Things I Learn From My Patients

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willow18 said:
Two-fake = toothache

And if you're 21yo, living with your momma, and get a little abrasion on your hand, you are considered "injured" and can now live with your "baby-momma" for a while to be pampered.
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Haha, I say this all the time, but I call it a "Too-Fake" because that's what it usually is in an attempt to score narcs.
 
Yeah so my surgical tech buddy just told me about a rectal foreign body of all rectal foreign bodies.

He was in the OR the other night and removed a talking Darth Vader doll. With moving parts that was still active upon removal.

Just wondering where/how/why the guy connected those dots... "Luke, I am your father..."
 
When you have an itch in your vajayjay, listen to the friend who tells you to kill the bacteria by rinsing in lemon juice. If that doesn't work, the next step is a vinegar rinse. If you are still itching, and now bleeding from the skin a little bit, the infection is getting worse and you now have to use rubbing alcohol to kill the bacteria. Also, rubbing it really hard with a washcloth will help scratch the bacteria away from your skin. Finally, after two months, if the itching just won't stop, your vulva is so painful that you can barely wipe, and the numerous tears in the skin make it almost impossible to pee without screaming--then come in. Ask for an antibiotic because those bacteria are really, really resistant to anything else killing them. Also, insist that it's not a yeast infection because a) you've never had one and b) you heard that they smelled really bad and your junk don't smell bad, beyotch.

When the doctor-in-training pulls out several clumps of yeast the size of peanuts, ask if it's toilet paper.

Finally, get offended when the attending tells you not to listen to your friend's advice about vaginal hygiene. After all, she was right. Right?
 
spacemummy said:
If you are a 500-pound female and want to have sex, you can have YOUR SISTER hold your folds of abdominal fat up out of the way while your husband does the job...

A 500 pound woman came into the ER and found out she was pregnant. When the doctor asked how she was able to even have sex, she casually replied, "Oh my sister holds up my belly for me." (Rural Arkansas).
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😱
 
Phledge said:
When you have an itch in your vajayjay, listen to the friend who tells you to kill the bacteria by rinsing in lemon juice. If that doesn't work, the next step is a vinegar rinse. If you are still itching, and now bleeding from the skin a little bit, the infection is getting worse and you now have to use rubbing alcohol to kill the bacteria. Also, rubbing it really hard with a washcloth will help scratch the bacteria away from your skin. Finally, after two months, if the itching just won't stop, your vulva is so painful that you can barely wipe, and the numerous tears in the skin make it almost impossible to pee without screaming--then come in. Ask for an antibiotic because those bacteria are really, really resistant to anything else killing them. Also, insist that it's not a yeast infection because a) you've never had one and b) you heard that they smelled really bad and your junk don't smell bad, beyotch.

When the doctor-in-training pulls out several clumps of yeast the size of peanuts, ask if it's toilet paper.

Finally, get offended when the attending tells you not to listen to your friend's advice about vaginal hygiene. After all, she was right. Right?
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I amazed she didn't try bleach...it really sounded like she was headed that way...
 
An excellent way to remove HSV vesicles from the penis is to use an undisclosed amount of unspecified acid on them. When they open, use a blowdryer to "burn" the fluid so it won't get transmitted to your sexual partner(s). Four years and seven partners later, ask your doctor if Valtrex is right for you, because the television told you to.

Personally, I'm waiting for someone to endorse the "Sear Your Pecker in a Waffle Iron, Slather it with KY, Roll it in Corn Flakes, and Hang a 'Don't Tread On Me' Sign" STD prevention method. I suppose Kellogg's might bite.

Thanks for the welcomes. Snark is my signature color.
 
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If you and your nice upper middle class hubby are driving by the ED of a nice suburban hospital at 2 am, you should definitely stop in and see if they can help you with your baby's diaper rash.

You should not, then, be surprised if your behavior, somewhat unusual in parents who seem reasonably intelligent and unimpaired, resulted in a full workup and a psych consult. The prevailing theory was that there must be something else wrong with the baby that they were just unwilling or unable to talk about.

The baby needed Desitin--it wasn't even much of a diaper rash. Ah, suburbia.

(the workup included, among other things, a head CT-not kidding)
 
Phledge said:
An excellent way to remove HSV vesicles from the penis is to use an undisclosed amount of unspecified acid on them. When they open, use a blowdryer to "burn" the fluid so it won't get transmitted to your sexual partner(s). Four years and seven partners later, ask your doctor if Valtrex is right for you, because the television told you to.

Personally, I'm waiting for someone to endorse the "Sear Your Pecker in a Waffle Iron, Slather it with KY, Roll it in Corn Flakes, and Hang a 'Don't Tread On Me' Sign" STD prevention method. I suppose Kellogg's might bite.

Thanks for the welcomes. Snark is my signature color.
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Sounds like you have a few great stories! Welcome to the board and looking forward to future posts. 👍
 
bullpup777 said:
If you and your nice upper middle class hubby are driving by the ED of a nice suburban hospital at 2 am, you should definitely stop in and see if they can help you with your baby's diaper rash.

You should not, then, be surprised if your behavior, somewhat unusual in parents who seem reasonably intelligent and unimpaired, resulted in a full workup and a psych consult. The prevailing theory was that there must be something else wrong with the baby that they were just unwilling or unable to talk about.

The baby needed Desitin--it wasn't even much of a diaper rash. Ah, suburbia.

(the workup included, among other things, a head CT-not kidding)
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So the parents registered as patients too? I've already had my fair share of family and friends of patients in the ED who I wanted to get psych consults on, but my philosophy is if they aren't my patients, they aren't my probelm.
 
Phledge said:
Personally, I'm waiting for someone to endorse the "Sear Your Pecker in a Waffle Iron, Slather it with KY, Roll it in Corn Flakes, and Hang a 'Don't Tread On Me' Sign" STD prevention method. I suppose Kellogg's might bite.
.
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I like the treatment for pubic lice that involves rubbing alcohol, a lighter, and an icepick. Douse affected area with alcohol, ignite, then stab they flee.
 
Phledge said:
Personally, I'm waiting for someone to endorse the "Sear Your Pecker in a Waffle Iron, Slather it with KY, Roll it in Corn Flakes, and Hang a 'Don't Tread On Me' Sign" STD prevention method. I suppose Kellogg's might bite.
.
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I like the treatment for pubic lice that involves rubbing alcohol, a lighter, and an icepick. Douse affected area with alcohol, ignite, then stab as they flee.
 
If you're a Japanese tourist, who it turns out is also a neurosurgeon (spine specialist), don't jump into a pond head first and hit your head on a rock. Because when you fracture C-5 and have profound deficits, I'm going to have to tell you, throught the translator, that our only neurosurgeon on the island left this morning for vacation.
 
EMDoc0411 said:
If you're a Japanese tourist, who it turns out is also a neurosurgeon (spine specialist), don't jump into a pond head first and hit your head on a rock. Because when you fracture C-5 and have profound deficits, I'm going to have to tell you, throught the translator, that our only neurosurgeon on the island left this morning for vacation.
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Damn... just damn.
 
If your friend asks you to look after their dog for a couple days, please make sure you leave your stash lying around, and the dog unsupervised.

Then, when you take the dog into the vet for "acting scared/shaking slightly" and "having trouble walking, like he's drunk or something" (which are often pot dog symptoms) you should cover up the fact that you have some awesome cali hydroponic weed in your house by explaining that "well, maybe he had a seizure, but I didn't see him twitching or anything" (dog had been previously worked up ~1 month ago for a "possible seizure"-- all labs normal, no neuro consulted, o's previous pet died from sz disorder complications, so o's very paranoid about anything related to seizures).

When you tell the vet these things, he will believe that the dog did indeed have a seizure, and give said small dog two huge doses of valium, to see if he can get it to stop tremoring. When this does nothing, he will then give it a huge dose of pentobarb, "to effect." The "effect" of the pentobarb will be that the dog is now comatose and unresponsive. The vet will now explain to you, the totally freaked-out pet-sitter, that this dog will be comatose for a minimum of several hours, possibly up to "forever" and that you should take the dog to the 24/7 veterinary ER where I work for supportive care. En route, said dog will go into shock and show up at my hospital on death's doorstep with a BP of ~60 and a temp of 93 and some change. This will all be REALLY HARD TO EXPLAIN TO THE ACTUAL OWNER OF THE DOG, when she arrives at the emergency vet hospital in hysterics, to find her small dog in a baby incubator with an ECG, a constant rectal temp probe, and an IV line.

It will however, give me something to do for the duration of my shift: namely, sit next to aforementioned dog and evaluate mentation on the coma scale Q2 hours, and trying to keep it from freaking out too badly as it slowly, slowly revives from the depths of its lovely THC/valium/pento induced disaster. oh, and also talk to the real owners Q 30 minutes as she keeps calling back to see if her baby has "woken up" yet. (No, ma'am, sorry, we really don't anticipate any changes for at least a few HOURS, but yes, feel free to call for updates at any time!)

Little dog was actually sternal and somewhat alert by the end of my shift, although definitely still in La-la land... As far as I know he went home the next day with no major, long-lasting effects! Sturdy little dude!
 
starlene45 said:
If your friend asks you to look after their dog for a couple days, please make sure you leave your stash lying around, and the dog unsupervised.

Then, when you take the dog into the vet for "acting scared/shaking slightly" and "having trouble walking, like he's drunk or something" (which are often pot dog symptoms) you should cover up the fact that you have some awesome cali hydroponic weed in your house by explaining that "well, maybe he had a seizure, but I didn't see him twitching or anything" (dog had been previously worked up ~1 month ago for a "possible seizure"-- all labs normal, no neuro consulted, o's previous pet died from sz disorder complications, so o's very paranoid about anything related to seizures).

When you tell the vet these things, he will believe that the dog did indeed have a seizure, and give said small dog two huge doses of valium, to see if he can get it to stop tremoring. When this does nothing, he will then give it a huge dose of pentobarb, "to effect." The "effect" of the pentobarb will be that the dog is now comatose and unresponsive. The vet will now explain to you, the totally freaked-out pet-sitter, that this dog will be comatose for a minimum of several hours, possibly up to "forever" and that you should take the dog to the 24/7 veterinary ER where I work for supportive care. En route, said dog will go into shock and show up at my hospital on death's doorstep with a BP of ~60 and a temp of 93 and some change. This will all be REALLY HARD TO EXPLAIN TO THE ACTUAL OWNER OF THE DOG, when she arrives at the emergency vet hospital in hysterics, to find her small dog in a baby incubator with an ECG, a constant rectal temp probe, and an IV line.

It will however, give me something to do for the duration of my shift: namely, sit next to aforementioned dog and evaluate mentation on the coma scale Q2 hours, and trying to keep it from freaking out too badly as it slowly, slowly revives from the depths of its lovely THC/valium/pento induced disaster. oh, and also talk to the real owners Q 30 minutes as she keeps calling back to see if her baby has "woken up" yet. (No, ma'am, sorry, we really don't anticipate any changes for at least a few HOURS, but yes, feel free to call for updates at any time!)

Little dog was actually sternal and somewhat alert by the end of my shift, although definitely still in La-la land... As far as I know he went home the next day with no major, long-lasting effects! Sturdy little dude!
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Hey stranger - fancy seeing you in these parts! Congrats on all the acceptances!
 
thanks n, 😀. i'm a veterinary emergency medicine junkie so i lurk this forum quite a bit.
 
When your retired-carpenter father is put on a blood thinner (Lovenox, I think), do not under any circumstances actually tell him not to do anything requiring him to get stitches.

The week after you tell him this he will get hit in the back of the dominant hand by a piece of plywood coming off the tablesaw the wrong way, and require a neighbor to drive him to the urgent care clinic for eight stitches.
 
starlene45 said:
Little dog was actually sternal and somewhat alert by the end of my shift, although definitely still in La-la land... As far as I know he went home the next day with no major, long-lasting effects! Sturdy little dude!
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I'm glad the little dog got a happy ending! 😀
 
When you and your friends celebrate a birthday by drinking flaming shots, don't even think about extinguishing the flame before drinking. How silly!
 
Kittenmommy said:
Kittens have really sharp little teeth. Kitten teeth + nipples = DO NOT WANT. 😱
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Is it sad that after seeing all of the kitten teeth = sore nipples, that I keep on trying to figure out how all the cats don't have really sore nipples? I remember our baby cat(bottlefed) chewed all of the nipples off the bottles, and growled the entire time she was eating.
 
Keona said:
Is it sad that after seeing all of the kitten teeth = sore nipples, that I keep on trying to figure out how all the cats don't have really sore nipples? I remember our baby cat(bottlefed) chewed all of the nipples off the bottles, and growled the entire time she was eating.
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I don't know. I mean, one would think that kittens would start to wean around the time their teeth come in... but I'm not sure about that because I've never had a pregnant cat/kittens who were still nursing.

I know that some women nurse their kids way beyond the time any sane person would into the preschool years and beyond, and those kids sure as heck have teeth. 😱
 
I am involved with dog rescue and have fostered several pregnant and nursing mother rescues and their litters... when those teeth come in, pups get weaned REALLY fast. And their little claws scratch as much as the teeth.

I just can't imagine... oh wait, yeah, I probably can.
 
dchristismi said:
I am involved with dog rescue and have fostered several pregnant and nursing mother rescues and their litters... when those teeth come in, pups get weaned REALLY fast. And their little claws scratch as much as the teeth.
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So Mama Dog declares enough's enough and weans them? That's what I pretty much figured. Ouch!

Why anyone would think that nursing a kitten is a good idea... IDGI. 😱

dchristismi said:
I just can't imagine... oh wait, yeah, I probably can.
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Yeah. As I said in that other post, DO NOT WANT. :scared:
 
Stitch said:
Oh, this happens in Virginia too! I moonlight in the nursery and had a similar revelation by a 450 lb woman and her skinny as a pole husband. How does that conversation with your sister even begin, that's what I want to know.
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I think it's a fairly common episode in the South... One of my friends at LSU, told me a pretty much the same story, except it was the neighbor who was doing the good deed...
 
Stitch said:
Oh, this happens in Virginia too! I moonlight in the nursery and had a similar revelation by a 450 lb woman and her skinny as a pole husband. How does that conversation with your sister even begin, that's what I want to know.
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I think it's a fairly common episode in the South... One of my friends at LSU, told me a pretty much the same story, except it was the neighbor who was doing the good deed...
And I would like to know the conversation as well.
 
MedicSix said:
If you decide to OD on your friend's loritab, pass out, lockup the accelerator, miss your turn, and slam head on at 45 MPH into the EMS station, don't ask me to do you a favor and grab your cigarettes from your truck. You have caused more paperwork then you can imagine.

Of course he had no injuries, and got to spend the rest of the night with the nice man in the brown uniform and taser.
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The Law Of Inverse Value... unfortunately so true...
 
Finally finished reading through the whole thread; I'm a Physics grad student specializing in Medical Imaging, and this whole thread is priceless! SOCMOB is now one of my favourite acronyms. I did hear a neat story from one of the physicists here, though.

A patient was "cooling down" after thyroid imaging with I-125, and after the cleaning staff removed the radioactively contaminated sheets/pillows/etc. there was still some activity left in the room. The mattress was removed, bathroom scrubbed down, floor cleaned again, but the room still had a large radiation source in it. The physicist is surveying the room with a Geiger counter trying to pin down where it's coming from, but every local spot is clean. As he stops to think, he casually points the probe at the wall near the bed, and the meter goes nuts. Turns out the patient liked to pick their nose, and smeared their (radioactive) boogers all over the wall!
 
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MadMac said:
A patient was "cooling down" after thyroid imaging with I-125, and after the cleaning staff removed the radioactively contaminated sheets/pillows/etc. there was still some activity left in the room. The mattress was removed, bathroom scrubbed down, floor cleaned again, but the room still had a large radiation source in it. The physicist is surveying the room with a Geiger counter trying to pin down where it's coming from, but every local spot is clean. As he stops to think, he casually points the probe at the wall near the bed, and the meter goes nuts. Turns out the patient liked to pick their nose, and smeared their (radioactive) boogers all over the wall!
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We have 2 lead-lined rooms on our onc floor for radioactive iodine patients. Whenever patients discharge from any room, the unit clerk writes "Dirty" on the census board so housekeeping knows which ones need to be cleaned. When the iodine patients d/c they write "Hot and Dirty" on the board which cracks me up every time I see it.
 
gutonc said:
We have 2 lead-lined rooms on our onc floor for radioactive iodine patients. Whenever patients discharge from any room, the unit clerk writes "Dirty" on the census board so housekeeping knows which ones need to be cleaned. When the iodine patients d/c they write "Hot and Dirty" on the board which cracks me up every time I see it.
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I would have been so fired by July 2nd if I worked here.
 
Don't get completely trashed and sit on the windowsill on the 19th floor of your friend's high-rise apartment while you attempt to smoke a cigarette. You *will* lose your balance, you *will* fall, and worst of all, you *will* die. And a lot of people will really, really miss you.

Y'all weren't kidding about buildings being an effective suicide method. Her death really was just an accident, but, damn. I didn't think these things really happened.

RIP BS.
 
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gutonc said:
The best/worst part is that the clerk who usually writes it up there is quite a bit of the former and (per her own report), a little bit of the latter.
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Ok, I would have been fired before the ink on my contract was dry.
 
Both I and a 'daddy' learned something from my patient the other day. She was 5 years old.

"My mommy has a baby in her tummy, but daddy didn't put it there..."

Hello awkward! 😱
 
Ivory12 said:
Heard second hand, but I figured sage wisdom like this should be shared.

If things are getting a bit stale with your lady, just detach the colostomy bag and you have yourself another exciting orifice.

Should the stoma become red and painful and start discharging pus, don't worry, plenty of people get gonorrhea in their large intestine.

Just another day at LA County.
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I dated a girl with an iliostomy bag once... NEVER did that thought enter my head!! :scared:
 
FM doc here, but I've done some moonlighting in rural EDs in the past (Never again!) /duck

I've learned that if you refuse to prescribe Percocets for a known drugseeker's back pain then you will answer for that sin to St. Peter himself at the pearly gates. Good thing I'm agnostic.

While moonlighting as a weekend locums for a rural prison hospital ward, I learned that if you molest children and go to prison, you might end up as a quadriplegic with a trach and peg laying in a prison hospital bed for the rest of your likely short life when the general population finds out what your in for.
 
bullpup777 said:
If you and your nice upper middle class hubby are driving by the ED of a nice suburban hospital at 2 am, you should definitely stop in and see if they can help you with your baby's diaper rash... resulted in a full workup and a psych consult... The prevailing theory was that there must be something else wrong with the baby that they were just unwilling or unable to talk about...
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I recently began my first suburban ER rotation. I've been "downtown" or "at the County" up until now. I'm comfortable with stab wounds and crackheads. These people are freakin' CRAZY.
 
Most people who have arthritis are just using it as an excuse not to do anything, but if you just suck it up and take some Tylenol you'll be okay. Well, I guess it depends on how decapitated you are.
 
That after giving birth, I should use a potato as a pessary to keep my uterus from falling out.

😱
 
The lesson: do not use a coaxial cable as a rectal probe. Why??

My cousin is an EMT and this happened several years ago. They were dispatched after receiving a 911 call from someone complaining of severe pain. On arrival to the home, a man answers the door holding a VCR in his hands, and the cable went from the VCR into his rear. When he couldn't removed the cable (apparently perforated his rectum), he called 911.

So stupid was this guy, not only did he shove the cable up there, it never occurred to him to remove the cable from the VCR and had been carrying it around his house all night.

For entertainment, my cousin brought him into with the ER with VCR still attached. Just to see the reaction..........
 
The amount of time passing is not an issue. If you have extreme abd pain in the morning, but can't get a ride to the ED until the next morning, you can still show up even though the pain is completely gone.

Presented as female with CC of abd pain that has no abd pain. Yes, the attending thought I was messing with them.
 
EM2BE said:
The amount of time passing is not an issue. If you have extreme abd pain in the morning, but can't get a ride to the ED until the next morning, you can still show up even though the pain is completely gone.

Presented as female with CC of abd pain that has no abd pain. Yes, the attending thought I was messing with them.
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We see that all the time. My favorite is "Well, I had a little twinge in my chest last night...thought I should get it checked out"...at 2pm the next day. I love it when the conversation that ensues"
Nurse: "Ok, so what's your pain level now?"
Pt: "Oh, no pain"
Nurse: "Ok, so what exactly is your emergency?"
The stupefied look on the patient's face is priceless.
 
If you are a 21 year old with musculoskeletal chest pain, be sure and call 911 and go to the nearest hospital. After they send you home, the next time it happens, find a different hospital and insist on the million dollar workup. It's ok; me and the other taxpayers don't mind covering it. Also don't accept it when they say that all your tests are negative... after all, who is your completely devoted and enabling boyfriend sitting at your bedside gonna believe: you, or all those dumb "cardiologists" with all their fancy "echos" and "labs"?

Be sure to rinse and repeat with every hospital in the area until you finally land at mine at 4 in the morning. Also be sure to whine and writhe in agony so I know how debilitating your condition is and how tough life is on poor you. When I gently suggest that it might be related to stress, anxiety and depression, which doesn't mean the pain isn't real at all!... it's best to suddenly ignore your life-destroying pain, stop crying, get dressed, and storm out AMA before being seen by the attending.
 
Tigerz_Fan said:
The lesson: do not use a coaxial cable as a rectal probe. Why??

My cousin is an EMT and this happened several years ago. They were dispatched after receiving a 911 call from someone complaining of severe pain. On arrival to the home, a man answers the door holding a VCR in his hands, and the cable went from the VCR into his rear. When he couldn't removed the cable (apparently perforated his rectum), he called 911.

So stupid was this guy, not only did he shove the cable up there, it never occurred to him to remove the cable from the VCR and had been carrying it around his house all night.

For entertainment, my cousin brought him into with the ER with VCR still attached. Just to see the reaction..........
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Delurking long enough to wonder if said nutbar tried pressing "Eject"... :idea:
 
When you are s/p open heart surgery and are in afib with occasional pauses, your pacer wires are hooked up to the external pacer with vpacing on demand, DO NOT UNPLUG THE EXTERNAL PACEMAKER BECAUSE THE POUCH IT IS CARRIED IN "CHAFES" YOUR NECK!!!!!!
When you arouse after 9 seconds of asystole to find your nurse reattaching the pacemaker, your bed in the low CPR position, alarms going off, one person with their hand on your carotid, another getting ready to do compressions on that fresh sternotomy inc. and you say "I feel dizzy..." Your primary nurse will have to be restrained from clubbing you upside the head with the external pacemaker.
 
For taking my already unproductive week and making me laugh about it. As a volunteer with a hospital foundation I have many opportunities to talk to various members of the medical community and shared in some of these first hand. Still, while having only my first responders ticket in an earlier life, BF (Before Finance) I have had the chance to be in the right place at the wrong time.

Not nearly as out there as those that have spent time working in the ED, but, here are a few that popped into my head over the last couple of days.

Lessons learned in pre hospital care.

When attending your first serious mvc the law of inverse value will begin to formulate in your head when your brain registers cognitive dissonance between a vehicle that cannot be towed, but must be placed in boxes while the occupants stand on the shoulder of the road smoking and DRINKING A BEER!!!!! (Late 1970’s) It will however take until 2009 for me to find someone to clearly articulate the term. Cleansing the gene pool may also have been vaguely considered, but not articulated.

When responding to an unknown emergency call it is extremely disconcerting to arrive at a scene of an attractive unconscious woman with a one litre shampoo bottle inserted in her ummm, vaginal orifice. It will cause insecurity issues among the responders.
She did regain consciousness within a minute of our arrival and did not seem the least bit embarrassed. According to her husband she fainted frequently during “recreational activities.”

If hospital security is busy doing the waiting room dance with a 6’9” 400 lbs man whose occupation appears to be pulling mature trees out of the ground, Do not, DO NOT, DO NOT, get the bright idea to help by stepping between an approximately 75 y/o Asian man who is 5’2” and at least 90 lbs and the doors of tx rooms when his son has been hit by a drunk driver, even if the triage nurse is saying he can’t go in there. Your 6’4” 255 lb unarmed combat instructor ass will see many bright lights, feel excruciating pain in so many places you will think it can’t possibly be happening and you will most certainly fall down. However, while you are trying to remember what planet you are on the gentleman will bow and apologize continuously for the next hour. You also will not make notes or attempt an arrest for assault PO (LEO) as it would lead to too many questions.

The conversation with your partner will then go something like this.

Ha ha, You got taken out by Grandpa.

Noooo shirt…

He hit you eleventy billion times…before you hit the ground.

Yeah I know. *shallow breath* I’ll know for a while I think.

You know, everyone thinks you are a big bad mofo, wait til they hear this.

Heeeeyyy, how come you didn’t step up?

Are you nucking futz? I saw what he did to you.

Thanks…
 
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