having to instruct a health pro on starting yer IV

[red26]

I've had to do this on many occasions and Im wunderin how many of us have had to do the same. Fer me it always starts with "GOD! your skin is like leather!" and then repeated attempts accompanied with frustrated comments until I jump in and tell them where to stick it(no pun int.).

When I went in a few years ago and was diagnosed with type 1 diabetis and friggin Mono at the same time the nurse was the type you could tell partied, and she was also the 5th person to try. The previous4 had attempted 4 times each and I was getting really tired of it. Amazingly, at great risk to her license, she let me start the IV myself.

So far it's been I think 6 times Ive had to tell them where to start it, the last time being no more than a month ago. Theres always that "do I tell them Im an IV user or not?" thing, and Im wondering if from a health pro's perspective it'd be a big help or not as well.

So lets hear it kids! Do you tell them where to stick it or not?!?

[Consumed.]

No, unfortunately it's on my fucking medical records from that now.

[red26]

No, unfortunately it's on my fucking medical records from that now.
wudda you mean? You told them that you're an IV drug user and, well I just dont understand yer post bro. Please explain.

[rockbottom]

i get alotta blood work---the lab techs are fucking butchers----i tell them my veins are shot out-i tell them where to go--i tell them if u miss dont dig around--poke me again---but always they go fishing--fucking hurting the hell otta me-----i get pissed and tell them "u want me to do it--this is ridiculous"

so far they wont let me:cool:

[nick]

Hell,I've asked to do it myself before,but they wouldn't let me due to health and safety.


Last time I had blood drawn a succession of folks tried and eventually they sent for this old,old lady who looked just like a witch.She got me first time,a true pro.

[red26]

Hell,I've asked to do it myself before,but they wouldn't let me due to health and safety.


Last time I had blood drawn a succession of folks tried and eventually they sent for this old,old lady who looked just like a witch.She got me first time,a true pro. I've had that happen too nick. When I end up in my local hospital now I just ask for my man Josh. He hits first time every time, but if he's not there I gotta tell 'em where to go. Otherwise they start trying to go in my wrist or other really painful places and that REALLY pisses me off to no end cuz they go to really small veins and start blowin shit up ontop of trying in the ouch places. I can take alotta pain and have even had my arm crushed by a forklift once but I have no patience for incompetant people with needles.

[Consumed.]

wudda you mean? You told them that you're an IV drug user and, well I just dont understand yer post bro. Please explain.


No I didnt say anything but I ended up with "IV drug user" on my records. It destroyed my life for a time. I had ODed but I wasnt quite dead and was found about 18 hours later at the bottom of my steps. I tumbled down the stairs. After I shot up I new I was ODing so I wanted to get my dog out. I really didnt make it to the stairs, I guess I dont really remember. Somehow I did get the door open and my dog out. i didnt want him to die with me and no one find him in time if i didnt come to. It didnt matter too much because this was NY and no one called the police. I was outside sprawled on the stoop somehow. Like I said I was laying there for about 18 hours and my downstairs neighbors where not around. I got something called rhabdomyolysis. THis is when you are laying on you in a position for too long like a drunk in an alley or something passed out. After about 18 hours it can kill you from degredation of the muscles and blood pooling one spot too much. Finally my neighbors got home and called 911. I went to the ER and landed in the ICU for 6 days almost dead. They actually had no clue what was wrong with me. I couldnt speak until the last day in the ICU so they where performing every test possible on me. I didnt reveal any information about drug use when I did come to. I told them I fell down a flight of stairs. I was in the hospital for 35 days and when it came time for pain meds, well I think my tolerance gave it all away. I didnt have any blatent track marks either. All my records ended up saying IV drug user on them though. I thought this would be against the HIPAA act but I guess it's not.


Anyway I lost my apartment, lost my dog and had to stay with family in MA. I had two months worth of meds in MA and was then told to go to a pain clinic. I was on 80 mg methadone, 50 mcg Fent, and 40 mg OCs for breakthrough. It actually took a neurologist in MA to find out what the real problem was. My legs where numb and just plain fucked so in NY they thought it was nerves in my back. When a neurologist did a frontal MRI in MA they found I had a torn femoral nerve. Believe me, its fucking painful.


My mothers a nurse and shes telling me no problem we'll find a pain management clinic to take you in. the neurologist did and EMG and said it would take about a year and a half to heal. I started going to pain clinics early on because of course number one i didnt want to have to worry about meds. Well, one by one by one they rejected me. It was getting very close to the point where I was going to run out of meds. THE DAY CAME. I couldnt believe it. The neurologist helped me out for a couple of weeks and then says "this is out of my juristiction." I was fucked. I had set up one more PMC but i knew the deal. These fuckers knew I was in pain. Anyway the withdrawals where actually nothing compared to the pain i felt unmedicated. Seriously the w/ds where a walk in the park compared to what was going on with my body. In my nerve it felt like an electrified BB shocking my leg constantly. I couldnt eat, I couldnt sleep, I couldnt do anything. It was pure horror.

So I start ordering dope from the man. Now Im staying at my mothers house and she couldnt watch the pain i was in and new i was doing this. At 125 a gram my habit started to become like that huge fuckin gorilla we all know about. THis was not the way to do it. I couldnt continue like this either. This was pure pakistani shit and ended up doing the whole gram in one day. No good. So I head to the methadone clinic. Cant get in. Benzos in my system. Two weeks go by, Im prescribed Kpins the only fucking thing good that the doctors where giving me. They are finally willing to let me in if my doctor sends a protocol of my benzo taper. Now these where two weeks of hell. I didnt have dope everyday. The pain again was worse than the W/Ds. When I get into the clinic finally i really look like a dead person. The benzo protocol there was to take my BP every 15 min up until 90 minutes for one week. And I had to stay at 30 mgs the whole week. So the methadone wasnt doing shit for me. Finally the protocal was over and they started raising me. I was literally sick up until 90 mgs. Im now at 115.
Moral of the story? Having IV drug user all over my records prevented me from being a chronic pain patient and caused me to go to the methadone clinic. I wasnt even fit to walk at the beginning going to the clinic. I know Im an addict too but i should have been treated. I wasnt though all due to those three words; IV drug user. http://forum.opiophile.org/images/icons/icon8.gif

[nick]

No I didnt say anything but I ended up with "IV drug user" on my records. It destroyed my life for a time. I had ODed but I wasnt quite dead and was found about 18 hours later at the bottom of my steps. I tumbled down the stairs. After I shot up I new I was ODing so I wanted to get my dog out. I really didnt make it to the stairs, I guess I dont really remember. Somehow I did get the door open and my dog out. i didnt want him to die with me and no one find him in time if i didnt come to. It didnt matter too much because this was NY and no one called the police. I was outside sprawled on the stoop somehow. Like I said I was laying there for about 18 hours and my downstairs neighbors where not around. I got something called rhabdomyolysis. THis is when you are laying on you in a position for too long like a drunk in an alley or something passed out. After about 18 hours it can kill you from degredation of the muscles and blood pooling one spot too much. Finally my neighbors got home and called 911. I went to the ER and landed in the ICU for 6 days almost dead. They actually had no clue what was wrong with me. I couldnt speak until the last day in the ICU so they where performing every test possible on me. I didnt reveal any information about drug use when I did come to. I told them I fell down a flight of stairs. I was in the hospital for 35 days and when it came time for pain meds, well I think my tolerance gave it all away. I didnt have any blatent track marks either. All my records ended up saying IV drug user on them though. I thought this would be against the HIPAA act but I guess it's not.


Anyway I lost my apartment, lost my dog and had to stay with family in MA. I had two months worth of meds in MA and was then told to go to a pain clinic. I was on 80 mg methadone, 50 mcg Fent, and 40 mg OCs for breakthrough. It actually took a neurologist in MA to find out what the real problem was. My legs where numb and just plain fucked so in NY they thought it was nerves in my back. When a neurologist did a frontal MRI in MA they found I had a torn femoral nerve. Believe me, its fucking painful.


My mothers a nurse and shes telling me no problem we'll find a pain management clinic to take you in. the neurologist did and EMG and said it would take about a year and a half to heal. I started going to pain clinics early on because of course number one i didnt want to have to worry about meds. Well, one by one by one they rejected me. It was getting very close to the point where I was going to run out of meds. THE DAY CAME. I couldnt believe it. The neurologist helped me out for a couple of weeks and then says "this is out of my juristiction." I was fucked. I had set up one more PMC but i knew the deal. These fuckers knew I was in pain. Anyway the withdrawals where actually nothing compared to the pain i felt unmedicated. Seriously the w/ds where a walk in the park compared to what was going on with my body. In my nerve it felt like an electrified BB shocking my leg constantly. I couldnt eat, I couldnt sleep, I couldnt do anything. It was pure horror.

So I start ordering dope from the man. Now Im staying at my mothers house and she couldnt watch the pain i was in and new i was doing this. At 125 a gram my habit started to become like that huge fuckin gorilla we all know about. THis was not the way to do it. I couldnt continue like this either. This was pure pakistani shit and ended up doing the whole gram in one day. No good. So I head to the methadone clinic. Cant get in. Benzos in my system. Two weeks go by, Im prescribed Kpins the only fucking thing good that the doctors where giving me. They are finally willing to let me in if my doctor sends a protocol of my benzo taper. Now these where two weeks of hell. I didnt have dope everyday. The pain again was worse than the W/Ds. When I get into the clinic finally i really look like a dead person. The benzo protocol there was to take my BP every 15 min up until 90 minutes for one week. And I had to stay at 30 mgs the whole week. So the methadone wasnt doing shit for me. Finally the protocal was over and they started raising me. I was literally sick up until 90 mgs. Im now at 115.
Moral of the story? Having IV drug user all over my records prevented me from being a chronic pain patient and caused me to go to the methadone clinic. I wasnt even fit to walk at the beginning going to the clinic. I know Im an addict too but i should have been treated. I wasnt though all due to those three words; IV drug user. http://forum.opiophile.org/images/icons/icon8.gif




Bro,you shouldn't have worried about your dog,he'd have eaten you .

[Consumed.]

Bro,you shouldn't have worried about your dog,he'd have eaten you .


Ha ha ha, then what???

[Cherry's Jubilee]

No I didnt say anything but I ended up with "IV drug user" on my records. It destroyed my life for a time. I had ODed but I wasnt quite dead and was found about 18 hours later at the bottom of my steps. I tumbled down the stairs. After I shot up I new I was ODing so I wanted to get my dog out. I really didnt make it to the stairs, I guess I dont really remember. Somehow I did get the door open and my dog out. i didnt want him to die with me and no one find him in time if i didnt come to. It didnt matter too much because this was NY and no one called the police. I was outside sprawled on the stoop somehow. Like I said I was laying there for about 18 hours and my downstairs neighbors where not around. I got something called rhabdomyolysis. THis is when you are laying on you in a position for too long like a drunk in an alley or something passed out. After about 18 hours it can kill you from degredation of the muscles and blood pooling one spot too much. Finally my neighbors got home and called 911. I went to the ER and landed in the ICU for 6 days almost dead. They actually had no clue what was wrong with me. I couldnt speak until the last day in the ICU so they where performing every test possible on me. I didnt reveal any information about drug use when I did come to. I told them I fell down a flight of stairs. I was in the hospital for 35 days and when it came time for pain meds, well I think my tolerance gave it all away. I didnt have any blatent track marks either. All my records ended up saying IV drug user on them though. I thought this would be against the HIPAA act but I guess it's not.


Anyway I lost my apartment, lost my dog and had to stay with family in MA. I had two months worth of meds in MA and was then told to go to a pain clinic. I was on 80 mg methadone, 50 mcg Fent, and 40 mg OCs for breakthrough. It actually took a neurologist in MA to find out what the real problem was. My legs where numb and just plain fucked so in NY they thought it was nerves in my back. When a neurologist did a frontal MRI in MA they found I had a torn femoral nerve. Believe me, its fucking painful.


My mothers a nurse and shes telling me no problem we'll find a pain management clinic to take you in. the neurologist did and EMG and said it would take about a year and a half to heal. I started going to pain clinics early on because of course number one i didnt want to have to worry about meds. Well, one by one by one they rejected me. It was getting very close to the point where I was going to run out of meds. THE DAY CAME. I couldnt believe it. The neurologist helped me out for a couple of weeks and then says "this is out of my juristiction." I was fucked. I had set up one more PMC but i knew the deal. These fuckers knew I was in pain. Anyway the withdrawals where actually nothing compared to the pain i felt unmedicated. Seriously the w/ds where a walk in the park compared to what was going on with my body. In my nerve it felt like an electrified BB shocking my leg constantly. I couldnt eat, I couldnt sleep, I couldnt do anything. It was pure horror.

So I start ordering dope from the man. Now Im staying at my mothers house and she couldnt watch the pain i was in and new i was doing this. At 125 a gram my habit started to become like that huge fuckin gorilla we all know about. THis was not the way to do it. I couldnt continue like this either. This was pure pakistani shit and ended up doing the whole gram in one day. No good. So I head to the methadone clinic. Cant get in. Benzos in my system. Two weeks go by, Im prescribed Kpins the only fucking thing good that the doctors where giving me. They are finally willing to let me in if my doctor sends a protocol of my benzo taper. Now these where two weeks of hell. I didnt have dope everyday. The pain again was worse than the W/Ds. When I get into the clinic finally i really look like a dead person. The benzo protocol there was to take my BP every 15 min up until 90 minutes for one week. And I had to stay at 30 mgs the whole week. So the methadone wasnt doing shit for me. Finally the protocal was over and they started raising me. I was literally sick up until 90 mgs. Im now at 115.
Moral of the story? Having IV drug user all over my records prevented me from being a chronic pain patient and caused me to go to the methadone clinic. I wasnt even fit to walk at the beginning going to the clinic. I know Im an addict too but i should have been treated. I wasnt though all due to those three words; IV drug user. http://forum.opiophile.org/images/icons/icon8.gif




Stories like this infuriate me. First of all, it's outrageously inhumane not to treat an injured person who is in severe pain for any reason ESPECIALLY as members of a profession that, as a whole, swears an oath to practice according to a code of ethics and do everything within their power to help any person who is sick, injured, or in pain and to recognize the inherent value and worth of every human being and their right to be treated with respect and dignity and to receive appropriate medical care regardless of their personal circumstances, characteristics, or history. And it just isn't a rational or logical thought process that someone should have to endure pain because they have used drugs. Where do they get that? How do they justify that? You know they'll take murderers and rapists and horrible people out of prison to operate or do whatever procedure they may need and i'm sure they treat them for pain just like everyone else, all funded by our tax dollars of course. and i'm sure a registered sex offender or known wife-beater or pedophile could walk into the ER and get treated for pain because otherwise it would be discrimination. But it's perfectly acceptable to refuse to provide adequate medical treatment and pain control to someone who has used drugs. apparently we're the only people in the world who have done something bad enough to deserve that. <end rant>

sorry for going off-topic that just pisses me off so fucking much

unfortunately, for those reasons, i think you should probably just sit there and endure some idiot poking the shit out of you until they finally get it rather than risk getting the scarlet letter IV DRUG USER on your permanant record. they might as well just write DERSERVES TO BE HUMILIATED, TORTURED, AND GENERALLY TREATED LIKE SHIT.

p.s. the part about your dog broke my heart.

[Consumed.]

Stories like this infuriate me. First of all, it's outrageously inhumane not to treat an injured person who is in severe pain for any reason ESPECIALLY as members of a profession that, as a whole, swears an oath to practice according to a code of ethics and do everything within their power to help any person who is sick, injured, or in pain and to recognize the inherent value and worth of every human being and their right to be treated with respect and dignity and to receive appropriate medical care regardless of their personal circumstances, characteristics, or history. And it just isn't a rational or logical thought process that someone should have to endure pain because they have used drugs. Where do they get that? How do they justify that? You know they'll take murderers and rapists and horrible people out of prison to operate or do whatever procedure they may need and i'm sure they treat them for pain just like everyone else, all funded by our tax dollars or course. and i'm sure a registered sex offender or known wife-beater or pedophile could walk into the ER and get treated for pain because otherwise it would be discrimination. But it's perfectly acceptable to refuse to provide adequate medical treatment and pain control to someone who has used drugs. apparently we're the only people in the world who have done something bad enough to deserve that. <end rant>

sorry for going off-topic that just pisses me off so fucking much

unfortunately, for those reasons, i think you should probably just sit there and endure some idiot poking the shit out of you until they finally get it rather than risk getting the scarlet letter IV DRUG USER on your permanant record. they might as well just write DERSERVES TO BE HUMILIATED, TORTURED, AND GENERALLY TREATED LIKE SHIT.

p.s. the part about your dog broke my heart.

Fuckin CJ, you always hit the nail on the head. Thank you so much. It's so true what you said. I have been humiliated, and treated like shit for it. It really made me think about what you said with them taking prisoners etc. out and treating them. I dont think I could have read a more heart felt post.....http://forum.opiophile.org/images/icons/icon21.gif

[nick]

Ha ha ha, then what???

Dial a pizza!! I'm sure someone would have found you before your dog ran out of you.

[reddragon3668]

You should have taken her home, Nick. She'd come in handy I'd expect! ;)

I don't IV these days and they have all kinds of trouble finding mine. Its usually a nightmare for me. I had a EMT try and start an IV once on an ambulance and I bet she stuck me 20 times or more with the fishing expedition after every stick.. I finally told her to stop. When I got to the ER they had the same trouble.. thing is, the nurse wasn't wearing a bra and I could see everything.. I have no idea how many times she stuck me but at the time I didn't give a shit... :D


Hell,I've asked to do it myself before,but they wouldn't let me due to health and safety.


Last time I had blood drawn a succession of folks tried and eventually they sent for this old,old lady who looked just like a witch.She got me first time,a true pro.

[tonyk]

Consumed, My heart goes out to you! So very true that we drug users(especially the IV ones) get discriminated against by medical personel. Being a paramedic I have lived on both sides of the stick! So I feel like it is a team effort when a patient advises me where to best find a usuable vein to access. The information never goes any further. That is the goal anyways, to deliver the patient to the ER with a patent IV in place, not to mention if immediate access is needed to give a life-saving medication! I think a lot of medics are a bit more compassionate, but then, that is just my bias thoughts. Some people just have no business even being in the medical field, they have no heart. TK

[blutuesday]

I've had to do this on many occasions and Im wunderin how many of us have had to do the same. Fer me it always starts with "GOD! your skin is like leather!" and then repeated attempts accompanied with frustrated comments until I jump in and tell them where to stick it(no pun int.).

When I went in a few years ago and was diagnosed with type 1 diabetis and friggin Mono at the same time the nurse was the type you could tell partied, and she was also the 5th person to try. The previous4 had attempted 4 times each and I was getting really tired of it. Amazingly, at great risk to her license, she let me start the IV myself.

So far it's been I think 6 times Ive had to tell them where to start it, the last time being no more than a month ago. Theres always that "do I tell them Im an IV user or not?" thing, and Im wondering if from a health pro's perspective it'd be a big help or not as well.

So lets hear it kids! Do you tell them where to stick it or not?!?

OMG, story of my life and IAM a healthcare professional! When I go, they can never get venous blood, most of them never even try after looking for veins, so then they try to do an arterial stick. Well guess what, that never works either. The last time I had blood drawn successfully was several years ago, and it was a femoral stick. (no fun!) I mean, like, I tell ppl I am a hard stick, and they always say "well ive been at this 34 years, blah blah" and then come up looking foolish because I literally don't have a decent vein in my body. I have ruined it with IV cocaine use then heroin didnt help I guess, and when I say I have nothing I mean I have nothing. Even my neck veins are caput. Superficial breast veins, tiny finger veins, and when I was desperate, palm of my hand veins. Now, all this makes me the one they send the hard sticks to when Im working, but being on the other end is no fun. I try to never let them know Im a nurse, because that can intimidate a lab tech. (which is dumb.) I worry for emergency paramedic IV what they would do. I mean, they could put in a deep subclavian line, but I am afraid that if I was unconcious that they would have no way of knowing that my veins suck and that they need to just skip right to the subclavian, and in this business, seconds are precious. I could die before they figure out I have no veins! Anyway, I rambled again. Sorry. Not sure if I even answered the question.

[candy]

Consumed,
It's unfortunate that we live in a society where our medical care is deemed upon our social/economic status.
I always make sure that before I draw blood I talk to the patient ahead of time to access the situation and get an idea of what I may need. Ex: Warm compress or warm blanket to get the blood pressure up which helps bring veins closer the surface of the skin. Hydration is important as well and if I have some time, I get them some cold water to drink. So make sure before any ordered blood tests, you drink lots of fluids.
I also do a thorough exam before I even stick and ask the patient if he/she knows a good spot.
I do this with everyone and if I can tell someone is an IV drug user I know I have my work cut out for me and hydrate and warm them up long before I stick them.

My policy: Don't ask; Don't tell. If the nurse or tech doesn't ask, don't offer info unless: you are having a medical emergency. Most likely if your out, they will start an IV where they can, but if you are awake, play stupid, unless it is a matter of life over death.

As far as your records where they named you as an IV drug user....Go get copies of your entire medical record if they will give it to you. I see no reason why they won't and I believe they have to give it to you! Then you can read it through and see what else is written in your medical records. Unless you already have them.

And I am sorry that happened to you. I have had similar problems myself and ended up extremely frustrated.
No one, a nurse, a doctor, or a tech, should try to play practice with their IV skills on a patient who is a hard stick. As a nurse, if I ever felt I could not get an IV in, I would not even poke the patient. And that was how I instructed new nurses.
I have started my own IV's at times and drawn my own blood, but it is unusual that I get that chance.
One suggestion if your needing an IV for say an MRI or another out-pt. procedure, like a blood draw, find out if your hospital or clinic has an Infusion Center in the building or at the hospital. If they do, ask to have your blood drawn there or IV put in there. These are nurses who take care of infusing chemo and other agents, so they are used to hard sticks and can generally find veins where others cannot.
Just a suggestion.
You can also call ahead before getting blood drawn or before procedures and let them know you are a difficult stick and ask that it be put on your chart or orders from the doctor.
Also make sure you are really hydrated before you go and take a nice hot shower as well( other than in an Emergency)

In an emergency, they will know what to do! But then again shit does happen and we have done havoc to our veins, which should not matter. Because no matter who sticks you, they should show nothing but professionalism and courtesy.. And even if they can get their fat asses out of the chair and away from the donut box long enough to treat you, it should be done with compassion and care!

And if you can never find a nurse, they are either all busy with patients or having a pot luck!

[Consumed.]

Consumed,
It's unfortunate that we live in a society where our medical care is deemed upon our social/economic status.
I always make sure that before I draw blood I talk to the patient ahead of time to access the situation and get an idea of what I may need. Ex: Warm compress or warm blanket to get the blood pressure up which helps bring veins closer the surface of the skin. Hydration is important as well and if I have some time, I get them some cold water to drink. So make sure before any ordered blood tests, you drink lots of fluids.
I also do a thorough exam before I even stick and ask the patient if he/she knows a good spot.
I do this with everyone and if I can tell someone is an IV drug user I know I have my work cut out for me and hydrate and warm them up long before I stick them.

My policy: Don't ask; Don't tell. If the nurse or tech doesn't ask, don't offer info unless: you are having a medical emergency. Most likely if your out, they will start an IV where they can, but if you are awake, play stupid, unless it is a matter of life over death.

As far as your records where they named you as an IV drug user....Go get copies of your entire medical record if they will give it to you. I see no reason why they won't and I believe they have to give it to you! Then you can read it through and see what else is written in your medical records. Unless you already have them.

And I am sorry that happened to you. I have had similar problems myself and ended up extremely frustrated.
No one, a nurse, a doctor, or a tech, should try to play practice with their IV skills on a patient who is a hard stick. As a nurse, if I ever felt I could not get an IV in, I would not even poke the patient. And that was how I instructed new nurses.
I have started my own IV's at times and drawn my own blood, but it is unusual that I get that chance.
One suggestion if your needing an IV for say an MRI or another out-pt. procedure, like a blood draw, find out if your hospital or clinic has an Infusion Center in the building or at the hospital. If they do, ask to have your blood drawn there or IV put in there. These are nurses who take care of infusing chemo and other agents, so they are used to hard sticks and can generally find veins where others cannot.
Just a suggestion.
You can also call ahead before getting blood drawn or before procedures and let them know you are a difficult stick and ask that it be put on your chart or orders from the doctor.
Also make sure you are really hydrated before you go and take a nice hot shower as well( other than in an Emergency)

In an emergency, they will know what to do! But then again shit does happen and we have done havoc to our veins, which should not matter. Because no matter who sticks you, they should show nothing but professionalism and courtesy.. And even if they can get their fat asses out of the chair and away from the donut box long enough to treat you, it should be done with compassion and care!

And if you can never find a nurse, they are either all busy with patients or having a pot luck!

Thanks Candy, and thing is Im not a hard stick. I dont have any blown veins. I DO have copies of ALL of my medical transcriptions/records from the time of the accident/OD up until now. I dont reveal any information that is not imperative anymore.