Monday, May 13, 2019
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A Blog detailing the insanity of my medical practice and the stupidity of everyday life.
Welcome to my whining!
This blog is entirely for entertainment purposes. All posts about patients, or my everyday life, or anything else may be fictional, or be my experience, or were submitted by a reader, or any combination of the above. Factual statements may or may not be accurate. I could be making all this up. I may not even be a doctor. The only true statement on here is that I probably drink more Diet Coke than you do. A lot more.
Singing Foo!
Singing Foo!
Twitter fans- you can follow me @docgrumpy
Cast of Characters:
Annie: My Phenomenal MA
Mary: My Awesome Secretary
Ed: The office fish
Dr. Pissy: The guy I share an office with
Mrs. Grumpy: My Boss (also the world's greatest school nurse)
Frank, Craig, and Marie: The Grumpy Tribe
Garlic and Riley: The Grumpy Dogs
Questions? Comments? Biting sarcasm? Write to: pagingdrgrumpy [at] gmail [dot] com
Note: I do not answer medical questions. If you are having a medical issue, see your own doctor. For all you know I'm really a Mongolian yak herder and have no medical training at all except in issues regarding the care and feeding of Mongolian yaks.
Cast of Characters:
Annie: My Phenomenal MA
Mary: My Awesome Secretary
Ed: The office fish
Dr. Pissy: The guy I share an office with
Mrs. Grumpy: My Boss (also the world's greatest school nurse)
Frank, Craig, and Marie: The Grumpy Tribe
Garlic and Riley: The Grumpy Dogs
Questions? Comments? Biting sarcasm? Write to: pagingdrgrumpy [at] gmail [dot] com
Note: I do not answer medical questions. If you are having a medical issue, see your own doctor. For all you know I'm really a Mongolian yak herder and have no medical training at all except in issues regarding the care and feeding of Mongolian yaks.
14 comments:
Translation: Her dealer's in jail.
Love it. But it is like at work - the pain medications are PRN and have pain level parameters. But most of our pts want them around the clock and often give very very low pain levels. When questioned they say - but I don't want to have pain. I so want to say - but how do you even know you are going to have pain since you have not tried to find out?
But we have to give the PRN pain medications ACCORDING TO THE PTS REQUEST and not the written parameters because lord knows, we don't want to have THAT on the surveys.....
Maybe she's in agony half the time and ecstasy the other half, so it averages out?
Somebody should put her in touch with the expert in the ultimate long-term pain relief: Mrs. Lumbar.
Maybe the left side of her body is in agony, and the right side is in ecstasy, and it averages out?
Do you get a lot of hypochondriacs?
I had a friend in the military who was assigned duties like 'removing future dust'. Maybe, you're in for a discussion on the philosoheoretical issue of ameliorating 'future' pain? Or, past pain? Heavens, knows, we've got enough to handle right now, with current pain that is present.
I suppose we could look at this and say it's just a typo but.....It's a female patient discussing pain with her health care provider. OF COURSE her complaint of pain was downplayed and wasn't recorded properly! I'd have been a hell of a lot more surprised if it was!
Now that's planning ahead...
Get her some weed and send her on her way.
She may not be having pain at the moment the question is asked...as that is often what the person entering data asks the patient.
Pain that is due to an acute problem generally does decrease over time with healing - generally.
Pain that is due to chronic condition(s) or cumulative injuries/illnesses can wax and wane, may be rated by pt as "0", 'none', 'absent' even when a different patient might rate that pain as 4 or 5.
Pain is all in our heads, you know - that is where our brains receive information that our cognitive brain labels as 'pain'. It's what we all do next that has made it such a mess.
And the 'nobody should ever have pain' is as bogus as the idea that in America you can have it 'your way, right away' or that having a great 'curated' digital existence is reality.
Anon at 8:12 on the 14th has my vote.
Pain is not just "in your head." Pain is a stress on the body; it can delay healing as well as reduce the ability to fight off opportunistic infections. Chronic or frequent pain often increases c-reactive protein which is linked to cardiovascular disease.
Yes, there's a mess with the over-prescription of narcotics, but while trying to solve it we're leaving behind people who have real need of pain relief. We need less stigma, more compassion, better tools, and far, far less stories like the ones of cancer patients being denied narcotics for "fear of addiction."
So as part of my job, I see pain almost every day. Real, obvious, pain. The sort of pain that makes other people seeing it, wince.
Which means my pain scale is out of whack compared to normal people. I've seen 10/10 pain, I know what that looks like, doesn't require much of an imagination to realize I am not in 10/10 pain. It meant when I dislocated my elbow, the pain was at "less than one" on my pain scale, same when I broke my leg, I only broke through to a 1.5 when it was being moved for the x-ray.
Sometimes this causes issues, when pain scales are used to determine treatment options for example. I had an injured ligament, but physical therapy is only offered to those whose pain scale was above 4/10 on assessment.
It also means that yes, my constant pain score is a 0/10, even though someone who hasn't seen the simply scaring image of true 10/10 pain would inevitably rate it higher.
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