Sunday reruns

Due to an insane amount amount of kid activities today, I'm just putting up this post from 2009.


Before Viagra and it's cousins, there were 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 your winkie 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 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.

Memories

It was the early 70's.

My dad has always been on the lookout for a good deal. On this day he took us to a Potluck auction. I don't know if they still have them, or what they're called now.

Basically, a moving/storage company auctions off unclaimed goods. Some of it is typical, like furniture, but the Potluck part is where they sell off big unopened packing boxes that were never picked up. So you have no idea what you're getting. Every bidder dreams of buying a forgotten box with something valuable in it.

I'd never been to an auction before. It was certainly interesting to watch and listen to. Dad bid on a few items that he didn't win. I vividly remember them dragging a large refrigerator out on stage. After the winning bid had been placed they were rolling it off for the new owner to claim, when suddenly the entire door fell off.

My parents spent time looking over the displayed boxes very carefully. Dad was particularly taken with one box. It was unusually heavy for it's size, and all bound up in tape and twine. It was, as best I remember, roughly 2-3 feet on each side. Across the top, in big letters, it said "TBC".

Anyway, at some point 2 guys carried the TBC box out, and the bidding began. Somewhere in there Dad entered the competition, and after a flurry of bidding, he'd won! My sister and I were excited, and cheered. We had no idea what had happened, except that our dad had won. The box cost $14.83 (including tax). I'd guess in today's terms it would be $50-$60.

It was HEAVY. It took both my parents and a guy pushing a dolly to get it out to the car, and I don't remember if the trunk closed all the way. We got home, and with much pushing and shoving got it into the kitchen.

Mom and Dad got out some knives and hacked their way through the heavy wrapping. We were all excited. It contained...

A Telephone Book Collection.

Yes, someone (who apparently needed a life) had collected phone directories from major cities all over the U.S.: Boston, New York, Miami, Chicago, Dallas, Seattle, Los Angeles, and many others. All neatly stacked in the box.

With quiet disappointment, the box was closed and put in the garage.

I'd forgotten all about it a few weeks later, when it was my birthday party. I had a bunch of friends over. We had the usual cake, presents, and games. And as they were getting ready to go my dad offered each kid... a phone directory.

It's been almost 40 years. I don't remember if any of them took one. Or what finally happened to the box.

Patients behaving badly

This morning I was on my usual hospital rounds, working at the nurses station. I absently noticed a patient pushing his IV pole around the hallways, writing on a notepad every now and then.

I dictated a note, moved to the next chart, reviewed some labs, scribbled a bit. The typical patient care stuff went on around me.

Suddenly, all was interrupted by someone loudly clearing his throat. "AHEM!"

We all looked up. Mr. Notepad was standing at the front counter.

Mr. Notepad: "I would like to speak to the nurse in charge."

Nurse Commander: "I'm the charge nurse today. What can I do for you?"

Mr. Notepad: "The decorative pictures in my room are not acceptable. I don't like them."

Nurse Commander: "I'm sorry."

Mr. Notepad: "I have prepared a list." (hands over a piece of paper) "I've written down the names and locations of pictures you have in the hallway that I prefer. I want to have them switched out with the ones in my room."

Long silence.

Nurse Commander: "Sir, this isn't a hotel or art museum" (hands paper back to him). If you're unhappy with the pictures, I suggest you make a donation to the hospital foundation, and send the list to them."


Mr. Notepad stomped back to his room. I went over to Nurse Commander and told her she was awesome.

Today's safety tip

DO NOT, under any circumstances, pour gasoline from open buckets and water bottles DIRECTLY into the engine of your car WHILE YOU ARE DRIVING IT!!!

Here's the story.

Thank you, Susan!

Guessing games

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

Mr. Anon: "Is he in today?"

Mary: "Excuse me?"

Mr. Anon: "Is he seeing people today?"

Mary: "Yes, can I help you?"

Mr. Anon: "I want to come in today."

Mary: "I'm sorry, but who is this?"

Mr. Anon: "I'm one of his patients and I want to see him today."

Mary: "What's your name?"

Mr. Anon: "I just want to make an appointment. If you can give me a time, I'll tell you my name."

Mary: "I can't give you an appointment unless you tell me your name."

(long pause)

Mr. Anon: "I'll just call back tomorrow." (hangs up)

Wednesday afternoon

Dr. Grumpy: "Are you allergic to any medications?"

Mr. Grief: "Penicillin... Doc, will this visit take long?"

Dr. Grumpy: "Maybe another 30 minutes. Do you have another appointment?"

Mr. Grief: "No, but my mom's funeral is in an hour."

Medical research

Okay, I'd like to thank Kayden for sending in another fine example of research.

The journal Alcoholism: Clinical & Experimental Research did a study on tailgating before sports events (football and baseball, specifically). They found that (GASP!) people who tailgate were MORE likely to get drunk than people who don't tailgate.

This came as a complete shock to me. I'd always assumed those people partying in the parking lot hours before a game were sticking to Diet Coke.

Here's the article.

"You mean we're smokin' dogshit, man?"

(If you recognize the title, it says more about me than I want to admit)

Okay, if you're a cocaine fiend, I know you're not particularly discriminating in what's going up your nose. I mean, you have to make sure it's not talcum powder or drain opener, but I don't think you're going to care if there's a little salt or flour or whatever.

On the other hand, breaking into a house and stealing just ANY powder to snort isn't a good idea.

As these guys found out.

Thank you, Carol!

Dear Main Line Health,

A reader sent me a copy of your invitation to an "all girls" activity.

While I, personally, have never had a mammogram (although Craig once slammed a dictionary closed on my chest), I've shown this to several ladies. And they had a few comments on it.

(click to enlarge)





"What's with the fucking mocktails? If you're going to slam my boobs between 2 ice-cold metal plates, the least you can do is buy me a REAL drink!"

"The only reason they're offering a manicure first is so I don't claw the tech to death."

"Define 'light refreshments'. Are we talking a bag of pretzels or some GOOD chocolate?"

"Who the hell is that skinny? I don't think either of them has boobs!"

"Gee, do you think they meant 'just for the girls'" as a double entendre?"

"Bryn Mawr? Can't they afford to buy more vowels?"

"Notice how they show a patient getting a manicure, instead of getting her breasts squashed."

"I don't want to see some stuffy 'expert' in a white coat. Can't they hire Chippendales dancers?"

"Is this a combo thing? Because if someone is trying to do a manicure on me, and I'm having my breast crushed at the same time, I'm not going to be holding still."

Sorry, no cape

I mentioned having a migraine this past weekend, and was somewhat surprised by how many people commented and wrote to me, surprised that a DOCTOR, let alone a NEUROLOGIST, would actually get migraines.

What's up with that?

I know this may be hard to believe, but WE GET HEALTH PROBLEMS, TOO.

I see this odd view surprisingly often. People who somehow expect us to be beyond the health concerns of non-doctors.

We may be doctors, but we're also humans. Prone to the same illnesses, bad luck, and erroneous judgments the rest of mortals are.

When I have to take a sick day (rare), and Mary starts frantically canceling people, most of them are fine with it. But we get the occasional person who gets angry because I'm sick. In their minds, apparently, that's impossible. So I must be making it up to go golfing.*

In 12 years I've had 3 patients change neurologists because I was sick and had to reschedule their appointments.

As a neurologist, I also take care of (gasp) other doctors! I have patients, who are also doctors, with epilepsy, MS, Parkinson's disease, and more routine stuff. I've seen young doctor's die with brain cancer.

Being a doctor doesn't protect you from the things that ail others. Including bad karma.

On the flip side, sometimes we're surprised when something serious happens to us. At times there seems to be an unspoken belief that by devoting ourselves to caring for others, it should magically protect us from those same diseases we fight. Nope.

If anything, the high stress nature of our work makes us MORE likely to have shit happen. We often ignore our own issues because of the time needed to care for others. Most of us live sleep deprived, caffeine-overdosed, and on food that we'd never endorse to you.

I chew out patients for not exercising, or a poor diet, or forgetting to pick up their prescriptions. But I likely do the same stuff as much as, if not more often, than they do. After a long day at the office and hospital rounds, and picking up kids, and Mrs. Grumpy having an after-work meeting, when the hell do I have time to pick up my Lipitor and get something decent for dinner? So I put the pharmacy off for another day and grab a pizza. And hope that over the weekend I'll find time to exercise. My average work week is about 60-70 hours. I doubt that's conducive to longevity.

So yes, I get migraines. And if you think your doctor is superhuman, they aren't. Even if they try their best to make you think they are.

*For the record, I've never golfed on anything other than a miniature course.

Whiskey Tango Foxtrot, Over?

My 11:00 today was a guy I've seen for years. He's a retired pilot, and now flies for fun. He shares a small plane with a couple other guys. During the appointment his cell phone rang.


Mr. Wright: "So now the pain is going down my right leg, and..." (cell phone rings) "Hang on doc... Hello? This is Orville."

(pause)

"Wilbur? I thought you were going flying this morning?"

(pause)

"Fuck. What's your altitude?"

(pause)

"Can you see an airport, or highway, or something?"

(pause)

"I'm sorry. Yeah, it was making a weird noise yesterday when I was up. Didn't I tell you about that?"

(pause)

"I could have sworn I did. It was loud, though, when we were talking. Maybe you didn't hear me."

(pause)

"That's pretty far out there, but you may not have a choice. Can Dave pick you up if you land there?"

(pause)

"Then call him, for crying out loud! I'm at the doctor's." (hangs up) "And my right foot has some numbness along here."

Riding the rapids

Okay, for the purposes of safety, we at Dr. Grumpy, Inc. generally DO NOT recommend using a sex toy as a flotation device.

We also suggest keeping your pants on under these circumstances.

Not like this pair.

Thank you, Alison!

Insanity

Due to the insanity of surviving a bowling party, night at Local Buffet, and the morning aftermath of a sleepover of 4th grade friends from the twins, I don't have much to write today.

A group of them decided to go out on the trampoline at 5:00 a.m., in pitch darkness and 23° F, and set off our burglar alarm in the process. The resultant cacophony of sirens, screaming, and barking did not help the migraine I had.

At the moment we are trying to cook pancakes. There is some sort of bizarre Wii game going on. And the dogs are still barking.

I need a nap today.

We will return to our regularly scheduled program tomorrow.

Saturday

My twins turn 10 today.

My dad turned 70 last week.

Why is it that my own birthdays never faze me, but those of others do?