Wednesday, January 13, 2010

Going in circles

Dr. Grumpy: "Do you have high blood pressure?"

Mr. Brainless: "No."

Dr. Grumpy: "Do you take any medications?"

Mr. Brainless: "Zestril."

Dr. Grumpy: "What do you take that for?"

Mr. Brainless: "My high blood pressure."

Dr. Grumpy: "I thought you said you don't have high blood pressure?"

Mr. Brainless: "I don't if I take the Zestril."

32 comments:

  1. Sounds like my the same line of thinking my kids use... but they're kids.

    Morons make the world go 'round. Without them there would be 97% fewer blogs on the net.

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  2. He's an engineer. That's the way they think. You asked if he had high blood pressure- at that precise moment, it wasn't high, because of the medication. You didn't ask about the medication, so he didn't say it at first. Engineers literally cannot conceive of any other possible interpretation to your question. I know- I was married to one for ten years.

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  3. This is hilarious! Just yesterday, one of the techs at my store was talking about how, after calling a patient about her metformin and why she hadn't filled it recently, he was told that she'd "taken herself off and was fine." And I said, "Yeah, like those people who think they don't need to take their blood pressure medicines because the blood pressure reading is fine." And then, this entry.

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  4. Uh oh - am I as bad as one of your patients? Whenever I have to check a "high blood pressure" box on any kind of waiver or insurance form, I never know what I should do because technically, my blood pressure IS under control, albeit with a whack of medication.

    Although, if an actual doctor asked me if I had hypertension, I would say yes, so I'm not quite that guy.

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  5. As a triage nurse I always ask about the medications first, because people always deny any medical problems before telling you they take hctz, metformin, lipitor and coumadin. Guess they think they are all cured??

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  6. I've met a ton of patients like this. A little dim I guess, but then I remember that I would have responded like that guy before I went to med school.

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  7. I almost had that exact conversation with a patient yesterday who was hypertensive after surgery. It took all of my restraint to not slap my palm to my forehead in front of him!

    Dr Grumpy, I promise you are not the only person dealing with these people. We are all suffering along with you and feel your pain :)

    Ortho RN

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  8. to go against the tide here, he was telling the truth. he doesn't have high blood pressure cause he is taking his medication. what part of that don't u elitist medicos understand?

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  9. Sort of like Clinton saying, "No I am not having sex with Monica Lewinski." Not at that moment at least.
    And ya, I get that all the time from my patients, too. The thought process is that the disease is cured (not controlled) with the medicine.

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  10. Oh lord, have I ever heard this one before!

    I related a very similar conversation to my philosophy professor (who also teaches ethics and logic) last semester - he got quite a laugh out of it, then said that "in a very simplistic, circular kind of way" my patient was right: he DIDN'T have HTN.

    Anon is right; you aren't the only one dealing with people like that. We're all here with you!

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  11. I try to make an end run around this by asking "Does your doctor have you take any medicines for any problems or diseases?" Doesn't always work, but in my old job in home care time was money. And that doesn't even begin to address the oft-cited problem of "I take a blue pill for my heart and a white one for my water and..."

    How DID we keep our sanity (such as it is..) in the pre-internet blogless and message boardless days of yore???

    Dr. G and followers...thanks for gettin me through the day, smiling, without the use of psychotropic medications!

    Pattie, RN

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  12. I don't have HTN, I just take amlodipine because I like the way the name of the drug sounds...it just rolls off the tongue...
    Am-Lo-Di-Pine.

    That and I like the color of the pills.

    But I don't have HTN.

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  13. I get that all the time with high cholesterol, heart disease, and HTN. "I don't have it any more because of the meds I am on".
    Sigh

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  14. Not an engineer? I'm dying to know, what does/did he do for a living?? Please please tell-

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  15. Maybe then, the question should be, are you cured of any medical conditions...no, wait a minute, you might get clap in there. How about, 'what medications have you taken in the last year?'

    (I always like the answer, 'nope, I never took anything for no sickness, but I'm allergic to big penicillin doses, metronidazole, and disulfiram'.)

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  16. I don't believe there is anything wrong with being just a tad mentally behind...

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  17. I don't have high blood pressure if I take my medicine, either.

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  18. I used to wonder, too, what to say. "But with the drugs I don't have high blood pressure!" Eventually I realized that with the insulin I'm STILL a frakkin diabetic, and smacked myself upside the head.

    I'm not an engineer, I've just spent way too much time around them.

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  19. Sorry Grumpy...weird reasoning BUT quite true. He does not have high blood pressure now due to proper meds. Better question...what drugs do you take at this time. Duh.

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  20. You have to give him brownie points for being honest... it could be much worse. Surely you didn't lose brain cells when interviewing this patient... coming out annoyed and feeling like your IQ score just took a dump are two completely different kinds of patients... Just sayin.

    Leave it to the nurse to advocate... lol.

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  21. Every once in a while, I read the stuff your patients do and think, man, I'm glad I don't do that! Or at least I hope I don't. As a patient, I always stumble over mobility questions - if asked whether I can move something a certain way, I'm never certain if I'm being asked if it's physically possible for me to do it, or if I can do it without pain.

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  22. Priceless.

    word verification: micturea. interesting...

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  23. How hard is it to answer:

    "Yes, I have high blood pressure, but it is well-controlled with Enalapril/HCTZ."

    ???

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  24. Your stories and your patients make me giggle :)
    They also make me want to become a doctor even more.

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  25. Well, sometimes doctors don't ask questions the right way. Once I mentioned to a doctor that some of my symptoms went away when they stopped allowing people to smoke at work. The doctor said, "Is that when you quit smoking?" I have never smoked, and so I was trying to figure out whether the answer to that was "yes" or "no" and the doctor added, "Oh, you still smoke?" Yes, no, I don't know, pick one, they're all wrong.

    Sigh.

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  26. My husband is a physician and he has a similar story about his patient information form. It asks for "number of pregnancies; number of children," and he says many of the men answer, "zero; 2," or something along those lines.

    He thinks they are being dense but they ARE answering the question his form asks!

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  27. My grandfather עײה was going through his meds with me and the following conversation ensued:

    Me: "And the nexium, that's for your stomach."

    Him: "I don't have nothing wrong with my stomach!"

    Me: "That's because you're taking the nexium."

    Grandmother: "Oh, are those the purple ones I keep finding behind the radiator?"

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  28. I used to enter missing persons into NCIC (long before my current gig). One evening, I was entering a mental patient. Most of the meds listed on the report were in the benzo family. I had to flag the entry if he was dangerous, so I called the 'home'.

    "Oh, no, he's not violent."

    "I notice that he's on a number of tranquilizing meds. What is he like when he doesn't have them?"

    "Oh, then he gets right nasty. Takes a couple of men to control him."

    I flagged the entry.

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  29. Best question I've ever seen on a medical form:

    Do you practice an alternative lifestyle?

    (And, yes, there was a box to check for yes and a box for no....)

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So wadda you think?