February 14th, 2010 by Michael Sevilla, M.D. in Better Health Network, True Stories
Tags: Burn, Cancer, Chemo, Chemotherapy, complication, Dermatitis, Dermatology, Oncology, Rash
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One of the great things of being in a group practice is meeting and taking care of patients who may not necessarily be on your own personal patient panel. Walking into the room, I hear the patient say, “Doc, you gotta help me.” I see a red right forearm and on the “complaint” section, the nurse wrote “burn.”
So, I ask, “Well how did you burn your arm?” “Well, doc, I got cancer.” Hmm, that’s interesting. I didn’t make the connection until the next sentence. “It was my last treatment with chemotherapy about 2 weeks ago and for some reason, the needle slipped and the stuff went all over my arm. The cancer doc prescribed these pills, but they don’t seem to be helping. I asked the pharmacist about some salves and this is what they said.” He showed me a handful of creams and ointments purchased at the pharmacy.
Since I didn’t know this patient at all, I was leafing through a very thick paper chart to try to catch up. “Yeah, I’ve been coming to see Doc [name] for a long time now. I’m glad you were able to see me today since his schedule was full.” This very pleasant patient then told me about how they diagnosed his cancer – a tear came to his eye – it’s like he was re-living that moment again. Read more »
*This blog post was originally published at Doctor Anonymous*
February 14th, 2010 by KerriSparling in Better Health Network, True Stories
Tags: Endocrinology, Glucose Meter, Grape Juice, Hypoglycemia, Obstetrics And Gynecology, Pregnancy, Type 1 Diabetes
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BEEEEEEEEEP!
Reaching for the alarm, but it’s not the clock. Check the cell phone, but it’s not a text message. Grope for the cat, but she’s not beeping, either.
BEEEEEEEEEP!
Oh yeah, how could I forget?
52 mg/dl. Not too low, but apparently I’ve over-corrected with those basal changes I made two days ago, and I need to retweak just a little bit.
Wandered out to the kitchen, leaving the BEEEEEEP!ing behind in the bedroom, and also leaving the tube of glucose tabs resting on the bedside table untouched. Make a beeline for the bottle of grape juice that sat, unopened, in the fridge. Read more »
*This blog post was originally published at Six Until Me.*
February 14th, 2010 by David Kroll, Ph.D. in Better Health Network, True Stories
Tags: Bed Rest, Bronchitis, Chronic Illness, Internal Medicine, Pneumonia, Pulmonology
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I have just a couple of thoughts today that I offer to the reader not for sympathy but, rather, for scientific observation and reflection.
I’ve been dealing with a case of bronchitis that became pneumonia. I tried to teach through it, do grant reviews, finish a book chapter, etc. but was finally ordered by my pulmonologist to recuperative bedrest at home for approximately four weeks.
When told I’d be confined to bed for a month, I thought that it would be great – that I’d get two papers and a grant renewal done and still have plenty of time for blog posts I’ve been wanting to get to, finish writing a couple of songs to take to the studio, get all the tax documents together, maybe learn a little CSS and webpage design and get around to a hosted personal website for the domain I’ve had for a year, etc. Read more »
*This blog post was originally published at Terra Sigillata*
February 12th, 2010 by Shadowfax in Better Health Network, True Stories
Tags: Back Pain, Emergency Medicine, Epidural Abscess, Fever, Heroin, Illicit Drugs, Infectious Disease, Instinct, Lab Tests, MRI, Radiology, Veteran
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Sometimes in this job you just get lucky. You have an elusive and/or dangerous diagnosis just dropped in your lap. Something devastating that you would never have been able to tease out otherwise just gets handed to you by the patient. There’s a catch, though: you have to be smart enough to know when to listen to the patient, when not to blow off their crazy talk as just crazy.
So it was recently when I saw a guy with back pain. From the chart, it didn’t sound like anything complex: a middle-aged to older guy, maybe 60 or so, with a history of chronic back pain and multiple surgeries for the same. He was on Oxycontin 80 mg three times daily (a very high dose, and a red flag for an ER doc naturally suspicious of drug-seeking behavior). I went to see him, and it was clear in seconds that this dude was JPN: Just Plain Nuts. Read more »
*This blog post was originally published at Movin' Meat*
February 11th, 2010 by Emergiblog in Better Health Network, True Stories
Tags: Emergency Medicine, kids, Nursing, Pediatrics, Sick
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Something is in the air.
Work has been uncharacteristically crazy, nuts, bananas busy since I returned from my influenza-induced hiatus. Scores of very sick people, no real pattern. And a ton of pediatrics.
Feverish, coughing, runny-nose, wheezing, stridorous, vomiting, diarrhea-having, screaming, combative, medicine-spitting small humans.
It’s not easy triaging these little folks. You have to get the history over the crying/screaming, try and obtain vitals while they kick off any and all probes, do a rectal temperature if they are under 2 years old (wrestling to keep them still), and weigh them for medication dosing. Read more »
*This blog post was originally published at Emergiblog*
