One of these things is not like the other, one of these things just doesn't belong. Can you tell which one of these doesn't belong, before I finish my "song". (those who never watched Sesame Street won't get it."
And no doubt it is the constipation that is causing the patient the most problems in followup. (seriously- you know what I mean if you have ever been seriously stopped up)
The Opioid pain medication causes constipation. It seems like a natural progression, beaten to near death, a host of intervening crisis medical situations, heroic effort to save a life and the ignominious discharge with constipation.
Gotta go with Lizard and Packer. Constipation is natural outcome of treatment for all the others.
And we all know once a diagnosis is listed in a medical record anywhere, it cannot be resolved and eliminated (as it were) from all future lists of medical diagnoses attached to this patient.
He (or she) now has an ADDITIONAL preexisting condition - that in our brave new world may disqualify from any medical treatment for this problem.
Hope he stocks up on prune juice, bran flakes, and his 9 servings of fruit and veg daily.
In a large hospital with lots of specialists, a patient like this is pan- consulted. The hospitalist cannot bill for what someone else is managing(even though the hospitalist is the one called for everything, particularly night), they have to bill for something not otherwise covered. Therefore, constipation.
Our physicians are advised by billing/coding to include all diagnoses that were treated on the discharge summary. There can be a diagnosis without a treatment, but not a treatment without a diagnosis. I would imagine as others have that this was iatrogenic 2/2 pain meds.
Apologies , but is the patient dead ?
ReplyDeleteConstipation? Maybe they meant consternation.
ReplyDelete"....aaaand METHODISTS!"
ReplyDeleteOne of these things is not like the other,
ReplyDeleteone of these things just doesn't belong.
Can you tell which one of these doesn't belong,
before I finish my "song".
(those who never watched Sesame Street won't get it."
And no doubt it is the constipation that is causing the patient the most problems in followup. (seriously- you know what I mean if you have ever been seriously stopped up)
ReplyDeleteOh, dear.
ReplyDeleteCan't constipation affect blood pressure?
ReplyDeleteI also gotta be nebby and wonder what the hell happened to his poor person.
Just lovely.
ReplyDeleteso, #5 makes me wonder how this is a discharge summary since this person appears to have been readmitted
ReplyDelete#6 is clearly iatrogenic because this person has to be on a fair amount of opiate pain meds, don't you think?
Talk about burying the lede...
ReplyDeleteHow is one diagnosed with assault, like you're diagnosed as having a hemorrhage?
ReplyDeleteRespiratory failure AND respiratory insufficiency? Damn. Sounds serious.
ReplyDeleteThe Opioid pain medication causes constipation. It seems like a natural progression, beaten to near death, a host of intervening crisis medical situations, heroic effort to save a life and the ignominious discharge with constipation.
ReplyDelete7. Hail
ReplyDelete8. Locusts
9. Darkness
10. The slaying of the firstborn
Gotta go with Lizard and Packer. Constipation is natural outcome of treatment for all the others.
ReplyDeleteAnd we all know once a diagnosis is listed in a medical record anywhere, it cannot be resolved and eliminated (as it were) from all future lists of medical diagnoses attached to this patient.
He (or she) now has an ADDITIONAL preexisting condition - that in our brave new world may disqualify from any medical treatment for this problem.
Hope he stocks up on prune juice, bran flakes, and his 9 servings of fruit and veg daily.
"Buy 5 and get the 6th for free" somehow never turns out to be as good a value as it sounds...
ReplyDeleteIn a large hospital with lots of specialists, a patient like this is pan- consulted. The hospitalist cannot bill for what someone else is managing(even though the hospitalist is the one called for everything, particularly night), they have to bill for something not otherwise covered. Therefore, constipation.
ReplyDeleteSounds like he had the shit beat out of him, and/or was too injured to give a shit.
ReplyDeleteOur physicians are advised by billing/coding to include all diagnoses that were treated on the discharge summary. There can be a diagnosis without a treatment, but not a treatment without a diagnosis. I would imagine as others have that this was iatrogenic 2/2 pain meds.
ReplyDeleteTo quote an attending who shall remain anonymous, "the more diagnoses you can come up with to put in the EMR, the better."
ReplyDelete