twins

sorry for the long wait, with my move and new job its been a mess with the hours
but on the bright side it brings new stories

25 yr old woman comes in with her 1 yr old baby and her best friend. The patient says shes pregnant with twins, and that shes afraid something happened to them because her bf tossed her around the house today and that she hasnt felt them move.

Obviously this is very distressing news, so i start to ask the patient questions about this
"when was the last time you felt the babies move?"
"yesterday, my friends 5 months pregnant like me, we felt it together"

she states that she just came from another hospital where they refused to do an ultrasound of her belly since it was part midnight and they dont perform those until 5am. so I got ready to do the ultrasound myself , but before i did that i ordered some labs on her, a urine HCG (pregnancy test) and a serum HCG (more accurate since its from the blood) .

The urine pregnancy came back negative.... a bit odd since even though it could be negative you wouldnt expect it to be with twins at 5months.

Serum HCG came back negative too.... wtf? even if she got tossed around the room and had a miscarriage the values would be high enough for a month. how could she have felt the babies move yesterday if shes not pregnant????

so i walked into the room, looked at the lady laying down and asked, "which obgyn have you seen?"
"oh the one at .... Hospital"

so i went back to my desk, called the hospital, pulled up the records there, and guess what
shes never gone to the OB there, shes made up the whole pregnancy.

and thats why the other hospital refused to do an ultrasound of her stomach, theres nothing there to ultrasound.....

i went back in told her that shes not pregnant and hasnt been for a month, guess her reaction?

not shocked at all.... go figure....

the friend (whose been lied to the whole time) demanded she be ultrasounded, so i figured its time to prove to them both theres nothing there, did the ultrasound, found no babies, printed it and gave it to them to frame.

my patients are special.

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!!!!"