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Things I Learn From My Patients
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Depending on the patient, you could go George Thorogood on 'em, "One Bourbon, One Scotch, One Beer"
Nice. Love the Buffett-cover avatar, too. Love old school Buffett. A-1-A, great stuff.
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Nor does being turned into an organ donor by a pissed off girlfriend who puts a .22 into the temple......lizard brain still works but higher function is gone.....
FYI- Lizard brain does not seem to hinder ones ability to fill out a Press Ganey survey, nor is it in the exclusion criteria, either.
(You're welcome. That's what I'm here for.)
I'm the night shift IT guy for a hospital system in the New Orleans area, and occasionally am down in our Main Campus ED fixing printers & such. A few years back I'm removing some malware off of a computer right next to the psych observation room as the following conversation happens.
Restrained Patient: ::repeatedly:: Oh, God! Oh, Jesus! Just... just take me back to where I was ten minutes ago, and I'll be good, I promise!
Scary Vietnam Vet Security Guy: Damn, that's getting annoying.
Me: How long has he been in there?
SVVSG: 'Bout 45 minutes or so.
Me: Sooooo, what you're saying is he *is* right where he was ten minutes ago.
SVVSG: ::chuckles as he catches my drift:: The Lord does work in mysterious ways, don't He?
Restrained Patient: ::repeatedly:: Oh, God! Oh, Jesus! Just... just take me back to where I was ten minutes ago, and I'll be good, I promise!
Scary Vietnam Vet Security Guy: Damn, that's getting annoying.
Me: How long has he been in there?
SVVSG: 'Bout 45 minutes or so.
Me: Sooooo, what you're saying is he *is* right where he was ten minutes ago.
SVVSG: ::chuckles as he catches my drift:: The Lord does work in mysterious ways, don't He?
owwwwww. That sounds awful.
I learned something from one of my patients today--
I was standing in the room listening to the nurse asking her assessment questions, and as part of their assessment, our nurses always ask a SH including living situation. Cue this scene:
RN: "Do you feel safe at home?"
Patient: "Um, no, not really"
RN: "Why is that?"
Patient: "... I'm a paranoid schizophrenic. I don't feel safe anywhere!"
I had to hand it to her... that's a pretty good argument.
I was standing in the room listening to the nurse asking her assessment questions, and as part of their assessment, our nurses always ask a SH including living situation. Cue this scene:
RN: "Do you feel safe at home?"
Patient: "Um, no, not really"
RN: "Why is that?"
Patient: "... I'm a paranoid schizophrenic. I don't feel safe anywhere!"
I had to hand it to her... that's a pretty good argument.
I would f*cking love to be standing there listening to this and trying my hardest not to laugh.
"White juice" is an acceptable urban colloquialism for propofol.
-Smashing the bottom of a wine bottle against a wall may not be the best way to open it.
-Shoving pieces of a Klondike Bar into one's vagina may not, in fact, enhance sexual pleasure. Nor will getting a beej from someone who just ate a meal full of hot chili peppers.
-Shoving pieces of a Klondike Bar into one's vagina may not, in fact, enhance sexual pleasure. Nor will getting a beej from someone who just ate a meal full of hot chili peppers.
http://www.wjem.org/upload/admin/201406/101b146d9480eb43a22ecd6dbd034639.pdf
Survival From Cardiac Arrest Due to Sushi Suffocation.
This article is full of emergency pearly. A must read.
Survival From Cardiac Arrest Due to Sushi Suffocation.
This article is full of emergency pearly. A must read.
There are worse things to which it could refer.
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Apparently if your hba1c is 12+, you become hypoglycemic at a glucose of 130
I just don't even understand how that's possible. Fish it out dangit! WEEKS? lawd.
Alcohol involved maybe. Too drunk at the time to realize the whole thing didn't come out?
So just out of curiosity, how often do people come in with actual sex toys as the issue (being used as designed)? Do you ever just say hey, they make things for this purpose?
Good question. Why buy a real one when you can find the same shape for free around the house? Kidding. (Toothbrushes even vibrate)
I've seen men come in with very large sex toys lodged and they swear it's the first time they've ever used them :/
Further reaffirmed the observation that those who commit horrible vehicular crimes killing people/almost killing child, never seem to get badly injured themselves. EtOH is protective from self harm in MVCs :/
Thumb typed from iPhone using Tapatalk
Thumb typed from iPhone using Tapatalk
If you are having severe flank pain...just like your last pyelo...you should smoke a bunch of meth "to help with the pain". Two days later, present to your nearest ER with sepsis, and look at your doctor like they have 3 heads when they ask why you didn't try Tylenol or motrin for your pain. Your response should be: "cause I don't like takin' no pills".
Well I guess I spent too much time working in a correctional center, because this guy actually makes sense to me!
I'm a non-med (for now, I'm currently a volunteer firefighter but trying to get the time to get my EMT-B), but my father was a paramedic for several years before I was born, and has a few rather colorful stories.
If you appear to have overdosed on drugs, and the paramedic tries to roll you over, don't reach out and stab him in the knee cap. You will get a boot to the head and the cop on scene will not care.
If you appear to have overdosed on drugs, and the paramedic tries to roll you over, don't reach out and stab him in the knee cap. You will get a boot to the head and the cop on scene will not care.
Walking around barefoot and not taking care of your huge infected diabetic foot ulcer is a great way to make sure that you get a fast-pass to another BKA to match the one on the other leg 😉
(And, no, I can't just give you some of those free bacitracin packets and send you home.)
(And, no, I can't just give you some of those free bacitracin packets and send you home.)
If you routinely get so drunk you fall out of your wheelchair you need to reevaluate your life trajectory.
..or get a better wheelchair.
At least get one that's low to the ground.
Some of them have seat belts.
And make sure it has cupholders so you don't spill your drink.
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Seen the ones with ash tray attachments?
Old school.
Old school.
Adding to the list of situations where you need to reevaluate your life:
1. Getting gonorrhea at your colostomy site
2. Giving gonorrhea to a person with a colostomy
1. Getting gonorrhea at your colostomy site
2. Giving gonorrhea to a person with a colostomy
.........What's the presentation?
Or the optimist would say that's living life to it's fullest despite great adversity.
🙂
Think positive.
Exactly. If I were in that situation, I'd probably be thrilled it was only gonorrhea or that whatever funny business occurred didn't mess up my stoma.
...so thankful to be in a monogamous marriage and to have a functioning GI tract.
Not really something I learnt from a patient .......
Patient presented to family doc with 2 weeks history of fatigue and myalgia. Sent to the ED "for investigation of SLE".
I am not sure we're really going to get to the bottom of this in the short 4 hours in ED.
Patient presented to family doc with 2 weeks history of fatigue and myalgia. Sent to the ED "for investigation of SLE".
I am not sure we're really going to get to the bottom of this in the short 4 hours in ED.
Why do patients love free bacitracin so much? I can spend an hour meticulously closing a complex laceration with a great result, but the thing they really thank me for is the packets of bacitracin.
Because it's free stuff (sort of)? Who doesn't like getting free stuff?
Right. They think you're a total heathen of you say no, or blow off the bacitracin goodie bag. Give free useless bacitracin, unnecessary antibiotics that breed multi-drug resistant GC, DNA-scrambling radiation or indiscriminate opiates and your patient satisfaction goes through the roof.
The government needs to get this, that patient satisfaction fuels bad medicine. It just does. We all know it, yet these toxic healthcare-system ruiners just refuse to believe it. That's why so many doctors just don't care anymore.
Thanks folks . . . just the right distraction from a flare of the fiberniagara (you can tell it's real because I am NOT in an ER) . . .I learned when I was 17, waiting for a friend at an ER, that there is nothing like taking your extended family to the ER with you to overhear the doc explaining to you (young married couple each under 20) that a) there are other methods of birth control than anal intercourse and that b) yep, it probably does really hurt . . .and *that* was when I learned that if it can happen in an ER, it does. Fortunately it was some years before I encountered some of the other beauts that you all run into so often. I was distressed this week, for everyone concerned, to realize how many folks in West Africa are unfamiliar with the germ theory of disease. Then I blundered onto here and face palmed on that one. I may just call some pizza in to my local ER without going anywhere near it my own self. (I was not with the young married couple or their family. . .just to be clear)
You can have "endstage Fibromyalgia" attacks
If you are so sedated you can barely stay awake from your meds, you probably shouldn't ride to ER on back of your son's scooter (ala dumb and dumber"
If you are 90 year-old, aphsiac stroke survivor, don't pet random cats in wander into your house, especially when you don't have cats, because they are probably opposums, and rabies shots hurt
Don't stick butter-nut squash in your rectum when you are high on cocaine...and when you do get discharged, don't tell me to tell your mother you now have a colostomy b/c you did "too much cocaine"
Speaking of cocaine, I learned through a patient that you should not let cats into your roommates supply of cocaine, b/c they will inevitably rip it open, and it will get into your air conditioning, and spread throughout your house. IF this does happen, please call 911--EMS will be happy to transport to the hospital, acting out of your mind, with a face covered in cocaine-powder, feeling like you are going to die. B/c everyone knows cats are trying to kill humans and cover their tracks through cocaine overdoses
And ladies, please look out for that guy who is "putting (cocaine, ectstasy, opiates, benzo's red dragon, etc) in your drink", b/c you will go to the ER and demand a note for your parole office explaining that we have a special machine that can determine whether your pan+ UDS is indeed from a nepharious guy at a bar spiking drinks with expensive street drugs, and that it is not your fault those drugs are in your system...
If you are so sedated you can barely stay awake from your meds, you probably shouldn't ride to ER on back of your son's scooter (ala dumb and dumber"
If you are 90 year-old, aphsiac stroke survivor, don't pet random cats in wander into your house, especially when you don't have cats, because they are probably opposums, and rabies shots hurt
Don't stick butter-nut squash in your rectum when you are high on cocaine...and when you do get discharged, don't tell me to tell your mother you now have a colostomy b/c you did "too much cocaine"
Speaking of cocaine, I learned through a patient that you should not let cats into your roommates supply of cocaine, b/c they will inevitably rip it open, and it will get into your air conditioning, and spread throughout your house. IF this does happen, please call 911--EMS will be happy to transport to the hospital, acting out of your mind, with a face covered in cocaine-powder, feeling like you are going to die. B/c everyone knows cats are trying to kill humans and cover their tracks through cocaine overdoses
And ladies, please look out for that guy who is "putting (cocaine, ectstasy, opiates, benzo's red dragon, etc) in your drink", b/c you will go to the ER and demand a note for your parole office explaining that we have a special machine that can determine whether your pan+ UDS is indeed from a nepharious guy at a bar spiking drinks with expensive street drugs, and that it is not your fault those drugs are in your system...
Apparently the human bladder (if properly conditioned) can carry greater than 2L of fluid without any obvious discomfort.
Also, the nurse handling the bladder scanner at the moment will describe the situation as: "Holy crap! There's a lot of pee in there!"
Also, the nurse handling the bladder scanner at the moment will describe the situation as: "Holy crap! There's a lot of pee in there!"
Hell, I can carry 2L in my bladder (literally).
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R
RTC19
3.5 L here. The EP and I had a grand old time laughing about that one.
Last edited by a moderator:
So why do all urinals (hospital/nursing facility/etc) hold 1L? Is there a "super size" one available for those extra-special patients?
/tangent
Hello Folks.
I'm not a med student, or anything like that in any field. But I've spent enough time in hospitals and Urgent Care over the years, to be thankful for doctors and the staff there, who are smart and know (most of the time) what's wrong with you.
Let me just give you some of what's happened to me in my 27 years of life.
First off, I am one of those unlucky folks who is allergic to Ibuprofen, Sulfa drugs, and Aspirin. Immune to Vicodin, and most....if not all regular cold medicines.
So let's just have some fun going through my rather fun life.
7 years old: Pneumonia and ear infection at the same time during the summer......not a fun summer......nor a fun rest of my life, because due to those two things I now no longer have a decent immune system.
Also, come from a family background that has cancer and other unfortunate things in the background.
Freshman year of college. IF after 3 days of coughing fits, and hacking, and other not pleasant things, you should have gone to the on campus health center to find out what's wrong with you; instead, wait until your dad comes to visit, dx's (He's worked around Hospitals enough as a sales rep that sells medical transcription devices and other assorted things) you with Pneumonia, and goes and gets you basic drugs to cure you......and be greatful, because your hallmates all but threatened to knock you out and take you to the E.R, even your R.A's roommate's girl at the time who was a medical student, DX's you as Pneumonia earlier in the week, and all but offers to take you to Urgent Care.
I also had my wisdom teeth removed over christmas break that year, and was on Vicodin, and something else.....the Vicodin I stopped taking after day 2.5, because it wasn't doing anything for me, and I had become more or less....immune.
Sophomore year of college. Punch through a glass panel on a door (accidentally with NO ALCOHOL INVOLVED) at 1 am in the morning because your housemates pulled a prank on you and you ran out of the house after them, only to have one of them close the door, and you, slightly sleepily knock on the window, not realizing how unstable it actually is. Hand goes through window, with you cursing, (which I rarely do) "ohhhh eff the door," folllowed by "OH EFFFF.....MY HAND." having them realize at that point, they may have screwed up. Have them help get your hand through the window part, with a very deep cut. Don't go to the E.R, instead, have a couple of them go to the all night safeway and get butterfly bandaids and neosporin, and keep your hand running under cold water. The next morning, go to class, with your hand bandaided up, and in a plastic bag (housemates idea), because based on their knowledge, your hand is fine. Go in to class, and have everyone stare at you as if you've grown a third eye. Have one of the Campus Security who is a student and in the class, who also dislikes you, look at you and ask what happened, say that an accident involving your house was all, and leave it at that. (find out later that he went and yelled at them). Come back from class and have your El Ed friend look at your hand ask what you did now, and if you need a ride to the E.R. Tell her you'll go have campus health services look at it later as you have class soon. Go back to your room, and have her IM you five minutes later and tell you that based on her Chem major roommate's advice that you need to go the ER. She'll offer to drive you up there (more or less threatening to take you if your refuse). Tell her you will go to Campus Health and have them take a look. Go to Campus health. Have them take one look at your hand, and immediately the nurse there says "uh.....hold on a second, I'm going to drive you to Urgent care." Go to Urgent care, have them take a look, and immediately have the Doctor ask if Alcohol was involved, when you tell him no, and he asks why you didn't go to the E.R, tell him that your housemates didn't think it was that bad. Have him again give you a skeptical look and inform you, that had the cut been any deeper or wider, you'd be facing tendon reconstructive surgery.....the cut was about 8/10th's away from the tendon. have them stitch you up, and then offer you Vicodin. Refuse and explain you're immune and it has no effect on you. Doctor and nurse look at you, like you're from another planet.
Junior year. Same thing that happened freshman year.....only worse. starting with a fever, vertigo and neausa and not feeling hungry, on a tuesday night. DX yourself as food poisioning and ask the head of food services the next morning if anyone else experienced what you did, and he says no, then go around your business. that's wednesday. Thursday, still not feeling well, go to health services, have them take your temp (103.4) and say it's just a minor cold, and tell you to go on your way, you should feel better. Friday night, feel even worse then you did Thursday morning, and call your parents and the girl you're dating at the time, who both tell you to go the Urgent care. Go there, and find they're about to close, and have them ask if you can wait til tomorrow.....be polite and say you're not sure you're going to be alive in the morning. They give you the location of an U.C 30 minutes away that's open late. call up one of your friends and ask her to drive you to there, when you explain what you've got, have her tell you to wait where you are, she'll be there shortly. Go up to the other UC and have the doctor there take one look at you, take your temp (105.5) and immediately DX you as Viral Meningitis, have him inform you to go immediately to the E.R in your town where you go to school. Have your friend drive you back down, and go to the E.R, and check in, have the ER attending take one look at you and inform you that you do not have Viral Meningitis, because if you did, you've be bemoaning the fact that you're alive, and that you don't need a lumbar puncture. Instead inform you that you have a very bad case (also rare) of Pneumonia (when he finds out your history of seven years old) have him be a little less surprised. Have him put you on a few drugs, and then perscribe you some very heavy horse pills. a week later you're feeling better, and alive.
didn't have any more problems in college, but after college:
Two weeks after getting fired from your job, start having heart palpations that feel like a heart attack, go immediately to the Urgent Care and have them do an EKG on you. find out that stress heart attacks on a minor scale are possible. Also find out that you have an irregular heart beat where your heart beat beats 3 or so times at the normal rate, even though this is not an adverse affect on you. Find this part out again later a couple of months later when you go to join a weight loss program that does an EKG as well as a few other things.
that's all I have that happened to me.
One thing I did learn since working in retail, with fork lifts and all that is that when your foot/ankle gets run through with a fork lift blade, do not have the idiot spotter take off the person's shoe, because if that does happen, the foot'll swell up and said patient will end up having to have reconstructive surgery and have to walk with a cane for the rest of your life (27 years old this person is) because of the damage done.
Once again, I am eternally thankful for doctors and nurses.
I'm not a med student, or anything like that in any field. But I've spent enough time in hospitals and Urgent Care over the years, to be thankful for doctors and the staff there, who are smart and know (most of the time) what's wrong with you.
Let me just give you some of what's happened to me in my 27 years of life.
First off, I am one of those unlucky folks who is allergic to Ibuprofen, Sulfa drugs, and Aspirin. Immune to Vicodin, and most....if not all regular cold medicines.
So let's just have some fun going through my rather fun life.
7 years old: Pneumonia and ear infection at the same time during the summer......not a fun summer......nor a fun rest of my life, because due to those two things I now no longer have a decent immune system.
Also, come from a family background that has cancer and other unfortunate things in the background.
Freshman year of college. IF after 3 days of coughing fits, and hacking, and other not pleasant things, you should have gone to the on campus health center to find out what's wrong with you; instead, wait until your dad comes to visit, dx's (He's worked around Hospitals enough as a sales rep that sells medical transcription devices and other assorted things) you with Pneumonia, and goes and gets you basic drugs to cure you......and be greatful, because your hallmates all but threatened to knock you out and take you to the E.R, even your R.A's roommate's girl at the time who was a medical student, DX's you as Pneumonia earlier in the week, and all but offers to take you to Urgent Care.
I also had my wisdom teeth removed over christmas break that year, and was on Vicodin, and something else.....the Vicodin I stopped taking after day 2.5, because it wasn't doing anything for me, and I had become more or less....immune.
Sophomore year of college. Punch through a glass panel on a door (accidentally with NO ALCOHOL INVOLVED) at 1 am in the morning because your housemates pulled a prank on you and you ran out of the house after them, only to have one of them close the door, and you, slightly sleepily knock on the window, not realizing how unstable it actually is. Hand goes through window, with you cursing, (which I rarely do) "ohhhh eff the door," folllowed by "OH EFFFF.....MY HAND." having them realize at that point, they may have screwed up. Have them help get your hand through the window part, with a very deep cut. Don't go to the E.R, instead, have a couple of them go to the all night safeway and get butterfly bandaids and neosporin, and keep your hand running under cold water. The next morning, go to class, with your hand bandaided up, and in a plastic bag (housemates idea), because based on their knowledge, your hand is fine. Go in to class, and have everyone stare at you as if you've grown a third eye. Have one of the Campus Security who is a student and in the class, who also dislikes you, look at you and ask what happened, say that an accident involving your house was all, and leave it at that. (find out later that he went and yelled at them). Come back from class and have your El Ed friend look at your hand ask what you did now, and if you need a ride to the E.R. Tell her you'll go have campus health services look at it later as you have class soon. Go back to your room, and have her IM you five minutes later and tell you that based on her Chem major roommate's advice that you need to go the ER. She'll offer to drive you up there (more or less threatening to take you if your refuse). Tell her you will go to Campus Health and have them take a look. Go to Campus health. Have them take one look at your hand, and immediately the nurse there says "uh.....hold on a second, I'm going to drive you to Urgent care." Go to Urgent care, have them take a look, and immediately have the Doctor ask if Alcohol was involved, when you tell him no, and he asks why you didn't go to the E.R, tell him that your housemates didn't think it was that bad. Have him again give you a skeptical look and inform you, that had the cut been any deeper or wider, you'd be facing tendon reconstructive surgery.....the cut was about 8/10th's away from the tendon. have them stitch you up, and then offer you Vicodin. Refuse and explain you're immune and it has no effect on you. Doctor and nurse look at you, like you're from another planet.
Junior year. Same thing that happened freshman year.....only worse. starting with a fever, vertigo and neausa and not feeling hungry, on a tuesday night. DX yourself as food poisioning and ask the head of food services the next morning if anyone else experienced what you did, and he says no, then go around your business. that's wednesday. Thursday, still not feeling well, go to health services, have them take your temp (103.4) and say it's just a minor cold, and tell you to go on your way, you should feel better. Friday night, feel even worse then you did Thursday morning, and call your parents and the girl you're dating at the time, who both tell you to go the Urgent care. Go there, and find they're about to close, and have them ask if you can wait til tomorrow.....be polite and say you're not sure you're going to be alive in the morning. They give you the location of an U.C 30 minutes away that's open late. call up one of your friends and ask her to drive you to there, when you explain what you've got, have her tell you to wait where you are, she'll be there shortly. Go up to the other UC and have the doctor there take one look at you, take your temp (105.5) and immediately DX you as Viral Meningitis, have him inform you to go immediately to the E.R in your town where you go to school. Have your friend drive you back down, and go to the E.R, and check in, have the ER attending take one look at you and inform you that you do not have Viral Meningitis, because if you did, you've be bemoaning the fact that you're alive, and that you don't need a lumbar puncture. Instead inform you that you have a very bad case (also rare) of Pneumonia (when he finds out your history of seven years old) have him be a little less surprised. Have him put you on a few drugs, and then perscribe you some very heavy horse pills. a week later you're feeling better, and alive.
didn't have any more problems in college, but after college:
Two weeks after getting fired from your job, start having heart palpations that feel like a heart attack, go immediately to the Urgent Care and have them do an EKG on you. find out that stress heart attacks on a minor scale are possible. Also find out that you have an irregular heart beat where your heart beat beats 3 or so times at the normal rate, even though this is not an adverse affect on you. Find this part out again later a couple of months later when you go to join a weight loss program that does an EKG as well as a few other things.
that's all I have that happened to me.
One thing I did learn since working in retail, with fork lifts and all that is that when your foot/ankle gets run through with a fork lift blade, do not have the idiot spotter take off the person's shoe, because if that does happen, the foot'll swell up and said patient will end up having to have reconstructive surgery and have to walk with a cane for the rest of your life (27 years old this person is) because of the damage done.
Once again, I am eternally thankful for doctors and nurses.
