Friday, January 30, 2009

Suffering patient

All right, today I had this talk with a migraine patient. For the record, I've been following her for over 5 years, and at every visit she tells me that her headaches have gotten worse from her last appointment (why she stays with me I have no idea).

Dr. Grumpy: "How are your headaches?"

Ms. X: "Oh, they're awful. They've gotten worse."

Dr. Grumpy (looking at chart): "At your last visit you told me they were constant and daily. How has that worsened?"

Ms. X: "They're now even MORE constant and MORE daily."

Thursday, January 29, 2009

Today's tip

Okay, Grumpy fans, today we have a helpful tip for other docs, which I learned yesterday when I went to go see a hospital patient I'd been consulted on.

It is NEVER EVER EVER a good sign when you go to see a new hospital consult, and when you get there the nurse is in the room, and she's just started doing chest compressions on your new consult, and as you walk in the nurse asks you to hit the "code blue" button on the wall next to you.

This is a bad sign. So now you know.

Monday, January 26, 2009

Psychologist who needs one

Okay, folks: one of my new patients today is a psychologist, who (according to his card) specializes in Obsessive-Compulsive Disorder (OCD).

He spent 50 minutes in my office while we reviewed his neck problems. During that time he got up 7 times to wash his hands in my sink.

Dude, you need to see a psychiatrist.

Friday, January 23, 2009

Why you should take your pills

Today I met a nice guy, early 20’s with seizures. He does fine if he takes his pills, and is good about doing so.

Unfortunately, last weekend he forgot to take his pills before going out for the evening.

He picked up a girl at a bar, and went back to her apartment. Apparently he had a seizure there.

All he knows is that one minute they were ripping each others’ clothes off. The next thing he knew he was lying on the stairs in front of her apartment, buck naked and freezing, with his clothes neatly folded on his chest.

Tuesday, January 20, 2009

Patient excuses

In a remarkable 8 hours of clinic today, an atypically large number of headache patients provided the following unusually creative excuses as to why their headaches were worse (not in any particular order):

1. My son and daughter-in-law went missing for 30 minutes, but it turned out they'd just stopped at a McDonald's.

2. My son married a Hispanic.

3. My son got lost during a tour of Alcatraz.

4. I was sexually assaulted, again.

5. My brother is brain dead at Downtown Hospital but he's only a little brain dead, not a lot.

6. My son's baby was born critically ill yesterday, but is fine now.

7. My daughter-in-law doesn't like her kids.

8. A bicycle hit my car, and ruined the paint.

9. I have a rectal abscess.

10. CPS took away my grandkids and gave them to the other grandma, and she's trailer trash.

11. I agreed to watch my grandkids, and now my daughter won't take them back.

12. I went to the ER for my headache, but they ran out of pain medicine.

Sunday, January 18, 2009

Bright families and sleepy people

I got called in today to see this elderly man, who lives with his kids.

On Friday night he fell asleep on the couch while watching TV. He looked so comfortable the family put a blanket over him and left him there.

He slept all day Saturday, barely moving. They left him alone.

And Sunday morning.

It wasn't until early Sunday afternoon that somebody thought, "Hey, Gramps hasn't woken up in over 40 hours. Maybe we should try to wake him".

Not surprisingly, they discovered they couldn't wake him up, and called 911.

So there's today's medical advice: It is NOT normal for the elderly to sleep for almost 48 continuous hours.

Friday, January 16, 2009

Idiocy at the Store

So after leaving the office last night I had to go to the store.

I'm waiting in line at the customer service counter. The guy in front of me has a shopping cart with 2 different kinds of coffee machines in them.

He goes up to the counter, and has this exchange with the girl:

Counter girl: "Yes, sir, can I help you?"

Guy in line: "I'd like to return a coffeemaker."

Counter girl: "Is something wrong with it?"

Guy in line: "No, I'd just gotten the GE by mistake, and I meant to get the Mr. Coffee"

Counter girl: "Okay. Can I see your receipt?"

Guy in line: "I don't have one. I haven't bought it."

Counter girl: "Excuse me?"

Guy in line: "I haven't paid for it yet. I'd just put the GE in my cart, then realized it was the wrong kind and got the Mr. Coffee. So now I need to return the GE."

Counter girl (looking shocked): "Um, if you haven't paid for it, sir, you can just put it back on the shelf when that happens."

Guy in line: "Oh." (pause). "Uh, what do I do now?"

Counter girl: (who's visibly trying not to laugh) "Just give me the GE and I'll take care of it, then take the Mr. Coffee over to check out".

He wandered off. I got up to the counter and said "I'm not with him, I swear".

She was laughing so hard she had to go to the break room, and someone else came over to help me.

Wednesday, January 14, 2009

Forgetful patient

Okay, we're back to patient stuff, and my first patient today has already provided material!

She was a nice lady in her 80's. While taking the history down, she mentioned having a mastectomy in 1990.

So I asked her which side the surgery was on. She frowned, then undid a few buttons, reached inside her blouse, squeezed each boob a few times, and said, "It was on the right"

Tuesday, January 13, 2009

Girl scout cookies

Ok, this will be my last non-medical practice entry for a while, but I felt like chipping this in after last weekend's entry on the Boy Scouts.

This is Girl Scout Cookie sales time, which means it's pretty much open season on anyone approaching the entrance to any local grocery store. My daughter and her henchgirls may assault you to try and sell cookies. So now you've been warned.

Anyway, my nurse, Annie, chipped in this story about her own daughter (Evie) and something that happened years ago. Take it away, Annie:

"We were in front of a Wal-Mart with the girls selling cookies. Evie said she had to go to the bathroom. Tired of her complaints, and cranky myself, I said no, just hold it. You can't go until you sell 3 more boxes of these damn cookies.

"So she goes back out to greet the next customer, a big lumberjack of a guy, and sizes him up for her cookie speech, with just one thing on her mind.

"So instead of asking, 'would you like to buy some cookies?', she asks 'Sir, would you like to go to the bathroom?'

"We all laughed enough to pee our pants, Evie did some kind of squat on the ground at the feet of the very embarrassed customer, where she sat on her feet in hopes not to pee herself.

"I abandoned the table and pulled both girls into the restroom, and laughed for the next 15 minutes until I caught my breath. Evie refused to leave the bathroom stall for the next half hour. Mr. Lumberjack bought 3 boxes of cookies on his way out, still smiling.

"That was our last cookie sale. Evie quit Girl Scouts the next day."

Saturday, January 10, 2009

Boy Scout Hike from Hell

Today's entry will have minimal, if any, medical relevance.

First, let me say that I'm an experienced hiker. When I was in residency I'd hike all over, regardless of time of year. I've hiked pretty much all terrain short of tundra. I've hiked to mountaintops in temperatures of 110 degress. I'm well aware of what precautions have to be taken, supplies carried, amount of water, and other emergency precautions.

So I recently took my son on a boy scout hike. I'm not a member of the den or any of that stuff. I'm just a parent who went on the hike with my kid. They told us to bring water, so I grabbed 2 of my old hiking bottles and we each took one, and some other junk, and took off.

The hike in total was a 2 mile round trip in a well maintained, ranger-patrolled, trail area.

We got to the meeting place, and I was AMAZED at what people were carrying for this pissy little hike on a surprisingly nice Winter's day. Water by the truckload. Cases of granola. Two people had backpacks with tents in them (no, rain was NOT forecast, or even suspected). Another guy was carrying a little coleman stove with a gas container (but no food to cook on it). There was a lady dragging a cooler with wheels on it, loaded with water (even though everyone had their own water bottle). Another bozo was even packing a BB gun, assumedly in case we ran into some dangerous, aggressive fauna, like a rabbit.

The leader was a guy in his late 50's with a beer belly, wearing a boy scout uniform. I have to say that nothing could possibly look more dorky on an adult male. They say women love a man in uniform, but I don't think that's the uniform they mean. If you wear it into a singles bar you'll be leaving alone (at least a STRAIGHT singles bar).

So the leader introduces himself, and says he'll take the front of the line, and his grandson, who had been an Eagle scout, will be the back of the line. At that point he gestured to his grandson, who was a sullen, glaring, teenager with multiple piercings, a few tatoos, and a pack of cigarettes in his pocket. He was mumbling into a cell phone and exuded a sense that he would rather be having his nuts chopped off than following his dorky looking grandfather around on a hike.

And off we went. 40 people and enough supplies to survive a nuclear war, for a 2 mile hike (NOT a "3 hour tour"). It was scenic and fun, and took about an hour. The only unexpected happening was when we wandered out of the grandson's cell phone range and he began screaming bloody murder. The ditzy woman with the cooler actually tried to offer him a bottle of water to cheer him up.

I was walking ahead of 2 dentists, who spent their time discussing different drilling techniques, the most pus they've ever seen in a dental abscess, and other interesting topics.

And so, at the end of this, we had to fill out a form for my son to get his hiking badge. As I've learned in the last year, the Boy Scouts award badges for the most mediocre of accomplishments, such as a 2 mile hike, attending a rodeo, or breathing. I think the badges would be more meaningful if they were for more challenging things, such as swimming the amazon, kayaking over waterfalls, and hand-to-hand grizzly combat.

And that's the way it is.

Idiocy in the news

A random pair of news stories.

The first is about a guy who robbed a bank after waiting in line wearing a ski mask!

And the second is a school bus driver who took the bus, and the kids on board on a beer run!

I can't make this stuff up.

Thursday, January 8, 2009

The FDA, drug companies, and your tax dollars

Okay, today I am going to rant about the FDA and tax dollars.

For years drug companies have given doctor's offices little junk like pens and post-it notes, with product names on them. This is a typical way of business in America. You see pens and sticky notes out there from paint stores, animal hospitals, car dealers, etc.

But the FDA decided that the bribery of physicians by 5-cent pens was a serious threat to the public health (as opposed to, say, Vioxx, a potentially dangerous drug that the FDA approved). Since a highly trained physician like myself (26 years of schooling all together) can apparently be swayed by a free plastic pen, it was in the best interests of the American public to ban cheap junk like free pens and sticky notes. So this went into effect last week.

So how does the FDA relax, knowing they are working hard to protect the public from abusive giving of free pens? By blowing $1.5 million of YOUR dollars on a "morale-boosting" retreat for their employees. That's how.

In addition, the FDA used some of this money to develop a slideshow portraying their top regulator, Janet Woodcock, as being a great visionary of the same stature as Gandhi.

I'm not making this up. Here's the article.

So, now that you feel good knowing that the FDA is both spending your money wisely and protecting you from medical-decision-altering plastic pens, let's consider what kind of drug marketing goes on overseas. For example, in Italy, where the drug reps went beyond pens, and just hired hookers to provide "services" to physicians.

I'm not making this up, either. Have a look.

And lastly: where else are your tax dollars and medications crossing paths? Why in the war on terror, of course! The CIA is using Viagra as another weapon on that front.

And here's that story.

And that's all I've got to rant about tonight. Actually, I'm sure I could think of more, but at this point am too tired and just want to go to bed.

Wednesday, January 7, 2009

Great cigarette quitters

Case I saw at the hospital today: Gentleman in his 70's, who was leaving his lung doctor's office after an emphysema appointment. The patient was quite proud that he'd been able to quit smoking for 6 months, and decided to celebrate by having a cigarette (REALLY!).

Anyway, he didn't have any cigarettes, but while walking to his car found a used butt lying in the parking lot, so he lit that. And then he passed out.

Monday, January 5, 2009

Sympathetic doctors

So I'm leaving the hospital after rounds, and stopped in the doctor's lounge to get a Diet Coke for the road.

As I wandered through there were 3 burned-out looking hospitalists watching TV. An ad came on for some antidepressant, featuring a sad-looking woman in a dark room, gazing blankly out a window.

The voice-over comes on. "Do you feel depressed? Have activities you used to like stopped being enjoyable? Do things seems hopeless? Shouldn't you talk to your doctor about these symptoms?"

All 3 of the other doc's together yelled "Fuck no!"

Sunday, January 4, 2009

Idiotic research

Doing some "catch-up" reading today.

The November 20, 2008 issue of "Neurology Today" actually featured an article which found that epilepsy patients who DON'T take their seizure medicines are more likely to have seizures, and seizure-related health problems, then those who DO take their pills.


Saturday, January 3, 2009

Radio station errors

Had to go in to the hospital this morning. I was listening to a station, when suddenly there was a CLICK!, and the song switched to the middle of a completely different song, then stopped.

DJ comes on, says "Sorry, got a technical problem here, let me switch to an ad while we work on it"

So this resturant ad comes on, in which a man and woman are listing menu items, then it switches to the announcer who says

“So if you're getting hungry, then come on over to Dave’s Grill, where we have (CLICK!) many programs available for HIV positive adults.”

I think they should just stop broadcasting until they get this fixed.

Thursday, January 1, 2009

Still more stupid phone calls

This time, one of my regular patients just called (and left a message) so I called him back:

Mr: X: "Hi, Dr. Grumpy. I had a seizure today, and one yesterday, too."

Dr. Grumpy: "Have you been sick or made any medication changes?"

Mr. X: "Nope. Same dose as always."

Dr. Grumpy: "Did you miss any doses?"

Mr. X: "I haven't taken any in 3 days."

Dr. Grumpy: "WHAT?!!"

Mr. X: "Yeah, I ran out, and haven't gotten it refilled. Do you think that's the problem?"

Dr. Grumpy: "Yes! Why didn't you get it refilled?"

Mr. X: "I didn't want to bother the pharmacist over the holidays."

Stupid phone calls

Today is a holiday, so my office is closed.

In the last 2 hours my office line has gotten 7 (count 'em- 7!) calls, all from the same local phone number on the ID, which I recognize as being one of my patients.

In spite of this persistent calling they are not leaving a message, just hanging up on the "our office is closed, if you need the doctor on call" notice.

Oh! They just called again, while I'm typing! And hung up again! What the hell are these people thinking? That we are going to open on a holiday? That someone dropping in to check the fax machine will see the phone ringing and answer it? That we will forget it's a holiday and open the office?

And I just know, when we are open again, they likely won't call then.
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