Things I Learn From My Patients

[Kittenmommy]

I actually had someone say "I was minding my own business... when some dude hit me in the head with a hammer" just the other day. Aside from the perfectly round, open, depressed skull fractures, he was pretty awake and with it. So be warned, "Some Dude" has branched out to hammers, now.

[Insert obligatory "Stop: Hammer Time!" joke here.]

---

Members don't see this ad.

 

[telenurse]

If you are a poorly controlled diabetic with CAD, CHF, PVD, AFIB with RVR, go ahead and pop those blisters all over you lower calfs, then when they don't heal, take scorchingly hot baths for 2 months to "soak out the infection". Continue eating as much chips and soda as you want. Then when you arrive to my hospital with oozing infected diabetic ulcers from your buttocks to your ankles with black wet eschar and yellow-green pus, crackles from your lower bases to your upper lobes and are on bipap continously due to pulmonery edema. Not too mention the ARF, SIRS, MRSA, and that you are a teetering a narrow balance from going into complete septic shock have your family threaten the nurse physically because she "hurt you" putting in a third IV because your IV meds aren't compatible and can't run in the same line. "but she has a perfectly fine working IV, can't we stop the heparin or the cardizem while the antibiotic is running?" "and why can't she have a Mountain Dew, she's thirsty, that mask is drying out her mouth"

 

[Depakote]

[Insert obligatory "Stop: Hammer Time!" joke here.]

 

[Kittenmommy]

I'm sorry; I just couldn't help myself.

ETA: I just looked up what Depakote is. I'd always just assumed that it was some kind of mind-altering drug (due to your Deadhead avatar, I guess). But evidently it's not. Why on Earth did you pick that as your username?

 

[Katydid]

If you are a poorly controlled diabetic with CAD, CHF, PVD, AFIB with RVR, go ahead and pop those blisters all over you lower calfs, then when they don't heal, take scorchingly hot baths for 2 months to "soak out the infection". Continue eating as much chips and soda as you want. Then when you arrive to my hospital with oozing infected diabetic ulcers from your buttocks to your ankles with black wet eschar and yellow-green pus, crackles from your lower bases to your upper lobes and are on bipap continously due to pulmonery edema. Not too mention the ARF, SIRS, MRSA, and that you are a teetering a narrow balance from going into complete septic shock have your family threaten the nurse physically because she "hurt you" putting in a third IV because your IV meds aren't compatible and can't run in the same line. "but she has a perfectly fine working IV, can't we stop the heparin or the cardizem while the antibiotic is running?" "and why can't she have a Mountain Dew, she's thirsty, that mask is drying out her mouth"

Good Lord.

So, was her family too busy going for gold at the Idiot Olympics to notice that she was getting horrible, infected, diabetic ulcers? I don't get it. I really don't.

Please, won't someone chlorinate the gene pool? Think of the children!

 

[da8s0859q]

Good Lord.

So, was her family too busy going for gold at the Idiot Olympics to notice that she was getting horrible, infected, diabetic ulcers? I don't get it. I really don't.

Please, won't someone chlorinate the gene pool? Think of the children!

For ONCE, a good use of "think of the children"!

 

[Depakote]

I'm sorry; I just couldn't help myself.

ETA: I just looked up what Depakote is. I'd always just assumed that it was some kind of mind-altering drug (due to your Deadhead avatar, I guess). But evidently it's not. Why on Earth did you pick that as your username?

I get asked that frequently enough, I have a blog entry for the answer.

 

[deleted109597]

Learned something on Vascular surgery last month. One person decided to inform us that his method of treating his ulcers was to pour lysol into his hot bath water, "you know, to disinfect it". When asked how much, he said about a quarter of the bottle. Thankfully, the LD50 is pretty high, but I'm not sure how the rest of the skin managed to hang on.

 

[Kittenmommy]

I get asked that frequently enough, I have a blog entry for the answer.

Awesome, thanks! I'm glad your migraines are under control. I've never had one, but I did have a real doozy of a headache a week ago. It was awful, and nothing would get rid of it. It finally went away on its own.

I can't even imagine the kind of pain a migraine would cause - ouch!

 

[Katydid]

For ONCE, a good use of "think of the children"!

Heh, thanks. I graduated from high school with the kind of children that kind of gene pool produces.

That's the kind of people who would be the family of the diabetic woman with horrible ulcers on her legs. Yep. Hell, could have been her family, for all I know.

 

[malingering]

If you're brought in circus-drunk by EMS after driving your car into a highway median divider (of course, you're fine), it's important to continually scream that you want your car back, because, you've got insurance. When confronted with the reality that your car is, in fact, destroyed, it's probably a good idea to leap off the trauma cart, sit up, and yell, "but I got Geico, bi**es!"

 

[Dr. Dukes]

If you're brought in circus-drunk by EMS after driving your car into a highway median divider (of course, you're fine), it's important to continually scream that you want your car back, because, you've got insurance. When confronted with the reality that your car is, in fact, destroyed, it's probably a good idea to leap off the trauma cart, sit up, and yell, "but I got Geico, bi**es!"

I'm sorry, but that's just funny...

 

[malingering]

It was truly funny, especially since the guy wasn't hurt at all. Also since he sounded a little like Dave Chappelle when he said it...

 

[ForbiddenComma]

If you're pregnant and want some time at the hospital and away from your jail cell, a good thing to do is to drink a lot of water, urinate all over yourself, and then claim your water broke.

Be sure and make it look like you are having the most painful contractions known to humankind since Eve. You may even fool your prison guard... maybe not the tocometer though.

 

[Dr. Dukes]

It was truly funny, especially since the guy wasn't hurt at all. Also since he sounded a little like Dave Chappelle when he said it...

I know I would have broken down laughing if I saw that, then randomly referenced it in conversations for months on end...

 

[malingering]

Yep...it's become a useful rhetorical device in almost any situation...And I did laugh my a** off...couldn't be helped.

 

[Dr. Dukes]

Yep...it's become a useful rhetorical device in almost any situation...And I did laugh my a** off...couldn't be helped.

When I first read your post I broke down laughing and my roommates came in to see what was so funny, and then left when they saw I was laughing at SDN.

 

[Chronic Student]

I have to admit that is one of the funnier things I've heard about in months.

They really should make a commercial out of it.

 

[telenurse]

Good Lord.

So, was her family too busy going for gold at the Idiot Olympics to notice that she was getting horrible, infected, diabetic ulcers? I don't get it. I really don't.

Please, won't someone chlorinate the gene pool? Think of the children!

Actually, I don't think I ever completely understood the family dynamics...they scared me...

 

[Depakote]

If you're brought in circus-drunk by EMS after driving your car into a highway median divider (of course, you're fine), it's important to continually scream that you want your car back, because, you've got insurance. When confronted with the reality that your car is, in fact, destroyed, it's probably a good idea to leap off the trauma cart, sit up, and yell, "but I got Geico, bi**es!"

Great one. I needed that...

 

[Katydid]

Actually, I don't think I ever completely understood the family dynamics...they scared me...

Holy crap, sounds like you got the prize residents of Yoknapatawpha County in there....

(for those who don't know, and some people honestly don't, Yoknapatawpha County is the home of the Snopes family, of William Faulkner's fertile imagination)

 

[howelljolly]

If you're pregnant and want some time at the hospital and away from your jail cell, a good thing to do is to drink a lot of water, urinate all over yourself, and then claim your water broke.

Be sure and make it look like you are having the most painful contractions known to humankind since Eve. You may even fool your prison guard... maybe not the tocometer though.

pure genious

 

[Katydid]

If you're brought in circus-drunk by EMS after driving your car into a highway median divider (of course, you're fine), it's important to continually scream that you want your car back, because, you've got insurance. When confronted with the reality that your car is, in fact, destroyed, it's probably a good idea to leap off the trauma cart, sit up, and yell, "but I got Geico, bi**es!"

My husband and I have been giggling over that one ever since I read it....

In fact, it's become the newest catchphrase when we're driving down the freeway. Especially when someone gets bent out of shape with us, and does the one-finger salute. We just yell at them, "But I got Geico, bi**es!"

Certainly makes them more entertaining!

 

[Wackie]

If 1 hydrocodone is good. 20 at once will be mo'bettah!
If 1 Tylenol PM make you a little sleepy. 10 at once will be mo'bettah!
If 2 ibuprofen will help your pain. 15 at once will be mo'bettah!
and finally if 1 PCN will help your dental abscess. 20 all at once will be mo'bettah!

He just wanted to be mo'bettah.

Forget AIDs, they need to work on a cure for stupid.

 

[hurricanemd]

There are two new types of seizures: the dreaded Grandma and Grandpa seizures. I am 100% sure the patient was trying to say that her husband had a Grand Mal seizure. Still made me chuckle later though...

 

[docB]

If your primary doctor orders serial stool samples to test for occult blood don't present to the ED with a chief complaint of "I'm 80 and I'm not gonna go digging in my own ****." This will just result in a long, blank stare of disbelief by your doctor. It will not help your position to also request that you be given a private room with a TV so that the nurses can collect your poop every day for three days. The assertion that you'll be happy to take the collected stool to your doctor won't allay any of the bemused resentment aimed at you by the staff. Finally, after your assessment and discharge, your accusations that we did nothing for you will fall on deaf ears.

 

[VonKarolinas]

Thanks for the laughs everyone. Keep up the good works and keep the stories coming.

 

[deuist]

If you have schizophrenia and weigh more than 400lbs, don't try to convince me that your delusions are under control only to yell, "Everyone's jealous of me! They want my sexy body!"

 

[docB]

Don't put bottle caps in your vagina.

 

[Burned Out]

I am new to this forum, and don't have enough time to go through all of these posts, but this thread is hilarious. Laughter is the best medicine, and this thread is giving me a good dose of it.
I've been around this for years and I have seen most of this. It's just so sad how true all of this is. Well, it WOULD be sad if it wasn't so funny.

Oh and when you threaten the gang banger with your little switch blade, make sure you turn and run like a girl, so you get shot in the butte.

 

[Annette]

If you crash you car while drunk and going to get more beer, develop an empyema from an untreated pneumonia because you wouldn't take a deep breath because it hurt too much, suffer an anoxic event, get pegged and trached, have multiple ischemic and hemorrhagic CVA's, step pneumoniae meningioencephalitis, thereby losing about a third of the volume of your brain leaving you in a vegetative state, don't worry. Your family can cure you with oil from Rome via Mexico. Or, get you a brain transplant.

 

[dnslay]

If you can't help but lick that last bit of tasty bean dip off the blade of your hand blender...

For God's sake unplug that thing first
Because when you accidentally squeeze the "on" button you will sever your lingual artery

 

[keisler]

I work in L&D triage, essentially the ER for pregnant women. And I have learned, if you get caught shoplifting $500 worth of merchandise from Macy's, get stopped by a security guard, dig around in your purse while threatening you have a gun, and then get jumped by said security guard, it is a great idea to urinate all over yourself and start screaming that your water broke and demand to be taken to a hospital. By ambulance.

When you arrive at said hospital, do not let the nurses or doctors examine you. Instead, demand to use a phone so your boyfriend (who was also driving the getaway car) can come pick you up.

This patient managed to escape before the police showed up, but then she came back! Lucky for her, she wasn't arrested, just received a ticket for shoplifting and a warning that if the cop had been there, he would have shot and killed her for threatening with a gun. She couldn't understand why, because she didn't really have a gun. Oh, and by the way, who dropped their bag of crack was that at her feet? Because it sure wasn't hers!

 

[docB]

The crack fairy strikes again!

 

[Dr. Dukes]

Oh, and by the way, who dropped their bag of crack was that at her feet? Because it sure wasn't hers!

Probably one of the two dudes, they're sneaky like that...

 

[deleted6669]

Probably one of the two dudes, they're sneaky like that...

hey!, it's not always the dudes....remember sometimes it's "my friend" or "that bitch"...

 

[da8s0859q]

hey!, it's not always the dudes....remember sometimes it's "my friend" or "that bitch"...

I had a "that bitch" guy when shadowing in the ED once. 'Twas a beautiful introduction to the world of emergency medicine.

 

[deleted6669]

I had a "that bitch" guy when shadowing in the ED once. 'Twas a beautiful introduction to the world of emergency medicine.

just in case you didn't know there are only 3 people in the world who cause most of the assaults, steal pts narcotics, force them to do stupid things, etc.if we could catch these guys we would all be out of a job:
they are:
some dude
my friend
that bitch

 

[EM2BE]

just in case you didn't know there are only 3 people in the world who cause most of the assaults, steal pts narcotics, force them to do stupid things, etc.if we could catch these guys we would all be out of a job:
they are:
some dude
my friend
that bitch

Also can be combined in any form:
"my friend, that bitch, she...."

 

[EM_Rebuilder]

Evidently, smoking DOES NOT cause cancer...

Crack head patient s/p MI 4 days ago, back with CP again:

Us: "Sir, one of the most important things is that you need to stop smoking crack"
He: "I dont do that stuff, I told you I live with a bunch of people that smoke that stuff and thats how it got in my urine"
Us: "Ok, well you also need to stop smoking cigs"
He: "That aint gonna happen, why the hell should I quit?"
Us: "well, it causes worse CAD and causes cancer"
He: "Like hell is causes cancer"
Us: "What do you mean sir, smoking does cause cancer"
He: "Have you ever seen a baby with cancer?"
Us: "Yes sir"
He: "Well, I dont think the baby was smoking were they?"
Us: "No"

Our work here is done...

 

[Perrin]

Evidently, smoking DOES NOT cause cancer...

Crack head patient s/p MI 4 days ago, back with CP again:

Us: "Sir, one of the most important things is that you need to stop smoking crack"
He: "I dont do that stuff, I told you I live with a bunch of people that smoke that stuff and thats how it got in my urine"
Us: "Ok, well you also need to stop smoking cigs"
He: "That aint gonna happen, why the hell should I quit?"
Us: "well, it causes worse CAD and causes cancer"
He: "Like hell is causes cancer"
Us: "What do you mean sir, smoking does cause cancer"
He: "Have you ever seen a baby with cancer?"
Us: "Yes sir"
He: "Well, I dont think the baby was smoking were they?"
Us: "No"

Our work here is done...

Welcome to UMMC. My passion is...self pay!

 

[deleted6669]

Evidently, smoking DOES NOT cause cancer...

Crack head patient s/p MI 4 days ago, back with CP again:

Us: "Sir, one of the most important things is that you need to stop smoking crack"
He: "I dont do that stuff, I told you I live with a bunch of people that smoke that stuff and thats how it got in my urine"
Us: "Ok, well you also need to stop smoking cigs"
He: "That aint gonna happen, why the hell should I quit?"
Us: "well, it causes worse CAD and causes cancer"
He: "Like hell is causes cancer"
Us: "What do you mean sir, smoking does cause cancer"
He: "Have you ever seen a baby with cancer?"
Us: "Yes sir"
He: "Well, I dont think the baby was smoking were they?"
Us: "No"

Our work here is done...

Had a similar discussion with one of my pts recently.
pt presented in v-fib post MI at the back door brought in by her boyfriend and we successfully resuscitated her.
the next morning:
pt:"why should I stop using meth and crack"?
me: well, it already killed you once....
pt signed out ama from the icu.
back the next day with(you guessed it) chest pain.....

 

[DasLemming]

Forgive the basic language, copied and pasted from another form. Did this about two years ago now.

On a really hot day some friends of mine and I decided to sneak into the local water park in Kalamunda (NE of Perth in Western Australia). It was closed down and there was no water on the slides so we went for a swim in the still functioning pool. After we had been swimming for awhile we decided to try going down the slides. I went down the speed slide on my swimmers and only got about halfway down before slowing to a stop so decided to look for something to ride down on a bit faster. I managed to locate a wheelie bin lid and decided to ride down the slide on that. I didn't stop until my feet hit the wall at the back of the concrete pool (it was empty). I instantly felt pain in my feet and knew something was wrong and asked my friends to call an ambulance (among all the swearing and cursing I was doing). The ambulance turned up and took me to Royal Perth Hospital where I was diagnosed as having broken both heels (the calcaneus) one of which was bad enough to require surgery. I spent the next ten days in a hospital bed as they tried to bring the swelling down to a level where my foot could be operated on. They did this with ice at first but once the swelling had gone down a bit moved me into things called "Cryo Cuffs". These are basically a bootie they wrapped around my feet and filled with ice cold water. This had the dual advantage of cooling the entire foot and applying compression to it in an effort to reduce the swelling faster. After the surgery was done they kept me in for another 5 days for pain management and observation and then moved me into a rehabilitation hospital.

Just wanted to give a big shout out and thanks to all EMT's and the like, wouldn't be walking around and riding my bike like a mad bastard if it weren't for them.

Not to mention the sadistic Physio's.

 

[MrBlack]

Well let me give you the following caveat before i proceed, i am not a doctor, but am an attorney and was referred to this website by a friend and must say that i throughly enjoy it and have a tremendous amount of respect for doctors, especially ED's, because of all the stress, difficultly, etc...

Anyway, i went to a ghetto medical clinic once because i got home from work and felt really realluy sick and an approx. 103-104 fever. I did not have insurance at the time bc i started a new job and was on the waiting period. I told the attending physician my symptoms and she was not sure what it was so she ran a bunch of tests on me and determined that my white blood cell count was slightly elevated. I also told her that my back, by my kidneys, felt a bit achey. Ok so here is where it gets weird, at this point i tell her that i am an attorney and explain a bit about my work. the attending goes into panic mode, with my gf right there, and starts telling me that i need to rush to the ER right now because my appendix are going to burst any second, then she tells me that she needs to tell me this and she will write it in my record because she does not want to "get sued." My gf asked the attending why her demanor changed so quick and she replied bc i am a lawyer she does not wanna get sued. Then she proceeds to tell me that she hopes i get to the ER bc if i do not then i will die in my sleep and she wont care at all, not will she feel bad.

Really weird, so i am FREAKING the F out at this point and i go to the ER where they tell me that the previous attending was crazy and that i had a mild cold and had kidnet stones (they had to do an ultrasound to rule out appendix). The ER doc, who was a good doc and a cool dude, told me that the woman was a "crazy paranoid b****"

I had a law professor tell me once that you should never tell a doc who is treating you that you are a lawyer bc you might be treated differently! Well guys n gals keep up the good work, but go easy on us lawyers!

 

[RetiredTooSoon]

Your family can cure you with oil from Rome via Mexico. Or, get you a brain transplant.

I know of an ICU nurse who was caring for a patient who was clinically brain dead from a hanging suicide. The patient and her family had immigrated from China 5-8 years prior and the family was insistent that she not be removed from life support for any reason, because they wanted to fly her back to China for a brain transplant.

What they didn't realize (over and above the obvious) and weren't ready to hear was that if she DID get a new brain and it actually worked-she wouldn't be the person they knew and loved; she'd be whoever the brain donor was.

 

[da8s0859q]

I know of an ICU nurse who was caring for a patient who was clinically brain dead from a hanging suicide. The patient and her family had immigrated from China 5-8 years prior and the family was insistent that she not be removed from life support for any reason, because they wanted to fly her back to China for a brain transplant.

What they didn't realize (over and above the obvious) and weren't ready to hear was that if she DID get a new brain and it actually worked-she wouldn't be the person they knew and loved; she'd be whoever the brain donor was.

What the f*ck? I feel bad for laughing while reading this.

 

[RetiredTooSoon]

If you've been to a rock concert and ingested a variety of interesting substances, by all means do not take your turn the stairs or escalator to get to the subway. Get on the hand rail and attempt to slide down past all the other concert-goers so you can be the first onto the train to get home.

That way, when you lose your balance and fall the 10-15 metres to the ground below, landing head first, there'll be lots of witnesses to your fall to call paramedics.

You'll be rushed to ER, but your time there will be short; the tissue retrieval team will be paged with a request to come harvest a CODS, or Cause Of Death: Stupidity.

 

[ccfccp]

Ooh! I finally got one to add:

Don't call your wife a bitch... cause she might have really good aim when she stabs you in the chest (overreaction?) She might actually go straight through and through your right ventricle, puncture your diaphragm, and give you a nice shiny new liver lac...

Just remember kids... be nice to your wife when she's chopping vegetables (and any other time for that matter.)

 

[RetiredTooSoon]

What the f*ck? I feel bad for laughing while reading this.

Don't feel too bad; I laughed as her husband told me the story, then would stop and try to look guilty, then start laughing again.

 

[EM2BE]

Forgive the basic language, copied and pasted from another form. Did this about two years ago now.

On a really hot day some friends of mine and I decided to sneak into the local water park in Kalamunda (NE of Perth in Western Australia). It was closed down and there was no water on the slides so we went for a swim in the still functioning pool. After we had been swimming for awhile we decided to try going down the slides. I went down the speed slide on my swimmers and only got about halfway down before slowing to a stop so decided to look for something to ride down on a bit faster. I managed to locate a wheelie bin lid and decided to ride down the slide on that. I didn't stop until my feet hit the wall at the back of the concrete pool (it was empty). I instantly felt pain in my feet and knew something was wrong and asked my friends to call an ambulance (among all the swearing and cursing I was doing). The ambulance turned up and took me to Royal Perth Hospital where I was diagnosed as having broken both heels (the calcaneus) one of which was bad enough to require surgery. I spent the next ten days in a hospital bed as they tried to bring the swelling down to a level where my foot could be operated on. They did this with ice at first but once the swelling had gone down a bit moved me into things called "Cryo Cuffs". These are basically a bootie they wrapped around my feet and filled with ice cold water. This had the dual advantage of cooling the entire foot and applying compression to it in an effort to reduce the swelling faster. After the surgery was done they kept me in for another 5 days for pain management and observation and then moved me into a rehabilitation hospital.

Just wanted to give a big shout out and thanks to all EMT's and the like, wouldn't be walking around and riding my bike like a mad bastard if it weren't for them.

Not to mention the sadistic Physio's.

I know your pain on this one actually. Except mine broke over time...got stress fractures in both of my calcanii and were walking on them (or at least trying my best). And of course they gave me the option of casting both and wheel-chairing me (and I was in 8th grade) or one at a time and putting up with the other one. And of course I chose the one at a time method because being in a wheelchair would have really cramped my style.