Things I Learn From My Patients

Discussion in 'Emergency Medicine' started by docB, May 2, 2003.

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  1. dingiswayo

    dingiswayo Senior Member 7+ Year Member

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    If somehow a ping pong ball should make its way into your rectum and you cannot retieve it, do not mix yourself a cement enema--as this will only make your problems worse.

    (I did not see this in person, but saw the radiograph. the hardened cement block was removed under anesthesia.)
     
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  3. imagin916

    imagin916 Member 7+ Year Member

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    I am not a doctor, but a nurse in the ER. Here are some of the stupid things that people have said/done in addition to the many things that others have already mentioned:

    1)If you are sitting up smiling, enjoying your meal and walking around the ED without any difficulty, I highly suspect your pain is NOT 10/10.

    2)If you can scream at us at the top of your lungs continuously for 10 minutes, you ARE able to breathe.

    3)Taking a whole bottle of diet pills at one time will not make you lose weight any faster for that date you have tommorrow night.

    4)If you havent had a bowel movement in 2 hours, this does not implicate constipation.

    5)No, you may NOT eat if you have come in for "severe" abdominal pain.

    6)No, the doctor cannot make the kitchen bring you and your family members some food or hot tea at 3 am.

    7) Patient: "Did the doctor tell you to give me this medication?"
    Me: "No, I just thought it would be fun to hang Tridal/Heparin/Cardizem/(add your choice of med that will require me to closely moniter the patient and take up most of my time) just for my amusement"

    8) "See, I told you I was having a heart attack, look at the monitor, its a flat line"

    I could go on forever...
     
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  4. BareFoot

    BareFoot Junior Member 7+ Year Member

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    if you have one leg, was just released from jail, have developed multilobar pneumonia and satting in the mid-70s on shovel mask, it is not a good idea to hop on one leg from bed to bathroom, without O2, shoot up with heroin and code
     
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  5. neglect

    neglect 1K Member 10+ Year Member

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    So much has been said, including: great thread, and I have another lesson of life that you might find useful (and sad), if you wouldn't mind my (HIPPA compliant) additions.

    If you are an excellent swimmer, but wearing heavy clouthing and have no flotation device, under no circumstances should you leap into the ocean to save the polypharm using woman who, under cocaine induced grandiosity, thought New Years is a perfect time for a dip, despite the cold and despite not knowing how to swim. Our gentleman swimmer didn't know one of the lessons of the thread, that people who use cocaine and heroin every day are about as fragile as reinforced concrete and bouyant as helium balloons. He never got to her. They both washed up cold, but after a few days of warming and herniating, he returned that way. She remained warm and active enough to start shooting up again - so one half of a happy ending.

    Also, one wouldn't think anyone would need to be taught this lesson, but, do not store your detergent in the refrigerator. Especially if you and your wife are elderly and mildly demented. You know where this is going, he did survive, he had already had kids, so no Darwin award was possible on both counts.

    How about a thread about stupid things DOCTORS/NURSES/STUDENTS do? I've got several of those stories. As patients and within the profession.
     
  6. lurkerboy

    lurkerboy exhalted mystic ruler 7+ Year Member

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    Great idea! You should start one in the general residency forum.
     
  7. Apollyon

    Apollyon Screw the GST Lifetime Donor 10+ Year Member

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    I posted one a while back where my attending, who just needed to listen to the family member state they wanted their father to be DNR, get them to everything except intubation. First and goal on the 1, and we get 3 points out of it (barely).
     
  8. Silvertip

    Silvertip Member 7+ Year Member

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    I once read a book written by an ER doc in which he told the following story (in my words):

    Woman comes into the ER. States that she has a sore belly/abdomen. A pelvic exam reveals some interesting findings. First, her vaginal vestibule is being held closed with a number of safety pins that are beginning to rust (if I remember correctly). When these are removed, several pieces of chicken- presumably making up a whole bird, were subsequently removed from her vagina. She then revealed that she was desperate to get pregnant, and thought that shoving a chicken "up there" and fastening it closed woud do the trick.

    I'm not kidding- I read this book many years ago, and this story has stuck with me since. Anyone else read this anecdote? I think the doctor's name was Brown- maybe not?????
     
  9. musiclink213

    musiclink213 My room is a mess 7+ Year Member

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    The book is called "emergency" by Mark Brown, MD, but the story you're thinking of is written by Brent D. Amey from Odessa, Florida.
     
  10. Doc Ivy

    Doc Ivy Miss Understood 7+ Year Member

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    :laugh: :laugh:

    I love it, I just love it ;)
     
  11. roja

    roja 7+ Year Member

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    This is for you guys:

    Do *not* inject your boyfriends Erectile Dysfunction drugs into your penis when you don't have ED. And don't cruise the internet for 12 hours masturbating.. this will chafe your skin.

    And when you get sent home from a small ED with psuedophedrine dont' wait 6 more hours to go to another ed.
     
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  12. ERMudPhud

    ERMudPhud Back for a visit 10+ Year Member

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    Signs that the neighborhood bar might not be too friendly.

    Middle aged bar tender keels over. Bar patrons place on her side in the middle of the room, call 911, and then leave so fast that the cops start checking to see what was stolen. Paramedics find patient siezing and in vFib in a completely deserted bar. Hows that for helping out your friendly bartender. By the way it was one of the longest arrests I've ever run. Like an ACLS megacode in real life. 40 minutes total CPR time. Every drug/rhythym in the book. Something around 20 defibrillations. 2 hours of work before she was stable enough to go to the unit. I don't think the ultimate outcome is going to be good.
     
  13. Jeff698

    Jeff698 Chief Resident 10+ Year Member

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  14. Apollyon

    Apollyon Screw the GST Lifetime Donor 10+ Year Member

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    "Caller: It smells like a dead man in my vagina. Should I come in?"

    :laugh:
     
  15. Sessamoid

    Sessamoid 1K Member 10+ Year Member

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    More proof that the world is circular. Will I forever be haunted by UTMB? :)
     
  16. Jeff698

    Jeff698 Chief Resident 10+ Year Member

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    Sadly, I can offer you no hope, my friend. UTMB is a virus; a sort of gift that keeps on giving. Why else do you think they've built the DefCon 4 buggy lab here? Other than they can easily quarantine the entire island? :D

    Take care,
    Jeff
     
  17. Sessamoid

    Sessamoid 1K Member 10+ Year Member

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    It's not just Galveston. It's that the web site you linked to is mine.
     
  18. docB

    docB Chronically painful Moderator Emeritus Lifetime Donor 10+ Year Member

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    If you're trying to convince me that you're not psychotic and should be allowed to go home don't tell me that the reason the police brought you to the ER is that they didn't know that you are the one, true you and that all the other yous are just replicants that have been being produce since "they" put microchips in your head. Seal the deal by saying that you may have to kill yourself to stop the replication process.
     
  19. Jeff698

    Jeff698 Chief Resident 10+ Year Member

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    Oh.

    Well, in that case.... cool website! :)

    Take care,
    Jeff
     
  20. lurkerboy

    lurkerboy exhalted mystic ruler 7+ Year Member

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    He must be friends with my patient, G-d! He was very disappointed that no one believed him.
     
  21. DrQuinn

    DrQuinn My name is Neo Moderator Emeritus 10+ Year Member

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    Ah, you changed the name of your website. Oh well, I always ended up just doing a search under your name to find it (ran across it a few years ago as an M3).

    Q, DO
     
  22. *Wing of Zock*

    *Wing of Zock* Member 7+ Year Member

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    Awesome thread:laugh: :laugh:

    By the way,

    If you happen to be a paraplegic who self-caths, and one day you decide that it would easier/cheaper/more fun to use that little red straw that comes with the can of WD-40 instead. . .Do not wait 5 days after it becomes stuck it your urethra to show up at the ED at 0300 on a friday night. Urologists hate to be woken up at O-dark-hundred with that news.
     
  23. Childe

    Childe Senior Member 10+ Year Member

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    The fact that you put a condom over the electric toothbrush lodged within you does not make it 'safe' anal stimulation.
     
  24. Seaglass

    Seaglass Quantum Member 7+ Year Member

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    I can't believe I haven't thought to throw some up here until now.

    Do not sign out AMA after major abdominal surgery just because "they won't let me eat." If you do decide to do so, do not present to the ED where I am working with a 16cm abdominal incision, packed, and healing by secondary intention. Please, stay home with your son who is obviously high and continually asking "Why were they so concerned about his farts?"

    Also, be careful when high. Your girlfriend may convince you to inject battery acid and baking soda into your penis in order to get "an erection that will last forever." The battery acid will eat away at your penis.

    IIRC, those were on the same night.

    Casey
     
  25. supercut

    supercut Senior Member 7+ Year Member

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    If you are a young male who suddenly becomes the victim of "some dude" or "these two dudes" while SOCMOB, and you have sustained no verifiable serious injury but yet somehow have become paralyzed (lucky for you, the onset of paralysis began at the same time the cops became interested in your activities for the evening), don't worry. We have a cure. Desipte the fact that you did not flinch in pain at all when 2 large IV's were put in (an intervention that sends most young males flying up onto the ceiling), and further despite the fact that you underwent a rectal exam without any reaction whatsoever (though you did have good tone), again, don't worry. You paralysis will be instantly and miraculously cured with one simple device that can even be used by a medical student.

    This device is called a foley catheter.
     
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  26. TotalEclipse

    TotalEclipse Junior Member 7+ Year Member

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    -If you come into the ER high on heroin, then jump up on your bed and start punching the ceiling panels down and ripping out the wiring, you will be shot full of ativan and/or haldol and put in restraints even if it takes 8 men to hold you down.

    -If you come into the ER in the middle of the SARS scare complaining of flu-like symptoms, it would be a good idea to mention IMMEDIATELY that you just came back from Hong Kong. (luckily it was a false alarm)

    -If you ask nicely, then of course we will remove your heart moniter, oxygen, IV, etc. so you can go to the bathroom instead of using a bedpan.

    -The ER is not a 5 star restaurant. You are lucky to get any food at all.
     
  27. Seaglass

    Seaglass Quantum Member 7+ Year Member

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  28. docB

    docB Chronically painful Moderator Emeritus Lifetime Donor 10+ Year Member

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    If you're going to float that red flag raising remark about being a really tough person with a high tolerance for pain you shouldn't shriek like a wounded animal and jerk your hand away losing the IV in your last stickable vein just because the nurse adjusts some tape on your wrist.
     
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  29. jesswise

    jesswise Sucker for a pretty girl 7+ Year Member

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    Other than my own adventures as a patient in EDs all over North America, I don't have any experiences to share.

    But thank you to all posters, this is the funniest stuff ever! I hope this thread lasts longer than YIFMBA and has more posts, too.

    Ok, from my own personal files (yes, this really was me)

    When being treated by paramedics at the scene of your motorcycle accident, in which you flew over a Lincoln Towncar which cut you off, and landed on the pavement on the other side, do not resist their suggestion that they take you immediately to the ED with the reply "I'll just go see my doctor in the morning."

    Especially when (unbeknownst to you) your spleen has splattered like a jello-mold dropped on it's way to the table. :wow:


    Luckily, I allowed myself to be persuaded, and was thereby saved from certain death. As it was, I nearly bled to death (internally) before they could get me prepped and under.

    Jess
     
  30. margaritaboy

    margaritaboy Senior Member 10+ Year Member

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    If you are a former nurse turned junkie, don't get out of your car after being in an accident. If you do, SOME DUDE will inexplicably drop-kick you in the chest kung fu style and then slam your head in the door or your own car. There won't be any witnesses.

    After being transported by EMS to the hospital, you will feel compelled to demand narcotics for your imaginary injuries.
     
  31. docB

    docB Chronically painful Moderator Emeritus Lifetime Donor 10+ Year Member

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    If you are faking a seizure that you think is due to a reaction to some drug given to you for your fibromyalgia and multiple chemical sensitivity (fake seizure due to fake illnesses, cool) don't don't drop your purse, reach down, pick it up and replace the papers that fell out of it while shaking. BTW this dingbat scared the hell out of the receptionist and the young triage nurse. They were rushing her back to a code bed when the purse thing happened in front of the charge nurse (never mess with the charge nurse). The charge stepped in front of the wheelchair and said "OK, honey you can knock that off right now." She put her back in the waiting room to cool off for a while.

    This was the opposite of the patient that a security guard lazily rolled in saying "This gentelman fell down in the parking lot. Should I take him to triage?" Of course, dead as Dillinger.
     
  32. Tazmaniac

    Tazmaniac 2 min. from a nice nap 7+ Year Member

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    I love this thread.
    ----------
    MS-IV: "Do you have any heart problems?"

    Pt: "No."

    MS-IV: "Are you sure?"

    Pt: "Yes, I'm sure."

    MS-IV: "But you do have a heart doctor, right?"

    Pt: "Yes, I have a heart doctor. He told me I have heart problems."
    ---------
    Lesson: They say History gets 80% of the diagnosis, but you will always get stuck with that stupid 20% of the population.

    -Todd MS-IV USC
     
  33. ERMudPhud

    ERMudPhud Back for a visit 10+ Year Member

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    I'm pretty sure I saw that same patient a few years ago. She used to like to seize in triage or even better in the ambulance bay or parking lot.

    Along the same lines there was a mundchausens patient we all saw at various hospitals who was a young male with a history of lymphoma who would fake massive GI bleeds (hematemesis) to the point of getting central lines and endoscopies all over town. With no source ever found it was never clear how he was faking the bleeds. A few years later I was telling two friends from LA about him and I only got halfway through the story before they both started laughing, completed the patient's history, and told me he had made the rounds of all the LA hospitals as well
     
  34. edinOH

    edinOH Can I get a work excuse? 7+ Year Member

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    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.


    When transported by EMS for syncopal episode after drinking a case of beer with your buddies, don't keep bothering the doctor about when you are going to be discharged. Especially when the reason you want to leave so bad is because you drive an 18-wheeler and you have to be in Texas by midnight. Your doc will begin inventing reasons to admit you.
     
  35. docB

    docB Chronically painful Moderator Emeritus Lifetime Donor 10+ Year Member

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    If you spend the whole night out drinking booze, don't drink any other liquids, stay up for 36 hours straight, then go sell some plasma to get more booze and gambling money don't be surprised if you get a little dizzy. Definitely don't call EMS to pick you up at the casino. And most definitely don't tell EMS to wait while you go cash in your slot ticket.
     
  36. Tazmaniac

    Tazmaniac 2 min. from a nice nap 7+ Year Member

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    Arrive at a busy ER during a multiple code situation. Yell, scream, and get the attention of an ER attending. Tell her/him that your perfectly benign nevus 'hurts.' Cry. Tell them it's 12/10 pain. They would love to take it out for you. And if when you get relegated to an outpatient dermatology appointment 5 months later, tell them the same thing. 12/10 pain, etc. Cry. It hurts all day and you can't sleep. Then cry some more at the lidocaine going through the tiny 28 gauge needle.

    -Todd MS-IV USC.
     
  37. beanbean

    beanbean 1K Member 10+ Year Member

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    Bumping this thread....keep the stories coming.

    Beauty tips from patients:

    Bring a smile and a laugh to the tired and overworked ED staff with your most interesting fingernail paint artistry: Black nail polish with silver airbrushed scenes of little people having sex, except the middle finger which was embelished with a little middle finger raised hand and the words F*** U.
     
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  38. dwgs

    dwgs Member 7+ Year Member

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    Just today...

    cc: Decreased hearing in right ear.

    HPI: When I put my finger in my ear, I can't hear anymore.

    No kidding...

    Dwgs
     
  39. Konrad-W

    Konrad-W New Member 7+ Year Member

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    If you're a 22 years old drunk coming in winter without shoes to a liquor store to buy some vodka don't be surprised to deal with 8 security guards and 2 police officers that arrive to get you out of the store and don't pull out a knife, cut your arms, neck and stick the knife 5 cm deep into your leg. After arriving at the ER, don't yell at the medstudent (me) checking you out for injuries: "What the f**k are you looking at?!?"
    After stitching you don't leave the ER without telling anybody. Remember? It's winter, snow, ice and you still don't have any shoes neither socks which, soaked with blood, were thrown away by the nurse.

    If you're two trained security guards don't be surprised by a drunk who cut himself and stick his knife into his leg, and don't pass out.
    :D
     
  40. Febrifuge

    Febrifuge Grizzled Old Newcomer 7+ Year Member

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    If you're just learning to walk, feel free to bash your noggin on the coffee table -- it's almost a rite of passage -- and commence crying as your forehead lac bleeds. When your concerned parents troop you in to the ED, go ahead and take a nap so deep the tech thinks you might have an adorable little concussion. Breathe slowly, and don't respond to any stimulus short of an attempt to start an IV after we rush you into the trauma bay.

    When you do come around, definitely shriek, cry, and act like the healthiest baby that ever was. I don't mind looking like a chump, if it means you're okay.
     
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  41. FoughtFyr

    FoughtFyr SDN Lifetime Donor Lifetime Donor 10+ Year Member

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    To quote an old mentor of mine (who was present when Moses coded):

    "Let 'em cry! Airway, breathing and red-faced circulation. ABCs all wrapped up in one look."

    Yep, love crying babies, always have, always will (unless they are mine).

    :cool:

    - H
     
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  42. gwyn779

    gwyn779 stargazer 7+ Year Member

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    Yup, I still view crying babies this way. Of course, I don't have any of my own yet.
     
  43. docB

    docB Chronically painful Moderator Emeritus Lifetime Donor 10+ Year Member

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    You really shouldn't come to the ER because you have a bunion. You really shouldn't be on Percocet and Soma for your bunion. You really shouldn't ask me to refill your Percocet and Soma for your horrible bunion pain. Thank God this jackass didn't come in by EMS.
     
  44. docB

    docB Chronically painful Moderator Emeritus Lifetime Donor 10+ Year Member

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    If it burns when you pee and you have the drip don't get angry at me for being the lucky one to tell you that you have GC. Furthermore, I don't care if "that bitch" swore she was clean. It won't change your current situation. When I suggest condom use in the future don't say (not making this up) "Well maybe that's OK for you but I'm a REAL MAN. I ain't using no thing."
     
  45. double shot

    double shot Junior Member

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    I love this thread.

    When you come into the ED after trying to OD on your phenobarb and are being forced to chug charcoal, you should definitely complain (in a howling voice loud enogh for the whole ED to hear and with your face covered in charcoal) that no one has offered you a glass of wine.
     
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  46. MoCookiess

    MoCookiess Hater of Biochemistry 7+ Year Member

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    This is seriously the best thread ever
     
  47. trex92499

    trex92499 Senior Member 7+ Year Member

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    Location:
    The South Pole
    If you buy, steal, or otherwise obtain a new gun, DO NOT show if to your friend, wife, ex girlfriend, etc, because you will end up shooting yourself in the face, arm, leg, or ass. I swear, all 4 of these nice fellas came in a single week, with the history starting off verbatim "well, I got this new gun...."

    If you are attempting to break into cars around an apartment complex, make sure the complex does not employ a security guard. If it does, make sure the security guard does not get really pissed off when your partner in crime holds a gun to her head, pissed off enough that when you tell her to hand over her gun, she decides to hand it over, but first she's gonna shoot your ass and fracture your femur.

    If you run out of places to inject methamphetamines, try your radial artery...your hand will ONLY become ischemic and require amputation of a few fingers. Several days later, try this again on the other hand...after all, symmetry is more more important than total number of fingers
     
  48. monkeyarms

    monkeyarms jello wrestler 7+ Year Member

    Joined:
    Mar 19, 2003
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    Location:
    all up in your area
    if you are coming to the ED for the third time in two weeks demanding narcotics and the doctor refuses, simply say "well, my friends are doctors and they told me i need percocet." sheesh.
     
  49. Flipchick

    Flipchick Member 7+ Year Member

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    If you suspect you have an STD, don't go to the ED with your girlfriend and tell the doctor your symptoms in front of her if she's not the one that gave you the STD. Don't act surprised, either, if she storms out of the room crying.
     
  50. margaritaboy

    margaritaboy Senior Member 10+ Year Member

    Joined:
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    Location:
    The Desert
    Status:
    Attending Physician
    If you have a brother, be sure to duck when he throws the TV remote to you. Otherwise, it will hit you between the eyes.

    The next day, your mother will think you have a horrible head injury and rush you to the ER, when in fact you have a mosquito bite on your forehead. The ER doctor will send you out without seeing you.
     
  51. Coleman

    Coleman Senior Member 7+ Year Member

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    Location:
    Cooper Univ Hospital!!
    The next time a cockroach crawls in your ear while you are sleeping, be sure to stick your finger in your ear and plug it so it can't get out then run to the ED for us to take it out. Then, as I squirt viscous lidocaine into your ear canal, tell me how gross that feels!
     

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