Yes, I'm juvenile

This invitation to a CME (Continuing Medical Education) course showed up in the weekend mail (I have no idea why there is a gray box instead of a picture. I didn't do that).

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For other great MD names, please see this post, and the comments that followed.

Sunday Reruns

Due to a lack of inspiration, and not seeing patients on a Sunday, I'm rerunning this post from April, 2009. It's from back when I had only a few readers, so some of you may not have seen it the first time.



Dr. Grumpy's Guide to Life, Chapter 1


(As a public service I have written the following, for you to print off and use before your next Pump-It-Up party. For those of you who don't have small children, or simply live in a box, Pump-It-Up is a national chain with indoor giant inflatable bouncers to hold kid's birthday parties at).


Congratulations! You've decided to host your child's party at Pump-It-Up.
They and their friends will enjoy it a great deal.

Key things to remember:

1. Going into the giant inflatable bouncing arena to fight your kids with oversized boxing gloves and paddles looks easy. Because of your higher center of gravity, however, you'll quickly find out that you're at a distinct disadvantage. In fact, you will likely get your ass kicked fairly easily by the swarm of 1st graders who will line up for a chance to beat you. Fighting on your knees does not improve the situation, and makes it easier for one of their partners to sneak up and jump on your back.

2. Although adults are welcome to go on all the giant bouncers, they are not adult friendly. In particular, the inflatable obstacle course is a good way to get yourself killed. When a kid claws up the inflatable steps and ladder to both of the slides involved, they have plenty of space to reposition themselves at the top to go down the slide feet first. YOU WON'T, and may find yourself pulling yourself to the top of the ladder, then as you are amazed you made it that far, you'll suddenly pitch forward uncontrollably, going down the slide head first and wrenching your neck at the bottom (which I did). While you're lying there, trying to figure out if you can still move your legs, a friendly teenage attendant will come over to remind you that head-first isn't allowed, and to please not do it again.

The steps in the obstacle course ladders are designed for kids and adult pygmies. You will be lucky to be able to use them as toeholds. Trying to climb them with your feet sideways only helps somewhat.

As you struggle through the obstacle course, you can expect to be passed by several kindergartners, who will wonder why their friend's Dad is so slow.

3. You WILL be injured. At present my neck is still stiff and my left ankle is killing me. I also have multiple bruises from falls and being stepped on, and several knee and elbow scrapes. When you first enter the facility and fill out the forms about how many kids you have with you and how many pizzas and bottles of pop you want, I recommend you give them a card listing your insurance coverage, hospital preference, and blood type.

4. Do not feed yourself or your kids a large meal before going unless you wish to spend some of the bouncer time you paid for watching a friendly teenage attendant clean Taco Bell out of a bouncer.

5. If one of the fun-loving kids traps you inside something by turning off the air compressor, don't panic. Before you asphyxiate from vinyl a friendly teenage attendant will turn it back on again, then lecture you not to do it again.

Enjoy! You just paid a fortune for your injuries!

If you follow these simple precautions, you will likely live to see your child's next birthday party - which will also be held at Pump-it-Up.

Saturday hot tub reading

Okay, sitting in the hot tub with Marie today, and catching up my journals. This afternoon I learned that:

Patients taking 2 pain medications have less pain then patients taking only 1 pain medication (The Lancet (2009; 374: 1252-1261).

For my fellow U.S. citizens who are convinced that only our country wastes money on this stuff, the study was paid for by the Canadian Institutes of Health Research.

This is not meant as a slight to my northern colleagues, but simply to point out that pointless research is a universal human trait. If our prehistoric brethren had journals, I'm sure they'd have studies on how wood held in the air is easier to light on fire than wood being held underwater.

Dear GlaxoSmithKline Pharmaceuticals,

Thank you for your recent letter concerning Super Poligrip denture adhesive.

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It was thoughtful of you to notify me that this product (all 3 varieties) will no longer be available. How much it cost you to send this letter to every doctor in the U.S. & Canada I have no idea.

In all honesty, I have never, ever, ever, recommended a specific denture adhesive to anyone. In fact, in 12 years of practice, I don't think a patient has ever mentioned their chosen brand of such a product to me. Generally, the study of neurology is pretty far removed from whatever substance people might be using to glue their false teeth to their gums.

My office colleague Dr. Pissy, for whatever reason, hasn't gotten your letter yet. I told him this was likely because he was on your Poligrip consumer, rather than prescriber list. He was not amused.

Yours truly,

Ibee Grumpy, M.D.

Anticipation

Dr. Grumpy: "So the meningioma has been stable on MRI for 10 years now. It should still be followed, but not as often. I'll check a repeat study in 5 years if nothing changes."

Mrs. Ocd: "So, another MRI in 2015?"

Dr. Grumpy: "Yeah."

Mrs. Ocd: (whips out iPhone): "Can I do a Tuesday afternoon?"

Thursday night, 8:05 p.m.

"Hi, I have an appointment with Dr. Grumpy tomorrow, but I keep my schedule on my cell phone calendar, and I've lost the phone. Can someone please call and tell me what time my appointment is? My cell phone is 867-5309. Thank you."

Weather Report

Yes, I know it's raining. I have windows at my office, and occasionally look outside.

And I understand you running late for your appointment. I mean, the rain mucks up traffic, and makes everyone fall a few minutes behind.

We appreciate you calling to say that you'll be a few minutes late. We believe you that it's raining. We can see that for ourselves.

You really don't need to send Mary a picture from your car to prove it.

Attention Boy Scouts of America

DO NOT EVER send out a note saying there will be no food provided at a night meeting, and so we should feed our kids dinner beforehand, AND THEN HAVE SURPRISE PIZZA AT THE MEETING!

My kids overoverovergorged.

Next time you do this I am calling the den leaders (you know who you are) at 2:00 a.m. to come over to my house and clean up 3 kids worth of barf.

Thank you.

Department of Contradiction

Looking through some hospital notes today, and came across this:

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Mary's Desk, February 24, 2010

Mary: "Dr. Grumpy's office, this is Mary."

Mrs. Gold: "Yeah, I have an appointment this afternoon, and wanted to make sure you have a TV there."

Mary: "Um, no..."

Mrs. Gold: "You don't have a TV in the lobby? My internist does."

Mary: "No, we never have."

Mrs. Gold: "How am I supposed to watch the Olympics?"

Mary: "Well... you are coming to see the doctor, not to..."

Mrs. Gold: "Just cancel me, then. I'll call back next week, to reschedule after they're over."

Let me think about this one...

Okay, gang. I was doing an online marketing survey last night, and got this question:


"The following are two attributes for a new Parkinson's disease product. Please select which one you find MOST desirable, and which you find LEAST desirable:

Attribute A: Efficacy in improving tremor and balance.

Attribute B: Serious side-effect profile."

Patient testimonials I don't want

Dr. Grumpy: "How have you been doing since starting the Parkinson's medication?"

Mr. Shakes: "Much better. My wife doesn't yell at me as much about my driving. And since you gave me those pills I haven't blown out any tires from hitting the curb, which is nice. Those replacement tires can get expensive."

Dr. Grumpy: "I bet".

Is she a person? A tree? Both?

From another physician's note:

"During the seizure she was shaking all her limbs, as well as all four extremities".

More drug company toys

For those of you who missed my previous post on drug company gadgetry, click here.

Okay, this awesome doodad was dropped off at my office last month. I took some shots of it when I had time, but didn't get to put them up until now.

This AMAZING doohickey thingamajig is designed to demonstrate how gout happens.

So let's start with the first shot. The yellow slider is on the right, showing a LOW blood level of uric acid. The patient on the left looks comfortable, and the joint shown has a soothing shade of blue.





BUT NOW we slide the yellow switch over to the left, RAISING the blood's uric acid level. The patient's joints now glow red (get it? He's hurting?) and the big joint on the right is now bright red, with sharp, ugly, uric acid crystals causing gout pain.





Isn't it amazing what technology can do these days? And I can't even use it for a fish tank. Look for it at my next garage sale. After I remove the AA batteries to use in my Wiimote.