Sunday, May 30, 2010

Guest Blogger

the first guest blog was a great story and people loved it , heres a new one from Kelli. once again its from the point of view of the patient, i know ull find it hilarious, i did.

Rectal Examination

By Kelli Petersen

One evening, I discovered blood in my poop. (Hey, if you can’t talk candidly to the Internet, then who can you talk to?) I’m not usually the kind of person who checks out bowel movements—unlike my boyfriend who not only examines it, but also takes an occasional picture and texts it to his friends. But as I reached over to flush the toilet, I saw a flash of bright red in my peripheral vision. I glanced down and saw small streams of blood lacing on and through the poop.

I made a sound like “muleh!” then started to flush the toilet, before pausing to wonder if I should somehow stick the poop in a plastic baggy. Would a doctor need to actually see it or have it tested? I decided a camera phone picture would suffice.

The next morning, I called my doctor’s office from work. Note to self: sitting at the front desk while fielding incoming calls and greeting visitors is not the place to call your doctor about bloody poop. The conversation went something like this:

Nurse: …and what is the problem you are experiencing?

Me: Um, well, it’s complicated…so, um, I think I may be sick?

Nurse: Sick with what?

Me: Well, there was something, uh, strangeaboutmypoop…last night…

Nurse: I’m sorry?

Me: Therewasbloodinmypoop…that’s why I need to make an appointment…

And so on. I was finally able to secure an appointment for the next day. Unfortunately, upon signing in for my visit, I was faced with sharing my problem with the front desk staff. C’mon, do they really need to know? I wondered. I gave the same stunted explanation as on the phone, except with hand gestures filling in wherever “bowel movement” should have been said.

Finally I was in the private examining room where I could speak openly about the issue. The doctor sat on a stool, slightly lower than the table upon which I sat, naked from the waist down, covered with what seemed to be an enormous paper towel. She asked about the color and consistency of the blood. Was it a dark red or brown? Or was it bright red?

Proudly, I pulled out my camera phone and declared, “I took a picture!” She stared at me for a moment before waving it away, asking, “How about you just tell me about it?” I described the poop in detail, adding creative flourishes here and there: “I would say the blood was the color of a red apple, freshly plucked from a tree.”

I answered more questions: no, I wasn’t constipated; no, I wasn’t feeling nauseous; no, I wasn’t allergic to anything. Finally, the doctor set the clipboard down and instructed me to lie down. Being a woman, I was well accustomed to being pants-less at a doctor’s office, so I shimmied down, ready to put my feet in the stirrups.

“I’m going to have you turn on your side, actually. Facing toward the window.”

Awkwardly, I turned onto my side, as the doctor snapped on latex gloves and rolled her stool behind me, putting her face level with my butt.

“Uh…should I, um, do anything?”

“Just relax, this may feel a bit uncomfortable.”

While looking out the window, I felt her spread my buttocks apart and put a finger inside the hole. “Try not to clench,” she instructed.

Taking her cue, I forced myself to relax and quickly found my thoughts drifting to sex. While she probed and examined, I dreamily looked out the window and focused on not moaning. In my head, the doctor had become a sexy 20-something man with strong arms, and who didn’t really have to do an anal exam (I was only there for an annual check-up, after all), but “just wanted to make sure everything looked good down there.”

The doctor said something, which I missed. “Excuse me?” I hadn’t realized she had pulled away from the table and was making notes on her clipboard.

“Everything looks good down there. My guess is it was a bit of food poisoning, something your body didn’t like. Keep an eye on it and let me know if it gets worse or if you feel pain.”

“Oh, uh, okay. Thanks!” I smoothed my hair which, strangely, seemed to be more unkempt than when I arrived.

She paused for a moment, looking as if she had smelled something strange, then said, “You’re…welcome?” She quickly left the room, closing the door behind her.

I hopped off the table and pulled on my pants. Feeling more refreshed than I had in days, I swung open the door, and giddily walked out of the office.

http://BohoInTheBurbs.blogspot.com

Thursday, May 27, 2010

one liners

in the quotation marks is the patient, my response is right after

"are you a doctor" - no i just dress up as one for halloween... "but todays not halloween" - oh, in that case yes, yes i am


"doctor how old are you" - 45 - " really?" - no



"doc my hurts when i move it this way" - im pretty sure you know how this ones gonna end



"this is my 14th pregnancy" wtf... do you use birthcontrol "no" -- why not--- " i dont like how condoms feel, i have sex with multiple guys so i cant use the iud, the patch hurts, the pill makes me fat" --- im pretty sure being pregnant makes people fat too., how bout no more sex? "are you kidding"



"i have 3 daughters that would be perfect for you" --- all three at the same time? "maybe" --- wtf

Saturday, May 22, 2010

Guest Blogger

Since my posts are all from the doctors point of view, its time to hear how weird and awkward it is from the patients point of view. So here is Jeffrey with a funny story of his own, thanks for writting it for us. if anyone else is interested in posting their own, let me know

So first allow me to introduce myself. My name is Jeffrey, I blog over at www.fartooimportantblog.blogspot.com and this story was about the romantic experience that occurred as a result of an inflamed appendix. Let me set the scene. The town of State College in Central Pennsylvania. November, snow had already fallen and accumulated fairly high. The Wednesday before Thanksgiving (I remember because there was a thanksgiving themed episode of "Top Chef"). 2AM...

Have you ever woken up in the middle of the night and knew something was wrong? Well it happened to me last November. I woke up with the most severe pain in my right side. Believe it or not, I had had appendix problems before, but it had never been serious enough to take out. Well, after calling the hospital, they seriously told me that I should come to the hospital. I had just moved to a new state for grad school and didn't know the area well. As I was riding down in the elevator of my apartment building, I was trying to focus through the pain and remember where the hospital was. I finally got to my car and realized "dammit, I don't have my glasses." Was I about to waste more time and go back upstairs? No.

By the grace of a higher power, I managed to find the hospital. I checked in and when through all the paperwork. They finally take me back and this poor man has been tasked to put an IV in me. Needles and I do not get along. Not only did it feel like it took forever, I think I may have scared the man away from his chosen profession with my, considerably non-masculine weeping and screaming(because of the pain). I finally get some morphine in me, and I'm doing pretty good. The entire time I'm thinking, any second now they're going to come get me. Two hours later, I have fallen asleep. Yet again, I am awakened by the most dreadful pain you can imagine. I practically screamed at the top of my lungs. The poor man who had put the IV in me was doing the same to my mysterious unseen neighbor behind the paper wall. As I'm writhing in pain, he's coaching me like I'm giving birth. Well let me say, if giving birth was a fraction of what I felt, I have so much more respect for my mother.

Well, before they can get some more morphine in me, they decide this is the optimal time to come get me for the X-ray. At this point, I don't remember much. I remember lying on the machine, but that's about it. They must have given me something good without me noticing.

Next thing I know, I'm being woken up and told I have to have surgery ASAP and they need signatures. I manage to call my mother and my classmate. Next thing I know I'm in this room asking about things like "could you wax me instead of shave?" and "if you want to suck some fat out while you're in there, I'd appreciate it" with the nurse who was attending me. I'm still fairly loopy and unsure whether my candidness is a coping mechanism or drugs.

The doctor finally comes in to talk to me. He's talking. Naturally, I'm not understanding a word of it. Whether it was the big words or the drugs, I'm not sure. Finally, I stop him. He's looking at me like he thinks I have a question for him. Apparently, I did. I found out later that the words that then came out of my mouth are "Damn, You're cute. After this is over, you wanna go out?" From then on I really have no recollection of what happened until I woke up to see my professor looming over me. I was sure that I had died and gone to hell.

Well fast forward a week or two. I was recovering. I had already been to a physician to have my staples out and everything. I get a call from the doctor, but it didn't come up as the doctor's office which was in my phone. And we chat briefly about my recovery. About 5 minutes in he says "well, what I'm really calling about is...(pause)... you said you might want to hang out sometime and I was calling to see if you were still interested." Well damn, a doctor was asking me out. And his good looks had, indeed, not been a hallucination. He was fairly handsome for someone nearly twice my age. Me 23, him 45. We met a few times. We went out for a fancy dinner (in central Pennsylvania fancy is a relative term) and bowling (I schooled him so badly). We chatted a few more times, but, sadly, it didn't work out. However, I later discovered when the hospital bill came that, what my insurance hadn't covered, he had taken care of. I called and thanked him, and we still chat sometimes. In the end, it was a surprisingly fun experience, except for the painful part.

Saturday, May 15, 2010

dipping

while on my pediatric rotation i had a 16 yr old girl come into the office with her mother complaining of abdominal pain on both sides. the girl had a slight fever as well so I took a thorough history of the complaints and previous medical conditions. when i came up to the part of the sexual history and drug use history, i always ask the patients parents to leave the room since kids always lie and that they all seem to be saints. this girl actually said "no, i want her to be here"
the mother looked at me and said "we are very open with eachother since her abortion"
odd, but thats cool i guess.... "ok is there any possibility you are pregnant again?"
"no, i havent had sex since the abortion 9 months ago" she said with a smile..
"ok, any drug or alcohol use in the past?"
"no, no drugs or alcohol" she said
" do you smoke?"
"never"

ok, well to be honest i wont know whats wrong unless we do an abdominal catscan, and a blood draw to check her enzymes, liver function, kidney function and also a Urine analysis and a pelvic exam, your mom can wait outside if youd like.

"no, i want her here"
"ok" so i get a nurse to draw the blood and stand by as i do the pelvic exam, quick swab and a bimanual exam (aka 2 fingers to check if theres any tenderness) and the next thing i know the girl and mother are competing for my attention and flirting with me. they go from asking me questions about my life to the daughter grinding her hips on my fingers. the look of shock on my face should have given it away, but the mother was too busy checking my ass out to care.

so i quickly backed off, pulled the glove off, tossed it in the garbage and ran to wash my hands and left the room before i got molested anymore.

so after washing 3 times, i came back ot speak with hte patient and informed her that we would send all the samples to the lab and that i would call her with the results. she gave me her mothers cell phone number and told me it was fine to speak to the mother since she would be in school during the day.

so a few days passed, the cat scan was normal, all the labs were normal, she wasnt pregnant either. so i was waiting on the STD screening and ofcourse she had chlamydia. go figure the Virgin Mary of chlamydia.

so i waited till 5pm hoping that the patient would be home so i wouldnt have to tell her mother, and ofcourse she wasnt. so the mother picks up and i tell her the results and that I would call in a prescription for antibiotics at her pharmacy.

the mother is silent for a second. then starts yelling "that bastard is dipping his wick in her again!!!!"


Tuesday, May 11, 2010

every day Dave

some patients for one reason or another come to the ER every single day with random concerns. most of these patients are psych cases, some have major anxiety issues and some are just lonely and want human interaction. either way they all get the full work up and need to be taken seriously even though you know 99.9% of the time its nothing at all.

we had one guy called "every day dave". literally he would show up every single day. the guy was atleast very nice about it, so it wasnt that big a pain to see him. in the one month that i worked at the ER in philly I saw him 11 times myself.

my favorite story from him was on a 90 degree philly summer day. Every day dave walks into the ER complaining that he doesnt feel right. So i walk into the room, look at him and hes sitting all happy in the chair.

"Doc im sorry"

"Dont be sorry, whats wrong"

"im sorry, i shouldnt be here" he says

"well just tell me whats going on"

"well i was sitting in the car, waiting for my gf to get done at the gym, and i turned off the car, about an hour later i felt weird and i came to the ER. but the minute i got here i felt so much better, and now i want to go home"

"Im sorry Dave, did you say that you were sitting in the car, with no air conditioning on a 90 degree day?"

"yes, why"

"Dave, im not the best doctor in the world, but im pretty sure you felt warm from the heat, and the air conditioning in the ER waiting room cooled you down. I suggest next time you wait in the car, to either open the window , or turn on the air conditioning"

"Doc your a genius"

yet another satisfied customer.

Sunday, May 9, 2010

drug seeker

drug seekers are the worst part of being an ER doctor, trying to figure out whose pain is real and who is just there for a drug holiday makes life miserable for us.

as a medical student, i loved working in the ER in colorado, so much so that id come in every night even though i didnt have too. that plus the fact that i was scared of the random wild life and wanted to be around people made me work more.

so a 50 yr old guy came in one day complaining of severe back pain. the doctor and i evaluated him and we decided that he could use 10 percocet to go home with, i thought nothing of it

the next day the same guy walked back into the ER with a different name and different complaint. this time he was having knee pains. since the doctors switch every night, a different one was seeing him. i walked into the room and instantly remembered him.

wtf? does this guy have a twin? the guy looked at me saw that he was fucked and walked out...


the third night in a row same guy walked into the ER with a different name, different story , the nurse was bringing him back to the exam room when i practically bounced into him

"Dont you fucken go home?? i know all the doctors cars, i know when a new ones here so i can get my shit, why are you here!!!"

without waiting for my response, he stormed out.

nurse looked at me and asked, "do you know him?"

"not really, but im pretty sure he just told me i have no life"

Friday, May 7, 2010

steering accident

in a small town in denver called grand junction i was working in the ER one day when the nurse rushes in and says, "60 yr old guy in a steering accident, go see him asap"

steering accident, must have been a terrible car crash that the nurse is so worried, so i rush over and theres a guy sitting in the exam bed gushing blood from the back of his head. so i look it over , order a non contrast head CT to make sure theres no internal bleeding, while i wait for the tech to come by i take a quick history of the accident.

"Sir, were you wearing your seatbelt at the time of the accident?"
"what? no"
damn hicks, never wear the seatbelts, and then they wonder why the have head injuries... "Sir how fast were u going?"

" i dont know, probably a few miles per hour, what kind of question is that??"

"an important one, did you get hit head on? T-boned or from behind? and what kind of car were you in"

"son, what are you talking about, there was no car"

Holy shit this guy must have some major internal bleeding, he cant even remember he was in a car accident. i start flipping out and going through a full nuerological exam...

"sir what day is it, whats your full name and where are we now"
he answers all of those correctly... must have amnesia from the trauma .....

"sir, how did you hit the back of your head on the steering wheel?? were you turning around or something when you got hit? i cant really figure it out"

patient looks at me with a blank look on his face.... shit i need ot check and make sure his pupils arent dilated from all the internal bleeding.... and why arent the other doctors in here yet!!!!!!

finally the tech comes in to get him and takes him for the cat scan...

i start to present the story to the doctor in charge.
this is a 60 yr old male presenting with occipital lobe trauma post motor vehicle accident. patient has no recollection of the accident and complains of 10/10 pain. There is obvious hemorrhaging which will require staples, i sent the patient to get a head ct and ill finish getting the rest of his hx when he gets back. Otherwise patients alert oriented x3 and Cranial Nerves II-XII are grossly intact.

feeling pretty proud of myself for the presentation i look over at the doctor who has the biggest smile in the world.

"is there anything about the story that doesnt fit"

"yes" i say, " i dont get how the hell he hit the back of his head on the steering wheel, i mean hes got to have some severe cervical pain if his neck was rotated so much"


at this point the doctor cant stop laughing, "this isnt NY anymore city boy, he got hit by a steer, not a steering wheel"


i am like, oh, ok well that makes a lot more sense and i walk away still totally confused. i know this guy has to have more trauma than what hes saying. i figure a steer is some country thing so i quickly call katy. she will definitely know what a steer is.

frantically i call and ask her real quick... "what the FUCK is a steer?" she immediately starts giggling and tells me is a big cow with HUGE horns on it

She busts out laughing at me and tells me its an animal, not a car and that they guy must have some serious damage and to get back to work.

for those of us that doesnt know what a steer is, heres the pic



Tuesday, May 4, 2010

my cookie itches

during my obgyn rotation, i was in a small town that had a very high std rate and one of the highest teen pregnancy rates. needless to say i stayed home every night since people got pregnant just by standing too close

when the patient goes into the office, i usually see them first with a nurse and then report the chief complaint to the other doctor.

15 yr old girl comes in and says "my cookie itches"

"im sorry your what?"

"my cookie, it itches"

so your trained to write the patients complaint down word for word. so i write down
15 yr old hispanic female presents to the office with the chief complaint of her cookie itching of 3 day duration.

60 yr old male doctor walks in, reads it and looks at me like im on drugs. "what should the patient do?"

i look at him straight face "hmm, probably not let anyone in the cookie jar"

Saturday, May 1, 2010

are they even?

25 yr old gorgeous blond walks into the obgyn office.
before i even introduce myself she drops her pants. jumps on the table and says
"i want you to fix my pussy"

"ummm excuse me?"

"my pussy lips arent even, the left one gets caught in my jeans"

luckily i was too shocked to say what i was thinking ... they look damn good to me

"i think they look fine"

she sits up, and looks at me, "you think theyre just fine? would you do me?"

i look over at the nurse, shes giggling behind the clipboard
"umm i, dont know, i guess drinks first would be nice?"