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Things I Learn From My Patients

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

  1. Steve_Zissou

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    Iron fist is a Netflix superhero show and pretty early on he ends up in a mental hospital claiming he has powers but is unable to “gather his chi” to show them. Pretty good show.
     
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  3. Aquar1us

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    Aaand the other end of the spectrum - the drug-seeking missile from Down-Under.

    Excerpt:

    "Basically [OP's arrested friend] has been visiting doctor clinics and somehow (don’t ask me how you do this and get away with it) he’s been leaving these clinics with blank prescription paper. Legit doctor script paper. Out of their printers or drawers or something, I don’t know.

    Then he’s got a legit script from that doc for an antibiotic or a cough, or something, I don’t really know,. And doing this: (for the love for God don’t EVER attempt to do this, he’s facing jail time for this).

    Scanning a piece of blank legitimate prescription paper into Microsoft Word, adding text boxes and copying the clinic, prescriber and formatting details onto the blank scan, and then literally typing in whatever medication he wants, including the dose, quantity, how to take it (1 QID PRN) for example, and then putting the blank script paper in the printer and literally printing his own scripts. He’s then been practicing the docs signature and if necessary, handwriting the medicine if it’s something controlled (of Schedule 8)."

    Full story (link):
    I want to preface this with the fact that this is 100% a true story, and is not a “SWIM” or whatever you call it story, this is a guy I know that I am really ****ing concerned for. Let’s just say I got mate today who has really outdone himself. He’s a drug dependent person, good bloke, just crazy hooked on prescription pills. Benzos and opiates especially. He doctor shops, he tries his luck through people he knows – he will do anything to get a fix of some oxy or any type of benzo under the sun.

    I knew he was doctor shopping. I knew he was getting lots of scripts or sometimes going to hospitals presenting with fake pain to score even a single Endone tablet (oxy 5mg IR) and hope the ED doctor would send him home with a hospital script. I feel for the dude in a sense because I know deep down he’s a smart guy and he admits he has a problem, he just doesn’t want to seem to do anything about it.

    Well. Last night I got a call from the local police station, it was my mate. He wanted me to go down to the station with him because he had a search warrant executed and was arrested and taken in for questioning. Now this baffled me a bit. He’s smart. He keeps his drug addiction fairly close to his chest apart from myself and maybe his partner, I don’t know. But I found out he has a court date impending and I just stared blankly at him when he started talking and telling the cops what he’d been up to.

    Okay, so in Aus we have greenish prescription paper that doctors run through the printer when they’re prescribing you a medicine. There’s a fair bit of info on there, there’s the clinic, the phone and fax number, the doctor details, the docs prescriber number, Medicare and concession card details, medication details, dates, signatures, qualifications, the works. For controlled drugs there’s also hand written drug names, strengths and quantities. They’re fairly comprehensive.

    My mate is going to court in about a month facing 12 charges of forgery, fraud, attempted fraud, stealing and possession of dangerous drugs (pharmas in this case).

    Basically he’s been visiting doctor clinics and somehow (don’t ask me how you do this and get away with it) he’s been leaving these clinics with blank prescription paper. Legit doctor script paper. Out of their printers or drawers or something, I don’t know.

    Then he’s got a legit script from that doc for an antibiotic or a cough, or something, I don’t really know,. And doing this: (for the love for God don’t EVER attempt to do this, he’s facing jail time for this).

    Scanning a piece of blank legitimate prescription paper into Microsoft Word, adding text boxes and copying the clinic, prescriber and formatting details onto the blank scan, and then literally typing in whatever medication he wants, including the dose, quantity, how to take it (1 QID PRN) for example, and then putting the blank script paper in the printer and literally printing his own scripts. He’s then been practicing the docs signature and if necessary, handwriting the medicine if it’s something controlled (of Schedule 8).

    The paper comes out, it’s perforated, it’s the right colour, and it’s presented to a pharmacy and 12 times they’ve dispensed the medicine because he had the right doctor prescriber number and is medically smart enough to know the lingo they use when they’re explaining how and when to take it (one example they showed him which I saw was one he’d done for temazepam, and it said 1 PO nocte PRN (Google told me that means one by mouth at night if needed).

    He is in serious serious ****. I am so baffled as to how he got his hands on legitimate doctor’s script paper and copied the bunk antibiotic or whatever, and literally just printed his own scripts that were actually dispensed. He’s walked out of chemists with Kalma 2mg (alprazolam), OxyNorm capsules, boxes of Valium, Hypnodorm (flunitrazepam), fentanyl..... Like anything he wanted he just formatted a ****ing word document and somehow had proper Medicare prescription paper printing out of his home computer.

    Like me and this dude go so far back, but honestly this has got me so mentally ****ed up its not even funny. What the ****?!
    Is this the most resourceful/talented seeker you've ever seen?
     
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  4. Ceke2002

    Ceke2002 Purveyor of Strange
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    I'm from Australia, and I'm calling BS on this, or at least an incredible amount of exaggeration. In regards to getting hold of a prescription pad or paper, that part at least is believable. However apart from the Valium all of the other medications listed are schedule 8 drugs and generally speaking require an authority to prescribe, which means you have to call your state's department of health, or equivalent, and have them give you an authorisation number to be printed on the script before it will be dispensed - these aren't the sorts of scripts any bozo can just do themselves. Even in the case where a Doctor is allowed to prescribe a small, limited amount of opiates, chances are if the chemist has never seen you before, or never seen you with that type of a script, they will phone the surgery and double check that the script is legit. So I highly, highly doubt whoever this person was that he was just writing himself out scripts for Rohypnol, Xanax, and so on, willy nilly and getting away with it, unless he somehow managed to find the world's dumbest pharmacist.
     
  5. Saint Muzhik

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    This goes for everyone, especially folks of my generation, but TIDE PODS ARE NOT FOOD!
     
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  6. betsybugaboo

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    I'm sorry I laughed as hard as I did at this. It reminds me of this story my mom told me about when she was 13 and visiting hot springs in California. The women's changing room has no stalls or separators, so everyone changes out in the open, and there are always tons of little old naked ladies wandering around. But the worst thing she ever saw was this little old lady, probably in her mid 80s, with saggy sacs that were all stretched out, enough so that they hung to just above the navel. And so this little old lady seriously just takes a tit in hand and rolls it up to where boobs should be and tucks it into her bra, then proceeds to do the same to the other. Seems like a good way to get this sort of injury!
     
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  7. almirbhflfc

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    Man I completely disagree. I love the MCU, and Daredevil on Netflix is one of my favorites, but Iron Fist is a steaming pile of garbage. Some of the worst acting I have seen, plot holes left right center, the main character also was so miscasted it is unbelievable.
     
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  8. Steve_Zissou

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    Eh, it’s an entertaining watch. If I had to put the Netflix shows in order it would be

    1) Jessica Jones
    2) Daredevil
    3) Iron Fist
    4) Luke Cage (so damn slow and boring)

    Pretty big gap between daredevil and iron fist but at least iron fist was entertaining it you didn’t think about it too hard
     
  9. Arcan57

    Arcan57 Junior Member
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    1) Jessica Jones (either season)
    2) Daredevil season 1
    3) Luke Cage
    4) Daredevil season 2
    5) Defenders
    6) Iron Fist

    MCU works on the charisma of its heroes (and is occasionally great because of the Villians). The actor playing Danny is a yawning void where charisma goes to die after a long and debilitating illness. I’m not sure quite how they managed to screw up magic ninjas as villians but with the exception of the Chinese woman the Hand notably worsened every scene that featured it.
     
  10. Steve_Zissou

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    Danny was definitely not charismatic and more of an annoying child at times, but if you really didn't pay too much attention it was enjoyable. Luke was just a boring character with a boring story. I feel like they could've done so much more with both but they ended up feeling more like a more faded background story. The Punisher was ok. The whole military background and scenes they showed were so incredibly cheesy it was hard to enjoy at best and cringey at worst. If we're breaking it down I would say:

    1) Jessica Jones
    2)Daredevil season 1
    3) Defenders
    4) Daredevil season 2
    5) The Punisher
    6) Iron Fist
    7) Luke Cage
     
  11. Apollyon

    Apollyon Screw the GST
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    Take it elsewhere!!
     
  12. Arcan57

    Arcan57 Junior Member
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    Respectfully this once great thread has been completely gutted by non-provider anecdotes and has been for a couple of years. It’s basically our mini version of the Lounge.
     
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  13. Spectre of Ockham

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    If you are caught on national TV doing coke on the beach during spring break (srsly) by all means yell at the ER staff that your tachycardia was induced by the bad spicy food you ate , then try to bite the attending when she asks you if you took any medication. This guarantees extra special care for your vodka-reeking psychotic self.
     
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  14. Spectre of Ockham

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    Things I've learned from my patients 2018 edition ? Please ?

    Also can we please drop the "provider" thing ? At least between us ?
     
  15. Arcan57

    Arcan57 Junior Member
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    Typing out non-EM docs, nurses, NPs, PAs, EMS anecdotes seemed more cumbersome than needed. My main gripe was the layperson, usually written in first person, stories that features run of the mill carelessness not the epic stupidity that we face. This thread used to be the equivalent of what happens whenever you get EM types together and supply alcohol. We tell war stories that in any other profession would be made up or exaggerated. More of the “plowing through a forest at night on an ATV at fullspeed while drunk and high and encountering the neighbor’s barbed wire fence” and less of the “I had a hangnail that got infected and I waited too long to get it looked at and my hand pussed out”.
     
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  16. Spectre of Ockham

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    We only have doctors , students and pharmacists over there (thankfully). Pharmacists stick to their own corner since they actually respect us. So we're docs and students over here - quite a brotherly bunch if I may say so.

    Like a sweet old soccer mom denying taking any medication or having any prior condition and then when ask about the sleep pattern (I was suspecting being BSes) you get a gem like "oh I can only sleep if I take my diazepam" .... :hungover: <- me
     
  17. RespectTheChemistry19

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    I met the nicest lady the other day who became a grandma when she was 29.
     
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  18. dpmd

    dpmd Relaxing
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    Babies having babies does sometimes run in families
     
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  19. USCDiver

    USCDiver Percocet-R-US
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    When the overworked and distracted community health center pharmacist fills your Hydrocortisone 10mg TID bottle with Hydrochlorothiazide 25mg pills, you’re going to have a bad week before someone figures it out...
     
  20. HydroTwitch

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    Not in medicine, which I know is a gripe of many of you, but bear with me, this is good.

    Ex-housemate in his late 20s with Type 2 Diabetes, High BP, and High Cholesterol. Was all stable when he moved in, didn't really cause any problems. Other housemates and I actually forgot about his health stuff.

    Sitting in the lounge with the 2 other housemates one night and this guy emerges from his room (where he pretty much hermitted 23 hours a day) complaining of a headache and some nausea. Apparently he had also taken it upon himself to call an ambulance.

    Got an update from him a bit later saying that his BP, diabetes, and cholesterol were all out of whack. Based on suspicions aroused by his ongoing hermitting and having never seen the guy walk further than 20 metres or eat anything remotely healthy, another housemate and I take a peek around his bedroom door. Pepsi bottles and empty dorito packets for carpet. Basically prolonged suicide for someone with his history.

    So housemate gets home a few hours later, bitching because all they gave him was a few panadol for the headache, some insulin, and instructions to take his damn meds. Turns out the idiot had been rationing his medication! Claimed that he couldn't afford the $5-$6 per prescription so he was only taking his various medications every few days.

    Somehow managed to afford copious amounts of pepsi and doritos though :bang:

    Needless to say, as a frequent flyer to Emergency for conditions outside my control, I made it clear to this moron that I wasn't impressed at his antics that resulted in him taking a bed.

    Last I heard, he was still alive and still has all his limbs. No idea how.
     
  21. Perrin

    Perrin sittin in the morning sun
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    EMS buddy told me he recently ran a funny call. 20 something was arguing with his teenage nephew about some money and cell phone. He said what are you going to do, stab me. Well, the nephew returned a few minutes later and stabbed him.

    Don't give crazy impressionable teens any ideas when they're pissed at you.
     
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  22. BoardingDoc

    BoardingDoc Don't worry. I've got my towel.
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    [​IMG]
     
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  23. CajunMedic

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    Picking up a few shifts on the ambulance between graduation and starting my TRI since I'm still licensed as a Paramedic.

    If your family unceremoniously dumps you off at another relatives house, then gleefully videos themselves burning your clothes and smashing your insulin bottles, posting the whole thing on Facebook, you will have another stroke. This one will affect your good side and leave you aphasic. All they could verbalize was a god-awful cry. Code Stroke on arrival, Tele-neuro consult, and 45 minutes later, another high-speed ambulance trip to the academic medical center 2 hours up the road.
     
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  24. wholeheartedly

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    Please tell me your next post involves a rash of lightning strike victims?
     
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  25. GoSpursGo

    GoSpursGo Allons-y!
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    I've removed a few posts that were not relevant to this thread.
     
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  26. Apollyon

    Apollyon Screw the GST
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    Hey - you stole my "likes"!!

    Because it looks like you didn't move them to the "discussion thread".
     
  27. GoSpursGo

    GoSpursGo Allons-y!
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    Maybe you'll get 5 more on this post to make up for it :shrug:
     
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  28. Apollyon

    Apollyon Screw the GST
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    Hey, you got two out of it!!
     
  29. BoardingDoc

    BoardingDoc Don't worry. I've got my towel.
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    I'll happily give you more likes now in exchange for never having to re-read the angry drivel that you were responding to.
     
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  30. randombird

    randombird Illinois c/o 2017!
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    From the veterinary side:
    Today I learned that the best treatment for a dog's otitis externa is witch hazel extract, applied liberally to the inside of the ear. Nevermind that apparently that stings a heckuva lot based on the owner's description of the dog's reaction.
    Also, apparently feeding your dog a clove of garlic a day will keep away fleas. I agree only by the fact that there will be no blood for the fleas OR the dog after that.
     
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  31. Aoirann

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    Long time no see. But I have a great example of legit 10/10 via my dad. It's when you are literally writhing with pain on the floor of ER, pass out for a few seconds, and the staff are breaking out the crash cart because his BP and Pulse are insane.

    Best part? My dad walk out of ER an hour later just fine. The staff seemed annoyed. Heck, my dad was annoyed that he was in so much pain and it was nothing. Best they can tell a small part of his intestine got pinched for whatever reason, caused horrible pain, and then slipped right back into place. Most likely due to the writhing in pain. Oh and after suffering from it a few more times with less intensity over the course of a few weeks, you don't suffer from them again.
     
    #3980 Aoirann, Nov 7, 2018
    Last edited: Nov 7, 2018

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