Things I Learn From My Patients

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fromthesnow said:
watch the video clip... i think i would have really enjoyed being their doctor.
Lessons learned:

1) Don't buy grills at flea markets
2) Don't swallow them!


http://imnotboredanymore.com/weve-all-heard-of-bbq-grills/
Click to expand...

The stupidity, it burns! :nono:

my-grill-let-me-show-u-it.jpg


Sorry, I just couldn't resist. 😛
 
you being the good paramedic asked the patient what happened and she replies 'I was attacked by some amazon bitches'

I didn't know we had those in North Philly.
 
Did you know that having hypoglycemia makes it feel like you have "bleach running through your veins?"



I didn't, but I learned that from a patient yesterday. I looked at my partner after we transported and asked how one would know what that feels like and he (with a completely straight face) replied "her veins feel exceedingly fresh and white?" :laugh:
 
emtcsmith said:
you being the good paramedic asked the patient what happened and she replies 'I was attacked by some amazon bitches'

I didn't know we had those in North Philly.
Click to expand...

Oh, You do.

Just a few miles due east, paramedics were called for a patient who couldnt figure out why his spirit wasnt in allignment.

Not far from there, a young lady called paramedics complaining that her feet hurt. She demanded that they put a tube in them so they'd stop hurting. She was a prostitute, and it was 3am. I wonder why her feet hurt.

Its a good thing that I was there to save the day/
 
Learning point to all the narcotic addicts out there.
Even if you have sickle cell anemia, and therefore have the possibility of pain crises, etc, if you are not, you know, anemic, don't have an abnormal retic count, and the rest of your labs are normal, expect a certain amount of incredulity on my part.
If, when we round the next day, your mayo table exhibits the positive blackberry sign, I am less likely to believe you have 10/10 pain and need a dilaudid PCA that you ask for by name.
 
if you are together enough to use your Blackberry PDA, you aren't that sick
 
fromthesnow said:
watch the video clip... i think i would have really enjoyed being their doctor.
Lessons learned:

1) Don't buy grills at flea markets
2) Don't swallow them!


http://imnotboredanymore.com/weve-all-heard-of-bbq-grills/
Click to expand...

Okay, the sad thing is that I see swallowed grills all of the time. Usually teens buy a grill, then go on a circus ride, scream and then swallow the mother-fer. Oddly enough, I've never had a bounce back with rectal pain after passage.
 
If you're looking for a good way to piss off a bunch of EMS workers, follow these easy steps:

1. Call 911 while smoking because you have SOB

2. Get mad at the fire EMTs because they're doing their job. Yell at them calling them all bigots THEN demand albuterol treatment (for the record the pt was a white man, as were all the fire EMTs)

3. When the ambulance crew (7ft black male paramedic and 5ft white female EMT) walk into the room, state that you don't trust women because they're all "lying b******"

4. Once all the fire and women EMTs leave the room (but are still within earshot), apologize to the medic for calling him "bro" (because it's offensive) and tell him over and over that you voted for Obama. The medic will tell you that he didn't, and ask what you want. Tell him you don't want to go to the hospital if a "sl*t of a woman" will be driving.

5. Sign the refusal form.


If you really want to piss them off, repeat above steps half an hour later, stating you were hoping to get a different crew. When they do take you to the hospital, yell at the MD, telling him he's a bigot because he's a white male (just like you! 🙄).
 
silverhorse84 said:
When they do take you to the hospital, yell at the MD, telling him he's a bigot because he's a white male (just like you! 🙄).
Click to expand...
We had a really weird one like that a while back. Had a woman who yelled at her nurse "You're treating me bad because you hate Mexicans!" The nurse, Maria Hernandez (not her real name but quite similar and written quite large on her prominantly displayed name badge) said "What did you say to me?" They then carried on a heated conversation in Spanish for about 10 minutes that included every word you didn't learn in High School Spanish. It was wild.
 
i once saw a crack head in the ER with his penis sliced open, his reason for doing this is that he was trying to install a 2 LED light bulb in, one to coordinate it with his blood flow to this body part, so the more blood circulation he had the lighter the LED would shine, and another one to turn on when he had finished ejaculating so that his sperm would glow in a neon purple light.
so morale of this story, never slice it, nobody wants to deal with your junk
 
ij1889 said:
he was trying to install a 2 LED light bulb in, one to coordinate it with his blood flow to this body part, so the more blood circulation he had the lighter the LED would shine, and another one to turn on when he had finished ejaculating so that his sperm would glow in a neon purple light.
Click to expand...

I almost want to take up crack... just so I can have the logic that would make me think that kind of idea would work. It sounds like a wonderful world to live in. 😀
 
Not EM in nature but...

If you have acute leukemia and...
A. Refuse to believe me (and the 4 other oncologists who have told you that you have it) and therefore refuse treatment
or
B. Think that Jesus will cure you and you don't need chemo

Things are not going to go well for either of us for the next few days but I will get to go home to my kid and you, unfortunately, will not.
 
gutonc said:
Not EM in nature but...

If you have acute leukemia and...
A. Refuse to believe me (and the 4 other oncologists who have told you that you have it) and therefore refuse treatment
or
B. Think that Jesus will cure you and you don't need chemo

Things are not going to go well for either of us for the next few days but I will get to go home to my kid and you, unfortunately, will not.
Click to expand...

Did psych get consulted? (had a similar case the other day with another type of cancer - pt was found to be unable to make her own decisions per psych)
 
EM2BE said:
Did psych get consulted? (had a similar case the other day with another type of cancer - pt was found to be unable to make her own decisions per psych)
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Of course. Except for emergency ED consults, psych in my institution is generally useless. Both were felt to have capacity and no underlying psych issues.

Pt A is starting to come around as she feels worse. Pt B is long since gone.
 
gutonc said:
Of course. Except for emergency ED consults, psych in my institution is generally useless. Both were felt to have capacity and no underlying psych issues.

Pt A is starting to come around as she feels worse. Pt B is long since gone.
Click to expand...

missed the OR part of it. Thought A and B were both belonging to one pt. Guess I should get more sleep. 😛
 
"You cant tell me I got cancer in my blood, you never looked at my blood, youre not my doctor, my doctor looked at my blood, he didnt tell me I got cancer in my blood, you cant tell me what I got, you dont know me..."

*she said to the chief of medical oncology
 
In my first month as an EMT, taking a history of a patient with abdominal pain:

Patient: I've got fibromyalgia, asthma, and Anna Maria.
Me: Say what?
My Partner, A Veteran Paramedic (without blinking an eye): So how long ago was it that you stopped having your period?
 
When treating patients with GSW's with yellow-ish discharge, you are always a rival gang member.

When your doctor introduces herself as your doctor, try not to repeatedly call her nurse and ask for sandwiches.
 
if you are 92 years old and a paramedic offers you a blanket, asking him to sit in your lap followed by telling him he is a son of a bitch for bringing you to the hospital after you called them for help, will win you a trip to bed 51 with a very fuzzy and warm vest 😀
 
Today I learned, when you are a new mother, the perfect place to bring your 6 day old new born is the ED, at 10 pm on a Sunday, for a well baby check up. The EMERGENCY MEDICINE doctor will be more than thrilled to look at your child, tell you it is well, and then refer you back to your PEDIATRICIAN for the next day during office hours, where you should have waited a mere 10 hours more to bring the little tyke in. Guess she was just overwhelmed with joy and couldn't wait to hear that her child was doing well.

I also learned that obtaining a derm spot really is more about who you know than what you know. Case in point I have a 10 year old patient sent in by her Dermatologist and her parents tell me they are here to see a neurologist, that Dr. _________ told them they would see on in the ED. After a good chuckle, I go on to inform them "That in the ED, they will see an EM doctor, and unless their daughter was admitted, would have to see the neurologist outpatient. Oh yeah, and by the way, maybe you should skip the neurologist all together, since the reason your daughter's hand is turning colors and becoming painful when she is outside in the cold is probably due to Raynaud's. Let me set you up with a rheumatologist."
 
Here are some of the triage notes from the last few days....

1) Have had diarrhea for a week- "I have been going thru a bowel cleanse".
2) Two months pregnant- "I don't know why I feel so nausious".
3)Knelt down, hit eye with branch from bush- no pain or visual disturbance.
4) Sore throat times 3 days.
5)Hernia appt next day-"I don't want to wait until tomorrow". Pt states "if there is a 6 hour wait, can I go shopping and come back?".
6)Altercation in group home, wants to jump in traffic (thought that was really funny).
7)"rolled ankle"-wants to get it checked, no difficulties ambulating.
8)chest tightness times 3 days with deep breathing-smokes 1 1/2 packs a day.
9)"felt something out of my butt" -pt had BM tonight, strained during. Same when looked in mirror, could see "tissue sticking out".
10)syncopal episode. Had 4 drinks and smoked pot prior to LOC.
11)"feeling unwell" since getting Litho done. (this pt went from being discharge off the day surgery unit straight to emerg then lied down on the ground as he didn't want to leave hospital).

Do you need more? back at work in 3 days...:scared:
 
This is just a second hand story about a frequent flier on the nephrology floor I used to work on.

If you use crack, it is perfectly acceptable to call EMS to take you to the hospital for SOB and volume overload, especially since you were too busy with your crack to take your BP meds and go to dialysis for the past four days. Furthermore, you can demand that EMS wait for you to finish performing oral sex to pay for your crack.

Also, apparently EMS will wait.
 
Had a 73 yo patient come in with complaints of chest pain. He was from out of town. He said he had 5 MI's in the past but only 2 were picked up by doctors. He reported having another heart attack that afternoon (about 2 hours before presentation), but he "had stretched and that had made the blood vessel unkink". In the ED his pain had resolved and ECG, troponin and basic labs were normal. He was admitted on his insistence that he had am MI and did not want this missed by the doctors.
Follow up troponin - 15.2, subsequent cath showed some atherosclerotic disease but no critical stenosis.
Dx- suspected vasospasm or a "kinked blood vessel"
 
Thanks for the great stories. Just had a stay in the hospital for a discectomy and bilateralhemilaminectomy on my L1,L2,L4,L5 After the last year of participating here, I made sure to be as pleasant for the nurses and everyone as I could.
 
Drawing Dead said:
And finally, I was down in the ED to admit someone the other day (I'm on IM service right now) and I see on the track board "Garlic soaked cotton ball in vagina x 2 days" so naturally I inquire to the resident seeing her when he tells me "No, it was actually a garlic clove". So naturally, I learned an effective way to keep vampires away when Aunt Flow is in town.
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Though really, it just kills all the little yeast monsters.
 
Here's something I really did learn from a patient today: the term "Jcat."

My suicidal, meth intoxicated psych patient kept screaming about how she "ain't no f****** Jcat." None of us knew what she was talking about. Well thank you Urban Dictionary I now know that a "Jcat" is a catagory J inmate in the CA state penal system. A catagory J inmate is one who has been deemed mentally incompetent. So in one word my patient told me that she had a history of mentall illness, is from CA and has spent time in prison.
 
docB said:
Here's something I really did learn from a patient today: the term "Jcat."

My suicidal, meth intoxicated psych patient kept screaming about how she "ain't no f****** Jcat." None of us knew what she was talking about. Well thank you Urban Dictionary I now know that a "Jcat" is a catagory J inmate in the CA state penal system. A catagory J inmate is one who has been deemed mentally incompetent. So in one word my patient told me that she had a history of mentall illness, is from CA and has spent time in prison.
Click to expand...

more_you_know1.jpg
 
Depakote said:
I just stole the past 3 images that were posted.
Click to expand...

Wow, I didn't know that you med students were such kleptos! 😉

[*goes back through thread and steals every image that's not nailed down*]
 
MacBook said:
Altercation in group home, wants to jump in traffic (thought that was really funny).
Click to expand...

Wow, I just spit gatorade on my shirt, got a visual.

I had 2 mentally handicapped folks find something to argue about the other day, both in hall beds across from one another. I couldn't even figure out what the hell they were arguing about, but it was probably the funniest thing I've ever seen, my attending couldn't keep a straight face. Meanwhile, my little old lady patient, who's room provided her a front row seat to the fiasco, had an episode of fecal incontinence from laughing so hard, so now the ED had a little spice in the air.

And of course, the next patient I pick up stares in horror and goes "Is this what it's like in here every day?"

If they only knew 😉
 
"Smoking in bathroom"
Since when did we become the principals office?

[Old psych patient at home, not allowed outside to smoke, instead smoked inside, was combative to them when they tried to stop her]
 
Something a friend of mine did just post surgery, while still out of his mind on the meds. He doesn't actually remember it, which is why I'm glad I'm there to remind him. I just have to share it here.

One of his doctors had noted on his chart that 'patient is a little s.o.b'

What does my genius friend do in response? He writes 'well **** you too' underneath it, and then spent the next few days dying of embarrassment when someone gently points out to him that it stands for short of breath. Heavy duty painkillers are a wonderful thing.

As is, I've just trawled through this whole thread, and damn. Only times I've ever been in emergency I've been pretty unpleasant, mostly because I've been in agonizing pain [fist time spinal injuries, and then my appendix] but, uh, yeah. Watching my mouth from now on. I never really looked at it from the other side.
 
Had an interesting interaction last week with a patient with fibromyalgia and other psych issues:

60 yo F CC SOB, cough productive of green sputum. Pt left AMA from nearby hospital after being diagnosed with pneumonia 24 hours prior.

Me: Why’d you leave the hospital?
Pt: I knew they weren’t doing anything for me. So, I went home so I could take my home remedy.
Me: What “home remedy?”
Pt: I drink olive oil mixed with some herbal ingredients and vinegar.
Me: That’s salad dressing. You’ve been drinking salad dressing to deal with your pneumonia? Was it balsamic vinegar you were using?
Pt: Well it works.
Me: Then why did you call an ambulance again if it’s working?
Pt: Because I still need to be on Dilaudid.

So I learned that salad dressing cures pneumonia but not fibromyalgia. Who knew?
 
Ha! Ive heard plenty of that shot of olive oil or vinegar in the morning routine.......salad dressing.... Ive never made that connection.
 
docB said:
Pt: I drink olive oil mixed with some herbal ingredients and vinegar.
Me: That’s salad dressing. You’ve been drinking salad dressing to deal with your pneumonia? Was it balsamic vinegar you were using?

So I learned that salad dressing cures pneumonia but not fibromyalgia. Who knew?
Click to expand...

Wow, that is the new grand champion of quotes on this thread, not only for its wittiness, but also for its overall comedy.

DocB, you are my mentor!
 
If you are an emaciated, 90-lb female crack addict still high from your last dose, it is a good idea to try to jump the 250-lb OS resident when he tells you he wants to biopsy that bizarre lesion in your (edentulous) mandible, shreaking "ain't nobody be cuttin' ME" all the while. It is an even better idea to wander around the area in your socks, poking your head into all the rooms and warning all the other patients not to let the doctors "be cuttin'" them. This will endear you to all the staff and they will be happy to fulfill your requests for a drink, etc.

No, we will not extract your (vital, non-carious, maxillary!) front tooth because it is a slightly different color than your other teeth, not even when you explain to us that a big black gap would be much more esthetically pleasing.

We will also not extract the rest of your teeth because you need the money to support your heroin habit and you can earn higher "fees" in your "profession" if you are completely edentulous. (I don't even want to think about that one 😱 )

It is a good idea to scream obscenities and generally abuse the resident as she prepares to use many sharp, pointy things in your mouth. Then, when she turns around brandishing the lidocaine-bearing syringe, you will slowly turn pale and deflate as you realize that perhaps that was not the wisest course of action after all 😀

If we write a med consult for you to bring to cardiologist because you tell us you 1. have a history of MI and 2. are currently experiencing chest pain as you sit in the chair, it is a good idea to get really mad at us when we persist in our foolish insistence that you go see your cardiologist before we take out the troublesome tooth. When your arguments of "I know my own body! The pain feels different than last time and my heart's fine!" fail to persuade us, rip up the consult into small peices, yelling that you'll go to a "real dentist" who will take out the tooth and you will sue us and the hospital for not treating you. That will only make us snigger and wish you luck as you stomp out of the room, the little paper bits of (what used to be a) med consult drifting behind you.

It has been, shall we say, a very edifying experience...
 
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