The hallway from my exam room to the lobby is a straight 10 feet, so I use it to watch patients walk when they come in.
On the way back to my room the patient limped on his right leg, and held a cane in his right hand.
Afterwards, on the way back to the lobby, he limped on his left leg and held the cane in his left hand.
49 comments:
I needed that laugh. The husband went to visit an old family friend last year and was just disgusted that the man was proud of being on disability, the cause of his disability? I'll give you one FAT guess. GAH!
Failed claim!
Funny. Before he retired, my father worked in the Worker's Comp field and he would try to catch people thought to be scamming. Now, my father looks a bit like a cross between Alfred E. Newman and Ross Perot and at the time he was driving an old, beat up car. Keep that in mind when reading the rest of this, just so you can get a full picture. There was a guy who had been scamming them...said he couldn't work, totally disabled, couldn't walk, had to use a wheelchair at all times, that kind of thing. My father went out with a camera and took pictures of the guy who was UP ON A LADDER PAINTING A HOUSE. Yeah, really disabled, huh? The guy saw my father, ran down the ladder and started chasing him. My father (remember what he looks like and the car he was driving) took off running towards his car, jumped in and sped away, with this not disabled disabled guy in hot pursuit in his car! Hehehe. Hysterical. So glad that guy didn't have a gun.
Nice! Anybody that dumb should be busted. ;)
Oh, that would be my neighbor. On "full disability," yet: plays basketball in the driveway, plays football in the street, jogs every day, rides his bike every day, has a lawnmowing and snowblowing service (the profits from which he is obviously not reporting to Uncle Sam or the State), and does all of his own home improvements, including roofing and siding work. So what's the problem?
It's that kind of thing that makes us cynical:-)
obviously he is paralyzed on the west side of his body...
selective limp?
It was YOUR right coming in, YOUR left going out.
Anonymous at 8:13 - you can always anonymously report disability fraud, especially if he's working.
You know, I wrote up this long-winded reply about how SSDI isn't the same as workman's comp, how not all disabilities are visible, how, yes, some people cheat the system(s) but it's *very* hard to with SSDI (why do you think most people don't get in on the first try?), how SSDI is not "you're in for life", etc. etc. etc.
Then I decided I needed a day off from attempting (and, surely, failing) to educate know-it-alls who don't know shit about how SSDI works, how you qualify, and even fail the knowledge that you can work while collecting it, all too busy spouting their misinformation to bother finding out the facts.
But before I give a giant middle finger to the idjits here, I would like to point out the *other* failure of this "patient".
PAY ATTENTION HERE, YOU INSURANCE FRAUDSTERS.
If your RIGHT leg is damaged, you hold your cane in your LEFT hand. If you hold it on the RIGHT side and actually try to use it, and your leg actually is weak, I guarantee you you will fall on your ass within 20 steps.
Now, idjits, go STFU and go visit the Clue Farm. The Clue Fairy is waiting for you with her Magic Bat of Clue.
Maybe BOTH his legs hurt and he has to switch off resting them. Didn't think of that? Your yaks never hurt more than one leg at a time, you FRAUD?
Your hallway is tilted.
Moose:
Thanks for bringing up that not all disabilities are visible. My mother is on full diability due to some mental health problems. To look at her, you wouldn't see any reason to be on disability, but it's very necessary. She can do a lot of physical activities, but isn't capable of the personal interactions necessary to hold a job.
That being said, the guy actually referenced in this post does sound like he's trying to put something over on Dr. G...
Yes, Moose, but if you are confined to a wheelchair and can't walk, you probably also can't climb a ladder to paint a house and then chase someone to their car.
One thing of note though, I use a cane and sometimes switch between hands. I still limp with the same leg due to knee damage, but I mostly use the cane because of my spine issues. Both my hands have carpal and are in braces, so I have to switch the cane usage frequently or my wrists give out entirely. So it's not a sure-fire way to determine fraud, some of us may just be ridiculously injured because our bodies are against us.
Not certain switching the cane from hand to hand is a clue to fraud. But if he were twirling it while he skipped out of the office, now that would be a clue!
@sylphon: True that. Back on '09 I had knee surgery for a torn cartiledge and removal of osteophytes. I was sent home in an ace wrap and told I should be able to start walking fairly normally within two days. I ended up on two crutches for over a month, and then one crutch/cane for several more. Problem was, it was the left knee, but I was also due to have surgery on my wright wrist for other issues, and could not put any weight on it, no matter what type of crutch or cane I used.
I have had injuries to both knees. Post surgery, sometimes one hurt more than the other, so I switched sides with my cane and limped on the opposite foot.
I don't know if your patient is trying to commit fraud or not, but I know that it's possible to hurt on different sides on the same day.
:)
To MSGMD -- Laughed OUT LOUD! Thanks!
I won't say there are no exceptions, but it certainly seems that switching the cane when only one leg is supposedly injured is a giveaway. In my case, both legs were weak, and I started using a cane when I could barely get by without a walker. I almost never switched hands — I preferred to keep it in my dominant (right) hand, so had to go up and down stairs on the left so as to hang on. A physical therapist wanted me to get two canes, but I wanted one free hand. It worked out ok, so it is possible to walk with a weak leg on the cane side, but it's precarious.
@Moose: Yes, there are exceptions, but there are also people on disability who simply found a compliant doctor and/or did some good acting.
I personally am acquainted with a couple of women on full disability, who are nonetheless entirely able to run regular flea market stands.
Now, maybe you'll say that the rules allow this. If so, the rules need changed. These women are running their own small businesses, doing the same work as all the other people at the flea market. They very clearly are not fully disabled.
This kind of thing doesn't make us "idjits". It just makes us skeptical of any apparently able-bodied person on disability.
so, um, you didn't think it was your responsibility & duty as a physician to take the extra 30 seconds out of your busy day to ask him WHY? The answer might have been enlightening as to his condition.
I realize this blog is about jerky patients but....Cold...very cold Dr. Grumpy.
BTW
Kim -- I did point out that disability is not workman's comp, which is far more restrictive about what it covers. If you're supposed to be in a wheelchair, of course you aren't supposed to be able to run.
Anonymous Idjit at 1:40pm: Please listen to previous advice to STFU and MYOB. You're the classic example of what I was talking about. I could point out the 1001 things wrong with your idjit statements, but I'm on vacation from idjitcy today.
In general: An orthopedist told me that you're not supposed to use a cane if you're putting weight on it (ie. leaning on it with your hand). Canes are for balance. If a leg won't hold weight, you're really supposed to use a walker. I use a quad-pod cane, which has four feet. It's not a true walker, it looks more like a cane, but it's designed to actually hold someone up. The catch is, it can cause wrist problems if used too much for support. That's when you're supposed to switch to a walker.
I'll get the walker with my aarp card.
This thread got me thinking about people I know. I know one guy who is out on disability and collects SSDI because he is overweight. Seriously, he'll tell anyone about how he is working the system. He can work and actively seeks out jobs where he will make money but not so much that he'll stop getting benefits, or he works under the table. On the other hand, one of my very best friends was born without the use of his legs and several other medical issues. He had shunts to drain fluid from his brain, he had cancer, he was unable to walk, but that didn't stop him from going to school, getting a degree, living on his own and working. He was very independent until his sudden and very unexpected death last month. You'd never see him asking anyone for anything - he didn't want anything from anyone if he couldn't do it on his own. Very determined.
I'm one of those on SSDI who works part time.I work every other weekend,some months that means I work 3 weekends.When I do,I make too much money to qualify and SSDI wants to take back all money for the whole year because of that.Since I can not work full time I won't qualify for insurance through my job.If I lose my SSDI I lose my insurance.My meds run $1,800.00 a month,there are currently no generic meds available to me,so I can't afford to lose my SSDI.So yes,I can work a few more days and earn a living wage without SSDI but if I lose the insurance I'll be right back in the hospital and worse off then I am now.No I'm not "working the system". It's frustrating to know I'm stuck like this for the rest of my life.What I now make in a month I used to make in a paycheck.This was not in my life plan but I'm stuck with it.
People may see me out in my yard gardening or cutting the grass,what they don't see is that I then spend the rest of that day and most of the next in bed because I'm so exhausted from what I did.
But, anonymous 3:23, do you brag about how you are working the system? This person does. Therefore, you are not like him...he really is scamming and is proud of it.
Moose, your orthopedist may have been thinking only of people with injuries within his specialty. These are not the only people who need a cane. I have considerable experience with impaired strength and balance, but with no orthopedist in the picture. I put considerable weight on my cane quite often when there was no place handy to sit down for a rest. I wasn't about to take my walker around any more than was absolutely necessary.
Anon at 3:23, you are absolutely correct that people with legitimate claims to SSDI can nevertheless do some physical activity within their limits, and even earn a little money. The problem is that there are definitely those persons who are working the system, so there is a tendency for people to be suspicious.
A person who has had to give up a career because of disability should not have to sit around doing nothing to justify the SSDI payments. Do what you can and earn what you can within the SSDI rules.
Moose, you're not educating anybody with your rude and obnoxious behavior. Just who do you think you are that you can tell total strangers to STFU and MYOB on a public commenting forum. (Only Dr. Grumpy gets to do that and make it stick.)
Regardless of what you think, it *is* our business. Why? Because the folks out here who are working their asses off and paying the taxes are getting sick and tired of the moochers and freeloaders that are gaming the system. You are correct in that we don't always know what a particular individuals circumstance might be, and we all know that not *everybody* is gaming the system. Nonetheless, there are enough who are - and are brazen about it - to cause this sort of negative reaction from folks. Me and a lot of others along with me, are getting heartily tired of paying out more and more in taxes to support these neer-do-wells. And it's flippant and rude as hell to tell people to STFU and MYOB when they point this out.
Me thinks thou dost protest too much!
My daughter has a genetic disorder that affects all connective tissue in her body. Before she was 25, she had 13 surgeries - including open heart surgery to replace her aorta - and will have more on her joints that just refuse to behave as joints should. It took over 3 years, 3 denials, and a lawyer before she was qualified for SSDI for a whopping $600 a month and food stamps of $50 a month. Yep, she sure is getting rich on scamming the system.
Before Moose made a definitive comment, I too, felt a bit miffed about this story. As a pharmacist, we see all kinds of issues.
1. I used to work as a nurse aide, in pre-pharmacy days, and I will never forget the elderly patient that would moan and groan about her aches and pain until the nurse brought her acetaminophen, and then immediately she looked and sounded better. I didn't think there was time enough for drug to start dissolving, but apparently effective the moment it passed her lips--a degree of anxiety about receiving the meds in this case.
2. I work in a hospital and wear a white lab jacket. When I walk through the ER, it never fails to amuse me if walking slowly enough down the corridor, a calm person, apparently on seeing my white coat, immediately starts groaning and writhing. (It happens with the white-jacketed dietician, as well.)
3. When I worked with an orthopedic surgeon during pharmacy training, his watchwords were to 'keep moving', for patients to keep their joints flexible or they would end up fighting painful arthritic changes with weakened supporting musculature. Sometimes, braces, or other medical equipment are necessary to 'keep moving', and sometimes it's pain meds, or corticosteroids and anti-inflammatories, or swimming and other physical therapy.
4. I have arthritis, especially in right knee. I injured my left knee. I knew I had to keep moving or my leg would stiffen up, but I compensated for the aches in each leg so much that I ended up with both hurting, and me limping, and then my hips started aching.
5. When I had HCW (healthcare worker)-associated hepatitis C with enlarged spleen, the doctor told me to go home and stay in bed for two weeks, not to do anything, nor drive. After that, I was pretty de-conditioned. When I started taking interferon which made bones ache, it was an effort to walk across the parking lot to work, even. (One foot in front of the other, next foot, etc.)
5. As a HCW, I sometimes have what are called 'spidey senses' that may seem unexplainable to the average Joe about why we (not specifically speaking for Dr. G., but may be) make decisions based on experiences, and sometimes we have to acknowledge that opinions are based on something tangible such as switching a cane and limping on the other leg one way down the hallway. But, I do have to occasionally have to remind myself the reality of those really in need of care cannot trump the need of scoundrels for their own reasons.
i'm on disability for a mental health condition, and will be for another year or so... can't wait to get off of it, btw. i've worked really hard to learn, improve, and heal.
when i had to be evaluated, it was by a psychologist. i assume that if a neurologist is evaluating a patient, he is claiming to have some kind of neurological disability, and i assume dr. grumpy is qualified to do evaluations like this.
apparently some people have to try again and again to get their disability.... i didn't have any problem at all qualifying, but of course i applied when i was a court ordered patient at a state psychiatric hospital.... sort of hard to fake the need to be there.
that said, even on my worst days, i could sometimes, somewhat hide how bad things had gotten. i could present like a normal human being. the day i tried to kill myself (one of the times), i did so after attending worship at my church.
so it's true for psychiatric stuff, you never know how someone suffers in private or how their suffering affects their functioning at a regular full time job.
i don't know anything about limping, though, or canes, or any of that... that's far outside of my range of knowledge.
i do, however, know that working is much better than not working for me, and i can't wait to try again. gaming the system hurts everyone, especially the person doing the gaming, it seems to me.
I had to have a wee chuckle at that dr g. When i had to go to umpteen dr, for a medico legal thing from my accident they were all asked if it was a real head injury and to comment on the other injuries. Ok as far as the nuro but the ortho only knew the boney bits, so why ask about the dunt to the heid? The eye people knew the problem was not so much with the eys oncew they were both pointing almost the same way, but they couldnt comment on the boney bits. It did make my family wonder why they had asked the same questions of all the doctors..I dont look disabled now, injections in my eyes, broken bits mended and my arm is almost working normal,only people who knew me before the accident know i am not quite right now. I seem to upset people with the way i speak, but hey no one is perfect.
I think some people do the sue thing for a quick lump of money but i didnt care about money, still dont. and i ttook 7 yrs.
Glad you dont take much notive of eejits, get rid of the lawer who make squillions and then they wont bother you, and it wont take 7 yrs for people like me.
P.S. I like your style. i think skool nurse is cool and i never laughed so much reading your holiday stories!
S. UK
Come on people, some people scam, I know several. Some people don't. If you are on disability and it's legit, fine. If you're scamming, you're an idiot and thief. I didn't say everyone on disability was scamming, I said some people were. I didn't say anyone was getting rich off of it. If you're legitimately on disability and offended by my saying that some people are scamming, you shouldn't be. You should, however, be pissed off at the people who are scamming because they are the people who make other people suspicious.
Geeesh, Dr. Grumpy, I think you hit a nerve with this post! This thread reminds me of why I no longer blog. Well, that and the fact that I acquired stalkers who somehow figured out where I lived and wanted me to post nude photos. Sigh.
Five spine urgeries later and not much left to fuse I'll favor whichever side is making life miserable that day and the cane will swap sides, also. However, I do suspect your patient in question may have other issues. Just suspicious and cynical that way, I suppose.
Or does your hallway carpet have one of those "get 'em dizzy with this pattern" things going on with it?
No? I thought not. :-)
BTW, is a vacation report coming? As in a Paul Harvey REST of the story? C'mon, surely just a bit more can get family approval?!
Anon pharmacist, the phenomenon of people gaming the ER system is a little different, I think. Anyone who reads ER nurses blogs knows that a certain class of scammer is concentrated there.
It's often a state of mind. Even paraplegics can be completely disabled and others can work.
My customers are those folks. I've worked with quadriplegics who are attorneys and don't stay one second longer than needed at the Hotel, and others are repeat customers because "they have that insurance" that pays them to come in the hospital.
One character purportedly paid for three weddings by getting hospitalized for at least 3 months x 3.
We figured one guy (who was complaining about his stock portfolio) was "getting wounds" (suspected self-injury) every year in the summer so he could 1) stay with us for 3 months, 2) collect his insurance and 3) avoid paying high a/c bills.
It's always something...
we sell the OTC codeine cough syrup. And consistently hear people coming through the front door coughing, still coughing as they fill out the log book, but AS SOON AS they hold the bottle in their hands, they forget to cough anymore as they exit the drugstore!!! Remarkable healing powers, that!
Anon 10:06: In June I had pneumonia. I almost never get sick, and I am a runner and run 8 miles a day, so I didn't do real well the pneumonia. One of the meds I was given was prescription codeine cough syrup. I'm not sure how people like that. I took it twice and it made me mad! I thought maybe it would knock me out and I'd get a good sleep, but no, it woke me up and just made me hate everyone. That stuff is horrible!
Example: I personally know someone who is on SSDI. She rides horses, four-wheelers, takes her kids on trips, etc etc. Also her costly drugs (that she whines about paying $3 for) mostly do not end up in her own stomach... Yet when it comes time to have that check-up, she is invariably admitted to the hospital in intractable pain and just cannot move.
Scammers are everywhere. Sadly it only takes knowing one person like this to give someone a less-than-positive outlook, and a skeptical approach.
Those of you saying negative things about Dr. G have to realize as health care workers, we see this far more often than you would like to believe. HEALTHY skepticism is OK - since that is what uncovers those who ARE abusing the system.
Moose, if you are still reading -- canes are not always just for balance, sometimes they "unload" some weight from a joint or bone to protect it while it heals.
That's why a person with an injured right leg has to use the cane in the left hand -- its a triangle system. The good leg is the third "point" of the triangle and it bears all the weight as usual, then the bad leg and the cane move forward to touch down to the ground at the same time, so that some of the weight is being taken by the cane and some by the leg.
I agree, though, that you cannot use a cane for too much weight-bearing -- if you need a lot of help, then a walker is what has to be used, or crutches.
Sadly it only takes knowing one person like this to give someone a less-than-positive outlook, and a skeptical approach.
This. I am the Anonymous that Moose told to STFU and MYOB. And this is exactly the point I was trying to make. Scammers make one skeptical of any apparently able-bodied person on disability. It *is* my business, because it's *my* money that is being paid out.
If you are truly disabled, fine, you deserve the support. If you protest vehemently against the skepticism, perhaps you are a scammer who doesn't want anyone taking a close look at your situation. The genuinely disabled surely have the most reason to be upset at people who abuse the system.
That made me laugh, and reminded me of the Urgent Care I worked in for about 6 years.
We had a video camera monitoring the parking lot & the Dr. was ALWAYS watching that camera. We saw a LARGE percentage of workers comp patients: He'd watch them get out of the their car, walk to the door, then as soon as they hit the lobby they started limping (or jumping on one leg... Lot's of fun things seen at the urgent care.
Of course some people have like that lady "intractable pain", anon, because if they didn't they wouldn't get any more Vicodin (fill in the pain med of choice) and they wouldn't be able to sell/trade it for services or cash.
And that, friends, would really ruin your day.
Well, I have had to use a walker (Don't NOW!), and sometimes my balance is not what it should be. I congratulate a previous poster about mentioning switching hands. I would do that, too.
And for the record, I was not faking.
I am sure the good Yak Herder looked into why he/she/it changed sides. At least his/her/it's malpractice carried hopes so.
Enough, already! Point(s) made several times over. It is now time to examine Kim's mention of nude blogger photos... I guess I've never thought about acquiring nude shots of our favorite yak herder....
There, made you smile!
I'm more likely to walk better in the doctor's office than I do outside. I don't know why I do that. I guess it stems from the "be on your best behavior in public" thing. I was born with the ligaments on the wrong side of my kneecaps so that they kept creeping to the outside. I've had 10 knee surgeries (culminating in replacements on both sides). I started having to use handicapped slots when I was in my early 30s and I didn't start using a cane on a regular basis until this last year when I turned 50.
Now I have severe fibromyalgia, chronic fatigue syndrome and chronic myofascial pain to go along with my bipolar disorder, IBS yada yada yada. I'm on disability which I hate. I'm not getting rich on it by any means. If I weren't living in my ex's house and if he weren't paying for the phone and several other bills I wouldn't be surviving. My meds run several hundred dollars a month. I hate to think what's going to happen when our divorce becomes final and I lose his insurance. My medical bills run several thousand dollars a year. My pain levels go from 5-9 during the day and that's on maintenance pain meds. I try to walk for an hour in the little pool in the backyard while the weather is nice.
Oh yeah, cane use. both my knees hurt and I always use my cane in my right hand. I rarely switch up. That's always been the case for me. There have been times when I limped on both legs. However I was more likely to limp on the leg by the cane. That's because I was focusing on moving the leg that wasn't being assisted by the cane, whereas the leg by the cane had the support of the cane.
I love this. I will be using it in the future.
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