Things I Learn From My Patients

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EctopicFetus said:
Dude has bad aim hope he uses his bow for hunting with a little more skill!


Not to mention the fact that hard target tips (unbladed, same width as the bolt, not very sharply pointed) minimize chances of widening the wound track, interrupting major arteries or blood vessels, or severing signifigant neural material from its base lobe or blood supply, thus making this a VERY difficult way to actually KILL yourself, though a very likely way to end up crippled, blinded, partially paralyzed, or relatively minorly brain damaged, rather than dead...if you MUST use a bow/crossbow/other bolt-or-arrow-throwing-device, at least use broadhead or razorhead hunting tips that cut broad wounds along the track of penetration, maximizing chances of severing signifigant structures, and almost ensuring that if the spine/brain base recieve ANY injury, it's likely to be a fatal one, rather than a lifetime inconvenience sufficient to make further attempts damned near impossible without another party's willing assistance.
 
In the third year of peds residency at my program, we supervise and run the PICU overnight at the local county hospital. We have no attending in-house, but the generalist working the EC downstairs can come up to help in a pinch. Basically, we're on our own.

So when getting check out from the other team, it really isn't a good idea to say the following:

Pt is room 10 is a 4 year old old former 28 week preemie with developmental delay, bad tracheomalacia, difficult airway, chronic lung disease, ROP s/p laser surgery and grade IV IVH in for exacerbation of his lung disease. This morning we thought he could go home today, but he started to have respiratory distress about fifteen minutes ago. Could you reassess him later tonight and see if he can go home?

'Cause my answer is gonna be - HELL NO, and why is he still sitting on the regular floor when he's grunting, flaring, retracting and head bobbing? And why did you check this out to me?!? Why didn't you say something more reasonable like - can you help me transfer the child to the freaking PICU so ENT can tube his ass? With a freaking 3.5 ETT, no less. 😱

Yah - I had some words with that team the next morning.
 
BobbyJ said:
Not to mention the fact that hard target tips (unbladed, same width as the bolt, not very sharply pointed) minimize chances of widening the wound track, interrupting major arteries or blood vessels, or severing signifigant neural material from its base lobe or blood supply, thus making this a VERY difficult way to actually KILL yourself, though a very likely way to end up crippled, blinded, partially paralyzed, or relatively minorly brain damaged, rather than dead...if you MUST use a bow/crossbow/other bolt-or-arrow-throwing-device, at least use broadhead or razorhead hunting tips that cut broad wounds along the track of penetration, maximizing chances of severing signifigant structures, and almost ensuring that if the spine/brain base recieve ANY injury, it's likely to be a fatal one, rather than a lifetime inconvenience sufficient to make further attempts damned near impossible without another party's willing assistance.

Reminds me of Jeff Foxworthy talking about lawn darts on Blue Collar Comedy Tour.

"If you catch one of those things with your head, your going to be receiving coloring books for Christmas for the rest of your life."
 
BobbyJ said:
Not to mention the fact that hard target tips (unbladed, same width as the bolt, not very sharply pointed) minimize chances of widening the wound track, interrupting major arteries or blood vessels, or severing signifigant neural material from its base lobe or blood supply, thus making this a VERY difficult way to actually KILL yourself, though a very likely way to end up crippled, blinded, partially paralyzed, or relatively minorly brain damaged, rather than dead...if you MUST use a bow/crossbow/other bolt-or-arrow-throwing-device, at least use broadhead or razorhead hunting tips that cut broad wounds along the track of penetration, maximizing chances of severing signifigant structures, and almost ensuring that if the spine/brain base recieve ANY injury, it's likely to be a fatal one, rather than a lifetime inconvenience sufficient to make further attempts damned near impossible without another party's willing assistance.

What I want to know is how he shot himself in the top of the head twice in a row. I would think that would be the hardest spot to shoot yourself with a bow or crossbow unless he was shooting straight up in the air and trying to get the bolt to come straight down into his head. I did have a friend as a child who managed to do exactly that but without achieving anything close to the penetration shown in the xray
 
From my experiences shadowing (not an MS1 yet):

1) If you are "arguing with your old lady" and need to go blow off some steam... by all means pick a fight with your TV set on the way out :idea:. You'll find that its quite the contender! That, and you'll find that your 3rd, 4th and 5th metacarpals have at least 2 fractures each after going only 1 round with said TV set. You're weak dude!

2) If you are the proud parent of an 18 m.o. toddler, please play the "throw the child in the air" game. Then, proceed to not catch your toddler, resulting in your toddler having bilateral mid-shaft femur fractures, and being in traction for many months followed by relearning how to walk. Really, ortho has nothing better to do than string up your poor kid and refer you to DFS.

3) If you are playing hide n' seek with the police, by all means hide in the back of a pickup truck. Then, when the unsuspecting lawman finds you, pop up and surprise him by aiming your gun at him! :idea: They love that! Then, after the nice policeman shoots you in the knee, it is ok to beg everyone in the ED for some water to "get rid of this f****in cotton mouth". Yeah dude, we know you "won't even swallow it, I swear", because you aren't getting any! The 3 liters of saline that you've already sucked up are keeping you plenty hydrated, trust us. KTHXBYE!

4) If you are unfortunate enough to be homeless, and get hit by a car resulting in multiple tib/fib fractures, you get to go home that night because you have some 'bidness to take care of'. 😕

That was a fun day 🙂

👍
 
Even though I'm going into peds, I would say EM has the best forum on SDN. Too bad I waited to do my EM rotation until the very end...

Things I've learned from my one month in the ED.

1) My 1st one-liner on my 1st day: Pt is a 63yo male found unconscious in a tree (Huh?!?!). Body temp of 82F. Lesson - Don't sleep in trees, especially in a Chicago winter.

2) A 48yo clown presents with syncope, still in clown gear. Several still-dressed clown friends in full gear walking around the ER with him. Lesson - Clowns are good friends to have.

3) Pt was asleep on the 'L' in the loop (the elevated part in downtown Chicago that runs 2 1/2 stories above the street). Woke up to realize he had just missed his stop. Ran to the door and yanked the emergency exit lever, opening the door and stepping from the moving train. Except at this point the train was 20' past the end of the platform. He fell the full 2 1/2 stories onto the pavement. Ugly ugly pelvic film. Lesson - patience is a virtue; wait until the next stop.

4) Pt was a 29yoM stabbed in the R chest about 1mi from ED. Walked to the hospital afterwards. Before checking in to the ED, decided he was hungry. So he walked upstairs to the "Spice of Life" hospital cafeteria, ordered some chicken while bleeding from his side and having problems breathing, & carried it down to triage to eat there. I walk into the trauma bay to see a pile of fried chicken next to the chest tube equipment, and a big ol' PTX. 1-2hrs later pt, is being wheeled out of the trauma bay, smiling, and finally able to enjoy his (now cold) chicken. Lesson - finish food first, then to go to triage.

5) Ouch. Poor guy.
 
If you want to commit suicide by jumping off an upper floor of a parking ramp, LOOK before you leap. (So as to avoid landing on an innocent pedestrian.)

Happened during one of my shifts as a research assistant at the ER.
 
ERMudPhud said:
What I want to know is how he shot himself in the top of the head twice in a row. I would think that would be the hardest spot to shoot yourself with a bow or crossbow unless he was shooting straight up in the air and trying to get the bolt to come straight down into his head. I did have a friend as a child who managed to do exactly that but without achieving anything close to the penetration shown in the xray

I can think of several methods, offhand.

Most reliable,m assuming a compound crossbow with decent arm spread would be to place the arms between the forward legs of a standard 4 leg chair, run a string to the trigger, and either over the supporting crossbar (better, for less chance of shifting by "lift"), or over the seat of the chair to the hand...lay down with top of head in line with arrow, and slowly give string a firm tug...good compound crossbows are NOT light (most are iin the 15 pound plus range, with balance compensated to the stock, so nothing short of a YANK on the string is likely to deviate the angle enough to result in a miss from a range of less than 10 feet, if one lined onesself up properly to begin with). But as I said, the choice of bolt tips makes it a game of chance wth odds outrageously in favor of survival, decently in favor of permenant damages that cause signifigant lifestyle adaptations to adjust to, and near infantesimal chances of actual fatality.


Looks like one hell of a good "drama queen/attention *****" method for "cry for help" type suicide attempts, though, assuming you don't mind the risks of loss of full or partial vision, unpredictable mental disability through just as unpredictable brain damage, and moderately low risk of spinal/brain stem injury leading to signifigant paralysis. Fits all the bills...dramatic and bloody as hell, unlikely to kill, unpredictable in actual damage, but not all that likely to be severely/signifigantly life altering in damages, and the "pain" part is over in a hurry, so you can get down to the "center of attention" bit (*plus scars and damages aren't likely to be disfiguring, so you can keep being the Goth 'N' Go ("Hot Topic) shopper of the week emo geek, and the unpredictable neurological damage is as likely to just add another "eccentricity" or "behavioral disorder" to the repitoire such folks are fond of focusing their attention and concern on having as they are to result in something that would actually make them an actual "outcast" from the habitual "cry for helpers" anyhow.
 
If you are a 35 y/o male SOCMOB when you suddenly suffer a spontaneous open fracture of your left tib/fib (WTF?), and you decide, after getting 10mg of morphine and 6mg of Dilaudid on top of the 85mg of methadone that you took this morning for your avasular necrotic hip, that the light is really bothering your eyes, and your girlfriend can't find the light switch, it is definitely appropriate to attempt to get out of bed to find someone who knows where the light switch is. After a tech sees you trying to put the rail of your gurney down and asks you to stay in bed, and then turns the lights off for you, remember that he doesn't know what he's talking about and flipping *those* light switches will turn off your monitor (even though the monitor is still clearly on.)

Go ahead and argue with him for a while about it. Then, intentionally bump your leg lightly against the rail of the bed and howl in pain, demanding he give you more morphine. Don't take that BS about how he can't do that but will talk to your nurse about it! You know that even though he says otherwise he's a nurse and he can give you the MS right now. Later, after the doctor has ordered 2mg of Ativan to calm you down after that incident, take off your gown and hop naked down to ambulance door with your girlfriend, insist that you have to leave *right now*, and then start crying when someone says you need to stay a little while longer, because, "You guys didn't take care of my hip! The doctor said I would get hip replacement surgery and you guys didn't do it!"

This is definitely the best way to avoid getting a psych consult. But, if for some reason you get one anyway because the doctor is very mean, the best way to prove you are not crazy is to let the psychiatrist know that you are wise to the ER doctor's tricks and you can "hear his little VW Bug idling right outside my window" and you know how to get out of the hospital but you can't tell the psychiatrist because the ER doc is sitting outside in his idling Bug listening to you. All of this, you shout loud enough that even if the doc were on the opposite end of the department he would hear.

When you find out that the psychiatrist want to admit you to BHU, ask if the ER doc will be there. When you find out he won't be, act relieved and stop fighting. When the tech who turned your lights off for you transports you off to BHU with two security guards, tell him that he should not have turned off the monitor because your daddy will sue for big money. That will show him! That will show all those ER mother-effers!
 
I've learned that one of the most dangerous activities to take part in apparently is to stand around and mind one's own business.
"I was just standing around minding my own business when..." invariably precedes some form of physical trauma to the face or skull. Especially minding your own business in a bar on a friday evening...
 
Obviously from the x-rays, it was a few years ago that old' Arrow Head visited our ER. Thank God I don't deal directly in patient care, but none the less, they decide to plant my office right next to Trauma 2 (I'm transcribing reports) where I have to not only see, hear, and smell, but step over all the stuff going on there.

I remember EMS rushing him in. He was still talking to EMS and the doctors, amazingly, as they pushed him into the trauma bay. I remember seeing only the one cross bow sticking out of his head...it was only later I learned there were two. He definitely looked like Steve Martin, but that's probably not a smart comparison to make.

Anyhoo....he had swallowed the bottle of Tylenol first, then shot himself once with the crossbow (I'm assuming it was one of those hand-held cross bows, not a full-sized bow). When the first shot didn't do him in, he went ahead and shot again. Because of the placement of those arrows sticking through and out of his head, they couldn't even get an ET or NG tube down him to lavage out the Tylenol. ( Guess he was pretty smart in that respect of his death wish, but as I said, his dad's a physician, maybe he realized he might be more successful with a double-whammy.) As I said earlier, his parents had left out of town to take another brother to the airport, yet, there was still one remaining brother at home, who walked in to find this guy and summoned EMS. Listening to this other brother tell the story, it was quite strange that the kid, 16 years old, had no PMH of depression, no drug or alcohol problems, no cues that he was even suicidal. He simply just wanted to die.


However, as you guys know, once they leave the ER, the rest is history and we don't always get to know the end of the story. I'm not certain what transpired with him, I only know he lived through it. However, it was impressive enough of a case to put up on our web site:

Kern Medical Center ED

Oh, and BobbyJ?
Fits all the bills...dramatic and bloody as hell,
It wasn't bloody at all. There was absolutely no blood coming from the wounds! Amazing what a good solid projectile can do to inhibit blood loss! 😉
 
frontal lobe atresia is apparently more common than I thought

these stories are the funniest ****e I have ever read on this site. keep em coming please
 
Oh my gosh, I haven't been in here forever, these stories are great! I moved to Oz and couldn't get a job as an EMT here, something about licensing and all that. Anyway, I work for a shipping company now and am going crazy! I need back in EM! These stories are bringing back memories...
 
Alcohol and snakes don't mix.

While playing in the desert with your 2 drunken friends, please do NOT decide to pick up a rattle snake and swing it around, it WILL bite you. Then, while in transport to the hospital (via air lift) don't jump up and try to open the door of the helicopter to get out- you will be restrained!

Thanks!
 
ALMT said:
Alcohol and snakes don't mix.

While playing in the desert with your 2 drunken friends, please do NOT decide to pick up a rattle snake and swing it around, it WILL bite you. Then, while in transport to the hospital (via air lift) don't jump up and try to open the door of the helicopter to get out- you will be restrained!

Thanks!

One of our guys does a lot of work with crotalid envenomations, and said that his estimate is about 90% of snakebites involve a victim with some degree of inebriation. I think you might need to be if you want to kiss a snake that could kill you.
 
QUOTE=Level_II_Trauma]Oh, and BobbyJ? It wasn't bloody at all. There was absolutely no blood coming from the wounds! Amazing what a good solid projectile can do to inhibit blood loss! 😉[/QUOTE]



Good point, and one I'd not considered...aside from that, I still think it fits the bill for "cry for help and attention" more than "serious attempt at self-euthenasia", considering what can safely be assumed about the level of the kid's anatomical and medical knowledge. If he'd been aiming to die, he'd have stopped at Wally-World during the day and bought a box of good hunting tips (they screw right in, and are usually universal fit).

Also, doesn't matter if it was a "crossbow pistol" or a full sized model, as most compound bow pistols have a width when drawn of over 18"...more than enough for the "brace between chair legs" method I described above, and signifigantly more than what's needed for use with other "brace it against a pair of sturdy uprights, and run a string to the trigger and over the top of the object" routine.

Smallest crossbow "pistol" model capable of throwing a bolt hard enough to create those injuries I've ever seen was a "Firefox" model (recurve version) that had an 11" width on draw...and that was with THICK laminated composite arms.



*note edited to repair various habitual mispellings and typoes I later noticed...probably STILL missed some.
 
We need to put out a warning to the public.

WANTED

Some Guy

Beware of him. He's dangerous. He will invariably shoot you, attack you, or harm you in some way...and he will do so without provocation while you are "just standing there minding your own business". Be on the look out.
 
UCLA2000 said:
We need to put out a warning to the public.

WANTED

Some Guy

Beware of him. He's dangerous. He will invariably shoot you, attack you, or harm you in some way...and he will do so without provocation while you are "just standing there minding your own business". Be on the look out.

Last seen somewhere between the porch with Grandma on it and a church or place for bible study.
 
earmuffs said:
2) A 48yo clown presents with syncope, still in clown gear. Several still-dressed clown friends in full gear walking around the ER with him. Lesson - Clowns are good friends to have.
Did they all arrive crammed into the back of the same ambulance?
 
OK, this is not a story but something I saw on ebay. I can just imagine the user ending up in the ER though. 😱

ebay item
 
GoofyDoc said:
OK, this is not a story but something I saw on ebay. I can just imagine the user ending up in the ER though. 😱

ebay item


This begs the question of how you came across this. 😀
 
GoofyDoc said:
OK, this is not a story but something I saw on ebay. I can just imagine the user ending up in the ER though. 😱

ebay item

20 bids
$86 current bid
2 days 13 hours to go

I should start selling these things...
 
Apollyon said:
One of our guys does a lot of work with crotalid envenomations, and said that his estimate is about 90% of snakebites involve a victim with some degree of inebriation. I think you might need to be if you want to kiss a snake that could kill you.


Haven't you heard of the 5 Ts for snake bites? Curiously, works for trauma, too.

Toothlessness
Tattoos
pickup TRUCK
inTOXicated
Testicles
 
Perrin said:
This begs the question of how you came across this. 😀
LOL, I saw it on another message board. I didn't know such a device existed.
 
earmuffs said:
2) A 48yo clown presents with syncope, still in clown gear. Several still-dressed clown friends in full gear walking around the ER with him. Lesson - Clowns are good friends to have.


:laugh: good one !
 
mikecwru said:
Haven't you heard of the 5 Ts for snake bites? Curiously, works for trauma, too.

Toothlessness
Tattoos
pickup TRUCK
inTOXicated
Testicles

We use Testosterone....and you can't forget the "Low tooth to tatoo ratio"
 
Apollyon said:
All patients lie. Done.

PS - "steatopygia" - hahahaha! Right on! Someone described Dee Dee Myers as "callipygian" (in writing, in a newspaper) back in the 90's - funny stuff!

(For those of you not up on your Greek, click here.)


I am definitely going to do my best to work "steatopygia" in to an H&P.

By the way I did some Google action and found this for those of you whose procrastination/boredom skills are on par with my own.
It's from some random website:

chromopygous - having painted buttocks
hypopygous - having a deficiency of buttocks
apygous - having no buttocks
hypothermopygous - having cold buttocks
triplopygous - having three buttocks
monolithopygous - having one hard mass of buttocks
quesopygous - having buttocks that smell like cheese
cryptopygous - having mysterious buttocks
nebulopygous - having vaguely defined buttocks
andropygous - having manly buttocks
hippopygous - having horselike buttocks
megalomanipygous - having delusions of grand buttocks
sinopygous - having Chinese buttocks
rhinopygous - having a nose between your buttocks
aeropygous - having streamlined buttocks
orthopygous - having well-toned buttocks
harmonipygous - having well-tempered buttocks
jellopygous - having gelatinous buttocks
gelatopygous - having deliciously desserty buttocks
oratopygous - speaking through one's buttocks
calcipygous - having bony buttocks
lithopygous - having buttocks of stone
 
Another one:

78 year old guy who has a 50 year heroin habit (quit for last 5 years). I've met some people with long habits before, just not ones who've quit on their own volitition. He had just finished telling me about helping to build skyscrapers in NYC, so I ask him, eyebrows raised in some amount of disbelief, "You built skyscrapers while using heroin?"

"Yep." He looked pleased with himself.

"Well, how did you do that?"

"Carefully."

Many things to learn here.
 
If you're in the south, i wonder how many times a lot of these incidents began with the fated words, "Hey y'all, watch this!" If you ever hear that, run fast and far.
 
If you are trying to impress everyone taking care of you with your worldly wit and wisdom, making comments about Ghandi to a Persian (not Indian) doctor, Chairman Mao to a Fillipino (not Chinese) nurse, and Hitler to a Polish (not German) tech will only lead everyone to believe you are an "ignant sum'bich."

If you get really drunk before ingesting an ungodly amount of antifreeze, and you go to the Emergency Room to ask us why you aren't dead, not only will you not get a straight answer, but you WILL get a hemodialysis catheter in the crotch, and no we won't just "finish you off."
 
If the police pick you up for public intoxication and for some reason offer you the choice of the ED or detox don't chose the ED 'cause it sounds nicer than detox. After you see me you will still end up in detox and now you will get both a hospital bill and a detox bill.
 
ERMudPhud said:
After you see me you will still end up in detox and now you will get both a hospital bill and a detox bill.

Neither of which you'll ever pay.
 
Jeff698 said:
Neither of which you'll ever pay.

Actually in this case he probably will since yuppies who are too drunk to find their way back to their expensive downtown loft probably don't want the hit on their credit rating. Thats actually how our local detox centers survive. I think they bill >$300/day for a matress in a big open room full of drunks. The frequent flyers never pay but capture a few overly inebriated citizens each night and you've made your nut.
 
ERMudPhud said:
Thats actually how our local detox centers survive. I think they bill >$300/day for a matress in a big open room full of drunks. The frequent flyers never pay but capture a few overly inebriated citizens each night and you've made your nut.

Apparently they learned business practices at the hospitals.
 
mikecwru said:
Haven't you heard of the 5 Ts for snake bites? Curiously, works for trauma, too.

Toothlessness
Tattoos
pickup TRUCK
inTOXicated
Testicles

Forgot a few..

Tank tops
Tube tops
Tequila
Trailers
Tobacco

Just trying to be complete.. :laugh:
 
If I ever have an MI in the ED, and code for 30 minutes, only to be "revived" to a life of anoxic brain injury living on a vent, I want to be prepared.

For example, if I'm going to have a PEG and trach put in, I don't want the medical students to get confused about my nipples. Therefore, I will tattoo "SWEET" and "SOUR" over each areola, just to keep things straight in the wake of my unfortunate conditon.
 
If the constipation gets really bad do not use wd40 to try and break it up....

different pt....when your orif starts to hurt do not inject kerosene next to the external fixator screws to "loosen it up....." even if that's what your uncle from russia recommends....
 
PhantomShadow said:
After you bring your 775 lb body to the ED to w/u a foul odor from your rectum and upon examination (with one person holding up the left buttocks with all his might) a lost television remote is found abscessed inside your gluteal fold, by all means, ask if you can have it back because you were tired of changing channels with your cane and by throwing objects at the television. Really, there is no need to question just how or why the remote is there....😱 😱 😱 True story from my MS-III days......definitely propelled me into EM 😛

***I jokingly asked my attending if he thought passing gas would change the channels. Now that would be confusing for the patient 🙄

I was perusing this thread and ran across this one. That has got to be the funniest thing I have read in a long time! I laughed out loud on that one, gosh! :laugh:
 
A valuable lesson to all: A patient came into the ER with massive head and facial injuries. It seems he was a tank crew commander and while training, a shell jammed in his barrel. He decided it might come out if he put a stick in the other end of the barrel and banged on it.

Well, at least he got the shell out...
 
Febrifuge said:
I am also pre-med, and yet (no offense to UTH2003) I am not making this up; I don't need to. I volunteer in an inner-city ED.

1) Mosquito bites itch. A lot. Really, really bad. So much in fact that, what the heck, you may as well go on in to the Emergency Department.

Did I mention they really itch? Bad?

2) Under no circumstances should you apply calamine, or benadryl lotion, or really anything at all, to try to alleviate the itching. It's not like you can just get that kind of miracle drug at the store. Much better to just come on in.

3) If you've been triaged, you've been to see the ED admissions folks, and then you need to wait all of 30 minutes before being able to see a doctor, well shoot, that's too long. Just tell the staff you appreciate it all the same, but you need to go.

This patient saved the county some cash by eloping, so that earns them a tiny sliver of respect. I wonder how their insurance will like that charge for the triage, though...

working on an ambulance in my area, we are not allowed to refuse transport to anyone that wants to go to the hospital... for any reason. And I worked in an impoverished area, so needless to say there were a lot of homeless individuals. I have actually had to transport a person to the ED because they were hungry!
 
Taking the stool sample from three weeks ago for a test ordered for diarrhea will not help you when you come to the ED for constipation.
 
edinOH said:
A couple of things I learned yesterday...

Chest tubes apparently hurt a hell of a lot less than I&D of a 4 cm abscess on your ass. This 26 yo guy was crying like a baby from the minute the betadine touched his ass. It only got worse with the lido and the knife. What a puss.
I wouldn't discredit abscesses so quickly as minor. I had one on my shoulder that got so bad I couldn't even bear the pain of shirt in contact with it one morning and therefore went to a clinic to get it drained. The actual drainage (even with lido) was the worst pain I've ever experienced, and I had to get the FP to stop halfway through to give me a breather as I almost passed out due to that pain. Then again, I never made a peep though through the whole thing; just shut my eyes, clenched my jaw, and waited for it to be over. 😳
 
leviathan said:
I wouldn't discredit abscesses so quickly as minor. I had one on my shoulder that got so bad I couldn't even bear the pain of shirt in contact with it one morning and therefore went to a clinic to get it drained. The actual drainage (even with lido) was the worst pain I've ever experienced, and I had to get the FP to stop halfway through to give me a breather as I almost passed out due to that pain. Then again, I never made a peep though through the whole thing; just shut my eyes, clenched my jaw, and waited for it to be over. 😳

Ill second that, i had a absess on my shoulder. I could barely get a t-shirt on also. Plus is was winter adn i had to deal with a coat. It was some serious pain Luckily the keflex helped and it finally ruptured. I mean, real bad pain and it was a little one.
 
The thing about abscesses in the ED is that the majority of the ones I I&D are on people who have hypersensitized their Mu receptors so horribly painful to them is regular life to the rest of us. Regular abscesses on normal people can be done at a PMD's office or urgent care.
 
Just wanted to add one from a medical transcriptionist...

When you are diagnosed with fibromyalgia and IDDM, and you are out of methadone, by all means don't bother your doctor. Just dissolve your muscle relaxants in tap water, and inject them with your insulin needles.

Certainly the ER docs, pulmonologist, cardiologist, and infectious disease specialists will be astounded by this new method of pain relief.
 
If you come into the ER on a sunday morning because you think you broke your foot, dont tell everyone you accident;y kicked your cat. Even if it's true, they wont believe you. You'll only get odd looks and be laughed at.
 
I'm surprised that you didn't see the stylistic value of the coke mustache! It had flair, panache, joie-de-mourir, etc.
 
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