WhiteCoat

Speaking from Experience

I was having difficulty with a back pain patient who was being rather antisocial. He wouldn’t answer my questions about his history. He flopped forward on the bed and wouldn’t let me examine him. He couldn’t sit up because he was in too much pain. Then his next door neighbor adds to the problems.
“You know damn well that this is a kidney stone. My father had a kidney stone and acted the same way.”
“That’s one possibility, but with no blood in his urine and with a history of multiple visits for the same back pain in the past, kidney stones aren’t at the top of my list.”
“Yeah, well my dad didn’t have blood in his urine when he had his kidney stone, either.”

It must be me. Then I had a Tosh.0 flashback in my brain.
Thanks for sharing, ma’am. And by the way, my mom used to bake with her own breast milk. And once she dropped a piece of potato in my glass of milk at dinner time and didn’t say anything about it. When I got to the bottom of the glass and saw the potato sitting there, I almost puked up all the milk I drank. So we probably shouldn’t trust milk glasses, either.

Meanwhile, the patient was still flopped forward on the bed. He began moaning loudly, then sat up ans said,

“What the hell is the matter with you? Get me some pain medication, bitch!”

Oh. This is getting better by the minute. Pain too bad to give me a history, but have enough intestinal fortitude left over to call me a bitch? You really must be in pain. Well, in that case, I’ll just go out and have the nurse get you something right now.
And with that, the “bitch” left the room and ordered some Toradol.

Twenty minutes later, both the patient and the neighbor were trolling the hallway looking for someone in “authoriteh” to whom they could complain.

“That doctor was rude.”
“Yeah. I’ve been to 23 hospitals in the past 5 months and he is by far the rudest motherf***er I’ve ever met.”

23 hospitals in 5 months.

That’s a lot of kidney stones.

———————–

This and all posts about patients may be fictional, may be my experiences, may be submitted by readers for publication here, or may be any combination of the above. Factual statements may or may not be accurate. If you would like to have a patient story published on WhiteCoat’s Call Room, please e-mail me.

10 Responses to “Speaking from Experience”

  1. ndenunz says:

    Well, just consider the source.

  2. J says:

    WC, did you get your next Press-Ganey reviewer a glass of milk and cookies while he waited?

  3. SeaSpray says:

    Do you really want to flop forward with flank or back pain? I would think that would hurt more. matter of fact …fetal position seems to be the position of choice for me when really sick or in pain.

    “my mom used to bake with her own breast milk. ” :)

  4. Eric Atkinson says:

    Last year I went to my local ER, found I was passing a 4mm stone. They gave me Toradol.
    The shit is near about worthless. A total waste of an IV.

    • SeaSpray says:

      The hospital I worked in gave toradol with demorol. I had it once for renal colic and worked like a charm …although …I think the stone I had was beginning to make it’s presence known and then settled down again.

      Then the next time I felt it it had become stuck in my ureter. The hospital I went to after the 1st experience used Morphine. It helped, but they could not give me enough to remove the pain. I don’t know if it would’ve been better with the Demorol/Toradol mix. I doubt anything but a trip to the OR would help at that point.

      But, Toradol also worked well for me for an OR procedure. I guess it depends what is going on. I can’t imagine Toradol would be enough for a stuck kidney stone tho.

    • VA Hopeful says:

      I’ve had plenty of stone patients complain that morphine doesn’t help very much but that toradol does wonders.

      Then again, this was all at the VA…

  5. ER Murse says:

    Your milage may vary. I woke up from an open appendectomy a couple of years ago and asked for toradol rather than morphine. It’s a matter of expectations and individual physiology. If you expect anxiolysis with your analgesia, toradol won’t do what you expect. If you want the pain reduced to where you can function and you manage your own anxiety, then it’ll probably work. (Translation: Toradol makes the pain better but doesn’t make you high. If you wanted to be high AND pain free, sucks to be you)

    • SeaSpray says:

      ER Murse – I could be wrong, but I really don’t think any pain killer would work for a kidney stone stuck in the ureter. Urine bright red, vomiting – most painful experience ..even over labor contractions. I remember I kept saying ..”More morphine in between getting sick… even though I had so much I couldn’t keep my eyes open. (It was a large stone too. I don’t know if size matters though) I know the morphine had to be helping the pain ..but, it didn’t feel like it. Thank God for urologists. What did people do before that urology procedure?

  6. Twenty-three hospitals 5 months? I hate to say it, but this “patient” and his “next door neighbor” may fit some of the characteristics of what are known as “medical mystery shoppers.” Though I’m just a layperson, I’m strongly on the side of physicians here in opposing this deceptive, trust-destroying practice. In retail, it’s common practice to try and trip up the sales clerk by creating what is euphemistically referred to as an “atypical transaction” (source: Wikipedia). I can’t help but thinking that the Anna Brown case would have been considered a good secret shopper scenario, with doctors ultimately passing the test (as devised by MBA administrators) when they eventually booted her out, thus saving the facility further expenditure. Is your patient real or fictitious?–only the mystery shopper (and their bosses) knows for sure!

  7. Nurse k says:

    Poor guy is too dumb to just prick his finger and put a drop ‘o blood in his urine like normal people do.

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