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Same here. After a LONGGG phone call cradling the receiver while trying to type, etc., I had my neck spasm severely -- so much so that the following day someon

Same here. After a LONGGG phone call cradling the receiver while trying to type, etc., I had my neck spasm severely -- so much so that the following day someone else had to drive me to urgent care (1). They prescribed a strong muscle relaxant in combination with either Percocet or Vicadin -- I forget which. I switched over to the default over the counter dose of ibuprofen, and it worked better than the combination of those two "heavy duty" prescription drugs. I will say, though, that doctors in the U.S. have been damned cavalier about ibuprofen. One doctor with a popular radio show would cite the nickname, "Vitamin I", and routinely tell people to use it non-stop for a month or two. I've found that now, a few days on it will make me rather lethargic. My cardio strength and sometimes rhythm feels impaired. And lo, there are studies now coming out that indicate it may carry as much risk as Vioxx and the like. (Incidentally, a doctor prescribed me Vioxx a month or two before it was yanked from the market. I questioned this, remarking on recent news I'd read indicating it had problems. He had no clue and told me it was perfectly safe. Sure, it was still on the market, then, but he appeared to have no clue about the looming controversy.) With any medicine, it really seems TANSTAAFL. You have to carefully weigh the benefit against known as well as suspected risks. And the U.S. medical system completely falls down in not fully informing not just patients but also doctors to the existence and nature of these. 1) Well, that urgent care experience -- a new facility opened by the premier area hospital -- was itself a horrible experience. Deserted facility, by all appearances, yet it took about 2.5 hours to see a doctor. Who gave me no neck brace; family took me to their chiropractor, the next day, who DID give me a neck brace -- which provided the first real relief and stopped me from constantly retriggering the injury with every movement. To be clear, I refuse to have my neck cracked. And the chiropractor wouldn't have, at that point, anyway, given my severe spasming. But at least he had the sense to immobilize my neck. (Then he provided some ongoing care to encourage the release and healing of the spasming. To whatever extent this may have helped, that initial immobilization was key. WTF was wrong with that fully credentialed MD serving the urgent care's rather extensive ER facility?)

mholmes680 9y ago
I've found through my experience that the choice of urgent care vs a non-urgent care doctor is more important than I have always thought: An urgent care center wants to focus on the shortest path to getting you relief (your story aside). They'll err towards slightly over-prescribing. The non-urgent care doc will take a more comprehensive treatment path. A slight distinction that might not matter sometimes, but i often wonder how many antibiotics/pain killers I've taken prescribed from urgent cares that were possibly overkill.
- foobarian 9y ago
  For the ER in our town to take you seriously you would have to have visible bullet holes or severed limbs. Otherwise they dismiss you with a condescending sneer.
- pasbesoin 9y ago
  Yeah. Rather than your typical urgent care facility, this was the hospital's initial effort to significantly expand its effective service area. It was a quite substantial building -- since expanded to the size of some hospitals -- and they had labeled what I used an "emergency room". My family suggested going there as it was a lot closer. That ER doctor just gave me the prescriptions and sent me off. No follow-up care. I guess you'd have had to see my level of discomfort. My family was equally surprised and disappointed. I take your point. And much of the U.S. health care system keeps pushing patients towards urgent care and "the doctor at hand". Not that there aren't good urgent care staff; nonetheless, it doesn't exactly promote medical management. Also, I've delayed some care because I've been uncertain of the approach and awaited more information and perhaps improved procedures and techniques. This might well be called a conservative approach -- and these days, so much of the U.S. rhetoric is about the need to be "conservative". Well, much of that is actually "Conservative", which is actually a rather different ideology. Yet, insurance keeps worsening by the year. Patients who might otherwise be inclined to be conservative and await better knowledge as well as what would normally be lower costs (in most other industries, "product" costs decline with age and with technical improvements and growing marketshare). Well, in U.S. health care, patients can feel compelled to "act now", because while technology and standards of care may improve, next year's insurance may well not cover it or cover it enough for it to be affordable ($5000 deductible? $7500?), if one even has insurance next year.
giardini 9y ago
pasbesoin says> " They prescribed a strong muscle relaxant in combination with either Percocet or Vicadin -- I forget which. I switched over to the default over the counter dose of ibuprofen, and it worked better than the combination of those two "heavy duty" prescription drugs." Had you continued the muscle relaxant (the problem was an involuntary muscle spasm), you possibly could have avoided further treatment (the neck brace). If I suffer a muscle spasm that can't be massaged out, then a muscle relaxant + ibuprofen serves well for 1-2 days and, after that, only ibuprofen. IMO muscle relaxants + narcotics is not a useful combination, their purposes(muscle relaxation vs pain-reduction) being orthogonal, except in cases of severe injury where near-immobilization is required.
- pasbesoin 9y ago
  Thanks for that perspective. I was on the muscle relaxant for a full day, and I was no better. Any time I moved, I was retriggering the spasm. The neck brace stopped that. I still had to be careful, but at least I could walk around and sit and such without constantly re-spasming (which I suspect was actually exacerbating the injury). I do agree in concept with the concern about combining such an injury / muscle relaxant with strong pain killers. The pain is warning you as to damage; numbing it seems like it might well promote furthering that damage and/or hindering healing. In my case, once I was braced and stopped retrigging -- and possibly worsening -- the spasming, the remaining pain was entirely tolerable. Of course, the limited effective activity was another aspect requiring coping. That included sleeping: Getting into bed, and keeping things immobilized in bed, was a bit of effort. I learned how to sleep with a neck brace on, and I "trained" myself quickly not to roll from side to side -- despite my allergies that promote frequent shifting.

mholmes680 9y ago

I've found through my experience that the choice of urgent care vs a non-urgent care doctor is more important than I have always thought: An urgent care center wants to focus on the shortest path to getting you relief (your story aside). They'll err towards slightly over-prescribing. The non-urgent care doc will take a more comprehensive treatment path. A slight distinction that might not matter sometimes, but i often wonder how many antibiotics/pain killers I've taken prescribed from urgent cares that were possibly overkill.

foobarian 9y ago
For the ER in our town to take you seriously you would have to have visible bullet holes or severed limbs. Otherwise they dismiss you with a condescending sneer.
pasbesoin 9y ago
Yeah. Rather than your typical urgent care facility, this was the hospital's initial effort to significantly expand its effective service area. It was a quite substantial building -- since expanded to the size of some hospitals -- and they had labeled what I used an "emergency room". My family suggested going there as it was a lot closer. That ER doctor just gave me the prescriptions and sent me off. No follow-up care. I guess you'd have had to see my level of discomfort. My family was equally surprised and disappointed. I take your point. And much of the U.S. health care system keeps pushing patients towards urgent care and "the doctor at hand". Not that there aren't good urgent care staff; nonetheless, it doesn't exactly promote medical management. Also, I've delayed some care because I've been uncertain of the approach and awaited more information and perhaps improved procedures and techniques. This might well be called a conservative approach -- and these days, so much of the U.S. rhetoric is about the need to be "conservative". Well, much of that is actually "Conservative", which is actually a rather different ideology. Yet, insurance keeps worsening by the year. Patients who might otherwise be inclined to be conservative and await better knowledge as well as what would normally be lower costs (in most other industries, "product" costs decline with age and with technical improvements and growing marketshare). Well, in U.S. health care, patients can feel compelled to "act now", because while technology and standards of care may improve, next year's insurance may well not cover it or cover it enough for it to be affordable ($5000 deductible? $7500?), if one even has insurance next year.

giardini 9y ago

pasbesoin says> " They prescribed a strong muscle relaxant in combination with either Percocet or Vicadin -- I forget which. I switched over to the default over the counter dose of ibuprofen, and it worked better than the combination of those two "heavy duty" prescription drugs." Had you continued the muscle relaxant (the problem was an involuntary muscle spasm), you possibly could have avoided further treatment (the neck brace). If I suffer a muscle spasm that can't be massaged out, then a muscle relaxant + ibuprofen serves well for 1-2 days and, after that, only ibuprofen. IMO muscle relaxants + narcotics is not a useful combination, their purposes(muscle relaxation vs pain-reduction) being orthogonal, except in cases of severe injury where near-immobilization is required.

pasbesoin 9y ago
Thanks for that perspective. I was on the muscle relaxant for a full day, and I was no better. Any time I moved, I was retriggering the spasm. The neck brace stopped that. I still had to be careful, but at least I could walk around and sit and such without constantly re-spasming (which I suspect was actually exacerbating the injury). I do agree in concept with the concern about combining such an injury / muscle relaxant with strong pain killers. The pain is warning you as to damage; numbing it seems like it might well promote furthering that damage and/or hindering healing. In my case, once I was braced and stopped retrigging -- and possibly worsening -- the spasming, the remaining pain was entirely tolerable. Of course, the limited effective activity was another aspect requiring coping. That included sleeping: Getting into bed, and keeping things immobilized in bed, was a bit of effort. I learned how to sleep with a neck brace on, and I "trained" myself quickly not to roll from side to side -- despite my allergies that promote frequent shifting.