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Lisa, MSN, FNP-BC, CCRN, Nurse Practitioner
Category: Health
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Experience:  Board Certified Family Nurse Practitioner
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I am an oncology RN working graveyard shifts. I have 2

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I am an oncology RN working graveyard shifts. I have 2 months left of this job and night shifts and I am moving to days. At present I have an inflamed gall bladder, still to be confirmed by CAT scan next week. Nothing helps with the pain or the spasms, and I can't get treated for another 7-10 days and I'm wondering how to get through the next three intensely busy 14 hour 7p-8:30 am shifts with the gall bladder spasms I am experiencing. My PCP prescribed vicodin for the pain and it doesn't touch it. Zero caffeine, zero sugar and processed foods, bland foods in small more frequent amts are helping, however I do not think it will be enough to get me through the upcoming weekend. Any suggestions?


Thank you for writing in tonight.

At this point, do you have to work for some financial or insurance type reason? Would you be able to take the time off if needed?

Customer: replied 7 years ago.
AT this point I have used all of my paid time off to deal with this this past week and we are a small unit and it would be very difficult for me to get off until the end of October. I am the sole provider for our family right now, so financial considerations are huge and a large part of the stress which I feel has caused the problem. I have treated pts in my situation and they are in the hospital on IV fluids with nexium drips, NPO, and that's probably what I need, but just can't.


Thank you for responding.

If you were my patient, I would advise against working. However, I do understand the responsibilities of both the family and the facility. At this point, I would recommend only water and a bland diet. I would not recommend the Vicodin while working, but I doubt it will give any relief. You may consider checking with a local provider to see if he/she could offer some IVF and Nexium infusion on an outpatient basis, perhaps at the hospital before or after your shifts. If you had some supplemental hydration, you may not need to consume so much via the oral route. NPO is really most ideal. You could consider meditating and deep breathing when possible. Also, if available, you could try some acupuncture for pain.

I really, really wish I could make some amazing recommendation or recommend something you are not already trying, but I can't do that. You're already doing what needs to be done on an outpatient basis. If anything, if the unit drops to low census or you are able to trade any shifts, try to volunteer. If you absolutely can't tolerate the pain and need to rest, please remember it is important to take care of yourself too.

I hope you get some relief soon.


Lisa, MSN, FNP-BC, CCRN and other Health Specialists are ready to help you
Customer: replied 7 years ago.
OK. that 's kind of what I thought. I have 2 questions; wold something like ativan or xanax relax the spasms when I am not working? The idea here is to give my gut as much rest as I can-- right? If the situation becomes too acute I will report to our ER after my third shift. Don't wory about the vicodin, it doesn't work. What about carafate-- is that just for ulcers?Milk of magnesia?

At this point, I don't think that Ativan will have much of an effect on that level; however, given your degree of pain, I suspect you are having added muscle tension and rigidity. This may actually help your pain if you were more relaxed. Also, Ativan can be dissolved sublingually. I have also been thinking about your pain. I don't think you'll get much relief from the Vicodin at all. You may actually benefit from an NSAID, since prostaglandins are involved in the development of the pain; however, since you are having some dyspepsia, this wouldn't be a good idea orally. If you can get some outpatient care in the interim, you may want to ask about some IV or IM Toradol. Finally, the Carafate and antacid is worth a shot, since you are having some dyspepsia. I have seen Carafate used before, with some effectiveness.