Sorry for the lack of posts. I am on a difficult rotation right now! Very thankful for the Thanksgiving holiday coming up. I will be spending it with family and hope you all get to do the same.
Will try to post more starting Monday.
Happy Thanksgiving to you and yours!!!
Wednesday, November 27, 2013
Thursday, November 14, 2013
Mr. Sleepy
I know it is a necessary part of medicine but I do feel bad for patients that pre-rounds and rounds tend to be early in the morning. This particular patient was being treated for hepatic encephalopathy and not getting quality sleep due to seizures. Come 8am rounds we have to wake him up, and part of the exam is to document how oriented he was given his diagnosis.
Attending: Mr. Sleepy, how are you?
Mr. Sleepy: (snore)
Attending: Mr. Sleepy. Wake up. (gently shakes patient)
Mr. Sleepy: Huh, yes. Hi.
Attending: How are you?
Mr. Sleepy: Tired.
Attending: Yes, do you know where you are?
Mr. Sleepy: The hospital.
Attending: Good, and the month?
Mr. Sleepy: Huh, oh, September.
Attending: Well, today is October 1st so I guess that was a trick question.
Mr. Sleepy: (snore)
Attending: (gently shaking him) Mr. Sleepy, who is the president of the United States?
Mr. Sleepy: ..... (sigh, grunt).... Osama ..... (snore)
(The various residents and students is the room start laughing. Luckily Mr. Sleepy is undisturbed by this and continues to snore lightly.)
Attending: Ok, Mr. Sleepy, just don't say that to anyone else.
Mr. Sleepy: (snore)
(The Attending does a quick exam and we move on to disturb the rest of the next patient.)
Attending: Mr. Sleepy, how are you?
Mr. Sleepy: (snore)
Attending: Mr. Sleepy. Wake up. (gently shakes patient)
Mr. Sleepy: Huh, yes. Hi.
Attending: How are you?
Mr. Sleepy: Tired.
Attending: Yes, do you know where you are?
Mr. Sleepy: The hospital.
Attending: Good, and the month?
Mr. Sleepy: Huh, oh, September.
Attending: Well, today is October 1st so I guess that was a trick question.
Mr. Sleepy: (snore)
Attending: (gently shaking him) Mr. Sleepy, who is the president of the United States?
Mr. Sleepy: ..... (sigh, grunt).... Osama ..... (snore)
(The various residents and students is the room start laughing. Luckily Mr. Sleepy is undisturbed by this and continues to snore lightly.)
Attending: Ok, Mr. Sleepy, just don't say that to anyone else.
Mr. Sleepy: (snore)
(The Attending does a quick exam and we move on to disturb the rest of the next patient.)
Wednesday, November 13, 2013
Just get used to it
Interacting with patients as a 3rd year student is a great experience but you soon realize that many don't tell you the whole story so when the doctor comes in the room you kind of look like an idiot.
--------------------------------------------------------------------------------------------------------------------------
Me: So besides the refills on your hypertension medications is there anything else you are here for?
Patient 1: No.
Me: Great. So we already talked about diet, exercise and medication side effects. Any questions you want me to ask the doctor?
Patient 1: No, I don't think so.
Me: Ok. The doctor and I will be back in together in just a minute.
Doctor: Hi Patient 1, so my student says you are doing pretty good. Nice to hear!
Patient 1: Doctor, I hate that medicine you have me on. It makes me pee at night and I can't sleep!!
-----------------------------------------------------------------------------------------------------------------------------
Me: How does that abdominal pain feel?
Patient 2: Like an achy pain.
Me: Can you rate it on a scale of 1 to 10 for me and tell me if it radiates anywhere?
Patient 2: It is about a 5 and it just stays right here by my belly button.
(Later)
Doctor: How is your pain?
Patient 2: Oh, it is this sharp pain in my belly that goes all the way to my back and it gets so bad I can barely breath!!
--------------------------------------------------------------------------------------------------------------------------
Me: So besides the refills on your hypertension medications is there anything else you are here for?
Patient 1: No.
Me: Great. So we already talked about diet, exercise and medication side effects. Any questions you want me to ask the doctor?
Patient 1: No, I don't think so.
Me: Ok. The doctor and I will be back in together in just a minute.
Doctor: Hi Patient 1, so my student says you are doing pretty good. Nice to hear!
Patient 1: Doctor, I hate that medicine you have me on. It makes me pee at night and I can't sleep!!
-----------------------------------------------------------------------------------------------------------------------------
Me: How does that abdominal pain feel?
Patient 2: Like an achy pain.
Me: Can you rate it on a scale of 1 to 10 for me and tell me if it radiates anywhere?
Patient 2: It is about a 5 and it just stays right here by my belly button.
(Later)
Doctor: How is your pain?
Patient 2: Oh, it is this sharp pain in my belly that goes all the way to my back and it gets so bad I can barely breath!!
Sunday, November 10, 2013
Mrs. Patch
Me: So I see you are in for your physical today. Any health concerns for the doctor?
Mrs. Patch: None except my weight! I would like to lose.
Me: Okay. I see the nurse gave you some diet information.
Mrs. Patch: Yes.
Me: Some other things you can do are...
Mrs. Patch: Let me stop you right there. I don't want no exercise or diet advise. Just stick a patch right here (slaps thigh). A patch that will suck the fat right out!
Me: I don't think they have that yet but if it comes out how about I let you know?
Mrs. Patch: (laughs) Sounds good. Now how about you tell me those other things you were going to say. Even though I know I don't want to here it honey.
Mrs. Patch: None except my weight! I would like to lose.
Me: Okay. I see the nurse gave you some diet information.
Mrs. Patch: Yes.
Me: Some other things you can do are...
Mrs. Patch: Let me stop you right there. I don't want no exercise or diet advise. Just stick a patch right here (slaps thigh). A patch that will suck the fat right out!
Me: I don't think they have that yet but if it comes out how about I let you know?
Mrs. Patch: (laughs) Sounds good. Now how about you tell me those other things you were going to say. Even though I know I don't want to here it honey.
Saturday, November 2, 2013
Rough and Tumble
Dr. Boss: I want you to see this patient first. The mother thinks her son has ADHD but he is only 5 years old so it is a little early for diagnosis and I wouldn't treat him with stimulants anyway.
Me: Ok.
Dr. Boss: Ask them about family history and such, have her fill out this questionnaire and do a quick physical.
Me: No problem.
(Entering room.)
Me: Hi, I am a medical student. I am going to see you before Dr. Boss if that is ok?
Mother: Yes.
Me: So I hear you are concerned that little Tommy might have ADHD, can you tell me why?
(Before the patient can open her mouth Tommy peaks his head out from under the chair where he was hiding and screams at me.)
Tommy: Hi!! Watch what I can do!
(Tommy proceeds to dance around the exam room and "spin" like a helicopter.)
Mother: Um, well. He acts like this constantly and doesn't listen. He won't sit still. Tommy sit down!
(Tommy ignores her and begins to pull on my stethoscope, asking if he can play with it.)
Me: Not right now buddy, let me talk to your mom.
Mother: I just get so frustrated.
(Tommy is back under the chair now and is pretending to swim on the floor.)
Me: I can imagine. Does any behavior like this run in the family?
(Mom goes on to explain how she has three older boys, and none have ever been this wild. We talk about some other things such as aggression and other authority figures in the household.)
Me: Ok, great, now if Tommy doesn't mind I would just like to examine him really quick.
(I help him up on the exam table and just as I am explaining about listening to his heart....)
Tommy: SMELL MY FEET!! (He lifts his feet in the air and nearly kicks me in the head.)
Mother: I am so sorry!
Me: It's alright, he missed!
(I manage to listen to his heart and lungs but that is about it as he is squirming and won't let me do much else.)
Me: Alright, I am going to talk to the doctor but if you could just fill out this questionnaire.
Mother: I already did one! Please, show the doctor!
(She has indeed filled out three pages of questions about Tommy's behavior. I show Dr. Boss and report what I observed. He says Tommy might be showing some signs of ADHD but also might improve his behavior once he starts school and is in contact with more authority figures. I wish that mother the best of luck!)
Me: Ok.
Dr. Boss: Ask them about family history and such, have her fill out this questionnaire and do a quick physical.
Me: No problem.
(Entering room.)
Me: Hi, I am a medical student. I am going to see you before Dr. Boss if that is ok?
Mother: Yes.
Me: So I hear you are concerned that little Tommy might have ADHD, can you tell me why?
(Before the patient can open her mouth Tommy peaks his head out from under the chair where he was hiding and screams at me.)
Tommy: Hi!! Watch what I can do!
(Tommy proceeds to dance around the exam room and "spin" like a helicopter.)
Mother: Um, well. He acts like this constantly and doesn't listen. He won't sit still. Tommy sit down!
(Tommy ignores her and begins to pull on my stethoscope, asking if he can play with it.)
Me: Not right now buddy, let me talk to your mom.
Mother: I just get so frustrated.
(Tommy is back under the chair now and is pretending to swim on the floor.)
Me: I can imagine. Does any behavior like this run in the family?
(Mom goes on to explain how she has three older boys, and none have ever been this wild. We talk about some other things such as aggression and other authority figures in the household.)
Me: Ok, great, now if Tommy doesn't mind I would just like to examine him really quick.
(I help him up on the exam table and just as I am explaining about listening to his heart....)
Tommy: SMELL MY FEET!! (He lifts his feet in the air and nearly kicks me in the head.)
Mother: I am so sorry!
Me: It's alright, he missed!
(I manage to listen to his heart and lungs but that is about it as he is squirming and won't let me do much else.)
Me: Alright, I am going to talk to the doctor but if you could just fill out this questionnaire.
Mother: I already did one! Please, show the doctor!
(She has indeed filled out three pages of questions about Tommy's behavior. I show Dr. Boss and report what I observed. He says Tommy might be showing some signs of ADHD but also might improve his behavior once he starts school and is in contact with more authority figures. I wish that mother the best of luck!)
Subscribe to:
Posts (Atom)