Things I Learn From My Patients

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my new pet peeve: necklaces with small pendants on kids less than age 2....
saw several last night and advised moms that these were choking/strangulation hazards. their responses..." well she's worn it since the day she was born and nothing has happened yet. it would be INCONCEIVABLE that a child could choke on a st. (fill in the blank) metal."
my thought...inconceivable ....hmmmm
I do do not think that word means what you think it means......

Originally posted by docB



So true. When I was at Temple I don't think I ever actually saw a mother. All children were "cared for" by grandmother or some other maternal relative.

Chris Rock: "If you call your momma Pam and your grandmomma mom, You goin to Jail!"

If you're 50 y.o., taking coumadin, and drunk, it is probably not a good idea to go top speed on snowmobile in the middle of snowstorm.... because after all what could happen... oh crap that's a... tree....

If you're 71 years old, have arthritis and emphysema and several drinks under your belt already, it's dark outside and raining like stink, now is NOT the best time to go up on the roof and try to fix a leak.

obese patient (400+ pounds) p/w left scrotal pain secondary to sitting on his own testicle.. further analysis shows the guy crushed his own twig and berries..

african american pt (who needs surgery) tells me NPO really stands for "n*gger patient out"

swallowing batteries gives you energy (is the bunny inside you?)

Originally posted by Sessamoid
If you're 71 years old, have arthritis and emphysema and several drinks under your belt already, it's dark outside and raining like stink, now is NOT the best time to go up on the roof and try to fix a leak.

You CAN'T be in L.A. - this is verbatim the patient I had here in NC. Or maybe it was Christmas decorations, or shingles. He couldn't really say.

Originally posted by Apollyon
You CAN'T be in L.A. - this is verbatim the patient I had here in NC. Or maybe it was Christmas decorations, or shingles. He couldn't really say.

No, that was back in Florida.

the painless chancre of primary syphilis, the cauliflower-like growths of HPV, the blisters of herpes, and the urethral discharge of gonorrhea/chlamydia can, indeed, all exist on a single penis.

the owner of the above penis presented with a chief complaint of "cuts on my dick"...........hmmm

Originally posted by AznTrojan-MS
obese patient (400+ pounds) p/w left scrotal pain secondary to sitting on his own testicle.. further analysis shows the guy crushed his own twig and berries..

Whoops!!

when you have bilateral open fractures of your hands.. with compartment syndrome in both arms.. masturbation helps distract you from your injuries..

When you finish your night at the pool hall, be sure to keep your pool stick in a case after you unscrew it and wear your seatbelt if you drive a large van - otherwise you might hit a pole, fly out of your seat, and end up with a pool stick up your ass. 8 ball - corner pocket...

don't hold the log you are cutting with a chainsaw in your dominant hand......

(I only wish I'd seen this one, but it was the same dept on the same shift, so I think we can count it)

Only Santa will actually fit down a chimney. All the way down, anyway.

And Santa can get back out without the rescue squad.

The broad base on the 12 inch dildo is meant to be the place to stop...not additional stimulation as you jam that part in your rectum as well. If you do this, and you're an active duty Marine, just go to the local Naval hopsital. If not, you'll explain the whole story to a civilain Doc, who will label you "non-emergent" and package you off to the Naval hospital anyway. Be sure to bring your wife along to share the humiliation since it was her exuberance that got you there in the first place.

If you have a cauliflower like growth the size of a baseball obscuring your anus, and your an active duty Army Sargeant, just be quiet while we treat you...we won't ask, please don't tell.

Driving to Hartford, CT from Boston to have your rectal FB removed will likely mean you won't see any of your friends...good plan. Also, thanks for bringing the matching bottle of conditioner to give a size estimate for the missing shampoo bottle. Note to other Docs...a Graves speculum will allow visualization but not adequate access for removal. Foley worked fine, though.

Thanks for the thread, I haven't laughed this hard in awhile.
DD

If you are a homeless gentleman who presents with a minor finger scratch, but who - as an aside - starts to describe the symptoms of sudden onset Type II diabetes (dramatic weight loss of 40+ lbs, blood sugar of 500 tested on a friend's meter, frequent urination, numbness in your feet and hammer toes), by all means take more time to consider the possible seriousness of this condition.

After all, it's been what - eight months likes this already, you might as well spend more time thinking about it. You've got time ... no need to rush into something new ...

Also, if you tell me that you can't fill out the required medical forms because you "can't read too well," and you would rather have me fill out all of your personal information for you - please don't be offended if I ask you why you are carrying a paperback novel with you, and if you were in fact reading it in the waiting area.

I had a guy yesterday who is a diabetic heroin addict (Great combo sir! How's that workin' out for ya?). Anyway he came in septic from a shooter's abscess on his abdomen. He swore up and down to me, all the consultants and God Himself that the abscess was from his insulin shots. "I don't pop. I only use my veins. I just put insulin there." The guy actually seemed like he felt superior to skin poppers. Well the admitting doc came up to me yesterday and said those dreaded words "Do you remember that guy..." It turns out that the guy wasn't lying. He was just using the same syringe to shoot up and shoot his insulin.

Originally posted by docB
I had a guy yesterday who is a diabetic heroin addict (Great combo sir! How's that workin' out for ya?). Anyway he came in septic from a shooter's abscess on his abdomen. He swore up and down to me, all the consultants and God Himself that the abscess was from his insulin shots. "I don't pop. I only use my veins. I just put insulin there." The guy actually seemed like he felt superior to skin poppers. Well the admitting doc came up to me yesterday and said those dreaded words "Do you remember that guy..." It turns out that the guy wasn't lying. He was just using the same syringe to shoot up and shoot his insulin.

Awesome!

these may pale in comparison, but while volunteering i learned these things:

it's possible to put a wooden toothpick completely through the palm of your hand. (seems hard to do without breaking the toothpick even on purpose)

if you can complain, you are breathing

Originally posted by woolie
Also, if you tell me that you can't fill out the required medical forms because you "can't read too well," and you would rather have me fill out all of your personal information for you - please don't be offended if I ask you why you are carrying a paperback novel with you, and if you were in fact reading it in the waiting area.

Some people who have mild retardation (or are embarrassed by the fact that they are illerates) might carry books around with them - to hide from the public that they can't read (or are mildly retarded). I guess asking him about his illiteracy hit a psychological nerve.

anyway, that's my input

where does the psychological nerve run again? isnt psychological nerve entrapment what causes 'psychologica'?

you made a good point, just couldnt resist.

Originally posted by gdk
these may pale in comparison

Not at all - we enjoy them all! Keep them coming!

Originally posted by group_theory
Some people who have mild retardation (or are embarrassed by the fact that they are illerates) might carry books around with them - to hide from the public that they can't read (or are mildly retarded). I guess asking him about his illiteracy hit a psychological nerve.

anyway, that's my input

Hey, that was on "Law and Order"!

Originally posted by Apollyon
Hey, that was on "Law and Order"!

COOL!!! - I wonder if this is a case of life imitating art or art imitating life?

psychological nerve entrapment!!! HA
I wonder if you can treat that w/ OMT?

Anyway, my contribution

Gotta love people who try to fake attempting suicides for attention. This one lady tried taking rat poison - the one w/ the new formula (w/ the super warfarin). Guess this new super poison stays in your system for a long long time because she had to be admitted and stayed for close to a month to monitor her INR level. She definately got some attention alright. Well, at least she got some psychiatric help.

Doc: What meds are you on?
Pt: Peanut butter balls.
Doc: What?
Pt: Peanut butter balls! Peanut butter balls, for my seizures!
Doc: Do you mean phenobarbital?


Doc: Have you had any other illnesses?
Pt: Just smiling mighty Jesus.
Doc: You mean you've never been sick before?
Pt: (Looks at Doc like she's crazy) Oh no, I was REALLY sick with that smiling mighty Jesus!
.... she had had spinal meningitis.

I'm not a EM resident, but the wisdom I learned from working in the magical world of Neurodiagnostics is without bounds...

If you're trying to fake a generalized seizure, turning that ringing cell phone in your pocket off is gonna be conspicuous no matter how much you try to incorporate it into your clonic movements. Also, always fake the seizure before and/or after the EEG, not DURING.

not an ER story.. but i have a good one from non-trauma surg..

when you get tired of vaginal or anal sex.. try transverse colon.. there are individuals out there who will pay 1000 bucks a pop to screw a colostomy patient (yes.. the colostomy).. more amazingly is there are prostitutes who sell their colostomy..

Originally posted by AznTrojan-MS
not an ER story.. but i have a good one from non-trauma surg..

when you get tired of vaginal or anal sex.. try transverse colon.. there are individuals out there who will pay 1000 bucks a pop to screw a colostomy patient (yes.. the colostomy).. more amazingly is there are prostitutes who sell their colostomy..

Hey, we had that in our ED! A gay dude that ended up with rectal CA, and got a colostomy - then ended up with the clap in his colostomy!

Originally posted by AznTrojan-MS
not an ER story.. but i have a good one from non-trauma surg..

when you get tired of vaginal or anal sex.. try transverse colon.. there are individuals out there who will pay 1000 bucks a pop to screw a colostomy patient (yes.. the colostomy).. more amazingly is there are prostitutes who sell their colostomy..

Please. I have lead a sheltered life. Now I have to claw out my eyes.

when you are have a double AKA and 3 inch long fingernails, please dont spend the time in your wheelchair scratching at your crotch, gathering cheese under your nails and then show them to me exclaiming "doctor i think i have a yeast infection"

When you are shaving your legs and knick yourself, go ahead and call EMS to transport you to the ER. Also, since you're 300 lbs and worked up quite a sweat running around the house gathering up your things, demand that they carry you down the stairs on the stretcher, since you "just might not be able to make it on your own."

AND...Four days later, while shaving your legs again and happen to knock off the little scab that formed, go ahead and call EMS again. We are happy to help!

They're gonna throw Martha Stewart in jail but no one gets in trouble for EMS and ER abuse. I say we all get to carry billy clubs and dish out some quick trauma bay justice to anyone who comes in with something stupid.

BTW what does the black dot on the thread's envelope mean?

Originally posted by docB
BTW what does the black dot on the thread's envelope mean?

It means you contributed to the thread...

- H

Mom says 11 yo with acute on chronic tonsil pain had something in the back of her throat that looked like "You know when you get a titty behind your ear" (Quinn you undoubtably have some remark for that.)

Um, what?

When a titty grows behind your ear.

Guess it looked like her daughter had a keloid on her tonsil...hmm.

Originally posted by AznTrojan-MS
not an ER story.. but i have a good one from non-trauma surg..

when you get tired of vaginal or anal sex.. try transverse colon.. there are individuals out there who will pay 1000 bucks a pop to screw a colostomy patient (yes.. the colostomy).. more amazingly is there are prostitutes who sell their colostomy..

oh my god.

If you are REALLY drunk and need to urinate, the best place to do it is off of the ledge of a freeway overpass. You will never, ever fall off.

Sitting on the porch minding your own business is the #1 cause of knife wounds.

Mortality from penetrating trauma is inversely related to number of tattoos (especially prison tats).

The best place for a loaded sawed-off shotgun is in a drunk bangers baggy pant's pockets, the imaginary safety will make sure you don't blow a 12 cm wound into your thigh.

(Some of these have been covered in prior comments, just came across a link to this thread from the surgery forum)

Problem: You have been waiting too long in the ER.
Observation: The people being brought in by EMS are being seen ahead of you.
Solution: Go home. Call EMS and have them bring you back to the ER for your suture removal.

You have to give this guy credit for actually being goal-directed and intelligent enough to figure this out.

Also, be careful when heating your crack pipe over your old wood stove. If you do happen to burn your leg, please do not seek medical attention for at least a month. Arrive wasted on crack and septic from your massive wound, then attempt to leave AMA. However, stay because the doctors promise you three meals a day while in the hospital. But this is a trick because they will make you NPO in order to take you to the OR for an AKA. After 10 days in ICU you will finally make it to the floor and will soon be able to go home. However, when your man shows up with more crack do NOT go outside and smoke it with him. It will kill you and he will end with a massive MI and in ICU. You are still young (43) and your 12 kids (that's right, 12) still need you as a role model.

God Bless America

great thread guys!

...if you decide you're feeling suicidal and want to check into the VA psyc unit for a bit, don't bring the empty pill bottles from a home you broke into with you. And while you're at it, please learn that premarin does not equal percocet.

Rule #1: Always use EtOH prior to operating heavy farm equipment.

Rule #2: If you have followed Rule #1 and something gets caught in the thresher/corn auger/hay baler/wood chipper/farm implement of choice, your best bet for getting it un-stuck, is to try and push it through with one of your extremities.

Originally posted by dchristismi
great thread guys!

...if you decide you're feeling suicidal and want to check into the VA psyc unit for a bit, don't bring the empty pill bottles from a home you broke into with you. And while you're at it, please learn that premarin does not equal percocet.

Did the premarin make him feel any better? or at least closer to his feminine side?

Originally posted by LaCirujana
Rule #1: Always use EtOH prior to operating heavy farm equipment.

Rule #2: If you have followed Rule #1 and something gets caught in the thresher/corn auger/hay baler/wood chipper/farm implement of choice, your best bet for getting it un-stuck, is to try and push it through with one of your extremities.

Years ago.....on my first call as a basic EMT, I had to help treat a man with his hand caught in a hay baler. I thought I was going to hurl. I figured, If that doesn't make you want to run away then medicine might be the right path for ya

If you (being a 32 year old gay man) are planning to perform fellatio on your gorked out 84 year old lover on the medicine ward please remember to replace the foreskin when you are finished so he doesn't develop paraphimosis.

If you have a known aortic dissection, crack cocaine is a poor choice of recreation.

There is no need to waste your beer & liquor money on antiseizure meds. We are more than happy to just load you with dilantin a couple times a week.

If you come into the ER with a chief complaint of "Falling down because I'm drunk" don't cause a scene 20 minutes later when we tell you you're too drunk to sign yourself out AMA.

Originally posted by WaitingForJuly
If you (being a 32 year old gay man) are planning to perform fellatio on your gorked out 84 year old lover on the medicine ward please remember to replace the foreskin when you are finished so he doesn't develop paraphimosis.

A couple things I've learned

1) If you are a 640lb vet and need a cath and a pacemaker...don't accept the reply "the table can't support your weight." Talk to your VA patient representative....he'll make the physical plant build you a table.

2) Despite popular belief...coat hangers are not a cure for constipation

3) Post-coital narcolepsy....is a diagnosis of exclusion.

4) Incidence of MRI claustrophobia is directly proportional to abdominal girth.

5) Beet positive stool is not as clinically important as guaiac positive stool.

6) Trouble brewing: orthodontic braces + fellatio

7) Never go through with a surprise visit to your 15 yo girlfriend at her house at 1 AM when her father is card carrying member of the NRA.

8) AJAX may smell good...but for God sakes....don't huff it!!!

9) Fast track to intubation: fall asleep in the ER with an empty bottle of lortab in your hand

10) Broken glass is not the ideal surgical tool for self-castration

11) Avoid taunting a Rottweiler with your scalp


Cheers!

Originally posted by Eidolon6
11) Avoid taunting a Rottweiler with your scalp

"You see my face? You should see his fist! It's a mess!"

If you diagnose a patient with gonorrhea, be sure to ask if she has any family members she would like to treat as well, because I was at a loss when I was asked the question "Should I treat my dog, too?"

Q, DO

Poor dog...

If you have a colostomy, please please please please please have your partner wear a condom if you are going to have "pseudo-anal" sex. Seeing warts growing out of the side of your colostmy site is possibly the scariest thing I've seen in a while.

Q, DO

A few years ago my diabetic friend's blood sugar got really high, although she'd taken her insulin, and she needed to go to the hospital. Her roommates offered to take her. I had heard they were a bit nuts, so I went along. Right after we left, I learned that no one in the car knew how to get to the nearest hospital. I said we should stop because I could get directions easily. They wouldn't stop. Well, they got onto the freeway, and drove 45 minutes to get to the next city over, but then they realized that the person who thought they knew of a hospital there actually only knew that it was probably off one of two exits. The hospital we ended up at was more than an hour away.

Originally posted by QuinnNSU
If you have a colostomy, please please please please please have your partner wear a condom if you are going to have "pseudo-anal" sex. Seeing warts growing out of the side of your colostmy site is possibly the scariest thing I've seen in a while.

Q, DO

Condoms don't protect well against warts anyway, since you can have them around the base and the sac region. What the couple needs to have is an open line of communication before he violently penetrates the stool output site.

mike

If you decided to have your LEEP in Chicago and the next day get on a plane for Vegas where you inexplicably develop vaginal bleeding please don't get angry with me when I tell you that your gynecologist (the one in Chicago) will not be coming to see you in the ER and that I will not charter you an air ambulance to fly you back to him.