Things I Learn From My Patients

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I've learned that people really are stupid enough to play russian roulette.

And they lose.

Badly.
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corollary to "always pay your drug dealer"

always pay your pimp because otherwise he'll shove you out his car and then run over your leg. but it's cool because you've got a stash at your place that you need to save from your ho roommates so you can't stay in the hospital despite having a completely crushed right leg.
 
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If you home alone and start to feel a little excited its perfectly acceptable to rub sausage mince all over your genitals and let your dog lick it off...
when that dog then bites down on said genitals make sure you tell your doctor you had thrush and just scratched a little too hard even though you are bleeding heavily and have a large sized haematoma with puncture wounds visible for all to see...
 
melcandoit said:
If you home alone and start to feel a little excited its perfectly acceptable to rub sausage mince all over your genitals and let your dog lick it off...
when that dog then bites down on said genitals make sure you tell your doctor you had thrush and just scratched a little too hard even though you are bleeding heavily and have a large sized haematoma with puncture wounds visible for all to see...
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If only the doggie put a little more into those jaw muscles...
 
I recently learned that not only are SOCMOB and "some guy" not, as I had assumed, a rarely experienced inside joke, but that in the New Orleans greater area, the only way to get your jaw "broke" is to get "snuck", usually by 8-10 "guys" who proceed to "crowd" you.

If you're in New Orleans, apparently the only way to make it out without any broken bones is to spend your time minding other peoples business. And watch out, because "some guy" is reproducing.
 
melcandoit said:
If you home alone and start to feel a little excited its perfectly acceptable to rub sausage mince all over your genitals and let your dog lick it off...
when that dog then bites down on said genitals make sure you tell your doctor you had thrush and just scratched a little too hard even though you are bleeding heavily and have a large sized haematoma with puncture wounds visible for all to see...
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For those of you that remember the movie Road Trip
"Its not considered cheating since its your dog"
 
Today I learned that borrowing insulin from your friends is a good way to come in with a blood glucose of >1500 (Don't know the actual number, because our lab can't count that high.)

Also, when those mean IM docs upstairs just discharged you after HTN emergency due to non compliance, and you didn't get a chance to see the ICU, please be non compliant again. One week later, you will win an all expense paid trip to the ICU, complete with aortic dissection and CV surgery. As a bonus, you will code in the OR and get to stay in the ICU for the rest of your now shortened life.
 
Drawing Dead said:
Today I learned that borrowing insulin from your friends is a good way to come in with a blood glucose of >1500 (Don't know the actual number, because our lab can't count that high.)
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I'm confused, why was the BGL so high? Was the borrowed insulin defective? Or did the patient take Glucagon by accident? Please educated a poor, lonely third year. Thanks.
 
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I'm on shift when they wheel in this 40 yo female screaming at the top of her lungs "Get it out! Get it out!" She was diaphoretic, with sweat pouring down her face, and in apparent distress. I follow the nurses into the room we take turns asking her questions as they get an IV in her and get vitals. Apparently, she checked into the ED, and was waiting to be triaged. She was found by a fellow patient in the waiting room with her pants around her ankles screaming, "get it out, get it out!" and reaching up her vagina. In the exam room, now on the gurney, she tells us that she has had a tampon stuck in her vagina that she hasn't been able to get out for several days. She is tachycardic, and I'm suspecting toxic shock syndrome, so I go get the pelvic tray to see what I'm going to find. I put her on a bed-pan, rather than the stirrups, to hasten the exam, stick the speculum in thinking, "this is going to be scary", and I see... nothing... normal cervix, no significant discharge, no bleeding. I say, maam, I don't see a tampon in there." All of a sudden, she starts straining like crazy." She is in mega- pushing mode, face beat-red, jugulars poppling out, eyes protruding. I keep angling the speculum around to make sure I'm not missing something, and the nurses are telling each other, "she's going to have a baby!" All of the sudden, she pushes the speculum out with her straining. I stand back and, with 2 nurses and a tech, watch this lady have a massive bowel movement on the bed. She looked so bad, that I got some labs looking for metabolic derangement, or signs of infection, and a head CT to evaluate for a mass, or an abscess or something that would cause altered mental status. Everything was normal, and when I checked on her again, she looked perfectly normal, and had no complaints. Discharge diagnosis: Severely urgent need to defecate.

What I learned... Make sure to figure out whether there is something in your vagina or whether you just have to crap.
 
jbar said:
I'm confused, why was the BGL so high? Was the borrowed insulin defective? Or did the patient take Glucagon by accident? Please educated a poor, lonely third year. Thanks.
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Could be a difference in-between long-acting and short-acting insulin maybe?
 
Jarabacoa said:
on anti-psychotic meds, but wasn't actively psychotic after she calmed down from taking a crap. In my opinion, her main problem was an IQ around the 80's.
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Oh my. Slow and crazy. That poor woman! :(
 
Winged Scapula said:
Sure...its monsoon season right now (and besides, the link above is from Flagstaff, which is alpine in nature, not desert).
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Thank you. Gotta brush up on my geography (and remember not to move to Flagstaff when I relocate)

As far as the insulin thing, who knows. He could have been drinking it for all I know to come in with an unreadable BG. I was amazed when he was DC'd 2 days later.

And finally, I was down in the ED to admit someone the other day (I'm on IM service right now) and I see on the track board "Garlic soaked cotton ball in vagina x 2 days" so naturally I inquire to the resident seeing her when he tells me "No, it was actually a garlic clove". So naturally, I learned an effective way to keep vampires away when Aunt Flow is in town.
 
I was not aware that vampires went "downtown"!

You learn something new every day.
 
Chronic Student said:
I was not aware that vampires went "downtown"!

You learn something new every day.
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Oh yeah. Why do you think Count Dracula was such a pimp? It definately wasn't his fashion sense or his stunning good looks. He sure did get the ladies though.
 
Step 1: Remove angry fox from leg.
Step 2: Have husband shoot fox once you are out of the way.

Any alteration in the order of these steps and bad things can happen.

http://www.foxnews.com/story/0,2933,391544,00.html

And another: The more combative the hypoglycemic patient, the less clothes they will be wearing when you arrive on scene. I never wanted to be able to say the words "I wrestled this big naked guy". But I've done it more than once.
 
exi said:
At least he didn't make a damn kabob out of his twig and berries.
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If you manage to be naked and somehow put a rusty 8-inch spike through your groin, you probably don't deserve to have your reproductive function.

That's one of those generic, blanket statements I'm comfortable making.
 
Depakote said:
If you manage to be naked and somehow put a rusty 8-inch spike through your groin, you probably don't deserve to have your reproductive function.

That's one of those generic, blanket statements I'm comfortable making.
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Oh, yeah, I mean "at least..." for HIS sake. Myself, I'd have barbecued his kabob.
 
Ok, so I'm not an ER doc yet, just a lowly EMT for the time being, but here's a lesson:

If you take your motorbike out to the sand dunes, while it may be fun to go up the side of one hill as fast as you can, it's not so fun to then fly across the small sand ravine and land head first into the wall on the other side. See, many people feel going to the sand dunes is safer because sand is soft, however, any local can tell you that flying at high speeds into a wall of sand doesn't feel so soft.

By the time we get there you will have no radial pulse and be so far gone into shock you have no idea where you are or who we are. You will then become combative in the back of the ambulance and insist, very loudly, that you are chocking and need to lay on your side so you don't suffocate.

If you are lucky, your squirming will not sever your spinal cord which has a good chance of being damaged and you will not end up paralyzed.
 
ParamedicMan said:
You just can't stop stupid...

http://www.reflector.com/local/content/news/stories/2008/07/31/LacyStabbing.html
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This is an article about a guy who somehow sustained a stab wound to the chest while intoxicated in an attempt to prove that a bulletproof vest could stop a knife. If you follow the link there's a comment section and this reply:
By Tracei

Aug 1, 2008 8:23 PM | Link to this

Yes indeed, the comments here are brutal.
I can't believe the number of people who believe everything that they read.
I am Anthonys Aunt.
Anthony was far from a *****, a very fine and decent young man.
First off, the toxicology reports indicates a .15 alcohol content. They take the samples from the organs where the alcohol settles. Which gives a much higher read than if a person were to take a breathlyzer test.
Anthony, more than likely, at the time of his death, would not have even blown half of that.
He had after all, not been out of work for long. A man has already admitted to police that he was the one to stab Anthony. But that it was an accident. I don't see how stabbing someone in the heart could be an accident, but anyway, the point is that the investigation is far from over.
The case is NOT closed.
It was not a party, as someone on here commented.
And the the person who said that me and my family should be glad that he is dead because he wouldn't amount to much anyway????
I certainly do hope that you never lose anyone close to you and have to read what some insensitive person, who doesn't have a clue, other than what he reads, what is going on with the situation.
The comments on this site as well as anothers from a UNC forum site really demonstrates the lack of human decency, to me anyway.
I hope that you all have a very wonderful life where tragedy never strikes.


By Laura
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This is just fascinating. I'm not sure what not having "been out of work for long" has to do with one's BAC. I am also curious which organs are the ones where "alcohol settles" and where the alcohol content is much higher than in the blood.
 
I assume she meant, when stating that he had not been out of work for long, was that since he had just left work, he hadn't enough time to get as drunk as he usually would if he had had the entire day off!

I am curious as to how drunk you have to be to KEEP stabbing yourself when the knife breaks the skin and it hurts? Wouldn't you just stop at that point without entering your chest cavity?
 
Winged Scapula said:
I assume she meant, when stating that he had not been out of work for long, was that since he had just left work, he hadn't enough time to get as drunk as he usually would if he had had the entire day off!

I am curious as to how drunk you have to be to KEEP stabbing yourself when the knife breaks the skin and it hurts? Wouldn't you just stop at that point without entering your chest cavity?
Click to expand...

The term, "feeling no pain" comes to mind.
 
engineeredout said:
.15 doesn't seem like the "beyond pain" point though.
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Yes, but there is more to the equation.

First you must find the reciprocal of the intelligence quotient, I'll take a guess in this case and say 80 IQ for an adjusted value of 120.

Then you need to multiply this value by the Darwin factor which in this case is around a 4 (the more *****ic the behavior the higher the number, 5 is the highest value. I'm not sure what a 5 is, but I'll know it when I see it).

This yields the modified Homer score, which in this case is (120 x4 = 480)

Then we have a correction factor of 0.0005 which we multiply the MHS by (480 x .0005 = 0.24).

This value is then added to the original BAC.

Then we plug it all into the equation:

0.15 (original BAC)
+
0.24 (MHS x correction factor)
=
0.39 and this value falls well within the accepted range of felling no pain. This is called the HARM score. (HARM is an acronym for Humans Attempting to Reach Maker)

BTW, I hate math. It was difficult for me to research and develop this.
 
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Sweet Tea said:
18 year old kids absolutely need new Audis-- especially the kind with the DVD player built into the dashboard so that they can watch "the fast and the furious" while driving along a windy road at say, 3am. the best thing to say (if you are an 18 year old driver of such a car) is "hey, watch my car handle this turn" as you careen into a tree. (unrestrained driver had not one but TWO spiral femur fractures in the same leg. his foot was pointed backwards). tree survived with minor scratches.
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That made my day thanks lol.
 
Chronic Student said:
Yes, but there is more to the equation.

First you must find the reciprocal of the intelligence quotient, I'll take a guess in this case and say 80 IQ for an adjusted value of 120.

Then you need to multiply this value by the Darwin factor which in this case is around a 4 (the more *****ic the behavior the higher the number, 5 is the highest value. I'm not sure what a 5 is, but I'll know it when I see it).

This yields the modified Homer score, which in this case is (120 x4 = 480)

Then we have a correction factor of 0.0005 which we multiply the MHS by (480 x .0005 = 0.24).

This value is then added to the original BAC.

Then we plug it all into the equation:

0.15 (original BAC)
+
0.24 (MHS x correction factor)
=
0.39 and this value falls well within the accepted range of felling no pain. This is called the HARM score. (HARM is an acronym for Humans Attempting to Reach Maker)

BTW, I hate math. It was difficult for me to research and develop this.
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If you don't publish a study of self-inflicted traumas and establish the validity of this formula, I swear to God I will!
 
I didn't realize until today that once again, we had made the national scene here on SDN.
Go reflector!!!!


My goal is to never be in the Scene Around section.
 
docB said:
This is an article about a guy who somehow sustained a stab wound to the chest while intoxicated in an attempt to prove that a bulletproof vest could stop a knife. If you follow the link there's a comment section and this reply:

This is just fascinating. I'm not sure what not having "been out of work for long" has to do with one's BAC. I am also curious which organs are the ones where "alcohol settles" and where the alcohol content is much higher than in the blood.
Click to expand...

The best part of that whole response is that she believes he was not as drunk as he may have seemed. As if that is some kind of excuse for stabbing himself, or letting someone else stab him. Wouldn't a proper excuse be his BAC was actually higher, like a .43, and that he had just mainlined some coke and meth, and he had severe MR?

And maybe he was sitting down, and the alcohol all settled in his *****. Surely his brains did.
 
Held true to the maxim that cracking the chest doesn't save everyone.
Can't comment too much due to HIPAA, but suffice it to say, it would be a good teaching point for all the attempted suicides out there as a way to do it right the first time.
 
When your six month old baby boy's diaper is full of blood, don't wait a few days before bringing him to the ER. It might turn out that he has a torn anus and is bleeding into his abdomen after being raped by one of your loser friends you let him stay with for a few days.
 
shaggybill said:
When your six month old baby boy's diaper is full of blood, don't wait a few days before bringing him to the ER. It might turn out that he has a torn anus and is bleeding into his abdomen after being raped by one of your loser friends you let him stay with for a few days.
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I'm not one for wishing ill of others, but may that particular individual burn in hell!
 
Occasionally you have a crap day. And then you hear about things like a raped 6month old boy, and you realise how much worse your day could have been. I truly hope that that man gets a taste of his own medicine in jail. And maybe worse. I am sorry that you had the terrible task of looking after this child.
 
shaggybill said:
When your six month old baby boy's diaper is full of blood, don't wait a few days before bringing him to the ER. It might turn out that he has a torn anus and is bleeding into his abdomen after being raped by one of your loser friends you let him stay with for a few days.
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I'm speechless. Not in a good way. I have the desire to tap this message into that womb donor's head via Morse Code....with my Louisville Slugger.

Please tell me that the police and social services have intervened.
 
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