Things I Learn From My Patients

Started by docB
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Katydid said:
Wha? 😱

Is there more to this story? Like, why the hell did she put bottle caps in her vagina? And they've got sharp edges, why in the HELL would any woman put sharp-edged metal things in her vagina?

Please do flesh this one out!
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Complaint was actually dysuria and flank pain. After UA came back with some blood (go figure) PA ordered CT without contrast to eval for stone. Radiologist called to ask "What's that?" You'd think this would only happen in a psych patient but this one just gets really drunk and stoned on a regular basis and "That kind of stuff happens to me." I was just glad she came in and we got 'em out before she decided to have sex with someone because if she had I'd have had 2 patients and a lot of suturing to do.
 
docB said:
Complaint was actually dysuria and flank pain. After UA came back with some blood (go figure) PA ordered CT without contrast to eval for stone. Radiologist called to ask "What's that?" You'd think this would only happen in a psych patient but this one just gets really drunk and stoned on a regular basis and "That kind of stuff happens to me." I was just glad she came in and we got 'em out before she decided to have sex with someone because if she had I'd have had 2 patients and a lot of suturing to do.
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only in Vegas...I hope...
 
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docB said:
Complaint was actually dysuria and flank pain. After UA came back with some blood (go figure) PA ordered CT without contrast to eval for stone. Radiologist called to ask "What's that?" You'd think this would only happen in a psych patient but this one just gets really drunk and stoned on a regular basis and "That kind of stuff happens to me." I was just glad she came in and we got 'em out before she decided to have sex with someone because if she had I'd have had 2 patients and a lot of suturing to do.
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Damn.

If that kind of stuff happens to you, maybe you should rethink the drinking and getting stoned.

Oh wait, then she wouldn't be your ED patient, would she?
 
If you are a crazy, drugged out hooker, and your customer decides to get a little rough and try putting it in holes you did not agree on, do not climb out of the car and onto the roof. You will fracture things when he decides to speed away and you topple off onto the road.
 
If you have a fused knee joint and you get electrocuted while standing on a ladder and you are subsequently knocked off the ladder, resulting in a compound fx of your femur and tibia which requires orif and casting- try not to get massive diarrhea that runs down your leg and under your cast and then walk into your orthopod's office asking for a new cast,
then after you get the leg re-cast, get 2nd degree burns on the top of your foot while burning trash doused with gasoline, thus necessitating yet another recast, which itches and slides around too much and bothers you, so you cut it off with your pocket knife, then show up at your orthopod's office yet again for another recast...

Rinse, repeat...
 
I linked to this forum from a HORSE RIDING forum!!

You guys are internet FAMOUS - thanks for the laughs.
 
Everyone knows about ischemic and hemorrhagic strokes, but I learned about a third type from my patient.

24yr male picked up from rural Kentucky BLS unit with c/o chest pain and acute inability to move his left side. He's not willing to communicate so I ask fiance about his prior strokes, trying to figure out if this guy gets ASA or not. Me - "So what type of stroke did he have?" Her- "The kind you get when you're really angry" Me - "Oh."
Hope he enjoyed the $6000+ bill for HEMS transport of his conversion disorder.

Also, if you're going to bring in your 6 yo kid to have his paronychia that's been there for more than a week I&D'ed, make sure he didn't miss his dose of Focalin that day.
 
I learned from a patient that people have extremely distorted beliefs about want we can and can’t fix in the ED. I have long known this, but it was concretely confirmed by a recent encounter. I found out the other day that some people think we can do Emergent DNA testing in the ED. I had a patient (we’ll call her Jane) who had sex with her husband earlier in the day. Apparently, her husband’s girlfriend (we’ll call her Maggie) made some insinuations that led to a lot of controversy. Maggie claimed that Jane had sex with another man that wasn’t her husband. Jane’s husband couldn’t believe how she could dare have sex with another man and was threatening her. The girlfriend of Jane’s alleged fling was mad at Jane. Things were getting out of control, so they decided to go to the ED, so that a physician could prove that she had only had sex with her husband. She had deliberately not showered since that morning, in case we wanted to collect samples for DNA testing, (this is 8 PM) To complicate matters was that the intercourse between her and her husband at first wasn’t consensual. They were fighting and he became aggressive, then she thought, “what the heck.” I asked if she wanted to report him to the police and she said no, that she had a good time.

To add some visual images… this is a 45 year old 250 lb, 5’2’’ patient with yesterday’s dinner spread over her rumpled sweater. I asked her if she wanted me to do a rape kit, or to just check her out for STDs, silently praying that she declines. She said no, that she just wanted to clear her name and prove that she wasn’t an adulterer. I go to present her to my attending so that we can get her the heck out of the ED, and he tells me he wants me to call a consult… to Jerry Springer. I laughed so hard that I couldn't type as I tried to think of a discharge diagnosis and instructions.
 
OK, so "Let's consult Dr. Springer" just entered my armamentarium alongside "I got GEICO bit**es".
 
When presenting to the ED for a CC of pain in your pinky toe, please don't bother looking down at your feet before you show up. You'd obviously just miss that long nail growing all the way from your big toe, curving around (from never taking your shoes off, evidently), and digging into the side of your 5th toe. 😱

At least it was easily taken care of - despite the thickness of the nail.


Another:

I learned from a patient's mother that it is my job (she must be privvy to the job description) to make sure that her daughter sees a nutritionist at the hospital because she's overweight - she must have been around 450 to 500 lbs! Nevermind the fact that the mother was feeding her McDonalds while she's in the examining room waiting for us to figure out why she's having SOB and hip pain (big surprise) because she "knew she'd be hungry from all that waiting because we're so slow!"
 
If you are a frequent flyer to our ed due to c.p, cardiomyopathy chf and a known drug user it is not a good idea to try to light your crack pipe while on six liters nasal cannula. Not only will this result in a nurse throwing the closest pitcher of water on your face to put out the fire/your burning mustache and goatee... it will also result in you getting quickly transferred to the nearest burn center for treatment of the burns you sustained to your face and neck. 🙁
 
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If you're a catholic priest getting ready to board a cruise to give easter sermon, don't take too many xanax and a vicoden and develop AMS. While sorting out the skittles bag of pills mixed together you an eager medical student may discover your VIAGRA :idea:
 
enfuegoEP said:
If you're a catholic priest getting ready to board a cruise to give easter sermon, don't take too many xanax and a vicoden and develop AMS. While sorting out the skittles bag of pills mixed together you an eager medical student may discover your VIAGRA :idea:
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:laugh::laugh::laugh::laugh::laugh:
 
I came here from the same horse forum!

I am an x-ray tech not a doctor, but I have seen a lot and really enjoyed this thread! :laugh: I had to pass it on the the docs I work with!

If you have broken your wrist, by all means give the ER doc the full story: that you had had your hemorrhoids worked on that morning, and when you got home, you dropped your drawers and crawled up on top of your dresser to have a good look in the mirror at your new butt, but then fell off breaking your wrist. The health records clerk is going to have a great laugh when she files that report (and probably the entire ER staff)!

Also, when you over hear her telling the story (anonymously, of course) to her friends in a bar nearly a year later, do come forward and complain to her boss, admitting again that you were the bare-bottomed, hemorrhoid-gazing klutz, who broke his wrist falling off a dresser.😆
 
XTech said:
I came here from the same horse forum!

I am an x-ray tech not a doctor, but I have seen a lot and really enjoyed this thread! :laugh: I had to pass it on the the docs I work with!

If you have broken your wrist, by all means give the ER doc the full story: that you had had your hemorrhoids worked on that morning, and when you got home, you dropped your drawers and crawled up on top of your dresser to have a good look in the mirror at your new butt, but then fell off breaking your wrist. The health records clerk is going to have a great laugh when she files that report (and probably the entire ER staff)!

Also, when you over hear her telling the story (anonymously, of course) to her friends in a bar nearly a year later, do come forward and complain to her boss, admitting again that you were the bare-bottomed, hemorrhoid-gazing klutz, who broke his wrist falling off a dresser.😆
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Oh man, thanks for joining and sharing that. That's awesome. :laugh:
 
Make sure you call an ambulance because you can't tell your imaginary "friends" to shut up. Make sure to try to bring your shotgun in the ambulance with you.
 
Just thought of another recent one.

Riding a horse while intoxicated and trying to make it thru the front door of your 1970's farm house is always a good idea-then calling an ambulance because you just couldn't make it.
 
Close the port to your DVD player or you might trip over it and lacerate the top of your foot. And if you're an extremely good looking girl and asked by the medical student suturing foot: "So, was it worth it, what were you going to watch?"

Don't be honest with the five thumbed 4th year medical student and say

"The movie was called, Take a Jill Pill, It's a girl on girl skin flick staring jill kelly, she's so hot."

You could cause a needle stick that way....
 
enfuegoEP said:
Close the port to your DVD player or you might trip over it and lacerate the top of your foot. And if you're an extremely good looking girl and asked by the medical student suturing foot: "So, was it worth it, what were you going to watch?"

Don't be honest with the five thumbed 4th year medical student and say

"The movie was called, Take a Jill Pill, It's a girl on girl skin flick staring jill kelly, she's so hot."

You could cause a needle stick that way....
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wow...just wow...
 
ccfccp said:
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.)
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Please tell me she went to jail for a long time...
 
Mozart45 said:
If you are a frequent flyer to our ed due to c.p, cardiomyopathy chf and a known drug user it is not a good idea to try to light your crack pipe while on six liters nasal cannula. Not only will this result in a nurse throwing the closest pitcher of water on your face to put out the fire/your burning mustache and goatee... it will also result in you getting quickly transferred to the nearest burn center for treatment of the burns you sustained to your face and neck. 🙁
Click to expand...

And will medicare pay? Hospital aquired and all . . .
 
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When reviewing your age with your physician, make sure you don't count the year you were born and the current year, because the real age is calculated only on the years between.

Thus, if you were born in January 1950, make sure you argue with and correct the doctor when she notes that you are 58 and state that you are only 56 years old. Also mention that you and your husband have the same argument all the time, while rolling your eyes and sighing, and you're not sure why you and he insist you're 58 years old.
 
Don't ride the roller coaster with your 'grill' in place on your teeth. You might just swallow it and provide a pretty Xray for the rest of us to enjoy for years.

Not to mention how much fun you'll have once the metal passes through your rectum...
 
Winged Scapula said:
When reviewing your age with your physician, make sure you don't count the year you were born and the current year, because the real age is calculated only on the years between.

Thus, if you were born in January 1950, make sure you argue with and correct the doctor when she notes that you are 58 and state that you are only 56 years old. Also mention that you and your husband have the same argument all the time, while rolling your eyes and sighing, and you're not sure why you and he insist you're 58 years old.
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Holy crap.

So a year after she was born, she had, what, her zeroith birthday!?!? :laugh:
 
doctawife said:
Don't ride the roller coaster with your 'grill' in place on your teeth. You might just swallow it and provide a pretty Xray for the rest of us to enjoy for years.

Not to mention how much fun you'll have once the metal passes through your rectum...
Click to expand...

Which reminds me of the patient presentation a friend of mine gave on rounds a few months ago. "Review of systems notable for total body dolor and a sweet-a$$ grill." He's the same guy who when asked by the dept chair during morning report "are you sure he has HIV?" responded, "I'm not just sure, I'm HIV positive."
 
pikachu said:
If you have sex with a girl, and your frat brother tells you right after you come downstairs that she has herpes, pouring bleach all over your privates will not take care of ANY of your problems!
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Oh waw thats funny:meanie:
 
gutonc said:
Which reminds me of the patient presentation a friend of mine gave on rounds a few months ago. "Review of systems notable for total body dolor and a sweet-a$$ grill." He's the same guy who when asked by the dept chair during morning report "are you sure he has HIV?" responded, "I'm not just sure, I'm HIV positive."
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God bless that guy. :laugh:
 
I'd like to propose a theme song for this thread....

"Orange Colored Sky"

There are a variety of arrangements, take your pick

Lyrics begin as follows

"I was walking along, minding my business
When out of an orange colored sky
Wham! Bam! Azamakaz!"

Seems approprate. Unfortuanely I don't know how to post a link (I'm an old person who grew up in the pencil and paper era). Perhaps someone else can.
 
doctawife said:
Not to mention how much fun you'll have once the metal passes through your rectum...
Click to expand...

Wait...are you kidding? Can a human being actually pass that amount of metal without their being significant damage to the dig system? Isn't surgery favored in that case? 😕
 
Winged Scapula said:
When reviewing your age with your physician, make sure you don't count the year you were born and the current year, because the real age is calculated only on the years between.

Thus, if you were born in January 1950, make sure you argue with and correct the doctor when she notes that you are 58 and state that you are only 56 years old. Also mention that you and your husband have the same argument all the time, while rolling your eyes and sighing, and you're not sure why you and he insist you're 58 years old.
Click to expand...

*snerk*
 
la petite mort said:
Wait...are you kidding? Can a human being actually pass that amount of metal without their being significant damage to the dig system? Isn't surgery favored in that case? 😕
Click to expand...

[serious content] As long as the offending object can get past the pylorus, it will also be able to pass the rectum. Will it be a fun experience? No. Will he perf his bowel? Also no. [/serious content]

And on a lighter note, I found out later that the pedi attending who saw this kid actually wrote the following on the chart:

Patient may replace grill once washed in dishwasher.
 
doctawife said:
[serious content] As long as the offending object can get past the pylorus, it will also be able to pass the rectum. Will it be a fun experience? No. Will he perf his bowel? Also no. [/serious content]

And on a lighter note, I found out later that the pedi attending who saw this kid actually wrote the following on the chart:

Patient may replace grill once washed in dishwasher.
Click to expand...

Learned something new today about the GI system.

Also learned something new about the faith some people have in their dishwashers.
 
Saw this demonstration of Good Idea/Bad Idea first hand:

Good Idea: Going to a New Year's Eve Party

Bad Idea: Drinking heavily and deciding to dive in the shallow end since, "I've been a swimmer for 7 years. I know how to pull up."

Good Idea: Consult the 4th year med student and PGY-1 that happen to be at the party when you "bump" your head on the bottom.

Bad Idea: Taking their evaluation of "Whatever damage that's been done is done" as gospel since they've been drinking heavily as well.

Another Bad Idea: Driving home and going to work (as a lifeguard) for 2 days.

Good Idea: Going to the hospital when you just can't seem to shake that violently excruciating headache.

Good Idea: Laying very, very, VERY still when the doctor sprints (yes, sprints) up to your hospital room white faced and pale because your x-ray shows a completely shattered C-5 vertebrae.

"Sir, you were a sneeze or a cough away from being a quadriplegic."
 
Bad Idea: Taking their evaluation of "Whatever damage that's been done is done" as gospel since they've been drinking heavily as well.
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Yeah, what's with that? The only times my EMT and now PA school training would be useful at parties (one diabetic seizure, one badly twisted ankle), I've been buzzed. How come nobody just flops over sideways in the grocery store when I'm awake and alert?

Props to you, ClockWork, for including the Juno quote in your sig. Very funny movie.
 
Febrifuge said:
Yeah, what's with that? The only times my EMT and now PA school training would be useful at parties (one diabetic seizure, one badly twisted ankle), I've been buzzed. How come nobody just flops over sideways in the grocery store when I'm awake and alert?
Click to expand...

The bunch of bastards! They're so inconvenient about getting sick and all f*cked up somehow :laugh:
 
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Febrifuge said:
Props to you, ClockWork, for including the Juno quote in your sig. Very funny movie.
Click to expand...

Thanks. Saw Juno with my girlfriend and she gave me good jab in the ribs when that line was said. She doesn't think too highly of doctors either...
 
if you missed your appointment to get an abortion because you couldn't afford the cab ride to the clinic, it is okay for you and your "fiance" to come to the ER and demand an emergency D&C. when the ED doc says that is not possible, it is okay to start yelling and screaming profanities and say that you hate this "f#$%ing" hospital and that you want to be transferred by ambulance to another hospital where they will take care of you...😱
 
another great one from recently...

if you have had a plantar's wart for 5 (yes, five) years, you should definitely come to the ED and say that no one has done anything for you and that you want the wart cut off today!😡
 
I did not know where to put this so here is the joke for today.


A guy walks into a bar, sits down, and asks, "Bartender, got any specials today?"
Bartender answers, "Yes, as a matter of fact we have a new drink, invented by a gynecologist patron of ours.
It's a mix of Pabst Blue Ribbon Beer and Smirnoff Vodka." The guy asks, "Good grief, what do you call that?"
The bartender replied, "It's a "Pabst Smir
 
I work in a rehab facility (medical, not substance abuse), and I learned that pouring Jack Daniels into your peg tube is more fun than pouring beer into it, but will elicit the same response from the nurse on duty.

Theresa
 
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