Wednesday, May 15, 2013

Tuesday morning, 2:17 a.m.

Dr. Grumpy: "This is Dr. Grumpy, returning a page."

Mrs. Batter: "Oh, Dr. Grumpy, I'm glad you're still up."

Dr. Grumpy: "I'm not. What can I do for you?"

Mrs. Batter: "I feel so terrible."

Dr. Grumpy: "What's wrong?"

Mrs. Batter: "I'm just torn up about your talk."

Dr. Grumpy: "The talk I gave last night at the hospital? Why, what did I say?"

Mrs. Batter: "It's not you doctor. I just... I, I, I wasn't there!" (starts crying)

Dr. Grumpy: "Okay... And you called me because...?"

Mrs. Batter: "I feel awful. My husband and I were planning on coming to it, but then he got tickets to last night's baseball game from his friend Ed, so we went to that instead. You remember Ed? I think he sees you for his foot problem. And now I can't sleep because I feel so awful about not going to your talk, because I knew you'd be offended that I wasn't there."

Dr. Grumpy: "It's okay Mrs. Batter. I'm not offended. The local Stroke Association chapter had announced the talk, so there was a decent turn-out."

Mrs. Batter: "You didn't even notice I wasn't there, did you?" (starts crying louder, hangs up).

Tuesday, May 14, 2013

Zzzzzzzzzzzzzzzzzzzzzzz

Dr. Grumpy: "Is the new sleeping medication helping?"

Mr. Stats: "Absolutely!" (whips out iPad) "As you can see from this graph, I"m sleeping 22.8% more than I was before trying Dozaway, and here... (swipe) it shows how I'm falling asleep 17.3% percent faster, and on this next screen... (swipe)"

Monday, May 13, 2013

Is this the Turing Test?

Snowball recently got some shots and had a tooth pulled, so spent a few hours at the veterinarian. That evening I noticed they had our phone number wrong on the bill, so called the next morning to correct it.


Phone Girl: "Local Animal Hospital, I..."

Dr. Grumpy: "Hi, this is Ibee Grumpy, and..."

Phone Girl: "I'd like to wish you a very happy National Hug-Your-Cat-Day this month!"

Dr. Grumpy: "Okay, I picked up Snowball yesterday, and realized you have our contact info wrong."

Phone Girl: "Did you know National Hug-Your-Cat-Day is this month? Cats do so many wonderful things for us, that it's important to take care of their heath, too!"

Dr. Grumpy: "I don't have a cat. I'm just calling about an error..."

Phone Girl: "Well, now would be the perfect time to consider getting one! We have 3 cats looking for loving homes here, and several animal shelters we're working with for National Hug-Your-Cat-Day are running offers to help you enjoy them!"

Dr. Grumpy: "Look, I don't want a cat. I just need to give you our correct phone number."

Phone Girl: "Cats are wonderful companions! I'm sure if you came over and met some of the adorable ones available for National Hug-Your-Cat-Day you would..."

Dr. Grumpy: "What time do you work to?"

Phone Girl: "I'm here until noon, but National Hug..."

Dr. Grumpy: "I'll just call back later."

Sunday, May 12, 2013

Space Oddity

Commander Chris Hadfield, the Canadian astronaut departing the ISS, posted this awesome cover today of the classic David Bowie song. Filmed, of course, on site.



Sunday reruns

Mrs. Hyve: "I'm allergic to all medications. I'm even allergic to Benadryl."

Dr. Grumpy: "What happens?"

Mrs. Hyve: "All medications give me a rash, so to safely take any pill, I have to take another pill first, to prevent the rash from happening."

Dr. Grumpy: "What do you take to keep the rash from occurring?"

Mrs. Hyve: "Benadryl."

Friday, May 10, 2013

Green bananas

Mr. Hills: "I need a refill on my Fukitol while I'm here."

Dr. Grumpy: "Sure..." (Grabs script pad, starts writing) "Hey, do you need this written for a 30 or 90 day supply?"

Mr. Hills: "Just 30 days. For crap's sake, doc, I'm 91 years old."

Thursday, May 9, 2013

And you couldn't use your 1 phone call?

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

Mr. Bar: "Yeah, this is Don Bar. I'm a new patient, and I need to reschedule my appointment from last month."

Mary: "Okay... It looks like you had an appointment last month, that you no-showed."

Mr. Bar:  "That's why I need to reschedule it."

Mary: "I'm sorry, but we have a strict policy for new patients who no-show and don't call at the time. You can't be rescheduled, and will have to ask your doctor to refer you to another neurologist."

Mr. Bar: "I was in jail, and just got out."

Wednesday, May 8, 2013

"Why can't you be more like that Khatri boy? He makes a nice living."

Every medical study has a "financial disclosure statement" in it, listing all the people who did the research, how much they were paid for doing it, and who financed it.

So, while glancing through an article this weekend, I noticed the usual disclaimer paragraph at the end. This caught my eye:



Personally, if I were Dr. Hartung or Montalban, I'd be pretty insulted. Worse, I'd be embarrassed that my friends (and my mother!) saw how much better everyone else was doing.

Tuesday, May 7, 2013

Why fathers go bald

Craig: "Dad, we need your help."

Dr. Grumpy: "What's up?"

Marie: "I lost my school ID today."

Dr. Grumpy: "Where did you lose it?"

Marie: "While we were walking home."

Dr. Grumpy: "Any idea where? It's a 2 mile walk."

Craig: "Along the road, somewhere between here and school."

Dr. Grumpy: (sighs) "Thanks, Craig."


(loads up car, drives SLOWLY to school and back, with kids peering out the windows and other drivers honking and giving me the bird for blocking traffic, while I randomly slam on the brakes any time a kid sees a leaf, or crushed paper cup, or piece of dog shit that vaguely resembles a school ID and screams "THERE IT IS!!!")

I finally gave up and drove back home.


Dr. Grumpy: "Marie, it doesn't appear to be out there anywhere."

Marie: "It has to be! It was while we were walking home today that I noticed it was missing!"

Dr. Grumpy: "When was the last time you remember seeing it?"

Marie: "Last Wednesday, during the field trip to City Park."

Monday, May 6, 2013

Drugs 'R' Us

Tonight we have two great tales about upstanding members of society.

First, we have Jarvis Sutton of St. Petersburg, Florida.

Mr. Sutton was unusually hopeful that if he called 911 enough, the police would deliver marijuana and munchies to his home. When they showed up and failed to bring either, he consoled himself by eating the police car instead.


Second, we have the remarkably organized Carolyn Murray of Pennsylvania.

This fine lady was involved in a car accident. While providing her insurance forms to officers she handed them a shopping and to do list, which included such items as "potato salad," "Xanax," and "cocaine." It also had a helpful reminder to "get high."


Thank you, Tanya and Webhill!

The Karate Octogenerian




Mr. Miyagi: "I need to get off Zuclox."

Dr. Grumpy: "What's wrong? You've been on Zuclox for almost 10 years without any problems."

Mr. Miyagi: "It's affecting my balance."

Dr. Grumpy: "Why do you say that?"

Mr. Miyagi: "I fell this weekend."

Dr. Grumpy: "What happened?"

Mr. Miyagi: "I was at the senior citizens dance, trying to meet some ladies. You see, back in 1946 I was stationed in Japan, and learned karate there. I was really good at it, too, and won a few tournaments. I haven't done it since I left the army though. Anyway, at the dance, some of the ladies and I were having drinks at the bar, and they were talking about those karate films, so I decided to show them my moves. I lost my balance and fell on my butt, and all those ladies started laughing at me. One of them laughed so hard her friend had to bring in her oxygen tank."

Dr. Grumpy: "I'm not sure Zuclox is why you fell."

Mr. Miyagi: "I looked it up. Balance problems are in the side effects."

Dr. Grumpy: "Yes, but you never had them with it before."

Mr. Miyagi: "Look, just tell me how to stop it. The next dance is in 2 weeks."

Friday, May 3, 2013

Patient quote of the day

Mr. Eosinophil: "I'm allergic to all man-made chemicals, including MSG, nitrates, glucose, oxygen, all proteins, and hemoglobin."

Thursday, May 2, 2013

Negotiations

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

Ms. Oxy: "Hi, I need to make an appointment to see Dr. Grumpy."

Mary: "I can help with that. Our next opening is..."

Ms. Oxy: "Wait, before you get to that, I need to know how many Percocets Dr. Grumpy will allow me per month."

Mary: "Did you just ask me..."

Ms. Oxy: "Because my current doc only gives me 150 a month. I'm not going to switch unless you guys make this worth my while. I'm thinking 180 Percocet per month would be enough."

Mary: "Okay, we don't work that way."

Ms. Oxy: "Of course you do. Patients are money to you people, and you need the money. All right, let's say 170 Percocet. I'll settle for that."

Mary: "I think you should stay with your current doctor. It doesn't sound like you're a good match for this practice."

Ms. Oxy: "Okay! 160 Percs a month, and I'll do co-pays in cash, will..."

Mary hung up.

Wednesday, May 1, 2013

50 Shades of Blue

A few months back I poked fun at Fycompa, a new epilepsy drug with an interesting side effect profile. Little did I realize I'd have the chance to do it again (different drug this time) so soon.


Like neurologists everywhere, I was surprised to hear the news Monday about a newly reported side-effect concerning the epilepsy drug Potiga.

Namely, that it makes people blue.

I'm not talking depression here, either.

Let's look at the official FDA announcement:


"FDA is warning the public that the anti-seizure medication Potiga (Ezogabine) can cause blue skin discoloration... (and) does not currently know if these changes are reversible.

The skin discoloration in the reported cases appeared as blue pigmentation, predominantly on or around the lips or in the nail beds of the fingers or toes, but more widespread involvement of the face and legs has also been reported. Scleral and conjunctival discoloration, on the white of the eye and inside eyelids, has been observed as well."


Now, with that said, I want to remind you that if you look at the side effects of ANY drug, you'll find scary shit on all of them. I'm sure I'll put patients on Potiga, and most will likely do fine. But that doesn't mean we can't have some fun with it.

For one thing, they don't even tell you what shade of blue. There are 45 of them. Some people if given the choice, would like a nice turquoise, while others would prefer royal blue. Hopefully further research will shed light on this important topic.

The interesting part is this: Let's say a patient had a choice between this drug and one with a "YOU COULD DIE FROM THIS!!!" black box warning. Felbatol, for example, while very effective for seizures, has the potential to cause TWO (not one, but TWO) great ways to die: severe liver failure and/or destruction of your bone marrow.

Yet, human nature is such that most people would prefer Felbatol, figuring the risk of death is preferable to that of turning blue. After all, death generally isn't socially embarrassing. We ALL die. But blue skin? That's just not fashionable.

Unfortunately, GSK (the drug's manufacturer) is likely going to see this as a drawback to Potiga. They'll tell their sales reps to minimize it and move on to something else. Or mumble "and they might turn blue" hurriedly under their breath.

The truth is they should turn it around, and make it a strength of their spiel. The best way to do this, as I see it, would be to go after some commercial tie-ins.

I've compiled a few modest examples:


Live theater:

Potiga is a proud sponsor of tonight's appearance by:

Blue Man Group


1960's psychedelic movies:


United Artists
To treat seizures, All You Need is Love. And Potiga.



1970's psychedelic movies:

Paramount Pictures
"Violet Beauregarde has been seizure free on Potiga. Next month she'll be endorsing juicers, too."



2000's movies:

Twentieth Century Fox
Potiga for epilepsy: It's out of this world!



2000's remakes of 1970's psychedelic movies:


Warner Brothers
Potiga is now available as chewing gum for your patients who won't swallow pills. Violet Beauregarde set a world record with it!



Music acts:


Atlantic Records
"We're both proud to be on Potiga. Otherwise we wouldn't be able to drive as safely as we do."



Historical tie-ins:


Bunker Hill: Would history be different if British officers had given their men Potiga beforehand?



Using it as an excuse...


ABC television




"No, officer, he wasn't into that sort of thing. He's that color from taking Potiga."



Currently Potiga is only approved for ages 18 and up. But maybe it will work in kids. If that happens, GSK is fortunate to have a wide range of endorsers to choose from!


Dupuis Cartoons
Shaky Smurf, Seizey Smurf, Ictal Smurf, and Aurette are all doing great on Potiga! If it's right for Papa Smurf, isn't it right for your child?



And, of course, who could forget

Sesame Street
New Potiga powder! You can sprinkle it on all your child's favorite foods! EVEN COOKIES!!!



Thank you, SMOD, for bringing this to my attention!
 
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