Archive for the ‘Random Thoughts’ Category
Sunday, March 24th, 2013
I happened to catch on Twitter a web site where people could search up their Twitter names and get their tweets translated into gangsta talk. Probably not something you should read at work or in church, tho … yo.
So I tried it with some other sites. I can’t decide which is more amusing.
A newspaper story about a crime?
A court opinion?
A medical article?
Press Ganey’s web site? Note at the bottom of the page the type of “Regionizzle Symposium” they have in 2013.
Or a WhiteCoat post?
Wanna be an instant YouTube sensation? Have someone video you doing a grand rounds translated by Gizoogle.
Wednesday, March 20th, 2013
Another factoid about the UnAffordable Care Act sparked by an e-mail link from DefendUSA (thanks!).
Number of pages in the document that formed the basis for creating our nation: FOUR. Well, five if you include the Bill of Rights
Number of pages in the document that purports to provide affordable “care” for everyone by requiring that people have “insurance” (which likely won’t be accepted by many medical personnel providing care), increasing the costs to purchase said insurance, encouraging companies to reduce their workforces so they don’t have to provide such insurance, and imposing taxes on people if they don’t purchase said insurance from third parties: 20,000 and counting according to Senator Mitch McConnell
Tuesday, March 19th, 2013
You’ll probably consider this post non-medical, but I consider it a discussion of anatomy which IS medical.
A New York newspaper article caught my eye. Two New York City miscreants were arrested for drug trafficking. Big deal, right?
The thing that caught my eye was how police found the drugs, the amount of drugs, and where the drugs were located.
First, Ebony Howard and William Waters need to choose their friends better because someone narcked on them.
OK stop there. English majors … what is the proper spelling of “narcked”? “Traffic” adds a “k” to make it “trafficking” (see above). Does “narc” add a “k” to make it “narcked”? Doesn’t look right. Should it be “narced”? That doesn’t look right, either. Or should I just change it to “tattled”? The American Heritage Dictionary doesn’t help much. It only contains the definition of a “narc” being a law enforcement officer who deals with narcotics violations. Now I am getting off track.
So Ebony and William travel to the quaint little Upstate New York town of Waterville to see the sights. But police arrested the couple as they filled up at a Waterville gas station based on a tip that the couple would be traveling to the town to deal drugs.
When police searched the couple, they found 645 oxycodone pills with a street value of $20,000 … packed in to Ms. Howard’s body cavities.
I thought about this. I have a bottle of 500 Tylenol pills that is pretty full and it measures 3 inches in diameter and 5 inches in height. Think of two tennis balls next to each other. I’m having trouble imagining how it would be comfortable taking a several hour car trip and then walking around a gas station with more than two tennis balls worth of contraband in one’s body cavities.
Then there’s the value of the pills. One can get 30mg oxycodone pills (I’m presuming that was the strength of the pills found in Ms. Howard’s cavities) at a pharmacy for about $6 each. According to police reports, the street value of the pills is more than $30 each. Even if someone faking pain in the ED only received 20 Oxys from the visit and then sells the pills, that’s a $500 profit in a few hours — a lot more than most doctors make.
Finally, there’s the manner in which the drugs were found. I need some help from police officers here. If one’s friend is found with a small amount of marijuana and another unknown substance (assumed to be ecstasy) on his person, does that give police sufficient cause to perform a pelvic exam and rectal exam on everyone in the same vehicle?
I’m not condoning what these people did, but just thinking that if police can do body cavity searches based upon an anonymous tip and some drugs found on a traveling companion, “SWATTING” is soon going to take a back seat to “NARCKING” … or “NARCING” – however the hell you spell it.
Wednesday, March 6th, 2013
Daughter WhiteCoat doesn’t have the stomach for her science class.
They were dissecting a sheep heart in her class not too long ago and she was becoming increasingly queasy. Apparently the sheep had been recently slaughtered because she said that there was still blood in the heart. She was more skeeved because the science teacher was manipulating and dissecting the muscle without using gloves.
She went up to the table where the dissection was taking place, but had to leave the class at one point because she thought she was going to throw up. Mrs. WhiteCoat and I? We can watch surgery while eating a plate of spaghetti and meatballs. Or eggs and sausage.
After the class, several “concerned” classmates came up to my daughter. Instead of consoling her, they said “Eeeeewwww. You have heart juice on your sleeve” or “Gross. There’s heart juice on your notebook.”
What the hell is heart juice? It’s called “blood” people. You all fricking fail.
I gave her a bottle of disappearing ink and told her to squirt it on those people’s notebooks, saying that they had crab heart juice on their notebooks (yes, horseshoe crab blood is blue and it contributes to modern medicine), but she wouldn’t do it.
Can’t wait for them to start discussing reproductive system. I’m going to have to send the teacher some smelling salts for use on my daughter.
Sunday, March 3rd, 2013
Lets see. What’s new recently?
Wrestling is officially over for the year. I happened to be the “trainer” for junior’s regional wrestling meet. Was busy most of the day. It seems as if the coaches give kids Coumadin before the meets. I haven’t seen so many nosebleeds in a long time … except maybe last year when I was the “trainer” for a wrestling meet. Not only nosebleeds, but there were also head injuries, an eye injury, and a broken arm. Nothing some 3 inch tape and gauze pads can’t handle, though.
During the match, I had a firsthand experience of why the UnAffordable Care Act isn’t going to help as much as many people believe. Again, it boils down to the fact that healthcare insurance doesn’t equal healthcare access.
A dad walked into the meet and from a distance I could tell he was having difficulty breathing. He was stopping every so often while he was walking so that he could lean on the wall or sit down and catch his breath. He made his way over to me and asked for a favor. Could I write him a prescription for ciprofloxacin? He had these same symptoms with pneumonia in the past and that is what his doctor prescribed to clear it up. This dad is a great guy, but he doesn’t live the healthiest lifestyle. He smokes. He’s heavy. He drinks quite a bit. I also knew from previous discussions that he had a history of anemia. There were literally 10 diseases that popped into my head that could have been causing his trouble breathing – besides pneumonia.
“You really have to go to the hospital. You need blood work and a chest x-ray, not a prescription for antibiotics. Besides, even if this is pneumonia, ciprofloxacin probably isn’t going to help. And if the pneumonia is bad enough to be causing you trouble breathing, you’ll need to be admitted anyway. This is serious.”
“I can’t afford it. The doctor’s visit will be $75, the chest x-ray will be $250, and my insurance won’t pay for any of it. I am having trouble paying my bills as it is.”
“But this is your life. I would rather see you have to pay a couple extra bills and be around for your kids.”
“I’ll be okay.”
I kept an eye on him during the meet, and he ended up leaving early.
I even texted him later in the day. He wrote back that he was okay as long as he was laying on the couch. I told them that I could call some people at the hospital to see if we could get him discounted testing performed. He said that he still couldn’t afford it.
I hope I don’t read about him in the obituaries.
It just sickens me that our government provides no-cost “insurance” for poverty-stricken people who earn no money, but many of the working poor get nothing but a mandate. If we’re going to make the system better, why can’t the government provide access to health care for everyone?
Friday, February 22nd, 2013
So I had a problem with a patient and family recently and I’m looking for solutions from everyone who reads this blog.
An elderly patient who lives at home with his wife, his son, and his son’s family was brought by the ambulance to the emergency department for “not feeling well.”
As I attempted to get more of a history about the patient’s symptoms, the discussions angered the family.
“When you say that you don’t feel well, what do you mean?”
“I’m sick! That’s why I came here so you could tell me what’s wrong.”
“But I don’t understand what you mean when you say that you’re ‘sick.’ Do you mean that you’re nauseous or you’re having pain or you’re feeling weak?”
“No, none of that.”
The daughter in law then stood up next to the bed and firmly said that he “just doesn’t look right.”
That didn’t help me much, so I said “I’ve never seen him before, so I don’t know where to begin in finding out what is wrong. What about him doesn’t look right to you?”
She threw her arms up in the air and rolled her eyes. “What do you want me to say? He doesn’t look right.”
No, I didn’t grab his head, turn it to the right and say “There … problem solved.” I just stopped asking about his symptoms.
“OK, well how long has he not been looking right for?”
“Oh, it’s been a while now ….”
After about 15 minutes, I was able to determine that the patient was sleeping more than usual for anywhere between 3 days and a week, depending on who was answering my questions.
After I left the room, the nurse told me that the whole family was upset with me because I was being “difficult.”
So the questions I have for you all are the following:
1. If you’re in the medical field, and a patient/family provide you with a vague history, do you try to find out more information? If so, what approach do you use?
2. If you’re not in the medical field, how would you suggest that a health care provider respond to you if the information that you are giving them isn’t helping them figure out what may be wrong with you?
I think that these are questions that a lot of people would like to know, so please chime in below.
Wednesday, February 20th, 2013
I hate the movie Pitch Perfect. Actually I like the movie itself, but my kids won’t stop singing the frigging songs. I have heard the songs from that movie in my sleep for months now. The latest thing that my kids have taken to doing is re-enacting the “cup” scene where Anna Kendrick sings You’re Gonna Miss Me When I’m Gone using a cup. Before school in the morning, “you’re gonna miss me when I’m gone.” At night after dinner, it’s a chorus of “you’re gonna miss me when I’m gone.” Without a doubt I am NOT going to miss that damn song when it’s gone. I can’t take it any more. Ditto for Don’t You Forget About Me. My head hurts just thinking about the words.
When I try to go to sleep, then it’s the dogs’ turn. About half of the nights of the week our boxer snores … loudly. Most of the time Mrs. WhiteCoat will call her name and wake her up to stop the snoring. Sometimes, Mrs. WhiteCoat has to throw a slipper at her to wake her up. When that doesn’t work, she’s actually had to tip over the bed a couple of times to get the dog to wake up. Even that didn’t work last night. After being dumped out of bed, the dog woke up, climbed back into bed, and promptly started snoring again. By that time, I was awake and I was tired. So I sat up in bed and yelled like a dog … I barked at the top of my lungs for about five seconds. I think it roughly translated into “wake up and be quiet or I’m going to tie your ears in knots.” Our older dog sat bolt upright in his bed and was looking at me with his head cocked to the side. The boxer was doing a John Belushi imitation (forward to 0:30) spinning back and forth trying to see where the attack was coming from. One of the girls let out a scream from down the hall. I laid back down and then I couldn’t sleep because I was giggling to myself. But the snoring stopped.
Once Mrs. WhiteCoat went to sleep, she had bizarre dreams. In one dream she was trying to get into our oldest daughter’s room, but she couldn’t get the door open. So she broke the door in. It was freezing in the room. Our daughter was sitting on the bed and she could see her breath. “Come on, let’s go,” Mrs. WhiteCoat said. “I can’t move,” our daughter replied. So Mrs. WhiteCoat ran into the room and grabbed her, then headed for the door. The door closed and she opened it. While doing so, she bumped something behind her. She turned around. It was her carrying a laundry basket. Her mirror image dropped the laundry basket, pointed at our daughter, and said … “check her potassium level.” Then she woke up. And no, we didn’t check her potassium level. What are we going to put for the reason … vision in a whacked out dream told me to?
Almost back to normal after surgery. There’s still a bulge there and yes, it is the hernia. Just some postoperative swelling. Have to wait another week before I get back into normal activity. It’s strange not feeling the area pressing up against my pant leg like it used to. And after about six days I no longer feel like I have a weight tied to one of my “boys” … if you know what I mean. Still a little sore walking around, but I’ll get over it soon enough.
I was going to try some walking this week and slowly get back to running on the treadmill, but I can’t do that because Junior WhiteCoat and his friends had to watch some dumb YouTube clips where people were trying to launch themselves off of treadmills. Then they had to try it for themselves and busted the damn treadmill. They bent a roller and they bent the platform and the manufacturer doesn’t make either any longer. Fortunately, I anticipated someone in the house being a victim of dumbassery (Junior was the odds-on favorite) which is why I bought a cheap used treadmill instead of a fancy expensive new one. So said treadmill goes out to the curb this week and I have to look for another used model. Doubt I’ll be able to beat the $150 I paid for the last one, but we’ll see.
So back to the wall thing. I was trying to videotape what I was seeing as I pushed through the insulation. So I had a camera in one hand and a MagLite in the other hand. I used the MagLite to push away the insulation and something flittered in front of the light. I jumped back thinking “Holy second cousin, Batman.” But how could bats be in a wall? Don’t they like to hang? I pushed through the insulation again and a loose piece of insulation pulled off the edge. I found a crawl space behind our closet that I never knew existed. Like 6 or so feet deep, 4-5 feet tall and about 20 feet wide. Damn. It was like a varmint party room in there. On the floor between two rafters were a bunch of chewed up sunflower seeds. Then I stuck my camera in the area and recorded to see if anything was around. Nothing when I reviewed the movie. I put on some protective eyewear and stuck my head inside to look around. Up in the corner of one wall, something had chewed its way through the wall leading to the outside. I stuck a straightened coat hanger in there and went outside to see where the end came out. Couldn’t find it. Then I realized that our house has a brick exterior. More secret passages inside to be discovered.
We called the exterminator, but apparently no one deals with varmints. Only bugs and mice. That’s when hernia surgery stopped me from climbing around further.
The good news is that since I stuck the hanger in the hole, the scratching hasn’t been back, either. So either whatever it is either became pregnant and is hatching spawn to create a habitrail through the walls of our house or it got scared and moved on to another house. I’ve already decided that I’m going to open up the wall and put flypaper and mouse traps all over the place. So I don’t think that the mysterious scratch is of a flying variety. My guess is on a squirrel. We’ll find out next week, I suppose. Maybe I’ll even post a couple of pictures.
Thursday, February 14th, 2013
Surgery went uneventfully, I think. Don’t remember much of it because of the dang Versed.
While walking back to the outpatient surgery room, I never thought what big business surgeries are for hospitals. The outpatient surgery floor had a long curving hallway of identical rooms, one after another, all with freshly-made beds, blankets folded neatly on top of the beds, and patient belonging bags draped over the blankets. Walking by the rooms, it was almost like having the same picture flashed in front of my face over and over again.
After I got settled in the room and started watching the news on the flat screen TV in the room, a rapid-fire succession of people came in and out of the room … nurse, nurse anesthetist, anesthesiologist, OR nurse, then surgeon. I could hear them going from room to room and could hear them repeating similar information with other patients. Most common question was whether my pain was being controlled. Thanks, Press Ganey.
I didn’t even have time to flip through the news stations before I was being wheeled off to the operating room. Traveling down the hall I could see little vignettes of other patients waiting for surgery through the doorways to the patient rooms. An older lady with a priest standing at the head of the bed talking to family. Little girl watching TV with her parents. An older businessman with reading glasses flipping through pages of the Wall Street Journal.
I felt a tug on my IV line. The nurse anesthetist was walking beside the bed and had a syringe that she was twisting onto my IV line.
“I’m just going to give you a little Versed.”
I felt the rush of cold IV fluid running up the veins in my arm, but was still wide awake as we waited in line for the doors of the OR to swing open.
I thought to myself “I wonder how cold the OR will be this time.”
Then I heard my youngest daughter’s voice.
“Wait a minute,” I thought, “she’s supposed to be in school.”
Someone was rubbing my hand.
I opened my eyes and my beautiful wife was sitting next to me with a smirk on her face. Apparently I was being an unconscious smart ass and don’t remember a bit of it.
I asked her several times what the surgeon said. She told me several times but I didn’t remember. I do remember her telling me that she was going to text it to me so she’d stop having to tell me.
The surgeon apparently told my wife that the hernia was fairly large and I apparently kept remarking that wasn’t the hernia.
The nurse asked me if I would rather have some water or some juice after surgery and I asked for a double shot of tequila.
I’m sure my wife couldn’t wait to get me out of there.
So I’m back home and relaxing. Groin is sore. Kids are feeding me their unwanted Valentine’s candy. Hope to be up jogging tomorrow.
Thanks to my excellent surgeon for his expertise and to the hospital staff for their prompt and courteous care … and for putting up with all of the other wisecracks that my wife probably didn’t tell me about.
Thursday, February 7th, 2013
Well, I thought we escaped it, but we didn’t. The past week has been full of emesis, diarrhea, and disinfectant spray. Just when we think that things are on the mend, someone else in the family starts having a stomach ache. The vomiting is the worst. When it starts out, it sounds like a loud belch … until you hear the progression of the sounds. Yeah. Too much information. But on a good note, I have seen that my kids are immune to boredom. They were able to watch the same episodes of Disney sit-coms a half dozen times and still got mad when I turned off the television.
I’ve cut back on my work hours a little which gives me some extra time to hang out with Mrs. WhiteCoat and the kids. Kind of fun taking a morning to walk through the mall or going to lunch and catching a matinee before the kids get home from school. In fact, I took about a 30% pay cut from previous years, but we’re happier than we were before, I get to see a lot of the kids’ events that I used to miss, and we pay a lot less in taxes.
Last weekend at one of my son’s wrestling matches, I had some mom from another team call me an asshole. Probably won’t be the last time. And I wasn’t even the one instigating.
Wrestling matches last 1:30 each round. There are three rounds per match. It was a team meet and my son’s team was just barely beating another team — whose parents were sitting in the bleachers right next to us. During one of the matches, their wrestler was getting beat and, while on the mat, he signaled the referee that he was hurt. The referee stops the match and the wrestler jumps off the mat and goes to get some water.
Several of our parents started yelling. Wrestlers aren’t allowed to take water breaks in the middle of matches. The opposing team’s parents started yelling at us. I kept my mouth shut.
Mom from their team: “You all can just shut up!”
Mom from our team: “You BETTER not be talking like that to my family.”
One of our team dads yells “Your kids get water breaks? Our kids don’t get water breaks. Is that in the rules somewhere?”
A loudmouth mom from the other team yells “Hey SHUT UP. He has ASTHMA.”
Then I just let out a spontaneous laugh. I wasn’t laughing at the kid’s medical problem. I just thought to myself that I’ve been doing it wrong all these years. I should just be giving patients drinks of water instead of steroids and albuterol for their asthma attacks. What a dunce I am.
Loudmouth mom looks at me and yells “What are you laughing at, ASS-HOLE?”
Them’s fighting words, of course. But I kept my mouth shut. I just smirked at her, held my water bottle high in the air, and took a long swig. Mmmmm. Breathing better already.
The water didn’t help as their wrestler got pinned shortly after his water break ended. I had about a half dozen snarky comments that I wanted to blurt out at the mom, but I didn’t want to start a brawl in the stands. So I opted to have another long swig of water. Mmmmmm.
Next week I’m having another surgery … on Valentine’s Day no less. Hopefully not a big deal. Just getting a hernia repaired. I’ve been dealing with it for a while, but now it has gotten big enough that it hurts, so sometimes I have to put my hand in my pocket to push it back into place to stop it from aching. I gave a lecture last week and noticed that a couple of people were watching my hand in my pocket while I was talking. When people in the front row think I’m playing with myself, it’s time to get the problem fixed.
The surgeon agreed to do the procedure under local anesthesia, so hopefully I’ll be out in a few hours. Just have to remember to get Valentine’s gifts before the 14th this year.
Saturday, February 2nd, 2013
Just in case anyone was wondering what happened to Open Mic Weekends …
If you’re bored with the Super Bowl, you can post any medically-related comments, questions, or observations in the comments section. I’ll try to answer any questions on Monday or Tuesday.
As usual, the only rules for comments are that there are no personal attacks and that the comments/questions have to be medically-related.