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Things I Learn From My Patients

Discussion in 'Emergency Medicine' started by docB, May 2, 2003.

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  1. Dr. Will

    Dr. Will

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    SDN Members don't see this ad. (About Ads)
    When you only have enough money to either go to dialysis, or pick up a new HDTV, it's nice to see picking up the HDTV wins everytime. Having to be admitted for dialysis then takes on new meaning as you just sat around for a few days watching your new tv, missing your dialysis appointments. Although, I'm still confused how this patient was able to get an HDTV when I don't even have one yet.
  2. ISR

    ISR Junior Member

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    I think this is one of the questions that baffles ALL of us. (or at least me)
  3. MetalDoctor

    MetalDoctor metalhead

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    My third day in the surgical ER rotation, and I was already taught some old (yet valuable) lessons by two of my colleagues:

    1- Just because you are a bright medical student with a record full of "E"s does not mean you can drive your car after midnight with a blood alcohol level of 0.15 If you try, you will receive a free visit to the ER.

    2- If you are a sober medical student, please do not ride with your drunk mate, he will take you along with him.
  4. docB

    docB Chronically painful Administrator SDN Senior Moderator Lifetime Donor

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    Oh, it's not free.
  5. docB

    docB Chronically painful Administrator SDN Senior Moderator Lifetime Donor

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    But those chairs are so comfy and they move!
  6. exi

    exi EM, home of the cool kids

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    Pretty much my thinking on that, yeah.
  7. MetalDoctor

    MetalDoctor metalhead

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    They have insurance, and as far as I undrstood they will pay a minimal amount. So it is not totally free, but at least I didn't pay for the lesson.
  8. 146233

    146233 Phthirius pubis

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    I learned that the best way to alleviate the pain from your acute chole is not analgesics, but getting oral sex in the ED. When the physician comes in to arrange your transfer for surgery, your "companion" should immediately pop her head up and scream, "HE IS MY HUSBAND, I SWEAR!" ...because that's both convincing and what everyone was wondering. :)
  9. SmileDr

    SmileDr Mental Surgeon

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    :laugh:

    I really DO need to try that someday.

    :laugh:
  10. Wackie

    Wackie Inappropriate, always

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    That's even better than the typical Viagra vs Lasix matter.
  11. Chronic Student

    Chronic Student So Fresh, So Clean

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    If you are going to bluff/threaten suicide then make sure the gun is unloaded INCLUDING the round that is chambered before placing the gun to your head and pulling the trigger.

    It's a really bad time to get your math wrong.

    -Mike
  12. EM2BE

    EM2BE Elf

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    I thought for years this is how my uncle died. I just found out tonight it was a freak accident and they knew it was loaded, but of course no safety and playing still wasn't smart.
  13. exi

    exi EM, home of the cool kids

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    Wha...? Whoa.
  14. Jwax

    Jwax Just a minor variation

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    Oh, gen chem lab... I remember the days.

    I have a chem lab story bound to impress.

    During one of our labs, we had to use those little mortar & pestel looking containers to heat up a powder. We placed these containers on a bunsen burner, and it had been sitting on there for a good 20 minutes or so (I think we were dissolving the powder? I don't know - it was probably 4 years ago). I intelligently removed the container with the forceps/tongs or whatever, but in the process I dropped and broke the very fragile and expensive lid. For some reason... I felt the need to pick up one of the broken pieces immediately. BOY was that the wrong move! It burned my thumb (and a little bit of my middle finger) sooo badly that I definitely teared up in lab. Unfortunately, we still had about an hour left in lab, and our lab was a half an hour from our school b/c they ran out of lab space, and we were taken there twice a week by bus... so I had to wait ~2 hours till I could go to the student health clinic. I think that was the only time in 5 years at my UG college that I went to the student clinic. It hurt like a SOB...

    Yes, I'm going to be a doctor in 3.5 years...
  15. Annette

    Annette gainfully employed Lifetime Donor

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    Several lab lessons learned the hard way:

    Hot glass looks like cold glass.

    Pyrex is heat proof, not flame proof.

    The cabinets in the lab are NOT flame-proof either.

    If you are nitrating toluene, and the other people in the lab are running away, join them.

    When you are supposed to do the experiments in the specially design "explosion room," it is better that you do . . .

    When you are spinning a 25# object at 50k/pm, it is nice to know the centerfuge is armor plated (and not recently thermited!) when it falls off the spindle.

    Soapstone lab benches are flameproof, nitrocellulose paper is flammable, and the combination is alot of fun until you are caught by the safety officer!
  16. Jarabacoa

    Jarabacoa non carborundum ilegitemi

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    Something I learned from a patient on toxicology rotation. If you are pregnant and have severe pica, please eat clay that doesn't have lead in it (ceramic clay). Otherwise, you will have a baby born with astronomical levels of lead, and they will have to get chelation therapy for years until they finally stop setting off metal detectors. I wonder what the kid's IQ is going to be... I suspect they didn't inherit much to begin with.
  17. EricVorheese

    EricVorheese

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    One of the best lessons I learned in my surgery rotation - if you're a diabetic who gets a perineal abscess, get it checked out ASAP before it turns into Fournier's gangrene of the scrotum!

    This was something I had only read about once before but when I actually saw the necrotizing fasciitis eating his junk for lunch.........I will never forget it. After the excruciating trip to the OR to see if his 2 veg could be salvaged via extensive debridement (they were), he was basically left with 2 balls and their cords hanging in the open air.

    Before getting a skin graft to patch up what was left of his ballsack, he also got daily dressing checks (just like any other surgery patient) and when the dressings needed to be changed, the pain was so bad that he had to be knocked out with ketamine!

    scarred me for the full 2 weeks I had to see this guy



    the funny part was he still found time to hit on every female that walked into his room
  18. ISR

    ISR Junior Member

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    I learned that the best hair removal technique for that pesky pubic hair is to rub yourself with lighter fluid and set it on fire?

    Apparently, the lighter fluid will cause all the hair to burn off without damaging your fragile parts. Or so he thought right before he lit his privates on fire.

    2% TBSA FT burn (burned his hands a bit trying to put himself out). Daily dressing changes with wound debridement, and four attempts at skin grafts (2 STSG and 2 FTSG).

    Lost to follow-up.
  19. Katydid

    Katydid

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    Pardon me while I have a moment of full body shudder.

    *gags*

    Never seen someone drop trou and plop a pile of feces on the floor....but I have seen someone "decorate" his nursing home room with fecal matter. I'm sure the smell was just as pleasant.
  20. El Cheba

    El Cheba New Member

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    If you are brought into the ED after an MVC, please neglect to inform the ED staff you take methodone for whatever reason. Once we give you nubain for your 10 out of 10 pain you will jump up from the back board you were previously strapped to, run out of your curtained off room and proceed to squat and drop a deuce in the hallway a mere 20 ft from the bathroom. You will then feel the need to drag this pile to the bathroom to dispose it. By the way, this all will take place not only in front of the desk everyone sits at to chart but also in front of the door that goes to the lobby.


    Follow up to this story, I recognized this individual because she was my really nice and toothless waitress at everyones favorite pancake place that we had ate at 2 weeks prior. Good Times!:)
  21. Depakote

    Depakote CA-2 Moderator Emeritus Lifetime Donor

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    what a trooper.
  22. exi

    exi EM, home of the cool kids

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    Best response possible to that story, I think. :laugh:
  23. rosanegra

    rosanegra

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    I've learned that if you are allergic to latex, accidentally sit on just about any household object you want EXCEPT a tennis ball. Otherwise you might die.

    Also, sex ed is very important, but was definitely not taught very well back in the day... and this is how a very old woman ends up coming into the ED repeatedly and being diagnosed with bladder infections.. until, with further examination, it is found that despite proclaiming to still be, "intimate" with her husband, her hymen is still mostly intact and her urethra is grotesquely stretched.

    Oh, and if you are going to use a catheter and a syringe to inject wine into your bladder so that you can then piss it into a wine glass for the patrons the gay bar you work at... well, first, you might not want to do it.. but if you insist, try using a new catheter each time.

    I admit to not having experienced these first hand, but I heard them from extremely good sources at the Fire Department I used to work at.
  24. Faze2

    Faze2

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    When your pregnant girlfriend was brought it as a level 1 MVC, (she was fine, just 8 months pregnant so they called a level 1. Baby was fine too) we will actually think you are an awesome guy when you are being very polite and lightly crying, not like a b*tch, and telling us that she and your unborn son are your world and that you would do anything for both of them. It was so nice to here that, until......the 3 WOMEN that were in the other car are brought in and you physically, yes physically, attack them and have to be wrestled down by 4 guards while you scream that you are going to wait for them outside and kill every last one of them. Apparently you are angry because they left the scene, but according to witnesses, they left the scene because immediately after the accident occured, you jumped out of the car, smashed in their window, and began choking the passenger, not even the driver, of the other car. Turns out these 3 girls did the right thing and called the police immediately after they left and explained the situation, and told the police they were coming to this hospital. So now instead of getting to go upstairs with you wife and soon to be born son, you are arrested and will most likely be charged with assault. Well done sir.


    Oh and by the way, the one girl he tried to fight was no joke. She was about 110 pounds, and when he ran up to her, she squared right up to him and said, "Come on motha******, I'll box you like a f*ckin man. Come on b*tch!" I would not mess with that girl.
  25. Wackie

    Wackie Inappropriate, always

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    How to get out of the "are you married" question:

    This all depends on if your wife can manage to get your girlfriend's cell number. As you enter the ER for "not feeling right", notice girlfriend answer her cell and her face turn red. When girlfriend asks you why this woman is claiming to be your wife, lose all color, collapse, code.
  26. Drogba

    Drogba

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    Oh. my. god. I've been reading this thread since the beginning of part I and this is the only one which has inspired true disbelief in me. Did this really happen? Is that even possible...
  27. rosanegra

    rosanegra

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    I wouldn't doubt the person that I heard it from, who experienced it first hand.

    According to him she was just told that, "it would hurt at first," and therefore didn't think there was anything wrong.

    The only thing I don't understand is how it is that she never once went to a gynecologist... But then again, the couple had also never had children... no wonder.
  28. persia

    persia Member

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    What about him??? he must have been a virgin as well.

    That's a terrible story - think of all they missed, including kids.
  29. Chronic Student

    Chronic Student So Fresh, So Clean

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    This is horrible, but my first thought was that maybe it was a good thing they didn't reproduce.
  30. deuist

    deuist Stealthfully Sarcastic Lifetime Donor

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    I read that story out of the book Emergency. In it, the lady was in her 70s.
  31. Drogba

    Drogba

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    I definitely need to get that book. I read "Just here trying to save a few lives," a while back, which was thoroughly depressing. Have you read that one?
  32. deuist

    deuist Stealthfully Sarcastic Lifetime Donor

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    Yes, that one was written by a physician working under Doctors Without Borders. She talked quite a bit about poverty. Emergency is made up of short stories written by lots of authors---some are funny and others are sad. I founf a used copy on Amazon for about $2.
  33. Katydid

    Katydid

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    Please excuse me while I clean the iced tea I just shot out my nose, while laughing, off the screen of my laptop....

    Pretty creative way to get out of answering THAT question!
  34. primadonna22274

    primadonna22274 Senior Member

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    I actually worked with this doctor Pamela Grim in our sleepy SC ER. She's a bit ADD but a nice person and has some great stories. I still haven't read the book (loser that I am). She is very modest about it, just one day somebody asked her about her book, which she then showed me a link to on amazon. She does have an annoying habit of saying, "well, in Croatia, this is what we would do...."

  35. deuist

    deuist Stealthfully Sarcastic Lifetime Donor

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    I learned that if you have only one child, you're allowed to 911 for a nose bleed and then tell the "amblans" driver, "I will not take it easy! This is my first child and I'm going to do everything for him. If you won't take my to the ER in the amblans, I'll drive him there myself." I'm glad that the paramedics refused to take her, even though she did make the trip herself.
  36. BIG STUPID

    BIG STUPID

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    On average, 100 people a year choke to death on ballpoint pens.
    Saw it on youtube, must be true.
  37. Pharmavixen

    Pharmavixen foxy pharmacist

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    I work in the medical unit of a jail. Okay if I post a few things I've learned here?

    If you are having a heated discussion with the police, by all means, try and forcibly take the gun from one of their holsters. The police REALLY hate that, so you'll get to spend part of your incarceration under guard in hospital instead of in the jail.

    If you go into your methadone pharmacy, threaten the pharmacist with a knife, tie her up with duct tape, make off with a 32-ounce bottle of methadone 5mg/mL solution, and come back two weeks later as if nothing happened asking for your usual dose, I'll be very happy to see you in my jail. Your rants about laying assault charges against "that bitch" (the pharmacist, who grabbed your arm and wouldn't let go while her assistant called 911) are especially amusing.

    If you don't want to go to jail for arson, get caught in your own conflagration. After ten months in the burn unit with 95% FT burns, the judge will look at you in your wheelchair, minus hands and facial features, and decide you are no longer a threat to society, and stay all charges.
  38. VonKarolinas

    VonKarolinas

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    HOLY CRAP!!!!!

    And, funny coincidence, I just finished a 2 day Oz marathon when I read this. Ah the imagery.
  39. Katydid

    Katydid

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    Oh man, you and my brother. He worked medical transport for the county jail back home, and he had some interesting stories. Mostly about the guys who were trying to get out of charges by playing the insane card. No, they weren't, but they sure did know how to play crazy.
  40. Bacchus

    Bacchus PGY Too-many-expectations Moderator

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    My friends reaction started bubbling. Inquisically she called over our instructor. The instructor, a sweet Italian lady, gets a look of pure panic on her face. She takes the sash, slams it shut, and tells everyone to back away immediately. Luckily, nothing happened. :scared:
  41. Flopotomist

    Flopotomist I love the Chicago USPS

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    Maybe I was absent in chemistry on this day, but what friggin lab has you do anything that could even accidentally involve the nitration of toluene?
  42. Sweet Tea

    Sweet Tea Girl Next Door

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    If you do not want to get caught by the cops after you steal an RV, stop the RV at the closest bridge and jump off. The resulting open-book pelvis fracture will keep you out of court for a good long time. Bonus points for shaking your head "no" when asked if you want your ETT out.
  43. exi

    exi EM, home of the cool kids

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    I wasn't ever absent, but I WAS thinking to myself, "So? You're nitrating a big ol' aromatic ring with a methyl group for a head. What's the big friggin' deal? It's not like it's gonna explo.... oh."
  44. Depakote

    Depakote CA-2 Moderator Emeritus Lifetime Donor

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    Physician Rocket Scientist hSDN Member hSDN Alumni SDN 7+ Year Member
    Who's bright idea was it to let a bunch of 18-20 year olds play with dangerous chemicals?

    Don't get me wrong, I'm all for letting natural selection kick in on occasion, but some of us poor saps had to supervise them.
  45. exi

    exi EM, home of the cool kids

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    :laugh:
  46. Bacchus

    Bacchus PGY Too-many-expectations Moderator

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    I just looked back at the lab book from that semester. We didn't nitrate toluene. I was passing on the story that one of my classmates told me. Sigh. The only think I see where we substituted to toluene was a reaction where HCL gas was a product. The student overexaggerated and then I tried to take the story as my own. Big mistake :rolleyes:.
  47. docB

    docB Chronically painful Administrator SDN Senior Moderator Lifetime Donor

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    There were some brilliant kids in my orgo lab but some of them had no common sense and no real world experience. For example anyone who has ever cooked for themselves knows you don't heat a closed system. At least one guy (who probably works for JPL or MIT now) learned that one in a really exciting and percussive way.
  48. Wackie

    Wackie Inappropriate, always

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    Back to the topic... :p



    Fun times are had by all by dousing an arm with paint thinner and seeing how close you can get it to an open flame before it ignites. Additional fun times are had by all ED staff while you sit in the bed with an expression that can only be read as, "What just happened?"
  49. IloveERS

    IloveERS One of your patients

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    First of all, I'd like to say that I have a deep respect for doctors and nurses. I've got family members who work in health care, and I've been around it enough to know how hard your jobs can be at times :love:

    I am not a person, but a bad case of the flu =P My mother was pregnant for 5 months, given all kinds of anti-nausea medication, in and out of the hospital for dehydration - and only the first doctor she saw gave her a pregnancy test, apparently to close to the time of conception. When other doctors asked if she could be pregnant she answered no, because the first test came back negative. A OB/GYN nurse finally gave her a repeat test when my mother was at an appointment to get a referral to a fertility clinic because she hadn't been able to conceive for 5 years.

    It can take 6 men to insert one IV in a hysterical 5 year old. If it took 6 men to insert it, you might want to put them in restraints, because it's going to take all 6 to reinsert it when the child pulls it back out.

    If a patients mother tells you to restrain her because she doesn't handle IVs well when coming out of anesthesia, you probably shouldn't tell her that you'll be fine, you handled your shots so well! Yes, that wailing, clawing mess IS the same girl that got 5 vials drawn and 3 shots 6 hours ago while joking with you :scared:

    It's not generally a good idea to wait so long to go to the ER for a broken wrist that you no longer remember how you broke it - cause by that time it's healed wrong :(

    If you are prone to breaking bones, do not joke about how it would be funny if you fell and broke something. You will find out EXACTLY how slippery the floors at your job can be when they're waxed. At least you'll have a good story for the ER docs :rolleyes:

    When the ER nurses joke with you that they have your 'regular room' reserved, it's probably not a good thing. My poor parents had been to the ER five times that week, two broken bones in the same child (me), a concussion with possible spinal injury in a second (my brother), and appendicitis in the third (my sister).

    Please, PLEASE do not mix up any pregnancy tests and announce the results IN FRONT OF the virgin 15-year-olds parents. That was a tough 10 minutes.

    This doesn't really have a lesson, but it's a story that involved my favorite nurse, Carol, at the pediatrician's office - We've got heart disease in my family and my mother is kinda psychotic about watching us kids for it. So she decides to get our cholesterol tested, which means we have to get blood drawn. I don't mind needles (unless they're attached to IVs) so I go first, but I've got bad veins. The nurse is having problems finding one and my brother is teasing me about it, so she jokes with him about how if they can't find one in your arm they have to take it out of your tongue. She finds a vein, I get my blood drawn and hop down...sister goes next and does fine. Now my brother really doesn't like needles...the nurse makes a big show out of trying to find one in his arm, and he's getting kind of nervous when she says "Well, it's just not going to work - stick out your tongue." I swear he turned the same color as the paper on the tables! He looked ready to faint. She couldn't keep a straight face after that :smuggrin:

    Also, I personally learned about SOCMOBing - I got hit by Some Dude with a stolen SUV. In a fight between the human body and an SUV the SUV will win! That was my introduction to the wonderful ER facilities in Los Angeles. I got teased a bit about my 'modesty' after I was aware enough to understand what was going on - while out of it at the scene, I was not really concerned about my injuries, only the fact that my shirt was missing.
  50. Katydid

    Katydid

    Joined:
    Dec 31, 2007
    Messages:
    145
    Status:
    Post Doc
    SDN 2+ Year Member
    I have learned, as a patient, that if you are the person sitting patiently in the waiting area, holding an ice pack to the nose that you may or may not have broken (I didn't, as it happens, fortunately), not making a fuss? The nurses take really good care of you.

    They actually came out to check on me, make sure the nice little gash on the bridge of my nose wasn't bleeding, ask me how much pain I was in, and got me a replacement ice pack.

    I wasn't screaming. I wasn't yelling. I wasn't flipping out about "I've been here for three hours, and I haven't been seen!" Hell, had my husband not insisted, I wouldn't have gone to the ER in the first damn place, but he freaked out when I called him and told him, "I'm okay, but I tried to knock myself out."

    I was attempting to put a CD rack, with CDs in it, on the top shelf of my closet. Gravity conspired against me, and the rack and CDs came down on me, smacking me directly in the bridge of the nose. Fortunately, I was not wearing my glasses, and was wearing contacts instead, so didn't break my glasses.

    That is some instant kind of horrible pain, dude.

    I think I freaked everybody out when I told them I didn't want painkillers and didn't really need them, I'd be FINE, dammit, I just wanted to go home, ice my face, and take a couple of ibuprofen for the swelling. The doctor was surprised I hadn't broken my nose (thank GOD I didn't). I was surprised I hadn't broken my nose, come to think of it....

    Anyway, I applied what I have learned from this forum to my visit. I didn't make anyone's life miserable, and gave as much information as I possibly could. When asked how I was doing, I didn't snarl, "if I was FINE, I wouldn't be f*ck*ng HERE," I shrugged and said, "Meh, I've been better, but any day on this side of the grass is a good one."

    Still hurts, but fortunately, I do not have a shiner!
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