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First time for me...

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First time for me... - February 25, 2008 1:53:16 PM   
Dr.Wagner


Posts: 1228
Joined: January 24, 2003
From: Indianapolis
Status: offline 		I had a patient last night that had snorted so many vicodin over a 2 year span of time (up to 10 daily), that he had created a chemical burn of his entire oropharynx and nasopharynx.

It was white necrotic tissue that looked like a post tonsillectomy that covered his ENTIRE throat.

So he comes to the ED so I can "save him".

Thought I would share.


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Dr. Wagner DO
Moderator of Medical Complexity Forum
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RE: First time for me... - February 25, 2008 3:45:34 PM   
jma

 

Posts: 2301
Joined: August 24, 2000
From: NY
Status: offline 		What did you for him and what was the prognosis?

(in reply to Dr.Wagner)
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RE: First time for me... - February 25, 2008 10:34:16 PM   
Dr.Wagner


Posts: 1228
Joined: January 24, 2003
From: Indianapolis
Status: offline 		Well, this didn't just start hurting today, clearly this is chronic.  I mean, sorry guy but you snort vicodin, now life sucks.  I will treat you like I treat all post surgical ENT patients, if you can't swallow your saliva, you stay in the hospital.  Otherwise you get Decadron IM (steroid) and education on clear liquid diet.  I spoke to ENT about admission  vs follow up.  They preferred follow up...because they are surgeons (surgeons only want good surgical candidates...surgeons are not humanitarians).
He was not a good candidate for drug rehab UNTIL his nose and throat healed.  He is appropriate for outpatient rehab, where he could recieve dissolvable pain meds from only ONE source (ie not me)


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Dr. Wagner DO
Moderator of Medical Complexity Forum

(in reply to jma)
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