Patients [strike]Say[/strike] DO the Darndest Things

[southerndoc]

Instead of a thread devoted to what patients say that amaze us, here's one that is devoted to things patients do that amaze us.

Yesterday I had a 15 year old who was chewing on a push pin (the kind you use on a corkboard to pin paper to). He started coughing and guess what? Yep, he inhaled it. CXR showed it in his right mainstem. To the OR he goes.

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[nymbarra]

I had a well-educated 30ish guy who walked into the ED because he had begun to vomit blood over the last two days. Said it may have been the spicy foods he recently had, otherwise no medical hx, trauma, etc.

Turns out, he has had some knee pain from sports, and was popping like 20 Motrins a day for the past few weeks!

Seriously, if it doesn't seem to work the first five pills or so, wouldn't you just stop? It's not candy!

 

[dchristismi]

So your kid fell off the monkey bars a week ago? Ok. And he's been complaing of pain? Ok. And you took him to an urgent care center yesterday for x-rays? And they told you it was broken and to come in right away... and why are you waiting until now (day and a half later) to come in for your kid's broken arm?!?

Kids heal fast. We couldn't reduce it, and ortho gave it their best shot... we'll see. Kind of important growth plate there.

 

[txterp98]

So you have rheumatoid arthritis? Yeah, that's a painful condition. But why take your entire bottle of Norco over the past 2 days?

Okay, your LFT's are elevated....luckily your coags aren't affected. Tylenol overdoses are easy enough.

But wait, why are you hypotensive? Why are you bradycardic? Why aren't you fluid responsive? Why am I putting you on pressors and admitting you to the ICU?

<Time passes.....I read the discharge summary about a month later>

When you ran out of NORCO, why did you then move on and take your entire bottle of NORVASC??!?!?!?!

(And no, she didn't mix up the bottles. She just thought that since it started with "Nor", it must have the same properties and dosing indications). Sigh...

 

[southerndoc]

So you have rheumatoid arthritis? Yeah, that's a painful condition. But why take your entire bottle of Norco over the past 2 days?

Okay, your LFT's are elevated....luckily your coags aren't affected. Tylenol overdoses are easy enough.

But wait, why are you hypotensive? Why are you bradycardic? Why aren't you fluid responsive? Why am I putting you on pressors and admitting you to the ICU?

<Time passes.....I read the discharge summary about a month later>

When you ran out of NORCO, why did you then move on and take your entire bottle of NORVASC??!?!?!?!

(And no, she didn't mix up the bottles. She just thought that since it started with "Nor", it must have the same properties and dosing indications). Sigh...

Interesting. Your patient must have taken a LOT of amlodipine to get enough cross-reactivity with cardiac calcium channels to induce bradycardia!

 

[roja]

So you have rheumatoid arthritis? Yeah, that's a painful condition. But why take your entire bottle of Norco over the past 2 days?

Okay, your LFT's are elevated....luckily your coags aren't affected. Tylenol overdoses are easy enough.

But wait, why are you hypotensive? Why are you bradycardic? Why aren't you fluid responsive? Why am I putting you on pressors and admitting you to the ICU?

<Time passes.....I read the discharge summary about a month later>

When you ran out of NORCO, why did you then move on and take your entire bottle of NORVASC??!?!?!?!

(And no, she didn't mix up the bottles. She just thought that since it started with "Nor", it must have the same properties and dosing indications). Sigh...

*sniff* hmmm. do I know you?

 

[BADMD]

I had a 39 year old who got sick of trying to explain exactly why he tried to scratch his friend's Eastern Diamondback on the head.

 

[southerndoc]

I had a 39 year old who got sick of trying to explain exactly why he tried to scratch his friend's Eastern Diamondback on the head.

Oh c'mon, you can't leave us hanging like that!

Why was he scratching his friend's Eastern Diamondback on the head?

 

[BADMD]

Oh c'mon, you can't leave us hanging like that!

Why was he scratching his friend's Eastern Diamondback on the head?

"Dude. Look. I was drunk. I thought maybe it would purr like cat. Ok. Yeah, I know it sounds stupid, but I was drunk."

 

[Katydid]

"Dude. Look. I was drunk. I thought maybe it would purr like cat. Ok. Yeah, I know it sounds stupid, but I was drunk."

Let me guess, preceded by, "Hey, hold my beer and watch this!"

 

[brianmartin]

So you are feeling weak and dizzy?

"yes"

Well let me check your heart and lungs...:looks at chest:...and when did your doctor increase your fentanyl dose from 1 to *5* patches?

"I don't have a doctor"

 

[enfuegoEP]

Heard this one while doing a rotation in a jail infirmery. Guy smoked crack for 15 years and had multiple MI's, has a pacer put in, and is in line at the local Walmart when he sees the manager collecting cash. Decides this is his big opportunity and grabs the bag and runs like hell...makes it about half way across the parking lot when he became "light headed" and passed out.

 

[CueDoc]

Guy runs through a bonfire to impress his friends, pants catch on fire. Good friend of his astutely tries to douse the fire on his leg with a bottle of whiskey.

 

[Wackie]

I had a well-educated 30ish guy who walked into the ED because he had begun to vomit blood over the last two days. Said it may have been the spicy foods he recently had, otherwise no medical hx, trauma, etc.

Turns out, he has had some knee pain from sports, and was popping like 20 Motrins a day for the past few weeks!

Seriously, if it doesn't seem to work the first five pills or so, wouldn't you just stop? It's not candy!

Have you ever licked the outside of an Advil? It's sweet like candy therefore it must be candy!



As far as things patients do... sometimes it's not the patients but those with them. I'm not sure what body slamming yourself into the wall, on the floor, off the cabinet, and against the door does when receiving upsetting news.

 

[BlackSails]

Guy runs through a bonfire to impress his friends, pants catch on fire. Good friend of his astutely tries to douse the fire on his leg with a bottle of whiskey.

Thats not so unreasonable. Alcohol has to be great than 100 proof to burn.

 

[dnslay]

Oh yeah, forgot about those

 

[aphistis]

Not if you heat it up enough... Once the water evaporates it quickly tips over the 100 proof mark into flambe territory

Volatility[etoh] >> volatility[h2o].

 

[RxnMan]

Volatility[etoh] >> volatility[h2o].

EtOH will burn off long before the water (H2O's got a lot more polar bonds working for it).

Thats not so unreasonable. Alcohol has to be great than 100 proof to burn.

Booze will burn just fine at 80 proof (~40% EtOH). How do I know this? Because I used to use this:

to do things like this:

And that is one of the darndest things I've ever done!

 

[78222]

Constipation and abd. pain. What does the xray show? A full can of beer which apparently got "lost" in the rectum.

 

[sparkleflower]

Ever look up 'rectal foreign bodies' on pubmed? This is my very most favorite line EVER: "On manipulation the mass of about 15 cm x 12 cm x 12 cm size came out of the vagina and it happended to be a brick."

I got the impression from the abstract that it was a complete surprise.

 

[deleted109597]

So, I learned that if you are drunk, you shouldn't try and sit down just anywhere. Because portable charcoal grills look like portable fold up chairs. The chairs don't bite you in the ass. The grill will.
On the plus side, you will get a work excuse out of it, so it isn't that bad.