First time for me... (Full Version)

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Dr.Wagner -> First time for me... (February 25, 2008 6:53:16 PM)

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.

jma -> RE: First time for me... (February 25, 2008 8:45:34 PM)

What did you for him and what was the prognosis?

Dr.Wagner -> RE: First time for me... (February 26, 2008 3:34:16 AM)

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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