Tuesday, January 19, 2010

Fun with patients

Mr. Math: "Doc, I'm concerned about my liver on all these pills."

Dr. Grumpy: "What dose are you up to now?"

Mr. Math: "Um, I've got the 25mg pills, and I'm taking 4 of them, twice a day."

Dr. Grumpy: "That's a standard dose, you should be okay."

Mr. Math: "I dunno. I read some scary stuff online about taking so many pills, and I'd like to change."

Dr. Grumpy: "How about if I change you to the 100mg pills, and you take one twice each day?"

Mr. Math: "Oh, that's fine. Thank you for working with me on this."

26 comments:

Banshee said...

haha, really? I'd have been pissed...but I am good at The Math. :)

I love your blog! Thanks for sharing

Grumpy, M.D. said...

May I point out he NEVER mentioned dosage size- he was concerned about the number of pills he was taking.

So I addressed that to his satisfaction. I never lied to him. I never said I was changing his dose- nor did he ask me to.

And we're both happy.

Maha said...

I find its not so much the dosage of the medication that has people concerned, its the number of pills/day. I had a guy argue with me about giving him two 20 mg tabs of lasix saying it was too much but when I waltzed in with a 40 mg tab, he was all sorts of happy.

Another satisfied customer!

terri c said...

This is great. The best part is that if your patient tells all his friends how helpful you were, you'll get more blog material!

Cate said...

.... that's crazy. can't wait til i have patients of my own lol

Stitch said...

must be a relative a patient that one of the orthos husband works with had over the weekend... totally relieved his ankle was just broken and not fractured.

mean_owen said...

It reminds me of a joke (most things do):

One day after work, Dufus walked into a pizza parlor and ordered a large pizza. When it was ready, the waiter asked if he wanted it cut into eight pieces or sixteen. "Better make it eight, he said. "I'd never be able to eat sixteen."

Helen said...

Oh, you're sneaky. Well done.

Albinoblackbear said...

A colleague of mine used to give patients a push of "normal saline" pronounced "norMAAL sal-YNE".

Worked wonders.

minimedic said...

Please tell me this man doesn't use math daily in his chosen profession. 'Cause I'm gonna make a mental note to avoid him!

WarmSocks said...

Seems like it would be the overall dose rather than the number of pills that would affect the liver. Then again, I gotta say I'd be happy to reduce my annual pill intake by 2,190. That's what you did for him.

Old MD Girl said...

Awesome customer service Dr. G.

donna said...

OMDG! The internet is such a
dangerous place. For better or worse! It is such a catch 21!
T.V. Tells patients (with the new
guidlines) to ask for the them
to ask for the pure formof amy given rx...ex. vicodan, they are asked for it w/out the tylenol. I
have hurd stories that this is done, them they are given the hairy eyeball! Then they are given
a red flag as a seeker. You can't win for losing. I hope this story
is appropriate for 'fun with patiens' Everything is getting too
complicated!

Please don't get me started with
Toradol!

ERP said...

Maybe he was afraid of aspirating the pills.

MJH, CPhT said...

Nice work! Especially since taking two pills a day instead of 8 pills a day will save him, his insurance, or both a -lot- of money in the long run. :)

Mr. Knucklehead said...

You have definitely figured out how to work with those nutjob patients of yours. Kudos!

Flavius said...

This could stem from the naproxen ads stating that you take less pills with naproxen than tylenol or advil. Because, as we all know, if you take less pills, you're obviously healthier.

Awesome, how you were able to stick it to him so surreptitiously.

-Flavius

Grinch said...

Oh, you are a crafty one, you are.

Julie said...

great work!

Lipstick said...

Oh Dr. Grumpy, I just laughed so loudly that Mr. Lipstick paused the TV and asked me what was going on.

We at Lipstick Pharmacy see these sort of mathematicians frequently. Sometimes they think the prescription vials are optical illusions too.

Anonymous said...

@MJH - it depends. If 8, 25mg LTG won't cause a pt to rash out, but 2, 100mg will due to different fillers... no one wins if the pt is switched to 2, 100mg LTG tablets.

Anonymous said...

So now I gotta know, was the drug Topamax? Its the first drug I thought of when I read this

RxTech

axl said...

You should have prescribed one 200mg tab (oval) cut in half with the nifty pill cutter.

Shalom said...

@Donna: There's only one problem with that, which is that hydrocodone by itself, without APAP (tylenol) in it, is a schedule II controlled substance and isn't commercially available in the USA...

Todd said...

Could be topamax. My first thought was Lyrica, in which case he is saving $$$ by taking 2 caps rather than 8.

Frantic Pharmacist said...

This is indeed a weird phenomenon. So many times I'm going over the directions on a prescription with a customer and all they want to know is how many they take PER DAY -- not how many, and not how often. It's odd.

 
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