January 10th, 2010 by GruntDoc in Better Health Network, True Stories
Tags: Caught In Throat, Emergency Medicine, Fish Bone, How To Remove A Fish Bone, Laryngoscopy, Magill Forceps, Radiology, X-ray
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A patient comes in with the entirely understandable complaint of “I have a fishbone lodged in my throat”. Came straight from dinner to the ED. When I ask a stupid question I’m given a stupid answer: “It feels like…a fishbone…”. Duh on me.
Now, I went to a pretty good EM residency, and while there I learned two things: the books say fishbones don’t show up on x-rays of the neck, and, fishbones sometimes show up on x-rays. I’m about 70% positive in my career…
So, I got an xray. See if you can spot the fishbone (hint: there’s an arrow pointing at it…)
So, it’s there… Now what… There are very few wrong answers. Call ENT, etc. My answer: go get it. Read more »
*This blog post was originally published at GruntDoc*
January 9th, 2010 by Happy Hospitalist in Better Health Network, True Stories
Tags: Diary, Exercise, Fat Prevention, Jogging, Jogging Log, Primary Care, Running
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Another year is done and my running log for 2009 is complete. For two years now I’ve kept track of my jogging/running/walking that I perform in my leisure time. In 2008 I completed just over 600 miles of leisure time exercise. The great thing about running is that it’s free. Minus the cost of shoes and socks and a few pairs of shorts, anyone can do it. You don’t need a GPS watch to get the job done. You don’t need a gym. All you need are your two front feet and a little inspiration and motivation.
The Biggest Loser lost over 55% of his weight, or 239 pounds and how did he do it? He kept moving. There is no secret to weight loss and fitness. Watch how much you eat. Make smart choices about how you choose to live your life and make it happen. If you have no expectations, you’ll meet them every time. This show is proof positive that even the super obese can lose remarkable amounts of weight with diet and exercise.
Running has become a part of my life. Without exercise, I often feel like my day is not complete. Seeking exercise is a state of mind that happens once you experience the benefits of feeling fit. Here is my running log for 2009: Read more »
*This blog post was originally published at The Happy Hospitalist Blog*
January 8th, 2010 by Emergiblog in Better Health Network, True Stories
Tags: Burnout, Constipation, Emergency Medicine, Nursing, Tired, Yeast
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Constipated since childhood, but after 63 years, she decided to deal with it on Christmas at 0400.
Okay, not really.
Apparently, if you are constipated you should eat yeast.
Plain squares of yeast.
I don’t get the mechanism.
Yeast rises in a warm environment.
So, if you eat it, does it keep expanding until it explodes everything in front of it out the, uh, exit door?
*****
I will say that the most interesting chief complaints tend to cluster around the holidays.
It goes something like this: Read more »
*This blog post was originally published at Emergiblog*
January 8th, 2010 by Bongi in Better Health Network, True Stories
Tags: Anesthesiology, Hand Washing, Infectious Disease, Perineal Abscess, Pus, Sepsis, Surgery
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Shaking hands is not really such a good idea, especially in a hospital where there are all sorts of nasty bugs floating around, seeking whom they may devour. So generally I do not shake hands unless the patient absolutely insists and I think the cultural slight may be more than he can bear. But one incident highlighted to me the reason you generally don’t want to shake hands so well it could just have well been written all over the hospital in bright neon lights.
I was on call that night so it fell to me to evaluate and treat the patient in casualties which the casualty officer said had a perianal abscess. I approached the bed and introduced myself, but I made a point of positioning myself in such a way that the patient wouldn’t be able to greet me with the traditional handshake. Experience had taught me that this was one case where this cultural idiosyncracy was patricularly ill-advised.
I asked what the problem was. without saying a word his hand moved to his gluteal cleft in one smooth motion. Moments later I found myself staring with morbid fascination as he pulled his butt cheeks apart and started prodding what was clearly an abscess with his finger. It had already broken open slightly so there was a thin stream of pus oozing out and following the natural pull of gravity. The patient’s grubby finger scratched, prodded and poked this poor stream of sepsis, completely disrupting its attempt to soil the bed linen. Read more »
*This blog post was originally published at other things amanzi*
January 6th, 2010 by Happy Hospitalist in Better Health Network, Humor, True Stories
Tags: Change Doctors, Doctor Patient Relationship, Internal Medicine, Obstetrics And Gynecology, Primary Care
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Have you ever thought you need to find a new doctor? Sometimes patients and doctors need to part their ways. Some doctor-patient relationships are so good that gifts are exchanged. Some are so bad that the doctor dismisses the patient from their clinic.
What about the patient who isn’t happy with the care they are receiving? What about the patient who wants to find a new doctor? Sometimes legitimate reasons exist. Perhaps the patient and doctor do not agree on the recommended therapies. When the patient and doctor do not have the same goals in mind, sometimes it’s best for the patient to find a new doctor that can better work with their needs. Read more »
*This blog post was originally published at The Happy Hospitalist Blog*
