Hospital Fun

I got called to the hospital yesterday afternoon. Nice old lady (80 +) who got a steroid shot in her back for pain. There were some complications with the shot, and she was (temporarily) paralyzed in both legs.

So, I checked her MRI to make sure nothing horrible had happened, and then went to meet with she and her husband. By the time I got there she was already improving.

Dr. Grumpy: "So you're feeling better now?"

Mrs. Oldbutcute: "Yes, but I was completely paralyzed for a while."

Dr. Grumpy: "Well, that was the medication, and it's wearing off now. It caused you to be dead from the waist down."

Mr. Oldbutcute: "Hell, doc, she's been dead from the waist down for 40 years."

He ducked as a copy of Newsweek came flying at him.

Anatomical Variant

From a history form a patient handed me today:

"I've had both right shoulders replaced twice."

Thank You For Sharing

Dr. Grumpy: "Do you take anything for the neck pain?"

Mr. Kreepy: "Viagra."

Dr. Grumpy: "Viagra isn't a pain medication."

Mr. Kreepy: "Yeah, but when I'm jacking off I don't notice the pain as much."

I need to learn not to ask. Sometimes I don't want to know. And the mental images are never pretty.

Medical Guidelines

Okay, medicine is full of guidelines and acronyms. Phrases like SOAP, BRAT, TURP, CAPRIE, HIT, CABG, CHOP, etc. all have meaning to different specialties.

So (and thank you to reader Kaitlin for bringing this to my attention) there's a scale used to help assess vomiting during pregnancy, called the Pregnancy-Unique Quantification of Emesis index, aka PUQE.

Really. PUQE.

I'm not making this up- Journal of Midwifery and Womens Health. 2009;54(6):430-444.

I can just see something like this:


Frantic husband: "Doctor, my wife is still throwing up!"

Doctor: "What's her PUQE index?"

Frantic husband: "Um, looks like pizza she ate last night, and maybe a cookie. Could be some pickles, too. Hard to tell."

Tuesday Evening, During Desert

Dr. Grumpy: "Dr. Grumpy, returning a call."

Mr. Duh: "Yeah, I was there this afternoon, and you told me to stop taking my Lipitor?"

Dr. Grumpy: "Yes, I did."

Mr. Duh: "And you wrote me a note, I have it here, it says 'Stop taking Lipitor'."

Dr. Grumpy: "Correct."

Mr. Duh: "So, does that mean I should stop taking it? Or just cut the dose in half?"

Dr. Grumpy: "It means you should stop it."

Mr. Duh: "Should I stop just the Lipitor, or should I stop stuff you didn't write down?"

Dr. Grumpy: "Just the Lipitor."

Mr. Duh: "Completely stop the Lipitor, you mean?"

Dr. Grumpy: "Yes."

Mr. Duh: "Okay, thanks for clearing that up, your note was kind of vague."

Averages Aren't Always Helpful

Dr. Grumpy: "At your last visit you were averaging 2 migraines a week, how has that been since starting the new medication?"

Mrs. Analytical: "Better" (whips out PDA) "The first week on it I went to 1.94 migraines, the second week I had 1.89 migraines, and the 3rd week I had 1.85 migraines. Last week, though was worse, and I had 1.91 migraines."

Dr. Grumpy: "How do you figure out these numbers?"

Mrs. Analytical: "I use accounting software."

Dr. Grumpy: "But how is 1.91 migraines different from 2 migraines?"

Mrs. Analytical: "The software says it is."

Not a Good Sign

On today's schedule, my first patient of the day is listed as "Mrs. Ancient, referred for memory loss".

I look in the lobby. She's out there, holding a magazine upside down. And she has her bra on outside her shirt.