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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. Spinach Dip

    Spinach Dip Delicious with nachos

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  2. RespectTheChemistry19

    RespectTheChemistry19

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    3.5 L here. The EP and I had a grand old time laughing about that one.
    Last edited: Aug 10, 2014
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  3. Apollyon

    Apollyon Screw the GST Lifetime Donor

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    Represent!

    Respeck!
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  4. Spinach Dip

    Spinach Dip Delicious with nachos

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    So why do all urinals (hospital/nursing facility/etc) hold 1L? Is there a "super size" one available for those extra-special patients?



    /tangent
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  5. EmpericalNinja

    EmpericalNinja

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    Hello Folks.

    I'm not a med student, or anything like that in any field. But I've spent enough time in hospitals and Urgent Care over the years, to be thankful for doctors and the staff there, who are smart and know (most of the time) what's wrong with you.

    Let me just give you some of what's happened to me in my 27 years of life.

    First off, I am one of those unlucky folks who is allergic to Ibuprofen, Sulfa drugs, and Aspirin. Immune to Vicodin, and most....if not all regular cold medicines.

    So let's just have some fun going through my rather fun life.

    7 years old: Pneumonia and ear infection at the same time during the summer......not a fun summer......nor a fun rest of my life, because due to those two things I now no longer have a decent immune system.

    Also, come from a family background that has cancer and other unfortunate things in the background.

    Freshman year of college. IF after 3 days of coughing fits, and hacking, and other not pleasant things, you should have gone to the on campus health center to find out what's wrong with you; instead, wait until your dad comes to visit, dx's (He's worked around Hospitals enough as a sales rep that sells medical transcription devices and other assorted things) you with Pneumonia, and goes and gets you basic drugs to cure you......and be greatful, because your hallmates all but threatened to knock you out and take you to the E.R, even your R.A's roommate's girl at the time who was a medical student, DX's you as Pneumonia earlier in the week, and all but offers to take you to Urgent Care.

    I also had my wisdom teeth removed over christmas break that year, and was on Vicodin, and something else.....the Vicodin I stopped taking after day 2.5, because it wasn't doing anything for me, and I had become more or less....immune.

    Sophomore year of college. Punch through a glass panel on a door (accidentally with NO ALCOHOL INVOLVED) at 1 am in the morning because your housemates pulled a prank on you and you ran out of the house after them, only to have one of them close the door, and you, slightly sleepily knock on the window, not realizing how unstable it actually is. Hand goes through window, with you cursing, (which I rarely do) "ohhhh eff the door," folllowed by "OH EFFFF.....MY HAND." having them realize at that point, they may have screwed up. Have them help get your hand through the window part, with a very deep cut. Don't go to the E.R, instead, have a couple of them go to the all night safeway and get butterfly bandaids and neosporin, and keep your hand running under cold water. The next morning, go to class, with your hand bandaided up, and in a plastic bag (housemates idea), because based on their knowledge, your hand is fine. Go in to class, and have everyone stare at you as if you've grown a third eye. Have one of the Campus Security who is a student and in the class, who also dislikes you, look at you and ask what happened, say that an accident involving your house was all, and leave it at that. (find out later that he went and yelled at them). Come back from class and have your El Ed friend look at your hand ask what you did now, and if you need a ride to the E.R. Tell her you'll go have campus health services look at it later as you have class soon. Go back to your room, and have her IM you five minutes later and tell you that based on her Chem major roommate's advice that you need to go the ER. She'll offer to drive you up there (more or less threatening to take you if your refuse). Tell her you will go to Campus Health and have them take a look. Go to Campus health. Have them take one look at your hand, and immediately the nurse there says "uh.....hold on a second, I'm going to drive you to Urgent care." Go to Urgent care, have them take a look, and immediately have the Doctor ask if Alcohol was involved, when you tell him no, and he asks why you didn't go to the E.R, tell him that your housemates didn't think it was that bad. Have him again give you a skeptical look and inform you, that had the cut been any deeper or wider, you'd be facing tendon reconstructive surgery.....the cut was about 8/10th's away from the tendon. have them stitch you up, and then offer you Vicodin. Refuse and explain you're immune and it has no effect on you. Doctor and nurse look at you, like you're from another planet.

    Junior year. Same thing that happened freshman year.....only worse. starting with a fever, vertigo and neausa and not feeling hungry, on a tuesday night. DX yourself as food poisioning and ask the head of food services the next morning if anyone else experienced what you did, and he says no, then go around your business. that's wednesday. Thursday, still not feeling well, go to health services, have them take your temp (103.4) and say it's just a minor cold, and tell you to go on your way, you should feel better. Friday night, feel even worse then you did Thursday morning, and call your parents and the girl you're dating at the time, who both tell you to go the Urgent care. Go there, and find they're about to close, and have them ask if you can wait til tomorrow.....be polite and say you're not sure you're going to be alive in the morning. They give you the location of an U.C 30 minutes away that's open late. call up one of your friends and ask her to drive you to there, when you explain what you've got, have her tell you to wait where you are, she'll be there shortly. Go up to the other UC and have the doctor there take one look at you, take your temp (105.5) and immediately DX you as Viral Meningitis, have him inform you to go immediately to the E.R in your town where you go to school. Have your friend drive you back down, and go to the E.R, and check in, have the ER attending take one look at you and inform you that you do not have Viral Meningitis, because if you did, you've be bemoaning the fact that you're alive, and that you don't need a lumbar puncture. Instead inform you that you have a very bad case (also rare) of Pneumonia (when he finds out your history of seven years old) have him be a little less surprised. Have him put you on a few drugs, and then perscribe you some very heavy horse pills. a week later you're feeling better, and alive.

    didn't have any more problems in college, but after college:

    Two weeks after getting fired from your job, start having heart palpations that feel like a heart attack, go immediately to the Urgent Care and have them do an EKG on you. find out that stress heart attacks on a minor scale are possible. Also find out that you have an irregular heart beat where your heart beat beats 3 or so times at the normal rate, even though this is not an adverse affect on you. Find this part out again later a couple of months later when you go to join a weight loss program that does an EKG as well as a few other things.

    that's all I have that happened to me.

    One thing I did learn since working in retail, with fork lifts and all that is that when your foot/ankle gets run through with a fork lift blade, do not have the idiot spotter take off the person's shoe, because if that does happen, the foot'll swell up and said patient will end up having to have reconstructive surgery and have to walk with a cane for the rest of your life (27 years old this person is) because of the damage done.


    Once again, I am eternally thankful for doctors and nurses.
  6. EmpericalNinja

    EmpericalNinja

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    I should also say that some of these things I've read are kinda hilarious and sad at the same time. I actually understand a lot of these issues, as I have a lot of friends who are med or what have you. and I also watched a lot of House, Scrubs and other medical shows and understand better thanks to those shows and friends when someone says they have this and that.
  7. acceptmeplease

    acceptmeplease

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    Did I really just read all of that?
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  8. docB

    docB Chronically painful Administrator SDN Senior Moderator Lifetime Donor

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    I totally agree. They will never admit it though. Just like no one will admit that our current "prescription pain medicine addiction crisis" was the utterly foreseeable and frequently warned about result of the "pain is under treated, oligoanalgesia, pain is the 5th vital sign and pain is what the patient perceives it as" movement of the late 90s.
  9. Birdstrike

    Birdstrike

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    Have you seen this?

    http://drwhitecoat.com/wp-content/uploads/Grassley-Feinstein-Letter-to-CMS-2014.pdf
  10. docB

    docB Chronically painful Administrator SDN Senior Moderator Lifetime Donor

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    Yes. And I agree with it wholeheartedly (yes, that's now on the record, docB agrees with Sen. Feinstein about something). However the mess we are in now started before the advent of the patient satisfaction movement. It started with the JCAHO led movement to increase narcotic use in the 90s. There were even lots of studies finding that minorities got less narcotics than whites which implied "if you're not writing for narcs you're a racist." Patient satisfaction is gas on that fire to be sure but it started before this lunacy.
  11. Birdstrike

    Birdstrike

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    It's started before that. It started right here:


    Chronic use of opioid analgesics in non-malignant pain: report of 38 cases.

    Pain. 1986 May;25(2):171-86.

    "No toxicity was reported ...We conclude that opioid maintenance therapy can be a safe, salutary and more humane alternative to the options of surgery or no treatment in those patients with intractable non-malignant pain ..."

    http://www.ncbi.nlm.nih.gov/m/pubmed/2873550/
  12. TooMuchResearch

    TooMuchResearch i'm goin' to Kathmandu... Lifetime Donor

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    On the lead author, for us young ones that don't know the details:

    http://hcrenewal.blogspot.com/2012/12/the-king-of-pain-recants-pharmaceutical.html?m=1
  13. Birdstrike

    Birdstrike

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  14. JustSpeechless

    JustSpeechless

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    Apparently homeopathy doesn't cure liver cancer. Who knew?!

    I've never seen a liver that extends into the RIF before.
  15. sb247

    sb247 wait...you mean I got in?

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    Probably wasn't diluted enough ;)
  16. Spinach Dip

    Spinach Dip Delicious with nachos

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    Or he took so many doses it reduced the overall effectiveness.
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  17. Perrin

    Perrin sittin in the morning sun

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    Reminds me of this skit.

    Spinach Dip and sb247 like this.
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