After Quinn's birth, Lyndsay was put on an IV anti-inflammatory (Toradol) and 10 mg of Percocet every 4 hours. Ohio doesn't use pain pumps unless someone is put under general anesthesia, and, so, this was her pain regimen.
A day and a half after Quinn was born, Lyndsay's IV blew, and so was removed. Due to the previous nightmares of trying to get IVs and epidurals going, Lyndsay was understandably tired of being poked with needles, and, so, decided that she didn't want a new IV or to have regular injections of the Toradol anymore.
The doctor on staff at the time, Dr. Flemming, decided, without informing Lyndsay of any consequences, that, to make up for not having the Toradol anymore, that he would up the dose of Percocet to 10 mg every 3 hours.
Keep in mind that Percocet contains 325 mg of Tylenol per pill. Any dosage that exceeds 4000 mg of Tylenol within a 24 hour period poses a danger to the patient's liver. Also, keep in mind that the dosage was being given to Lyndsay in the form of two 5 mg pills, thus doubling the normal amount of Tylenol while also increasing the total number of doses substantially.
At 1:00 am on day 2, it came time for the nurse to bring in Lyndsay's Percocet. Instead, the nurse informed us that the dose she was due would have taken her past the point of toxicity, and that she would have to wait until enough time had passed to be safe. We were then informed that it would be another 6 hours.
At this point, I was fed up.
"You need to get your nurse supervisor in here," I barked.
"Yes, sir," came the nurse's wise reply.
Within two minutes, the nurse supervisor was standing in front of a sleep deprived and pissed off Rusty.
"This is some bullshit. That egomaniac arbitrarily ups her dose of pain meds without informing her of risks or the fact that there would be a point in which she would have to go 9 hours between doses" I asserted.
"You're absolutely right," she answered correctly.
"Why don't they separate the oxycodone from the Tylenol and give them individually so that they can control the dosages to prevent that kind of buildup?" I asked.
"I'll ask the doctor," she replied, and then walked out of the room.
A few minutes later, she returned with bad news. "The doctor said to wait and take the Percocet."
"If I see that doctor in the morning, y'all better have security ready."
"Don't say that, please."
"Fine. He's not going to like me very much...I promise. You need to go over his head and help her. This is the fourth time I have seen her cry due to pain in the 3 years we have been together. She isn't a complainer. Get her some help."
"I'll see what I can do," she promised.
Five minutes later, the nurse supervisor returned with 50 mg of Demerol and an explanation that it was to be used to fill the gap until the next dose of Percocet can be administered. I was fine with that, so long as Lyndsay's pain was being addressed.
The next morning, Dr. Ortiz, of whom I have a very high opinion already, was the attending physician. I had left the room to take a walk, and, when I returned, he was in the birthing suite explaining to Lyndsay:
"We're going to separate the Oxycodone and Tylenol and give them to you individually so that we can control the amount of Tylenol in your system at any one time," he said.
Halle-fucking-lujah!!! What genius came up with that brilliant plan???
Without hesitation, Dr. Ortiz wrote the order and Lyndsay's pain was being properly managed.
Interesting side effect of my having put my foot down: every time I walked by the nurses station, everyone stopped talking until I passed by, and then resumed their conversation after they had deemed me a safe distance away. Even the doctors shied away after that. One of my better moments.
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