PHooDy

Best Reasons to Visit an Emergency Room

2008-02-23T19:54:00.002-06:00

My colleague was struggling with what to do with this one. A middle aged male presented to our emergency room today complaining that his stomach was making noises; no other complaints.
No abnormalities were found on his vital signs, nor the rest of his physical examination.

I suggested a diagnosis of Acute Bowel Sound Awareness.

2006-07-05T03:57:00.001-05:00

SWIMMING WITH SHARKS
Nope, this not figurative, (e.g. a reference to trial lawyers) but REALLY swimming with some big sharks. Though yours truely has had his share of being chased by hammerheads, smacked by a great whites while poking out from a shark cage, feeding nurse sharks, etc., nothing beats swimming with the gentle Whale Shark (Tiburon Ballenas) off the coast of NE Yucatan.
For a mere $80, you can get on a small boat from Isla Holbox (pron: /ol-bosh/), motor for an hour or so, and find a number of these gentle giants plankton feeding near the surface. This is a yearly phenomenon (June - August) recently discovered by the tourist industry; luckly, the Mexican authorities have had the sense to put these sharks on a special protection program.

2006-06-10T00:40:00.000-05:00

The Great American Name
a series of original and creative names in America

"Donkia" (f.) Recently changed legally from "Donkeya", due to some good advice from a well-read friend. The male version would be, well, just a Donkey. Due to privacy reasons, we can not print the last name of this individual, but if you could only know (or guess!) K _ _ g.

2006-06-10T00:16:00.000-05:00

Best Reasons to Visit an Emergency Room

Case 4: I need a lumbar puncture!
A 16 year old teen age girl presented to the emergency ward with her mother. Her complaint? Really bad back pain. Prior to coming in, the mom and daughter team had visited their Primary Care Physician, who was so impressed with the back pain that he thought the patient needed a spinal tap to "rule out" meningitis. Well, a pregnancy test in the Emergency Ward was positive, and a proper exam by a real doctor in the E.D. revealed a rather large mass in the belly, with a fast heart beat. The patient insists that she just finished her menstrual period, and denies ever being sexually active. No...it's not ALIEN; The mother was demanding that her daughter get some strong pain medications. at this point. What do you do now? Any strong pain medication could be dangerous to give to a pregnant patient, plus now, it's becoming obvious that the patient is probably in LABOR! The ethical dilemma is this; state law defines a pregnant teen as emancipated; therefore "competent" to decide her own healthcare, and federal laws (HIPPA) states that a patient's personal medical information is private, and only with consent by the patient, can medical information be given to someone else. It was obvious that the patient didn't want mom to find out she is pregnant, but knowing that it's just a matter of time before mom finds out anyway...heck I told mom the truth. "No medications for pain except Tylenol...you are being sent to Labor and Deliver to deliver a baby!" Two hours later, baby was delivered. Sorry no lumbar punture, (to rule out meningitis), and no epidural needed either!
Diagnosis: Back pain, resolved by labor and delivery.

2005-12-21T02:29:00.000-06:00

The Great American Name

a series of original and creative names in America

This week: "Jesus Noel" (pronounced as it reads). So what so great about this one? Well, every now and then, the Emergency Room Secretary gets to name a child or two. This typically happens when a baby is abandoned and then discovered, and brought into the ER. Typically, the parent does this in subzero weather (in this case, December), in an alley or outside a church. With great modern medicine, we reverse hypothermia, and voila! normal baby again! Except now, the baby is given some random, blatantly religious, in-your-face sectarian name that will haunt him forever.

2005-11-17T22:30:00.000-06:00

Best Reasons to Visit an Emergency Room

Case 3: Arrrrgh....Hair Loss!

Yup, after a whole month of finding hair falling off every time she showers, it was time for this 30 year old female to goto the emergency room. Upon exam, there WAS a general thinning of the hair, not like alopecia areata or androgenic alopecia, or something manly.

Diagnosis: To make things worse, we doctors use million dollar words like Telogen Effluvium to make our patients feel they have something special. In this case, there was nothing to explain this other than a bad diet. It turns out, this patient eats very little (though looking at her, you'd think she eats plenty); that is..she eats only beans. No rice, no corn, no meat.

Treatment: education on dietary requirements; specifically protein.

2005-11-06T03:54:00.000-06:00

The Great American Name
a series of orginal & creative names in America

This week: "Sweetie" (pronounced just as it reads)

Nope, it's not a nick name; it's the REAL LEGAL deal. I have to empathize...it's like someone named "Ted" sitting at United's budget airline terminal. You think someone is calling you every few minutes.

2005-10-23T05:36:00.000-05:00

Best Reasons to Visit an Emergency Room

Case 2: Must get to the hospital, NOW!
a 24 year old female was walking to the hospital, when she decided to call 911, complaining of "chest pain". Fair enough. But wait....
When the paramedics asked her why she called the ambulance, she said that she was scheduled for outpatient surgery, and was walking to the hospital, but running late; so she called 911, complained of "chest pain". Sure enough, she was whizzed to the E.R., and upon arrival to triage room, she said her chest pain was gone, but she needs to goto registration for outpatient surgery so she can have her procedure done. Suckers!

The Great American Name:

a series of orginal & creative names in America

This week: "Female" pronouced /feh-mal-lee/

Well, we know who messed up the pronouciation, but my question is, how dare the OB ward secretary name the baby without consulting her parents!

2005-10-22T22:35:00.000-05:00

wecome to the series:

Best Reasons to Visit an Emergency Room

case 1: Acute Tongue Emergency!!

My first case is a 27 year old gal, who presented to the emergency room because she noticed that there are big bumps on her tongue. This discovery REALLY alarmed her (as all cases that come to the ER should) There was nothing else bothering her. These bumps don't hurt, burn, itch, or cause difficulty breathing or swallowing. She noticed these "bumps" after she was scraping her tongue (Comment: is this the latest craze in America? I think tongue scraping is something that 1/4 of the world's population have done routinely in India for a long time, though)

Diagnosis: What does a doctor write for a diagnosis when there's nothing wrong? This problem plagues doctors regularly. I don't know one insurance company that will pay for a diagnosis of "acute awareness of tongue glands" (in this case-"vallate papillae awareness"), but that's what it is. Afterall, emergency rooms ARE the safety net for America's failing healthcare non-system. What would this 27 year old have done with out a visit to an ER? A nervous break-down...prevented!

Treatment: organize a Tongue Glands Awareness Week in suburban neighborhoods.