mgriffiths Posted April 19, 2021 Share Posted April 19, 2021 I'm an ortho PA covering a walk-in clinic/UC today for some extra cash...but had a new one I thought the students would like: 48yo male presents for abdominal pain "at the beltline" for a few weeks. It's only during the day, and he has no pain in the mornings or evenings/overnight. Before going to see him I checked his vitals and noticed he's gained about 20lbs over the last 2 months. Upon asking I learned he hasn't changed his belt loop.... He wears a belt for work, but changes when he gets home...right around the time his pain resolves. Treatment plan: loosen belt and/or lose the weight Also, did tell him to f/u with his PCP if persists on the off chance it's a hernia or something, but didn't seem like it. Hope the students here learned something and those with lots of experience were able to glean a few pearls from this incredibly complex case study... 4 2 Quote Link to comment Share on other sites More sharing options...
briansk Posted April 19, 2021 Share Posted April 19, 2021 Is there an ICD-10 code for "Belt too tight?" Quote Link to comment Share on other sites More sharing options...
mgriffiths Posted April 19, 2021 Author Share Posted April 19, 2021 1 minute ago, briansk said: Is there an ICD-10 code for "Belt too tight?" if there's not, I'm sure there will be soon... 1 Quote Link to comment Share on other sites More sharing options...
thinkertdm Posted April 19, 2021 Share Posted April 19, 2021 So...he went to the doctor because he couldn't figure out how to work his belt? 1 Quote Link to comment Share on other sites More sharing options...
sas5814 Posted April 19, 2021 Share Posted April 19, 2021 I remember an ortho PA presenting a case study for "wallet neuropathy". Traveling salesman type had neuropathy on the right side for months. Worse when he was sitting particularly on long drives. He had a wallet about 4" thick. Remove wallet from pocket. Pain resolves within a week. 1 Quote Link to comment Share on other sites More sharing options...
mgriffiths Posted April 19, 2021 Author Share Posted April 19, 2021 1 hour ago, thinkertdm said: So...he went to the doctor because he couldn't figure out how to work his belt? He just didn't put together the correlation of his symptoms resolving by taking off his belt...or that he needs to loosen his belt with a 20lb weight gain. He was obviously embarrassed when it dawned on him...we both laughed. While it is definitely not the greatest use of medical resources, it made for a good moment of comic relief in my day. I like the extra cash...but never understand why I agreed to the shift when I'm in the middle of them. Quote Link to comment Share on other sites More sharing options...
Administrator rev ronin Posted April 20, 2021 Administrator Share Posted April 20, 2021 12 hours ago, briansk said: Is there an ICD-10 code for "Belt too tight?" R19.07? Quote Link to comment Share on other sites More sharing options...
CAAdmission Posted April 20, 2021 Share Posted April 20, 2021 I can't find the clipping now, but I saw one from a doc with a 22 year-old who had a patient with a terribly itchy bottom. His erythematous anus was caked with stool. The doc advised him he needed to wipe his butt better. He asked, "How do I know when I'm done?" She replied when the paper is clean. He left with profound thanks, and she mused that she just taught a 22 year-old how to wipe his butt. 1 Quote Link to comment Share on other sites More sharing options...
GAPAC Posted April 20, 2021 Share Posted April 20, 2021 21 hours ago, mgriffiths said: I like the extra cash...but never understand why I agreed to the shift when I'm in the middle of them. Couldn't resonate more with that statement when picking up UC shifts. 1 Quote Link to comment Share on other sites More sharing options...
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