Things I Learn From My Patients

If your 3 month old baby is fussy, it's perfectly reasonable to give them some hard liquor to quiet them down. In fact, once their blood alcohol level hits 390, they'll sleep through the entire night!

I found out that if a pt is mad that the wait for a CT is taking forever, it is fine to want to pull out your IVs and want to walk out.

Pt said she had been waiting since noon (it was 4:40 at the time). In actuality, she was brought to CT at 1. Refused the CT and wanted pain medicine. Went back to radiology holding at 4:30, and was in the room by 4:45.

I swear some pts.........

And that was with another pt with a blown off nose decided he wanted to pull his IVs out to go to the bathroom.......

Now I feel better...

Shadowed one of my dads friends who is an ER doc tonight. The thing that I learned?

If you have a drug test tomorrow for your new "pimp job" at Sams Club. The best course of action isn't doing two lines of coke and then trying to drink Clorox to cleanse your body...

Way to go dumb ass

Not a doctor but I've seen some things...

1. How to give birth on a sidewalk:
Be in public and obviously in labor a week after your due date. When helpful bystander (that would be me) tries to soothe, comfort, call 911 and provide inexpert assistance, shout "NO! It can wait! If he's born now, he'll be an aquarius! We're holding on so he can be a pisces just like Curt Cobain!"

When bystander ignores you and calls the paramedics, start screaming about how aquariuses are money-grubbing hoarders and you don't want a thief for a son. When the paramedics arrive, refuse transport and insist that you ARE NOT IN LABOR. How do you know this? Because your midwife has been giving you XYZ herbs and ABC enemas to ensure that the kid is a pisces artist rather than a raging thief.
(apologies if i got the astrological signs wrong. I don't know astrology and I'm relying on memory)


2. Crushing up and injecting fentanyl lollipops is a fast-track to a pulmonary embolism (this happened while my idiot junkie ex-brother-in-law was crashing on our couch. The worst part is that my idiot ex-husband believed it when his brother said that HIS DOCTOR told him to inject the lollypops). And of course I wound up paying the bill for his idiocy

Had to recalibrate my threshold for stupidity yesterday. Guy with prior CVA, wheelchair bound. Decides that he needs to clean his electric wheelchair for the 4th of July. So does what anyone would do, which is drive it through an automatic carwash. Beater bar smacks him in the back of the head, knocks him forward, and the wheel chair runs him over.

Big sigh - If you "float" in around 1am asking for benzos while wearing necklace comprised of valiums... YOU WON'T GET ANYMORE!

And no, there will be no "tradesies" swapping two of your X and a Tic Tac for alprazolam. However I do need to congratulate the young lady on her candy necklace. Kudos on that novel idea.

Picked up a PT the other day after she fell face first onto the floor after being returned to her bed post dialysis treatment. She got up to visit her mother who lives across the hall, forgot she needs a walker, and fell into the foot of her mother's bed.
Anyway we back boarded her because of a head lac and back pain from the fall. Within 2 minutes of getting her to the ER they had her out of the backboard and the ER doc wanted to know why we boarded her. Protocol.
Anyway flash forward 5 hours, she's been discharged by the Doc and I hear a call over the radio for her to return to the ER. After she was returned to her bed, she did the exact same thing. Methinks there is something else at play...

If you have home O2 through nasal canulas, dont' lean over while lighting candles. "it was like a flamethrower shot up my nose!"

If you are in the ED for abd pain, sit your ass down, and don't pace around the ER with your IV pole looking for a doctor because you are hungry.

if you come in for treatment of your viral URTI (and you smoke in excess of a pack a day) it is a great idea to refuse the beclomethasone inhaler and the salbutamol you are offered because you "don't like to take medications"..... and then ask for a prescription for Viagra.
This won't get you laughed at, at all.

Tonight I learned that, at 45 years old, I am not old enough to be a doctor. I'm certainly not old enough to treat an 80 year old man with an acute GI bleed (which had nothing to do with his quart-of-rum-every-2-days alcohol consumption).
I did giggle just a little bit when I was told I don't look old enough to be a doctor. Not quite as good as the day some random old man asked why I wasn't in school, but still.

What I learned: taking medication as prescribed is important.

CC: head lac

Elderly gentleman and his irate wife. Pt is hypotensive in addition to head lac. Turns out he'd collapsed after taking three "night rose" pills for his chest pain.

"They're small."

This is a simple one.

I've learned from my patients that Percocet is a desirable entity.

Now, barely able to walk and covered in road rash, I understand the appeal.

Also mixes well with scotch.

If you're trying to get arrested in order to receive a meal and a warm place to sleep, don't do it by breaking into the K9 unit.

Don't mistake Krazy Glue for Visine.

Rattlesnakes do NOT make good pets. This will also lead to a hospital visit from Animal Control while you are recovering from your snake bite.

Children can make very stupid things seem reasonable. Story paraphrased from friend of family.

"Kid around 10ish gets brought in with an eraser stuck in his ear. Said he was itching it with end of a pencil when it came off. So I get the thing out and it's completely crusted and gross. Check of the ear shows infection likely from trapped water. I ask how long he had the eraser in and he says three months . I ask his mom why she didn't bring him in sooner and she says he didn't tell her until yesterday. I then ask the kid why he waited so long to tell.

The response I get? "It only hurts if I touch it and I don't sleep on that side anyway." "

I remember this from the Madison, WI newspaper a few years ago.

When pulled over for weaving, insist you are not DUI because you have not been drinking. Agree to be breathalyzed.

When the officer tells you you are being arrested for DUI, express surprise that this is possible, as you have not been drinking.

When the officer tells you you blew a .26, say, "Oh, sometimes my friends like to play a joke on me, and wait for me to pass out and inject me with alcohol." This will draw attention to the needle tracks on your arms.

If your philtrum is split full thickness all the way to the nose, you probably shouldn't smoke. And if you do decide to smoke, don't let go of the cigarette. If you do let go of the cigarette, it will fall in your lap.

If you only have enough money for one copay, by all means fill the percocet script instead of the antibiotics. The otitis media might get worse until there is thick white discharge dripping onto your shoulder, but you can just go back and get more scripts.

The sad part is that I think she really didn't understand the difference between the therapuetic value of the painkiller vs the antibiotic. I'm still quite naive but that ear looked too nasty to be merely a medium for drugseeking.

When your lips match the colour of your (blue) jeans, the ED is a good place to be.
Walk-in patient with an oxygen sat of 72% in triage. Cheers,
M

When you are a 17 year old suspected drug dealer/user and you are standing on the sidewalk, watch out for falling objects. For example, your champion cyclist mate who dropped you off and is now doing burnouts might crash into a light pole which might fall and hit you in the head.

1) If you hear birds chirping into microphones in your head and your hands feel like the speakers... You need a refill of your lithium.

2) Never stand in front of a puking alcoholic! When it hits the floor those bloot clots fly everywhere....

4) If you are allergic to ibuprofen, tylenol, and asprin, you have more than just a headache...

5) You can run a marathon the day before you have a heart attack. Sometimes its more than just heartburn.

6) Be nice to the nurses and you can get your stuff done.

If the conversation goes something like this... you're probably not changing the fellow's mind:

Pt:

Critical Care Fellow: Sir, whatever you were doing... you need to stop. You were on life support and almost died. Do you understand me?

Pt: What was that about...

CC Fellow: SIR! YOU ALMOST DIED! DO YOU UNDERSTAND!

Pt:

CC Fellow: Let's change his morphine to tramadol.

Pt: TRAMADOL!?! YOU DON'T KNOW WHAT KIND OF PAIN I'M IN!

Tonight I learned that if you have been "punished" for stealing your suppliers' crack by having a flat tipped screwdriver forced through your skull - from behind, at an upward angle - the correct response requires multiple efforts, such as: beat your girlfriend for insisting that you go to the ER, to the point that the neighbors call the PD after hearing her scream, repeatedly. Subsequently, after the PD arrives and calls for an ambulance (when they see the tool protruding from your head) you should become combative with them and need to be handcuffed (when they insist you sit down because they are a little freaked out). Then, be sure to threaten the EMT's in the ambulance while you are being transported because they "are out to get you", and be sure to scream at the nurses in the ER while they are trying to get you ready for emergency surgury, cause "[they] are trying to steal your stuff". And finally, threaten to "cut" the anesthesiologist before you fade out because she is "killin' you" by not allowing you to have your cell phone. Just another Friday night in the ER.

This weekend, I learned that it is perfectly acceptable to scream at the doctor and her nurse who are telling you that your child has measles and is extremely contagious, and does not need to be around ANYONE except immediate family for a few days, because your big family Christmas craptacular is TOMORROW, and how DARE they ruin Christmas for you.

This was at one of those Minute Clinic type places, and the whole damn store could hear her screaming. Lady, here's a thought for you, how about a)vaccinating your kids, b)showing some compassion for the poor kid who will spend his Christmas with measles, and c)oh, I don't know, some responsible parenting, that means canceling the Christmas craptacular, so you don't pass the measles around to your sister's brand new baby that you kept yammering about?

Oh wait, if she were a responsible parent, who cared about the health of others, she wouldn't be talked about on here, would she?

Because if you are frustrated at having to wait 45 minutes in the ER for a doctor, it is completely all right to leave, go out to your car, and use it to ram the front door of said ER. You'll definately get attention then (and a nice pair of silver bracelets, courtesy of the local police)

http://www.bclocalnews.com/news/112625429.html

When the patient is serving life without parole for homicide, and has a reputation for being good at picking locks, and has been taken to the city hospital because of self-induced wounds...

it's perfectly all right to let him use the bathroom by himself!

He won't pick the lock on his handcuffs, sneak past the guards, make it to the hospital parking lot, take a passing driver hostage, escape the city, and remain at large for almost seven months during which he kills another four people!

(Thank god I wasn't involved in this, but I lived in that city. That was a damn scary summer. http://en.wikipedia.org/wiki/Allan_Legere )

If you go down on your boyfriend, and discover that his thighs are duskily cyanotic and the soles of his feet are a strange red-brown color, take a look at the clothes on the floor before you freak out and call EMS. That way, you will save yourselves a lot of embarrassment, time and money by discovering on your own that the blue is from the dye in his brand new and never washed jeans rubbing off on his skin, and that he has been walking around barefoot all day.

Metody said:

If you go down on your boyfriend, and discover that his thighs are duskily cyanotic and the soles of his feet are a strange red-brown color, take a look at the clothes on the floor before you freak out and call EMS. That way, you will save yourselves a lot of embarrassment, time and money by discovering on your own that the blue is from the dye in his brand new and never washed jeans rubbing off on his skin, and that he has been walking around barefoot all day.

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Well, it sounds like his blue balls were about to be relieved, one way or the other.

If by some chance you find your pacemaker wires sticking out of your chest, it's perfectly alright to cut off the wires with your scissor, I mean damn they are annoying. And if the pacemaker itself should poke out, please by all means remove it. Then wait until all the winter holidays are over before coming in to be checked out. Well, before being dragged in by your son-in-law who's fed up after putting bacitracin on it for 2 weeks and probably annoyed as hell that you didn't mention that you actually removed hardware and cut wires.

Not being a med student yet, but am starting as a non traditional student, still working out how exactly I'm gonna get there.

But.. I've been reading this thread, and it's given me many laughs but also many shocks to see how stupid some people can actually be.

My own experience from recently spending a day in the ER unit as a patient, (I was there as I feared I had another MI, 28 year old female, don't even ask LOL) and they wanted to keep me in anyway even though I didn't have any elevated blood levels, so I got to spend a good couple of hours waiting before they could transfer me to the ward.

I was spending the waiting time in a bed, and saw a couple of other patients being treated in the bed next to me (not at the same time).
These ranged from a guy who fell out of a tree after he sawed off the branch he was sat on... He "only" broke his foot.
A girl who had a grown in toenail, with a big abcess on it, that broke open as she stubbed it against a door (it looked horrific!)

Not to mention to see how busy it was, I almost felt guilty for going to the ER, but well I already got an earful from the triage nurse who told me not to wait 3 days with chest pain before going to see a doctor LOL.

So I guess that makes me a "things I learn from my patient"; Do not wait 3 days with chest pain before you visit a doctor. I did this not once, but well I also did that on the actual day of the MI. A friend called the ambulance and made me go, I was just worried about the "time the doctor would need to free for me, that might be used by other more critical patients".

Oh and RESPECT! for all those doctors (and nurses and any other personnel) working in the ER. It's a damn hard job and then when it gets busy, I can imagine it being even harder.

I learned that it's a great idea to split a case of beer with your buddy before riding a bull. You definitely won't break your nose on the back of the bull's head as soon as it gets out of the gate. Also, your belligerently drunk friend won't attack the lab assistant (me) who's drawing a blood alcohol level in the ER.

If I refuse to give you more demerol (which just so happens to be the only drug you aren't "allergic" to), by all means get the patient rep and request a new doctor. Also, don't forget to wander around the ED telling everyone who will listen how your sadistic doctor refuses to treat your pain.

It's true, you are not my patient.

But after you take your mother's child-sized blood pressure cuff, place it around your scrotum and press the button on the machine like you saw the nurse do, you will probably be somebody's.

Hemerroids + Splinters = very unfortunate combination

Greeting! I'm a freshly minted DPT, so I don't have any ED patients. However, I do have some stories to tell:

1. From my old EMT roommate: Scumbags still care about their mothers, and will ask why you're paying more attention them instead of her. Amazing, considering he's the one who stabbed her 7 times in the middle of the street, then himself 4 times, then lit himself on fire.

2. From my brother's co-worker: it's entirely possible to nail your testicle to a 2x4 with a nail gun. Not just the scrotum though - it actually went went through the testicle.

Additionally, it's apparently easy to get your STD's from a toilet seat, but never from your cheated-on-you-twice-that-you-know-of girlfriend.

3. From my friend's uncle: Sudden onset abdominal pain during a family Christmas gathering is indeed a reason to go to the ED. You'll make the doctor's night when he gets to ask "Well, Mr. _____, has anyone ever told you that your full of crap?" He'll then show you the x ray showing a large amount of constipation.

4. From my mother (a chiropractor): Pt comes in, CC L-sided CP with radiation to the L jaw and arm. Mom: "You have 30 seconds to tell me why you aren't in the ER." Apparently, the lady had already been. Had been in the hospital for a week. EKG clean, blood clean, MRI clean, and had been seen by multiple specialists, DC home with an appointment for parasitologist consult the next week. In the meantime, pt decided to see a chiropractor on the off chance the they could help.

On palpation, Mom found the sternal costal joint the lady had somehow injured while stretching. No one at the hospital thought to palpate her ribs, since it was so obviously a heart problem. No one is perfect, and simple things can be missed by multiple people.

5. Finally: a 6 year old kid, after taking a header (actually, a chinner) onto solid granite, can hike 5.4 miles from the top of Nevada Falls in Yosemite back to the Ranger station with no problem, but will whimper like crazy when they put the needle in to give him a local. I now have a cool scar and a good story.

During the Gulf War, we learned that it is possible for a soldier to filter methanol based aircraft fluids through a loaf of bread to make them potable. The vomiting, hallucinations and writhing GI distress that occurs is clearly unrelated, and probably caused by the food, the desert heat or some Iraqi nerve "gas." It can't be due to the methanol, because he properly filtered it just the way his buddy told him to.

I've learned that the facial expression chart for pain is woefully inaccurate. 10/10 pain is characterized by a smiling face munching a bag of Fritos, not tears.

Feel free to call EMS at shift change for your 6-month old who has been crying for 2 hours. Oh, you mean that 45 minute nap he took in the middle doesn't count? Of course your primary care doc told you to go to the ER immediately.

Please bring me your bedbugs in an unsealed sandwich baggie. Yep, I'll get right on those lab tests....

You can totally turn off a remote-controlled vibrator even after it's moved up the colon. Though it kinda works like a shake-weight for your love handles if you leave it on, right?

If you have an allergic reaction everytime you take ibuprofen, just go ahead and take more ibuprofen when you get a headache. Then, when you come into the ED with facial swelling and difficulty breathing say "Why does this always happen when I take ibuprofen?" Bonus points if your girlfriend asks, after we start you on epi get and airway box, "But what are you going to do about his headache????"

TickTock719 said:

Please bring me your bedbugs in an unsealed sandwich baggie. Yep, I'll get right on those lab tests....

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...and don't forget to give up your crack pipe before you use kerosene as a home remedy.

If stabbed by a bird with a knife strapped to it during a cockfight it may be best to seek medical attention early. Your family members aren't going to want to deal with having to explain to people how you died.

I learned just yesterday that if you go the the ED screaming in pain and say you need a note that you can't go back to work ever because it hurts too much to sit or stand, they will call your regular doctor, find out your MRI was normal, you were assigned a 0% impairment rating and you were escorted out of their office two hours earlier for making the same scene. I also learned that the cops frown on having to deal with the same lunatic twice in one day.

If you're in jail, and you're a paraplegic from a GSW suffered when you tried to rip off other drug dealers, be sure to rip a strip off your orange jumper and tie it around a lower limb tightly enough to cause ischemia and abraded skin. When the jail doctor notices a couple of days later and asks, "What in the hell did you do to yourself?" giggle wildly, since infection has already set in, and a hospital admission seems likely. It's a lively mix of pathogens, including MRSA, and you almost die, but it's much easier to deal drugs from your hospital bed than a jail cell. Easier to get a Glock in, too.