admit, it is like nails on a chalkboard when I read things such as @raven-blackbird posted.  And the nurse in me, must correct misinformation.  Sorry.

Morphine sulfate is not a blood thinner in any way, shape, form, or fashion.  Any nurse knows that.  It is used to manage many different types of acute pain, myocardial infarction included.   However, the first treatment of choice for eligible patients would be TPA which would then negate any need for pain medications.  

But morphine sulfate is the drug of choice to manage pain in MI because is also decreases systemic vascular resistance and therefore decreases preload and afterload, to get technical.  But it is not a blood thinner. 

And yes there are individuals that have a heart attack with no pain at all.  These are called silent MIs.  Took care of many of those patients along the way as well. 

Protocol for nurses treating pain is to assess pain level and have the patient rate the pain on a scale of 0-10; 0 being no pain, 10 being unbearable.  If a patient reports a score of 0, no pain med should be administered.  For the majority of situation involving pain, any nurse administering a pain med for someone reporting a pain score of 0 would be having to answer to someone and could face questioning.  They most certainly would be liable in a potential lawsuit and could face discipline from their state board of nursing, depending.  The patient must report at least some level of discomfort in order for the nurse to administer a pain med to be within the scope of practice.

This is standard protocol and standard of practice for pain managment with the exception of pain in someone that is terminal.  The above does not pertain to that situation.

---

@pitdakota

not my belief but theirs...........raven

Thin blood is found among people who take Morphine, especially for people who are male, 60+ old , have been taking the drug for < 1 month, also take medication Lasix, and have Pain . We study 41,732 people who have side effects while taking Morphine from FDA and social media. Among them, 1,542 have Thin blood.

[pitdakota]

@raven-blackbird, you would have to post the authors of that study in order for me to really evaluate the research.

Of course someone on Lasix & Morphine would have a thinner viscosity of blood...but that is not what a blood thinner is in medical terms.  A blood thinner is something that actually works on one of the clotting mechanisms of the body as its primary action. 

Morphine dilates the peripheral blood vessels (thereby decreasing blood pressure & systemic vascular resistance) and Lasix pulls more fluid out so that there is more fluid circulating in the blood stream to be filtered by the kidneys for excretion. 

But that is not working on one of the factors of  the clotting system which is what the term blood thinner means....or an anticoagulant. 

[mstyrion 1]

---

@pitdakota wrote:

@raven-blackbird, you would have to post the authors of that study in order for me to really evaluate the research.

Of course someone on Lasix & Morphine would have a thinner viscosity of blood...but that is not what a blood thinner is in medical terms.  A blood thinner is something that actually works on one of the clotting mechanisms of the body as its primary action. 

Morphine dilates the peripheral blood vessels (thereby decreasing blood pressure & systemic vascular resistance) and Lasix pulls more fluid out so that there is more fluid circulating in the blood stream to be filtered by the kidneys for excretion. 

But that is not working on one of the factors of  the clotting system which is what the term blood thinner means....or an anticoagulant. 

---

--------------------------------------------------------------------------------------------

Thanks, Pitty.

That's a very understandable and thorough explanation.

I am on an anticoagulant commonly known as a blood thinner to ensure my stent is not compromised.  I don't think that people who haven't gone through this procedure quite understand the difference between "thin blood" and an anticoagulant.

[pitdakota]

---

@mstyrion 1 wrote:

---

@pitdakota wrote:

@raven-blackbird, you would have to post the authors of that study in order for me to really evaluate the research.

Of course someone on Lasix & Morphine would have a thinner viscosity of blood...but that is not what a blood thinner is in medical terms.  A blood thinner is something that actually works on one of the clotting mechanisms of the body as its primary action. 

Morphine dilates the peripheral blood vessels (thereby decreasing blood pressure & systemic vascular resistance) and Lasix pulls more fluid out so that there is more fluid circulating in the blood stream to be filtered by the kidneys for excretion. 

But that is not working on one of the factors of  the clotting system which is what the term blood thinner means....or an anticoagulant. 

---

--------------------------------------------------------------------------------------------

Thanks, Pitty.

That's a very understandable and thorough explanation.

I am on an anticoagulant commonly known as a blood thinner to ensure my stent is not compromised.  I don't think that people who haven't gone through this procedure quite understand the difference between "thin blood" and an anticoagulant.

______________________________________________

Hi @mstyrion 1, that is a good way of putting it!  They are 2 totatally different things.  Blood thinners or anticoagulants work on some factor in the clotting cascade so that the blood does not clot as quickly.

  And yes, we want to keep that stent clear and free!!!  Glad you are doing well!!!! 

---