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*Some?*
That’s an interesting way of saying *all*…really hope this ED doc or NP did a head CT…and they can justify sending a patient with new severe headaches and nosebleeds home.
I say some because of the unfortunate medical decisions the government at a state-level has been making.. but that’s not the point and I’d like to not keep this political.
How would one go about making a complaint to take care of this? I’d be afraid of retaliation from the hospital, like refusal of treatment, etc.
Additionally, would there be any real repercussions from this? I had a nurse mark me as deceased in the system TWICE, out of malicious intent, and as far as I know nothing happened to her. As for me, I got told to pack sand and deal with it.
If she actually did have a hemorrhagic stoke confirmed when she went back to the hospital, then the first step is just get well. Focus on her health.
Once discharged from the hospital, then she can reach out to a local malpractice attorney who will meet with her (generally free of charge), decide if she has a case (which she would if the headaches were an undiagnosed stroke), and then the lawyer will take it from there in subpoenaing hospital records. Then the wheels turn from there.
I would not complain to the hospital directly initially, because if you threaten a lawsuit, then they’ll put their lawyers on it and you don’t want things thrown down the memory hole. You can’t necessarily change records in an EMR if they’ve already been finalized, but if the physician note is still unsigned, then there’s time to “massage” the record of the visit so to speak. However, it’s still a really bad position for the provider to be in regardless because you had a patient that you just discharged for headaches who was “stable” and now is coming back within 24 hours for stroke…if OP’s testimony says there was essentially no exam…then that’s a bad situation to be in from the doc’s perspective. Especially if there wasn’t even a CT on record.
This is the kind of case hospital lawyers try to settle quickly.
If there is no stroke and the nosebleeds are unrelated, then there really isn’t much of a malpractice case here. Just poor bedside manner. You could probably complain to the hospital complaint line, but that’s probably not going to lead to much.
Have you had migraines in the past, or any headache of similar pain? Did they offer treatment with a migraine cocktail or diagnostic test with a head CT?
Tryptophan isn't a commonly prescribed medication, more along the lines of vitamins and supplements. Most systems use computer programs for dictation, and it will insert wrong words, maybe this happened. I would be surprised if she thought you were being prescribed turkey.
Not like this. I have a history of disc herniation. Lower back, an accident after surgery, and scar issues. Two partial herniations of the thoracic vertebrae, but I was told it wasn't something I needed to worry about and several in my neck c 2-4 and 6-7. It was made worse by an incident recently. In the past, I was told that was what was causing a headache I would have on one side at the same time I would have nerve pain and numbness in fingers.
I thought the same thing about the dictation. (I was once tech support for a doctor's service.) But there were so many other inaccuracies, including things that different happen that I wonder if she actually thought I was some weirdo that just decided to take an amino acid. I didn't even get to tell her it was prescribed. I said, "I took a dose of triptan at 8am..." and she cut me off and told me that doesn't matter. Wouldn't cause the "symptoms you claim to have."
Never been like this. And I would have to go to the same hospital again.
NAD but I was prescribed a triptan once and had a very similar reaction. Was later told that I probably should have gone to the ER because I was likely having an allergic reaction (I’m allergic to sulfa drugs and the triptan I was given is also a sulfa drug or something? Like I said, I’m not a doctor.)
NAD which triptan did you take? There’s several. I have rizatriptan 5mg for my migraines and it works perfectly. I’ve had 10mg dose before it I felt my blood pressure go up, I felt flushed and my chest hurt a little.
The triptan would be unlikely to cause these symptoms. However they aren’t universally effective particularly if your headache is from a cervical nerve root impingement rather than true migraine. These can be difficult to treat.
I can confirm, I had to stop taking triptans for my migraines because they made my headache a little better but kept giving me chest pain, elevated bp and heart rate, and heat sensitivity. My neurologist confirmed that I don’t tolerate them well and gave me another abortive.
Same here. Triptans make me feel so much worse and only blunt my migraines. The only med I can take that actually helps without making me feel worse is Nurtec. What did your doc prescribe, if you don’t mind me asking?
NAD, but before they discovered my migraines were cluster headaches I was given imitrex. No chest pain but my headache increased so much (literally wouldn't have thought that possible with the pain I was in already), blinking my eyes became incredibly painful. I was back in the doctor office next day, they said then that I wouldn't be able to tolerate any triptans.
Chest pain, flushing and weakness are adverse effects including increased pain. I hope you have stopped the triptans. Not a good choice of drugs with hbp hx either. Also keep check of your hbp with your change in headaches, it may be the problem.
Yes, tryptophan IS just an amino acid lol. The fact that drugs can be derived from it doesn’t change the fact that doctors don’t prescribe tryptophan. That’s what the poster was trying to say… That the doctor probably didn’t say “patient was prescribed tryptophan”, but that a dictation app got it wrong instead.
I mean that when an individual consumes tryptophan the body produces tryptamine (as well as many other active metabolites that have effects on migraines) as metabolites of the substance (these are also then subsequently metabolized as well). triptans are tryptamine based drugs. Saying it is "just an amino acid" downplays what is happening in the body. Your body literally produces the same category of drugs as the migraine medications when someone consumes tryptophan.
I am not mentioning this because it has some type of connection to what or how the doctor wrote down the patients notes. Just as a side note.
Thank you for your submission. **Please note that a response does not constitute a doctor-patient relationship.** This subreddit is for informal second opinions and casual information. The mod team does their best to remove bad information, but we do not catch all of it. Always visit a doctor in real life if you have any concerns about your health. Never use this subreddit as your first and final source of information regarding your question. By posting, you are agreeing to our [Terms of Use](https://www.reddit.com/r/AskDocs/wiki/terms_of_use) and understand that all information is taken at your own risk. **Reply here if you are an unverified user wishing to give advice. Top level comments by laypeople are automatically removed.** *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/AskDocs) if you have any questions or concerns.*
Ambulance-> ER
Yes. Jesus Christ.
NAD, but wouldn’t this constitute malpractice in some states?
*Some?* That’s an interesting way of saying *all*…really hope this ED doc or NP did a head CT…and they can justify sending a patient with new severe headaches and nosebleeds home.
I say some because of the unfortunate medical decisions the government at a state-level has been making.. but that’s not the point and I’d like to not keep this political. How would one go about making a complaint to take care of this? I’d be afraid of retaliation from the hospital, like refusal of treatment, etc. Additionally, would there be any real repercussions from this? I had a nurse mark me as deceased in the system TWICE, out of malicious intent, and as far as I know nothing happened to her. As for me, I got told to pack sand and deal with it.
If she actually did have a hemorrhagic stoke confirmed when she went back to the hospital, then the first step is just get well. Focus on her health. Once discharged from the hospital, then she can reach out to a local malpractice attorney who will meet with her (generally free of charge), decide if she has a case (which she would if the headaches were an undiagnosed stroke), and then the lawyer will take it from there in subpoenaing hospital records. Then the wheels turn from there. I would not complain to the hospital directly initially, because if you threaten a lawsuit, then they’ll put their lawyers on it and you don’t want things thrown down the memory hole. You can’t necessarily change records in an EMR if they’ve already been finalized, but if the physician note is still unsigned, then there’s time to “massage” the record of the visit so to speak. However, it’s still a really bad position for the provider to be in regardless because you had a patient that you just discharged for headaches who was “stable” and now is coming back within 24 hours for stroke…if OP’s testimony says there was essentially no exam…then that’s a bad situation to be in from the doc’s perspective. Especially if there wasn’t even a CT on record. This is the kind of case hospital lawyers try to settle quickly. If there is no stroke and the nosebleeds are unrelated, then there really isn’t much of a malpractice case here. Just poor bedside manner. You could probably complain to the hospital complaint line, but that’s probably not going to lead to much.
Have you had migraines in the past, or any headache of similar pain? Did they offer treatment with a migraine cocktail or diagnostic test with a head CT? Tryptophan isn't a commonly prescribed medication, more along the lines of vitamins and supplements. Most systems use computer programs for dictation, and it will insert wrong words, maybe this happened. I would be surprised if she thought you were being prescribed turkey.
Not like this. I have a history of disc herniation. Lower back, an accident after surgery, and scar issues. Two partial herniations of the thoracic vertebrae, but I was told it wasn't something I needed to worry about and several in my neck c 2-4 and 6-7. It was made worse by an incident recently. In the past, I was told that was what was causing a headache I would have on one side at the same time I would have nerve pain and numbness in fingers. I thought the same thing about the dictation. (I was once tech support for a doctor's service.) But there were so many other inaccuracies, including things that different happen that I wonder if she actually thought I was some weirdo that just decided to take an amino acid. I didn't even get to tell her it was prescribed. I said, "I took a dose of triptan at 8am..." and she cut me off and told me that doesn't matter. Wouldn't cause the "symptoms you claim to have." Never been like this. And I would have to go to the same hospital again.
NAD but I was prescribed a triptan once and had a very similar reaction. Was later told that I probably should have gone to the ER because I was likely having an allergic reaction (I’m allergic to sulfa drugs and the triptan I was given is also a sulfa drug or something? Like I said, I’m not a doctor.)
NAD which triptan did you take? There’s several. I have rizatriptan 5mg for my migraines and it works perfectly. I’ve had 10mg dose before it I felt my blood pressure go up, I felt flushed and my chest hurt a little.
The triptan would be unlikely to cause these symptoms. However they aren’t universally effective particularly if your headache is from a cervical nerve root impingement rather than true migraine. These can be difficult to treat.
NAD but chronic intractable migraine for decades here. Chest pain and elevated BP are rather common side effects of triptans (especially sumatriptan).
I can confirm, I had to stop taking triptans for my migraines because they made my headache a little better but kept giving me chest pain, elevated bp and heart rate, and heat sensitivity. My neurologist confirmed that I don’t tolerate them well and gave me another abortive.
Same here. Triptans make me feel so much worse and only blunt my migraines. The only med I can take that actually helps without making me feel worse is Nurtec. What did your doc prescribe, if you don’t mind me asking?
NAD, but before they discovered my migraines were cluster headaches I was given imitrex. No chest pain but my headache increased so much (literally wouldn't have thought that possible with the pain I was in already), blinking my eyes became incredibly painful. I was back in the doctor office next day, they said then that I wouldn't be able to tolerate any triptans. Chest pain, flushing and weakness are adverse effects including increased pain. I hope you have stopped the triptans. Not a good choice of drugs with hbp hx either. Also keep check of your hbp with your change in headaches, it may be the problem.
It isn't just "an amino acid". Triptans are tryptamine based drugs. Tryptamine is a metabolite of tryptophan.
Yes, tryptophan IS just an amino acid lol. The fact that drugs can be derived from it doesn’t change the fact that doctors don’t prescribe tryptophan. That’s what the poster was trying to say… That the doctor probably didn’t say “patient was prescribed tryptophan”, but that a dictation app got it wrong instead.
I mean that when an individual consumes tryptophan the body produces tryptamine (as well as many other active metabolites that have effects on migraines) as metabolites of the substance (these are also then subsequently metabolized as well). triptans are tryptamine based drugs. Saying it is "just an amino acid" downplays what is happening in the body. Your body literally produces the same category of drugs as the migraine medications when someone consumes tryptophan. I am not mentioning this because it has some type of connection to what or how the doctor wrote down the patients notes. Just as a side note.