Things I Learn From My Patients

[DrMom]

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Your drug dealer probably won't refund you for the "poor quality" drugs you just purchased from him. In fact, if you threaten him he may very well shoot you.

 

[Winged Scapula]

If you are bothered by a near constant temptation to masturbate, its a good idea to cut off your hand to prevent you from indulging in such behavior.

However, in hindsight you may wish you'd reconsidered, not because it hurt, but because you've still got another hand.

Another hand, which 6 months later after the stump has healed, you will use to slice open your scrotum in an attempt to self-castrate and stop those troubling throughts. Its a great idea to use a dirty kitchen knife and not tell anyone what you've done until someone smells you and your rotten scrotum and dead testicle.

(in his defense he was a VA schizophrenic)

 

[ERMudPhud]

If you have pseudoseizures you probably shouldn't "seize" when your local EMS service has just received an IO drill they are itching to try out. On the other hand it did effectively terminate the "seizure"

 

[Chronic Student]

Do you have video, that would be great!

-Mike

 

[Kittenmommy]

If you have pseudoseizures you probably shouldn't "seize" when your local EMS service has just received an IO drill they are itching to try out. On the other hand it did effectively terminate the "seizure"

Do you have video, that would be great!

OK, now I have to know: What's an IO drill?

 

[WallowaWanderer]

OK, now I have to know: What's an IO drill?

An instrument used for placing intraosseous access.

 

[Kittenmommy]

An instrument used for placing intraosseous access.

That sounds like something that would be extremely unpleasant. Why on Earth would someone fake a seizure?

 

[EM2BE]

That sounds like something that would be extremely unpleasant. Why on Earth would someone fake a seizure?

attention, drugs....

 

[Kittenmommy]

attention, drugs....

Goodness. I'm glad I can't relate.

Oh, and LOL at "one lazy eye". I've got one too! 😛

 

[EM2BE]

Goodness. I'm glad I can't relate.

Oh, and LOL at "one lazy eye". I've got one too! 😛

It's actually the eyelid, which is really lazy right now since I ended up getting Bell's palsy.

 

[Kittenmommy]

It's actually the eyelid, which is really lazy right now since I ended up getting Bell's palsy.

Oh geeze, I'm sorry. 🙁

 

[EM2BE]

Oh geeze, I'm sorry. 🙁

Thanks. At least I got a very mild case. Most people can't tell until I tell them or they talk to me for a while. I think the worst is over.

 

[Kittenmommy]

Thanks. At least I got a very mild case. Most people can't tell until I tell them or they talk to me for a while. I think the worst is over.

Well, that's good. 😀

 

[EM2BE]

Well, that's good. 😀

Now if I could just keep the slobbering under control, I will be good. Well, that and keep the eye moisturized.

 

[EM2BE]

You should start visiting the review mirror threads. You should fit in quite well. And you know how to pad it up.

 

[Kittenmommy]

Now if I could just keep the slobbering under control, I will be good. Well, that and keep the eye moisturized.

Gosh, that sounds like it's fun to deal with. Except, you know, not. 🙁

 

[Kittenmommy]

You should start visiting the review mirror threads. You should fit in quite well. And you know how to pad it up.

I have absolutely zero clue what you're talking about.

 

[antiXcore]

By all means, when examining the 11y/o female brought in for acute abdominal pain, ignore her claims that she is a virgin and tell her parents you suspect an ectopic pregnancy. When you go to do the pelvic exam and notice her hymen is completely intact, do not apologize to the girl who's mother had been screaming at her for the past 5 minutes. Also, refuse to believe her father when he says it's most likely appendicitis. Please tell him to "let the doctors handle it."

Also, before making such a colossal mistake, you might want to listen to the attending (doctor in question was a resident) when they tell you that the patient's father is a member of the board as well as being a highly recognized cardiologist/internist, at the hospital in which you used to be so gainfully employed.

 

[Kittenmommy]

By all means, when examining the 11y/o female brought in for acute abdominal pain, ignore her claims that she is a virgin and tell her parents you suspect an ectopic pregnancy. When you go to do the pelvic exam and notice her hymen is completely intact, do not apologize to the girl who who's parents have been screaming at her for the past 5 minutes.

It was, in fact, appendicitis.

When you examine a married woman with a burning sensation during urination and a rash all over her nether regions, be sure to ignore her claims that her only sexual partner ever was her husband and diagnose her with herpes and send her home with a prescription for Valtrex. Never mind that your patient may end up nearly divorcing her husband over your diagnosis because she believes that she now has herpes and she knows that she never cheated. The best part will turn out to be that her "herpes" was an allergic reaction caused by some fancy soap from Bath and Body Works.

Yes, the "she" in that story was me, and I can assure you that I was so unamused.

 

[docB]

By all means, when examining the 11y/o female brought in for acute abdominal pain, ignore her claims that she is a virgin and tell her parents you suspect an ectopic pregnancy. When you go to do the pelvic exam and notice her hymen is completely intact, do not apologize to the girl who's mother had been screaming at her for the past 5 minutes. Also, refuse to believe her father when he says it's most likely appendicitis. Please tell him to "let the doctors handle it."

Also, before making such a colossal mistake, you might want to listen to the attending (doctor in question was a resident) when they tell you that the patient's father is a member of the board as well as being a highly recognized cardiologist/internist, at the hospital in which you used to be so gainfully employed.

So this isn't actually something you learned from a patient, it's a recounting of a bad experience you had in an ED. Well, at least you played the VIP card and got some resident fired so I imagine that made you feel better. Yet you still felt the need to join an internet bulletin board to post about it. Hmmmm.

 

[Wackie]

Something I've yet to learn from patients-

A reason for missing dialysis when you're not paying for it, when it was scheduled, and why someone can't make it to dialysis but can make it to the ED for complications due to volume overload (arriving by cab). 😕

 

[Wackie]

So this isn't actually something you learned from a patient, it's a recounting of a bad experience you had in an ED. Well, at least you played the VIP card and got some resident fired so I imagine that made you feel better. Yet you still felt the need to join an internet bulletin board to post about it. Hmmmm.

And pushing the creation of another one of those doctors patients complain about "not knowing how to talk to me" or "not keeping me updated" or "not including me in the thought process" since they got fired for it last time instead of taught how to correct their mistake.

 

[ISR]

I have learned that if you get something stuck in your urethra, a screwdriver is NOT the recommended tool for extraction.

 

[enfuegoEP]

Guy comes in after a nasty abscess on the buttocks get's I/D a few days prior. He present back to the ED and complains that the abscess has not healed even though he didn't fill the abx he was given because he "didn't have the money" yet admits to smoking crack earlier in the day. After this guy offered up a horrific social history of swapping sexual favors with both men and women for drugs....he throws a fit, screams, and declares "THIS IS SO DEGRADING" when I pack the abscess 😱

Oh, and then asks "does smoking crack interfere with healing?"

 

[antiXcore]

So this isn't actually something you learned from a patient, it's a recounting of a bad experience you had in an ED. Well, at least you played the VIP card and got some resident fired so I imagine that made you feel better. Yet you still felt the need to join an internet bulletin board to post about it. Hmmmm.

Not a personal experience. My uncle is the doctor on the board, this happened to my cousin a week ago. I didn't really convey the horribly rude behavior from the resident. I understand that ED's are stressful environments but personally I think it's best to mention the possibility of an ectopic pregnancy after the pelvic exam. The girl was 11, it could have been treated in a much more delicate manner.

 

[antiXcore]

And pushing the creation of another one of those doctors patients complain about "not knowing how to talk to me" or "not keeping me updated" or "not including me in the thought process" since they got fired for it last time instead of taught how to correct their mistake.

From what I've heard, the doctor was not fired but it was highly suggested that they transfer to a different hospital, after lashing out at the girl's father.

 

[Winged Scapula]

I have learned that if you get something stuck in your urethra, a screwdriver is NOT the recommended tool for extraction.

On a related note:

if you're impotent and have a new girlfriend, a mercury glass thermometer is not the best solution to obtaining some "rigidity'

 

[EM2BE]

On a related note:

if you're impotent and have a new girlfriend, a mercury glass thermometer is not the best solution to obtaining some "rigidity'

 

[Kittenmommy]

On a related note:

if you're impotent and have a new girlfriend, a mercury glass thermometer is not the best solution to obtaining some "rigidity'

Ouch. 😱

I see a Darwin Award in his future!

 

[docB]

Not a personal experience. My uncle is the doctor on the board, this happened to my cousin a week ago. I didn't really convey the horribly rude behavior from the resident. I understand that ED's are stressful environments but personally I think it's best to mention the possibility of an ectopic pregnancy after the pelvic exam. The girl was 11, it could have been treated in a much more delicate manner.

Great. Wrong thread. The griping about the ED threads are on every other forum on the board.

 

[EM2BE]

Ouch. 😱

I see a Darwin Award in his future!

What I don't see is you posting in the review mirror forums!

 

[Kittenmommy]

What I don't see is you posting in the review mirror forums!

Tell me what that is (and where it is) and I will! 😛

 

[WallowaWanderer]

Tell me what that is (and where it is) and I will! 😛

There's two:

http://forums.studentdoctor.net/showthread.php?t=462026&page=12

http://forums.studentdoctor.net/showthread.php?t=462029&page=13

 

[Kittenmommy]

There's two:

http://forums.studentdoctor.net/showthread.php?t=462026&page=12

http://forums.studentdoctor.net/showthread.php?t=462029&page=13

Thanks. Now I have to see if I can figure out what they're about.

 

[WallowaWanderer]

Thanks. Now I have to see if I can figure out what they're about.

They're not really about anything!

 

[Kittenmommy]

They're not really about anything!

Oh, awsome! Depending on my mood, those kinds of threads are often my favorites! 😎

 

[Chronic Student]

This is a little hard to follow, so stay with me.

If you are AWOL from the military, then don't let your pet cockatoo [sp?] fly around the inside of your geo.

Patient was the driver, husband found DOS with a dead cockatoo in his hand. They had run off the road and hit the only tree for twenty miles.

The MP's came and picked her up when we released her.

You can't make this stuff up.

-Mike

 

[docB]

The MP's came and picked her up when we released her.

A long time ago I was a tech in an ED in northern San Diego county. Everything in northern San Diego county is near Camp Pendelton so needless to say we would occasionally see drunk Marines. When I say occasionally I mean daily. One sticks out in my mind. He was really wasted. Tried to hit on a 250 lb 50 yo nurse. Was actually trying to say "I love you man!" while vomiting. Came out like "Iiiiiaaalllllooooooauggggggman!" But I digress. The reason I remember him so clearly is that he woke up at about 0700 just as I was leaving and asked me "Hey man. What time is it?"
"0700."
Really crushed, scared face (kid was only 18). "Oh my God. My unit shipped out for Somalia at 0500."
Ouch.
By the time I was out the door the SPs were headed in.

 

[docB]

Try not to have your synpocal episode on an escalator. Not pretty.

 

[EM2BE]

Try not to have your synpocal episode on an escalator. Not pretty.

Odd question. But was it up or down heading? Just picturing the falling up / down direction and how that would work out.

 

[ISR]

Odd question. But was it up or down heading? Just picturing the falling up / down direction and how that would work out.

I'm guessing poorly.

On the other hand, maybe it can be used as part of a public service announcement to get parents to stop letting their kids play on escalators!

 

[dnslay]

I vote falling up is worse if you simultaneously start to roll down.

I'm guessing poorly.

On the other hand, maybe it can be used as part of a public service announcement to get parents to stop letting their kids play on elevators!

 

[EM2BE]

I vote falling up is worse if you simultaneously start to roll down.

Exactly what I was thinking. Falling up just to fall back down again vs falling down and staying down.

 

[howelljolly]

Try not to have your synpocal episode on an escalator. Not pretty.

Oh, and while you are trying not to syncopize on the escalator...

Pay attention to what is going on uphill from you. Thats what I learned from a patient.

Because, if someone at the top of the escalator has an itch on their nose, they will let go of their overstuffed suitcase, in order to scratch it. The law of gravity still being in effect, the suitcase will tumble down the escalator, and take everyone in its path along for the ride.

 

[docB]

Odd question. But was it up or down heading? Just picturing the falling up / down direction and how that would work out.

This particular one was going down. Per witnesses just went out and toppled over face first. That meant a 3-4 step drop onto his face. It was a mess. Lots of lacs from the ridges on the steps, clavicle, ribs, zygoma, max sinus. But since he was going down the escalator just kind of deposited him at the bottom and that was that. I had a guy who was pretty hammered and fell on the way up. At the top he sort of got bumped by every step that came by and gave him a lot of extra cuts.

 

[ERMudPhud]

This particular one was going down. Per witnesses just went out and toppled over face first. That meant a 3-4 step drop onto his face. It was a mess. Lots of lacs from the ridges on the steps, clavicle, ribs, zygoma, max sinus. But since he was going down the escalator just kind of deposited him at the bottom and that was that. I had a guy who was pretty hammered and fell on the way up. At the top he sort of got bumped by every step that came by and gave him a lot of extra cuts.

I had the same thing a few years ago. Guy had a seizure on the way up and then no one pulled him off for a little while. His face basically looked like it had been gone over with a cheese grater.

 

[docB]

I had the same thing a few years ago. Guy had a seizure on the way up and then no one pulled him off for a little while. His face basically looked like it had been gone over with a cheese grater.

Yeah escalators are a mess. I saw a LOL a few years ago who got dizzy on one and sat down on the step on the way up. It resulted in another thing I learned:

Don't sit down on a metal escalator step that is out in the sun in Vegas when it's 118 out. It will look as though you burnt your ass with a waffle iron.

I didn't learn it but it was a good illustration on the syncope guy. True syncope doesn't have colles fractures and hand abrasions. True syncopy doesn't put it's hands out to break the fall.

 

[WallowaWanderer]

Wow, I never knew escalators were so dangerous. Yet another reason to never go to the mall.

 

[Kittenmommy]

Wow, I never knew escalators were so dangerous. Yet another reason to never go to the mall.

When I was a kid, I was always afraid that escalators would "eat" my toes. Thanks to this thread, I'm afraid all over again!

 

[nachoDoc]

When I was a kid, I was always afraid that escalators would "eat" my toes. Thanks to this thread, I'm afraid all over again!

With good reason, you should be:
POSTED: 5:06 pm EDT July 16, 2007
PITTSBURGH -- The shoes are big, and colorful and very popular, but Crocs and similar shoes may have a hidden danger.

Crocs was the first to make the light and flexible shoe. Now many companies sell similar shoes, but they all have the same potential problem when it comes to escalators.

There have been reports of the rubber like shoe getting caught in escalators.

Eric Cohen, of Monroeville, said that is what happened to his 9-year-old daughter, Jillian.

Cohen and his daughter were at a Connecticut mall on Father’s Day.

His daughter was wearing her favorite Croc shoes and was going down the escalator with her dad right behind her.

Just as they got to the bottom of the escalator Cohen said, “She started screaming and she's like, 'My shoe!' and I saw her shoe going under the escalator. I literally grabbed her and watched her shoe go into the infinite beyond of the escalator.”

There have been stories just like this one reported in other cities.

A representative for Crocs said, "Crocs shoes are completely safe. The popularity of our shoes has helped draw attention to a long-existing issue that we think is very important – escalator safety. Escalators and moving sidewalks, particularly those that have not received proper care and maintenance, can be dangerous and pose risks to their riders."

Luckily, Cohen managed to pick his daughter up and out of the shoes and out of harm's way.

Some Pittsburgh-area malls now post warning signs cautioning people about wearing rubber shoes on escalators.

Dr. Barbara Gaines, director of Trauma at Children's Hospital, hasn't seen any injuries from Crocs but said escalators and kids can be a dangerous combination.

According to Gaines, “The motors in those things are fairly powerful and they aren't necessarily going to stop when a child falls.”

Every year about 10,000 people go to emergency rooms because of escalator accidents and 20 percent of those incidents involve hands, feet or shoes getting trapped.