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deleted77919
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Oh. My. God.
The guy who works on the gulf coast of Florida is going to go type up a LIST.
BRB.
The guy who works on the gulf coast of Florida is going to go type up a LIST.
BRB.
D
deleted77919
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Don't come to the ed at 3 am for your atypical chest pain x 1 year already been worked up with ecg xray labs stress test cardiac cath coronary cta cardiac mri pet panscan just because you had a sharp twinge and your pmd doesn't open until 8
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Might as well come in now because the pmd is going to send you this way, anyways
Discuss code status/end of life wishes with your family before it is time.
Carry a list of meds/allergies/PMHx/PMSx /etc in your wallet/purse. Attach a copy to your fridge for EMS to grab in the event of an emergency.
Carry a list of meds/allergies/PMHx/PMSx /etc in your wallet/purse. Attach a copy to your fridge for EMS to grab in the event of an emergency.
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Put your DNR form on the fridge (or the back of the front door?) so the medics will see it. And in your wallet, and a copy of meds and your PCP would be nice too.
D
deleted109597
I wish they knew to just up and die, without people being nearby
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Don't check your blood pressure at home. (or at Walgreens)
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Do not come in at night...after the freakin streetlights are out for social work problems (don't like our nursing home, wife/grandma is too hard to care for, bla bla)!!!!
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If your a known COPDer and still smoking...just be on F-ing hospice!!!!!!!!!!!!!!!!!!!!!!!!x10^100
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1. It is your responsibility to know WHO your (cardiologist/nephrologist/neurologist is). Write it down, put it in your wallet (or on the fridge, as suggested above). Answers such as - "He's the Indian guy; I can't pronounce his name, starts with a "R"." are not helpful.
2. Do not go to the supermarket/drugstore/etc and put your arm in that blood pressure cuff. Just don't do it.
3. Following (2): ASYMPTOMATIC HTN IS NOT AN EMERGENCY.
4. The ER is not "just to get checked out". This is the Emergency Department, not the "I'm just not sure, but won't accept any answer that I don't like" Department. If you have anything that sounds like an anginal equivalent, you're not going home without signing lots of AMA paperwork.
5. If you are a snowbird, and you spend 6+ months here in FL (or wherever)... YOU NEED A LOCAL PMD. No, I will not call your PMD in Michigan at 2 AM and ask him what meds you're taking and why.
6. We do not do "medical check-out" exams/visits prior to long trips/drives back to Canada/etc. No, prophylactic antibiotics will not be given to you "just in case you get sick on the way".
7. No, I cannot predict that you'll "be fine to go on the cruise in 3 weeks". I don't have a crystal ball.
8. Yes, you can pronounce the names of your medications. Cou-mah-din. If you can say "Schenectady", you can say "Ma-TOE-pro-lol."
9. The answer to "Why do you take this medication?" is never - "because my doctor told me to".
10. No, I cannot answer questions about your bill. I never see a bill. I never send a bill. I am not responsible for what and how you are charged.
11. Go back to Quebec. Please. Oh, and yes - we have this practice here called "tipping". The French word is "pourbois". Gratuity is generally 18%, you cheap Frenchies. (This one was not ER-relevant, but needs to be said anyways).
12. I am an Emergency Physician. Please don't confuse me with the concierge at your hotel.
I could go on all day. This reminded me that "season" is coming in hot in like... 8 minutes.
2. Do not go to the supermarket/drugstore/etc and put your arm in that blood pressure cuff. Just don't do it.
3. Following (2): ASYMPTOMATIC HTN IS NOT AN EMERGENCY.
4. The ER is not "just to get checked out". This is the Emergency Department, not the "I'm just not sure, but won't accept any answer that I don't like" Department. If you have anything that sounds like an anginal equivalent, you're not going home without signing lots of AMA paperwork.
5. If you are a snowbird, and you spend 6+ months here in FL (or wherever)... YOU NEED A LOCAL PMD. No, I will not call your PMD in Michigan at 2 AM and ask him what meds you're taking and why.
6. We do not do "medical check-out" exams/visits prior to long trips/drives back to Canada/etc. No, prophylactic antibiotics will not be given to you "just in case you get sick on the way".
7. No, I cannot predict that you'll "be fine to go on the cruise in 3 weeks". I don't have a crystal ball.
8. Yes, you can pronounce the names of your medications. Cou-mah-din. If you can say "Schenectady", you can say "Ma-TOE-pro-lol."
9. The answer to "Why do you take this medication?" is never - "because my doctor told me to".
10. No, I cannot answer questions about your bill. I never see a bill. I never send a bill. I am not responsible for what and how you are charged.
11. Go back to Quebec. Please. Oh, and yes - we have this practice here called "tipping". The French word is "pourbois". Gratuity is generally 18%, you cheap Frenchies. (This one was not ER-relevant, but needs to be said anyways).
12. I am an Emergency Physician. Please don't confuse me with the concierge at your hotel.
I could go on all day. This reminded me that "season" is coming in hot in like... 8 minutes.
At least they're taking their medication... better than the "I have cardiomyopathy, but don't take my metoprolol or lisinopril because my BP is good!"
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Ug... Foxy, I worry that Season is already here. Got my ass handed to me tonight... gotta love the unstable is-it-just-rapid-AF-with-rate-related-ST-changes-or-is-it-posterior-STEMI in the midst of "damn, pancreatic cancer is a bitch" +/- sepsis/PE/what-the-hell-grown-ups-aren't-supposed-to-get-intusseption kind of night. I was kinda surprised the rad didn't call me on that one. Geez.
Got killed all weekend. I'm afraid the snowbirds are returning early. It's going to make for an ugly winter. I had 4 hospice referrals this weekend alone. (As in 4 "go directly to hospice house, don't even get admitted" hospice referrals.)
On a brighter note, 2.5 parts vodka + 1 part St Germain + splash vermouth + olives is helping a great deal.
Ok, back to your regularly scheduled bitching, erm, I mean, programming.
Got killed all weekend. I'm afraid the snowbirds are returning early. It's going to make for an ugly winter. I had 4 hospice referrals this weekend alone. (As in 4 "go directly to hospice house, don't even get admitted" hospice referrals.)
On a brighter note, 2.5 parts vodka + 1 part St Germain + splash vermouth + olives is helping a great deal.
Ok, back to your regularly scheduled bitching, erm, I mean, programming.
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It's ok to go a day without pooping.
Drug interactions are real. If you take warfarin, double check with the pharmacist before you start taking amiodarone/Levofloxacin/etc
(Saw an inr of 24 this weekend who wasn't told to decrease her warfarin when they started amiodarone. Oops.)
Sent from my iPhone using SDN mobile app
Drug interactions are real. If you take warfarin, double check with the pharmacist before you start taking amiodarone/Levofloxacin/etc
(Saw an inr of 24 this weekend who wasn't told to decrease her warfarin when they started amiodarone. Oops.)
Sent from my iPhone using SDN mobile app
D
deleted109597
You drink vodka cocktails? Instead of actual martinis?
And I though we were friends...
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dChristismi and I used to work together at the same shop. Her place has crazy high acuity.
I feel yah, amiga. Embrace the suck.
I feel yah, amiga. Embrace the suck.
D
deleted77919
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This is like the lung transplant patient who stopped taking anti-rejection drugs because "I thought once I run out I don't have to take it anymore".
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I do not mean to hijack the thread, but as a PCP who sees my partners patients for acute illnesses as a courtesy a lot of these complaints are similar --- If I may --
1) Presenting with a complaint of "I don't feel good" without being able to elucidate a specific thing is either a) not going to go anywhere and no, you don't get antibiotics, steroid shots, Norco or anything else or b) a million dollar workup that you'd better be prepared to pay for, depending on your insistence. And yes, the ER did do something for you the last time you went there on your own --- you were discharged after they did a complete workup and found nothing acute/life threatening/worthy of admission -- the 2 bags of NS likely resolved the hyponatremia that I told you to follow up for in one week but you elected to blow off.
2) Do not decide to present to me as a new patient after stopping all of your meds including: digoxin, amiodarone,insulin,synthroid so that we have a "clean slate" to start from -- works well in engineering but no so good in medicine.
3) Research -- do not confuse a Google Search with research -- you tend to piss me off when you insist that you've done your "research" and insist that the 50 pound weight gain after 3 children is a result of you not being on Armour Thyroid yet you can't tell me the journal article title or present an abstract from the PubMed database.
4) yes, we will have to take the opinion of someone who did 4 years of undergrad, 4 years of med school, 3 years of IM, 2 years of cardiology/electrocardiology fellowship and has been practicing as a board certified cardiologist for 10 years over one Reader's Digest article.
5) No, the pain management specialist will not start reissuing prescriptions for pain meds because I call them since you admitted to SI and were hospitalized for it. You need to go to the new specialist that has agreed to take care of you.
6) I regularly give you ER warnings that are legit. Quit using them as a PCP office for every little sniffle/cough/joint pain.
7) Yes, your diet is likely a component of the abdominal pain you just presented for -- How do I know? Well, when you tell me that you had abdominal pain with nausea this morning which began resolving but you decide to test your ability to tolerate PO with chips, salsa and a coke and the pain returns with a vengeance, I can guess that the root of the problem is likely diet mediated....oh, by the way, spandex is a privilege, not a right.
1) Presenting with a complaint of "I don't feel good" without being able to elucidate a specific thing is either a) not going to go anywhere and no, you don't get antibiotics, steroid shots, Norco or anything else or b) a million dollar workup that you'd better be prepared to pay for, depending on your insistence. And yes, the ER did do something for you the last time you went there on your own --- you were discharged after they did a complete workup and found nothing acute/life threatening/worthy of admission -- the 2 bags of NS likely resolved the hyponatremia that I told you to follow up for in one week but you elected to blow off.
2) Do not decide to present to me as a new patient after stopping all of your meds including: digoxin, amiodarone,insulin,synthroid so that we have a "clean slate" to start from -- works well in engineering but no so good in medicine.
3) Research -- do not confuse a Google Search with research -- you tend to piss me off when you insist that you've done your "research" and insist that the 50 pound weight gain after 3 children is a result of you not being on Armour Thyroid yet you can't tell me the journal article title or present an abstract from the PubMed database.
4) yes, we will have to take the opinion of someone who did 4 years of undergrad, 4 years of med school, 3 years of IM, 2 years of cardiology/electrocardiology fellowship and has been practicing as a board certified cardiologist for 10 years over one Reader's Digest article.
5) No, the pain management specialist will not start reissuing prescriptions for pain meds because I call them since you admitted to SI and were hospitalized for it. You need to go to the new specialist that has agreed to take care of you.
6) I regularly give you ER warnings that are legit. Quit using them as a PCP office for every little sniffle/cough/joint pain.
7) Yes, your diet is likely a component of the abdominal pain you just presented for -- How do I know? Well, when you tell me that you had abdominal pain with nausea this morning which began resolving but you decide to test your ability to tolerate PO with chips, salsa and a coke and the pain returns with a vengeance, I can guess that the root of the problem is likely diet mediated....oh, by the way, spandex is a privilege, not a right.
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Depends on how I feel. Never fear, I drink plenty of gin too.
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