tag:blogger.com,1999:blog-24021163.post6526645576175729402..comments2024-02-18T01:56:38.508-06:00Comments on M.D.O.D.: Believing patients...911DOChttp://www.blogger.com/profile/06466669111561150174noreply@blogger.comBlogger31125tag:blogger.com,1999:blog-24021163.post-87193747400366381162012-06-14T12:42:29.616-05:002012-06-14T12:42:29.616-05:00Thank you kindly Jeanette,
God bless you for hangi...Thank you kindly Jeanette,<br />God bless you for hanging in. Few of us who wrote the meat of this blog are still in "the show". And when you find yourself wondering if there's something wrong with you for being frustrated with medicine today then know it simply mean you have not surrendered your skills of discernment. Now go get Botox training and GTFO. <br />;)911DOChttps://www.blogger.com/profile/06466669111561150174noreply@blogger.comtag:blogger.com,1999:blog-24021163.post-24448164111206553002012-06-13T18:21:36.873-05:002012-06-13T18:21:36.873-05:00I love you. I'm so glad I found your blog. I a...I love you. I'm so glad I found your blog. I am a family physician that was on the brink of a nervous breakdown dealing with these crackhead patients, until now. My co-worker (M.D.) and I read your blogs in-between patients.Jeanettenoreply@blogger.comtag:blogger.com,1999:blog-24021163.post-38629803037266291112010-03-25T20:56:17.928-05:002010-03-25T20:56:17.928-05:00Ah, yes.....everyone lies, the question is WHY?? (...Ah, yes.....everyone lies, the question is WHY?? (Lie to Me)Anonymoushttps://www.blogger.com/profile/06858329388442672301noreply@blogger.comtag:blogger.com,1999:blog-24021163.post-59501952546076690502008-04-08T22:21:00.000-05:002008-04-08T22:21:00.000-05:00On asking one of my supervisors if he thought the ...On asking one of my supervisors if he thought the patient was faking he responded... Don't you watch House? Everybody's lying.<BR/>Well put, thanks for blogging and giving us a taste of what real medicine is.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-24021163.post-85663109543105154902008-04-08T00:13:00.000-05:002008-04-08T00:13:00.000-05:00Was it really? That so sucks. It would be an awe...Was it really? That so sucks. It would be an awesome test. Thanks for telling me.Amelia Ameshttps://www.blogger.com/profile/17296224743117560163noreply@blogger.comtag:blogger.com,1999:blog-24021163.post-38466368353230525792008-04-07T20:16:00.000-05:002008-04-07T20:16:00.000-05:00Amy, please realize that the link you posted was p...Amy, please realize that the link you posted was part of thinkgeek's april fools joke. <BR/><BR/>Check out the "availability" section...Cheating Deathhttps://www.blogger.com/profile/07813533035326719783noreply@blogger.comtag:blogger.com,1999:blog-24021163.post-89137512408976151602008-04-07T13:21:00.000-05:002008-04-07T13:21:00.000-05:00Just an interesting thought. The Wal-mart brand E...Just an interesting thought. The Wal-mart brand Equate pregnancy test is more accurate than one you can get in your doctor's office. I have known people to get a positive on it then go get a HCGq which was 5. For me I got positives at 5 dpo and 7 dpo with two different kiddos. My ob's office test showed me negative both times. <BR/><BR/>Really though, you should check out this test:<BR/><BR/>How about a USB pregnancy test? You seriously hook the thing up to your USB and it uses the computer juice to electrophorese your pee. Then you get a numerical readout in a windows format. Who needs a quant from their doctor anymore? For $18, you get 20 strips. That's so much cheaper than a visit to the doc and a lab test. <BR/><BR/>http://www.thinkgeek.com/stuff/41/pteq.htmlAmelia Ameshttps://www.blogger.com/profile/17296224743117560163noreply@blogger.comtag:blogger.com,1999:blog-24021163.post-16990054589959529662008-04-05T21:16:00.000-05:002008-04-05T21:16:00.000-05:00Her comments on the previous thread just left me s...Her comments on the previous thread just left me shaking my head and wondering when stating one's dress size became a factor when trying to shore up the dikes of one's moral high ground.<BR/><BR/>I was also wondering why FAT was included in the list of the ER nurse's faults. You know:<BR/><BR/>-mean<BR/>-incompetent<BR/>-eats babies in the marketplace<BR/><BR/>oh, and<BR/><BR/>-FAT<BR/><BR/>*boggle*Unknownhttps://www.blogger.com/profile/15706098519078265801noreply@blogger.comtag:blogger.com,1999:blog-24021163.post-51722392039018585622008-04-04T17:05:00.000-05:002008-04-04T17:05:00.000-05:00It isn't about believing or not believing. It is n...It isn't about believing or not believing. It is necessary medical care. The 19th century Brittish physicians had a little two-part aphorism by which they required all their medical students to abide: "1. The reproductive age female is pregnant, until proven otherwise. 2. The pregnancy is ectopic, until proven otherwise." That is still not such a bad clinical pearl, even now in the 21st century.<BR/><BR/>Annonymous, it is not an insult to acknowllege that women become pregnant. Some of us think that this is an entirely honorable thing. I also have to tell you (and I truely do not mean to upset you by telling you this) but after 25 years as a registered nurse I have learned that there are three areas in the patient history that cannot be relied on, and they are the patients answers to questions related to sex, drugs, and alcohol. Today, tobacco use is also so stigmatized that patients often conceal it. Please don't get angry. This is not an insult, its just an honest appreciation of human nature. IT IS NOT PERSONNAL! We just have this wacky thing about not letting our patients die horrible, agonizing deaths while we are taking care of them, which is what can happen if you fail to catch an early ectopic pregnancy. Were just funny that way.CountyRathttps://www.blogger.com/profile/10228262536418983673noreply@blogger.comtag:blogger.com,1999:blog-24021163.post-40066318576483048082008-04-04T15:44:00.000-05:002008-04-04T15:44:00.000-05:00webhill, doc? you are right. most common causes ar...webhill, <BR/>doc? you are right. most common causes are gallstone pancreatitis, alcohol, hypertriglyceridemia, and medication related. i bet the patient had gallstone pancreatitis.911DOChttps://www.blogger.com/profile/06466669111561150174noreply@blogger.comtag:blogger.com,1999:blog-24021163.post-39070937554275338682008-04-04T15:41:00.000-05:002008-04-04T15:41:00.000-05:00Can anyone explain to me what the previous comment...Can anyone explain to me what the previous commenter meant when he suggested that a high lipase is proof of more than the occasional glass of wine? Is it not possible for humans to have elevated lipase due to, say, idiopathic necrotizing pancreatitis that is unrelated to alcohol intake? Or from a viral infection like one of the hepatitis viruses? Or due to hypertriglyceridemia or even pancreatic tumors? I see elevated lipase for all these reasons in my animal patients and no one is suggesting that either the labs are lying or someone is giving the pets alcohol.... <BR/><BR/>Thanks!webhillhttps://www.blogger.com/profile/05938934194973454729noreply@blogger.comtag:blogger.com,1999:blog-24021163.post-91608746107602901722008-04-04T10:11:00.000-05:002008-04-04T10:11:00.000-05:00Not having had any since I turned 50(not by choice...Not having had any since I turned 50(not by choice, I've always been mean and ugly, but when old got in the mix, sperm donors vanished) and being spayed at 40, it wouldn't bother me a bit to be asked for a pregnancy test.<BR/> Kinda like being carded at the beer and wine store.<BR/> Oh, and there is the fact that if I was in pain and wanted help, I would want to be cooperative. <BR/> Being clean and educated, I can both pour piss out of a boot and piss in a cup.<BR/> Just don't see anon's problem.<BR/> Maybe size 6 head not fitting comfortably up that size 2 ass?<BR/> Anyway, thanks for ALL that you do and the funny reporting.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-24021163.post-65110796628497750072008-04-04T09:52:00.000-05:002008-04-04T09:52:00.000-05:00let's be careful not to perpetuate a myth here. th...let's be careful not to perpetuate a myth here. the upreg is sensitive down to a serum quant of 25 - 50. not 25000 to 50000 but 25 to 50. so, a very dilute urine might, just might, be negative in a pregnant patient, but i suggest what happened to your patient is lab error. patients are convinced the serum pregnancy test is more accurate than the urine and this is not true. the serum quant is more helpful re dates but much more expensive, the serum qualitative is essentially the same test as the urine qualitative.911DOChttps://www.blogger.com/profile/06466669111561150174noreply@blogger.comtag:blogger.com,1999:blog-24021163.post-20334906649338228282008-04-04T09:05:00.000-05:002008-04-04T09:05:00.000-05:00I had an 11 year old that was pregnant the other d...I had an 11 year old that was pregnant the other day. No shit. I'm fucking serious. 11 years old. Nuts.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-24021163.post-79497983221770799612008-04-04T08:35:00.000-05:002008-04-04T08:35:00.000-05:00LOL - this "peri-menopausal" business sucks away b...LOL - this "peri-menopausal" business sucks away brain cells too!<BR/><BR/>That ogg above should have been off.<BR/><BR/>SighhhhhhhhhhSurgeon In My Dreamshttps://www.blogger.com/profile/13179150077622941677noreply@blogger.comtag:blogger.com,1999:blog-24021163.post-42619592488732290662008-04-04T08:34:00.000-05:002008-04-04T08:34:00.000-05:00A 54 year old woman!?!?! That is just...ugh...you'...A 54 year old woman!?!?! That is just...ugh...you'd just have to find me a nice quiet room where all the walls are covered with rubber.<BR/><BR/>I have PCOS and all my life I may or may not have a period. Now at 47...you could set a damn clock by my cramping, flooding, sagging uterus.<BR/><BR/>As usual, love your stuff (even when it pisses me ogg occasionally).Surgeon In My Dreamshttps://www.blogger.com/profile/13179150077622941677noreply@blogger.comtag:blogger.com,1999:blog-24021163.post-87768899816613086782008-04-04T03:44:00.000-05:002008-04-04T03:44:00.000-05:00My question is, why didn't Anon (who added another...My question is, why didn't Anon (who added another star to this highly entertaining thread) complain about the treatment she received to her OWN physician, nurse, ED, and hospital? Why take it out on the good folks at M.D.O.D.? Also, what does the fact that you have an "advanced degree and bathe regularly" have to do with anything? Lots of users and abusers fit in that same category.<BR/><BR/>Maybe she's Dr. Debra Peel (in cognito -- but not really).<BR/><BR/>Anon, have some chocolate and get back to me when you're a 57 YOF living with a broken humerus for 6 months in a rural village in a developing country with a "sling" as your only means of "relief." Hers must've been a comparatively bearable pain to that of your gallbladder. No Toradol, let alone Tylenol in sight...Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-24021163.post-12961736997300288752008-04-03T20:57:00.000-05:002008-04-03T20:57:00.000-05:00Just don't get too comfortable with the U preg. I...Just don't get too comfortable with the U preg. I had a hell of a case, should probably write it up. young gil wither her parents who had been to the children's hospital(where I also work) for back pain, got a uHCG(neg) sent home with motrin. Now back c severe pain, fever, a few white cells in the urine but back pain so bad that she couldn't walk(L-spine not CVA). upreg negative, other labs normal. MRI L-spine to R/O discitis, radiolgy calls me with the wonderful news that this gal has a bun in the oven. Serum HCG > 100,000. Of course I had to look this up and did find a handful of similar reports with no explanation. Oh nother Upreg was then positive when she went to the OB the next day.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-24021163.post-62865128800913255572008-04-03T20:14:00.000-05:002008-04-03T20:14:00.000-05:00CAM is subjective?Gosh.That is the problem, isn't ...CAM is subjective?<BR/><BR/>Gosh.<BR/><BR/>That is the problem, isn't it.<BR/><BR/>You can believe that you are getting better.<BR/><BR/>You just have to hope for a high rate of spontaneous remission or that you were misdiagnosed.<BR/><BR/>Not that traditional medicine doesn't have its share of things that don't work. <BR/><BR/>They just don't usually last long, due to the scientific method.Rogue Medichttps://www.blogger.com/profile/07598646309630074992noreply@blogger.comtag:blogger.com,1999:blog-24021163.post-19493838819636683222008-04-03T20:05:00.000-05:002008-04-03T20:05:00.000-05:00One of the things that drew me to medicine is the ...One of the things that drew me to medicine is the fact that it is science based. We treat based on what we see. Likewise, problem I have with CAM is that it is so subjective.<BR/><BR/>The problem with medicine is that we treat human beings. Human beings are flawed. We are here to protect you from yourself whether you like it or not.<BR/><BR/>Our instructor told us that "every female patient is pregnant until proven otherwise."<BR/><BR/>So there. Nyah!This is Sixtyhttps://www.blogger.com/profile/05909156117236911256noreply@blogger.comtag:blogger.com,1999:blog-24021163.post-61521609269906999012008-04-03T17:13:00.000-05:002008-04-03T17:13:00.000-05:00The scariest thing I've ever read in this blog is ...The scariest thing I've ever read in this blog is that a 50-something year old woman who had had a tubal ligation was pregnant! I got that done right after my seventh baby, and felt perfectly safe from pregnancy thereafter and now you're saying it can happen?????? How on earth? Tubes severed, how could the eggs make it down?Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-24021163.post-59096402501849683282008-04-03T15:27:00.000-05:002008-04-03T15:27:00.000-05:00Taught myself a lesson the other day in the ER (I'...Taught myself a lesson the other day in the ER (I'm an MSIV going into IM) - had a pt w 5d hx n/v/d - resolving n/v but continued diarrhea. I specifically ask smoking/drinking hx - "never smoked, but have an occasional glass of wine" she says. "Let's get belly labs, just for grins and giggles" says attending (I'm thinking resolving gastroenteritis as primary ddx).<BR/><BR/>When her lipase returns at 4200, the attending's comment was "are the labs lying, or do we need to redefine "occasional glass of wine"????" <BR/><BR/>--- I will NEVER "believe" pts again - I will double check everything positive.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-24021163.post-67884641506190402432008-04-03T10:43:00.000-05:002008-04-03T10:43:00.000-05:00S.O.P. in the O.R. Any woman of childbearing age ...S.O.P. in the O.R. Any woman of childbearing age gets no surgery until the HCG comes back. If it's positive it doesn't necessarily mean no surgery, but some things need to be adjusted for the baby's protection.<BR/><BR/>Never trust a nun.....make mine traumahttps://www.blogger.com/profile/18149160428613740527noreply@blogger.comtag:blogger.com,1999:blog-24021163.post-91799167833518832892008-04-03T08:21:00.000-05:002008-04-03T08:21:00.000-05:00Never understood why the pregnancy test is such an...Never understood why the pregnancy test is such an insult. I got one on a nun once. She was there for a knee scope, quite attractive actually, and we didn't roll back to the OR till it came back negatorie.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-24021163.post-54542994440415127392008-04-03T04:40:00.000-05:002008-04-03T04:40:00.000-05:00I like your blog, it's amusing and straight on! Ig...I like your blog, it's amusing and straight on! Ignore the idiots and continue what you like to do:)Evil Transport Ladyhttps://www.blogger.com/profile/16427244472516019901noreply@blogger.com