Sunday, February 08, 2009

Humpin Hampton

Every now and then you see something that you remember from Med School (learned between naps and pounding coffee. This was actually one of those times I pursued a workup from a gut feeling and luckily so. The patient here was moderately ill, but not so much that I might not just have treated the "pneumonia", which she did have, as an outpatient. Temp 99.9, oxygen sat 96% and white count 12. Something about her pleuritic pain, which you can get with pneumonia, triggered me to get a CT, in that it seemed to radiate to her shoulder. The xray on the right shows what could easily be called a right lower lobe pneumonia-end of story,home on Levaquin and albuterol. But the consolidation at the lower lung border is a sign called Hampton's Hump, a pleural based consolidation caused by a clot. The CT on the left confirmed a large pulmonary embolus. She also had pneumonia on top of it all.

And by the way, the Congressional Budget Office (non partisan) says this great Self-Stimulation package pushed by FDO (Franklin Delano Obama) will actually decrease the GDP in the long run. So I say let's make the American people scared and get this thing passed in a hurry. My kids are already saving to pay their share of the increased tax burden. (Just had to throw this in )


  1. The demoncrats must have had this bill (millstone) written last year; just ready to pop it out for swift enactment. How else could they have had it all set to sign so soon!?!??
    They are using a bar bouncers strategy...hit 'em hard and hit 'em fast; before the opponent understands what's going on.
    I just don't understand how a "normal" human can accept this Porky Pig pile!!!!! I mean you don't even have to be conservative and realize that this pile of pork is going to bankrupt the country and enslave the population.
    Oh well, it looks like Karl Mark and his ilk were right..."get the population interested in things like sports and sex and you can control them..."


  2. Isn't that one of those things Medicare won't pay for?? Can't wait for the miraculous decrease in PE's, UTIs, and Central Line infections over the next few years...

  3. Health Care Reform in the bill discussed here:

    Sounds like they might be sneaking in their national health care, after all.

  4. Holy Hell! I just read the article and I am terrified.

  5. Just read the article also, what can we do to stop this? Holy crap.

  6. Good case Cat.

    On a political note, were fucked. 911, could you write another angry political rant for me. It makes me feel better knowing I am not alone.

  7. What? It will only be a problem if you're old. It's like paying your taxes -- you should feel proud and patriotic to have your health care rationed.

    After all, you're just a non-productive, useless eater.

    (Anyone want to join me in a cave in the high hills somewhere?)

  8. hampton's hump is one of the cooler named diagnoses althouhg my personal favorite is getting a calling from the tele tech saying the patient is in wenckebach...first time I heard that I thought is that like luckenbach, texas (waylon, willie and the boys)

  9. Looked at the link. Ahhh yes, legislation by enema.

    So I have a 30yr old female with right lower quadrant pain, negative pregnancy test and a white count of 10,000. I have to send her home because she doesn't meet federally mandated criteria for a CT, lest I get a fine for not being a "meaningful user" of CT scan technology. Will the government be there in court standing beside me when the appendix ruptures and the patient gets septic and dies? I'm sure "she didn't meet criteria" will play well in front of a jury of my "peers".

    As I am already a professional risk taking "crash test" dummy, what is a little more force fed government risk in my diet?

    A career as a long distance trucker has never looked so good.....

  10. And here I thought Hampton's Hump was like Galt's Gulch, where we sane thinkers could escape our patriotic duty of being taxed into oblivion. Talk about bovine scatolgy...

  11. Wouldn't a d-dimer have been massively elevated? and compel you to do the CT to R/O an embolus? I know the test is not sensitive to specific clots and is frequently elevated from other non PE conditions, (leading to plenty of negative Chests CTA's) but a negative test is pretty good screening to exclude a clot? Did you do this blood test?, our ER docs Do em on a large percentage of pts.

  12. I did a d dimer and it was markedly elevated, but at times at our hospital the result comes back AFTER the CT is done. The CT was ordered first.