Attention FDA!

Vicodin and Percocet don't kill patients!

It's the big pillow I want to smother them with when they ask for more Vicodin and Percocet that could kill them!

Neurotics at Law, P.C.

I had a deposition in my office yesterday. One of the lawyers showed up a few minutes late, set his briefcase down in the hallway, and we got started.

But after a few minutes he started squirming in his chair, like a little kid who had to pee. He looked very jittery and uncomfortable. So I told the court reporter to stop recording, and asked Mr. Attorney "Are you okay? Do you need some water, or to use a restroom?"

He said: "No, but I really need to get something out of my briefcase". Me and the other lawyer said fine, so he went out to his briefcase and opened it.

He came back in a few seconds holding a large rubber band. He sat back down and began playing with it, twisting it back and forth between his fingers. After that he was fine and calm for the rest of the meeting.

We Have a Winner!

My secretary Mary saved this awesome message that came in over lunch hour.

Slurred voice: "I need to make an appointment to see Dr. Grumpy. I take lots of pain medications, because I'm in constant pain, sometimes. But I'm not taking any right now, because my pain is so bad that I can't take my medicines. I've run out now, but still have plenty, but think I might need more."

I told Mary that if they call back to tell them I don't take their insurance. Even if it's cash.

Does Anyone Else Think This is Weird?

All right, this is an actual e-mail Mrs. Grumpy got from her Mom today about a new set of pots & pans my in-laws bought. I think it's weird, but maybe it's just me.

"Okay, we went to a Salad Master sales dinner and bought us some top-of-the-line cookware.

We didn't get the big set, which has enough pans to cook for an army. We bought a starter set and got 3 extra pieces just for foolishly buying this over-priced cookware. It is very nice, and I know I will like it.

It comes with a 'beyond your lifetime warranty', meaning it's guaranteed to outlast us. So we had to list you as a next of kin for who the set and warranty will transfer to when we die.

So your name is listed as an owner also...so when we no longer need, or can use the cookware...behold, you are the proud owner, and are already registered with the company as the future owner."

MJ Follow-Up

Thank you all for your comments on Michael Jackson's death impacting my patients.

To briefly touch on my only other professional encounter of this insane sort, in 1997 I was taking call for an Epilepsy Monitoring Unit. The night nurse was named Sue and, while a good nurse, she was unusual to say the least.

Anyway, one night I'd dozed off at home in bed, and was woken by Sue.

Dr. Grumpy: "This is Dr. Grumpy."

Sue: "This is Sue, in the EMU. She's dead."

Dr. Grumpy: "Oh my God! Who? Mrs. McFadden in room 3?"

Sue: "No. Princess Diana."

Dr. Grumpy (still a bit drowsy): "Is that the lady in room 4? I thought she went home yesterday."

Sue: "No, Princess Diana, ya know, the British royal family and all. She died in a car crash."

Dr. Grumpy: "You paged me at nearly midnight to tell me this?"

Sue: "I think it's important."

Dr. Grumpy: "Are the patients okay?"

Sue: "Yes, I haven't told them yet."

Dr. Grumpy: "Please don't and let them sleep. Good night, Sue."

Espanol para Nurses

Last night, while I was on rounds, the staff was looking at a book of medical Spanish. In a section of phrases that nurses should know it included translations for:

"You can smoke in your room."

and

"Please don't hang from the ceiling."


How useful is that? And not a single phrase for "don't pull out your IV" or "You're in a hospital, not a Hilton".

How About "My Dog Ate My Reminder Card?"

Okay, I just want my patients to know that there are some good excuses to cancel your appointments at the last minute. AND MICHAEL JACKSON'S DEATH IS NOT ONE OF THEM!!!

So far today I've had 1 person cancel because she's too depressed over his death to make her appointment today, another who said he can't come in because he's too busy watching continuous coverage on E! about it. And a third who (somewhat vaguely) canceled "because of the world situation".

You people need a life.

Hazards of Multitasking with Age

Mary, my wonderful secretary, had to run out early today for her kid's little league game. In the chaos of trying to shut everything down, she forgot to roll the phones over.

I don't have an answering service. I just roll the calls over to my cell phone. I don't find this a problem, though I know other docs are horrified at the idea.

Anyway, while I was frantically trying to finish dictations, I rolled the phones over myself, then dialed back in to make sure it was working.

Then my cell phone rang, and I immediately grabbed it, saw the number looked vaguely familiar, and answered my own call.

I'm so glad Mary wasn't here to see this. She'd be giving me crap about it for weeks.

It's the End, the End of the 70's

(for those of you who recognize the title, congratulations!)

WARNING: THE FOLLOWING POST IS NOT FOR THE SQUEAMISH. I MEAN, IT'S NOT AS BAD AS THIS STORY FROM MY ESTEEMED COLLEAGUE ERP, BUT IT AIN'T GOOD EITHER. SO STOP READING NOW IF YOU THINK IT'S GOING TO FREAK YOU OUT, OR IF YOU'RE EATING.

Before Viagra and it's cousins, there were some other methods of waking Sheriff Woody. They're still out there, for those who have issues with Viagra.

One of them is Caverject (or Alprostadil for my pharmacy fans). This is fairly effective at getting it up for special occasions. They have to be pretty special, though, because Caverject has to be injected directly into the side of your winkie for it to work. What fun.

Because it came to market before the era of direct-to-consumer celebrity advertising, we were fortunately spared TV ads featuring Eric Clapton singing (to the tune of "Cocaine"):

"If your lady is hot
Just give yourself a shot-
Caverject."

But I digress.

I have a patient who's been using Caverject for years. For whatever reason he can't use one of the newer drugs. He's kind of an aging, swinging, disco guy. In the 70's he was swinging, single, wearing gold chains, and picking up babes at the disco. In 2009 he's still swinging, still single, still wearing chains, and now picking up aging babes at the disco.

A few weeks ago he had a small stroke (he's fine now), and as a result he's now on Coumadin, a potent blood thinner. This gives new meaning to "Stayin' Alive".

So last Saturday he was out getting his boogie on and picked up Ms. Agingdiscoqueen. They went back to his place for some wild times. He shot himself up with Caverject and the fun began.

And abruptly ended. Apparently she got on top, and while she was riding the disco pony, blood began squirting out the side where he injected Caverject (thanks to Coumadin). Seeing blood flying all over those dark areas killed the mood fast. She ran out, and likely went home to douche with bleach.

He's been visiting me and his cardiologist today, to discuss stopping Coumadin.

Thus endeth the 70's.

No Shit, Sherlock

A drug rep brought my staff a jar of mixed nuts today.

On the label, I swear, it says:

"Allergy information: This product is packaged in a facility that handles nuts."

Uh, Oookeeeeeeeeeee.................

I saw a guy this morning who was in ER over the weekend, and he brought in the generic preprinted instruction sheet they gave him. I glanced over it, and noticed this line:

"If you've been given suppositories for your condition, do not store them above room temperature or unwrap one before you are planning on using it. If you haven't been given suppositories for your condition, don't".

Words Fail Me

This morning the hot water heater for my office was on the blink. So I called maintenance to let them know.

The 12 year old answering the phone kept telling me someone would be over "in 5 minutes". So after 3 hours of nothing happening (except for my staff getting pissed off) I called again, only to reach the same 12 year old.

I asked her when a realistic idea of a repair would be:

Ms. Twelveyearold: "Look, I really don't know. Um, do you live near here?"

Dr. Grumpy: "Yes, why?"

Ms. Twelveyearold: "Then why don't you just go get some?"

Dr. Grumpy (not sure I've heard right): "Excuse me?"

Ms. Twelveyearold: "Why don't you go home and fill up some tupperware with hot water? Then you could store it in your office or fridge or wherever until you need it, while we try to get someone up there to fix it."

Okayyyyyyyyyyyyyyyyyyyyyy.

So Much For My Nap

I saw a lady on Friday for a tremor, and put her on a drug called Inderal for it. She gratefully called today to wake me from my Saturday afternoon nap.

Dr. Grumpy: "Hello, this is Dr. Grumpy."

Ms. Ruinedmynap: "Hi, I'm calling because I woke up this morning with a small bruise, about the size of a dime, on the left side of my forehead. Maybe I bumped my head on the night table during my sleep. Can Inderal cause a bruise like that?"

Dr. Grumpy: "No, it shouldn't".

Ms. Ruinedmynap: "Good. Because I haven't started taking it yet, but wanted to be sure before I do."

My Readers Write

Okay, gang, today I am going to hit the email bag! One of you writes in:

"Hi Dr. Grumpy,

Hello! I am a staff pharmacist for an evil chain pharmacy, and had an interesting moment while working today. We received a fax for a prescription for a patient, but the date of birth didn't match our records. When we called the office to verify the prescription, the nurse said that the prescription wasn't supposed to be for that specific patient, and she didn't know who the prescription was for. I guess WE'RE supposed to figure out whose prescription this is? Anyway, I was wondering if this happens in your office.

Thanks!

PS."


Well, PS, I gotta say that we have our share of prescription confusion on this side of the trench, too. I'm not infallible, and am sure me and my staff have (unintentionally) given a pharmacist cause to apply Rogaine. On the other hand, we honestly do try our best to play nice with you guys. I mean, we need each other, right?

We do get a lot of patient voice messages like "Hi! I need my medications! Thank you.", with no useful information. Or "Dr. Grumpy wanted to know how many of the brownish-white pills I take, and it's three." And Annie's favorite "Hi, I saw Dr. Grumpy back in 2005, and he said there were pills that might help whatever my condition is, and I'm ready to take them now."

To answer your question, though: that physician's office appears to have staff from a planet where mind-reading skills are everyday norms, and expect no less from those who fill prescriptions. Many of my patients are from the same place. So, since it appears that you are as incompetent as I am at reading minds, I'd have to say we will both continue to get such odd calls.

The physician's office should have known better then to suggest you solve the problem with your mind-reading skills. Since they originated the script, somebody there should get off their butt and go ask the doctor what he REALLY meant, although he may not know, either. In fact, for all you know it was sent by a chimpanzee playing with his fax machine.