thinkertdm Posted June 25, 2021 Share Posted June 25, 2021 These are some things that make me stop typing my note and make sure I’m not in bizarro world. ”my pain is 10/10. Worst pain of my life” ”my chiropractor said…” ”my <family member> is in the medical ‘field’” ””I drink enough water” ”I couldn’t move from the bed for ‘x’ days” ”I’ve tried everything. Nothing works” ”I decided to wait until my appointment today “ 1 1 Quote Link to comment Share on other sites More sharing options...
sas5814 Posted June 25, 2021 Share Posted June 25, 2021 My pain is 13 out of 10. I know my body I need (insert name of obscure and pointless test) I took my Dad's Hydrocodone and it made me feel better The specialist said you should prescribe (name a drug that won't help or is inappropriate) The specialist said you should order an MRI My last doctor and I agreed I could (name treatment that is malpractice and has a high chance of being fatal) My mom said I should (in a grown ass adult) 1 1 3 Quote Link to comment Share on other sites More sharing options...
Reality Check 2 Posted June 25, 2021 Share Posted June 25, 2021 Dr Oz said - anything, anything at all and my head hurts I want a whole body MRI because I had a headache once (can't make this up) I am very sensitive to all medications and you are giving me too much thyroid (TSH 4) This has bothered me for a long time but I haven't said anything - TEN notes in the chart from 4 specialists finding nothing My hydrocodone is for my back - my knee is what hurts now Why would you say I am anxious? - bouncing knee, fidgeting, fifth visit for vague sx and constant worry I don't want to take an anxiety medicine everyday - those are dangerous. Just something when I need it - like Xanax.... And the full moon was last night and the spaceship just landed out back with all my morning patients in it Godspeed everyone 1 Quote Link to comment Share on other sites More sharing options...
thinkertdm Posted June 25, 2021 Author Share Posted June 25, 2021 41 minutes ago, Reality Check 2 said: Dr Oz said - anything, anything at all and my head hurts I want a whole body MRI because I had a headache once (can't make this up) I am very sensitive to all medications and you are giving me too much thyroid (TSH 4) This has bothered me for a long time but I haven't said anything - TEN notes in the chart from 4 specialists finding nothing My hydrocodone is for my back - my knee is what hurts now Why would you say I am anxious? - bouncing knee, fidgeting, fifth visit for vague sx and constant worry I don't want to take an anxiety medicine everyday - those are dangerous. Just something when I need it - like Xanax.... And the full moon was last night and the spaceship just landed out back with all my morning patients in it Godspeed everyone I’m on vacation this week. Had to get away. Quote Link to comment Share on other sites More sharing options...
DizzyJ Posted June 25, 2021 Share Posted June 25, 2021 "I have a high tolerance for pain" Answering "I don't know" to the question "any chance you could be pregnant?" "Google says..." When patient or family member starts using medical terms....because lucky for me one of them is something medical "I stopped taking my blood pressure medicine because my blood pressure was better"....because of the medicine "I took left over antibiotics" Quote Link to comment Share on other sites More sharing options...
Moderator ventana Posted June 25, 2021 Moderator Share Posted June 25, 2021 My chiro said I need X-ray mri ct and you need to order it i want labs to make sure I am okay ( from healthy young person) I ask “any medical problems”. Answer “no”. Med list is > 10 long. stopped my cholesterol med cause my cholesterol was great. Quote Link to comment Share on other sites More sharing options...
Reality Check 2 Posted June 25, 2021 Share Posted June 25, 2021 The former meth user tells me he needs something "to give me energy" - he is tired all the time. The immunocompromised guy tells me he needs something to boost him immune system so he won't get colds so often while working with the public and declining COVID vaccines. Why don't you think I can lower my LDL of 300 with diet and exercise? You just want to push pills. BP 147/92, A1c 8.0 =================================================================================== I am putting the tinfoil back in my hat................ need protection for the rest of the day 1 1 Quote Link to comment Share on other sites More sharing options...
sas5814 Posted June 25, 2021 Share Posted June 25, 2021 I had a meth addict tell me it saved his life because it got him off cocaine. Probably just saved him money. 1 Quote Link to comment Share on other sites More sharing options...
bike mike Posted June 25, 2021 Share Posted June 25, 2021 I recently had a guy in with atrial flutter, ventricular rate 130 bpm. Refused Diltiazam. Refused ablation. Said he was taken off his beta blocker because his primary care doctor told him "beta blockers slow the body down" and then he proceeded to tell me that beta blockers should only be given in a hospital setting because they are so dangerous. I told him we'll be seeing him in the ER soon with tachycardia induced cardiomyopathy. 1 1 Quote Link to comment Share on other sites More sharing options...
Reality Check 2 Posted June 25, 2021 Share Posted June 25, 2021 Any chance you could be pregnant? Pause, dull look "What exactly do you mean?" Sharp rock under head, bang head repeatedly Quote Link to comment Share on other sites More sharing options...
thinkertdm Posted June 25, 2021 Author Share Posted June 25, 2021 This one: “it’s in my record” 1 1 1 Quote Link to comment Share on other sites More sharing options...
Randito Posted June 25, 2021 Share Posted June 25, 2021 4 hours ago, DizzyJ said: "I have a high tolerance for pain" At least 3-5 times per shift. Usually just after telling me that they're taking Norco q4 for chronic pain. Quote Link to comment Share on other sites More sharing options...
Incognito Posted June 26, 2021 Share Posted June 26, 2021 Retirement is so sweet! My stress is gone. Quote Link to comment Share on other sites More sharing options...
ohiovolffemtp Posted June 26, 2021 Share Posted June 26, 2021 On the other hand: Psyche patient tells me he worships the devil and they have services on planets in another dimension. I ask him, "but do they have bingo?" He laughs. ... I tell my wife about this. She says, "So you have to go to work and deal with the mentally ill to find someone who laughs at your jokes?" (See what happens when you marry someone smarter than you.) 3 4 Quote Link to comment Share on other sites More sharing options...
ANESMCR Posted June 27, 2021 Share Posted June 27, 2021 (edited) “The surgeon said I should see a psychiatrist but I know there is definitely some kind of blockage” ”Blockage” is generally a trigger word for me in GI. I swear, people with CIC, IBS-C, and OIC (without rectal dyssynergy) truly believe there is a magical fairy troll that closes the gates and must be removed immediately. “My son said you shouldn’t have put me on that constipation Rx and he’s a PA” Oh really? What kind of PA? “Dermatology PA”. Edited June 27, 2021 by ANESMCR 1 Quote Link to comment Share on other sites More sharing options...
thinkertdm Posted June 27, 2021 Author Share Posted June 27, 2021 6 minutes ago, ANESMCR said: “The surgeon said I should see a psychiatrist but I know there is definitely some kind of blockage” ”Blockage” is generally a trigger word for me in GI. I swear, people with CIC, IBS-C, and OIC (without rectal dyssynergy) truly believe there is a magical fairy troll that closes the gates and must be removed immediately. I feel that way in primary care as well- they block up the schedule, the waiting area and my patience. They look at me like I’m speaking Latin when I discuss fodmaps or generally tell them to stop eating crap. I figure you guys in gi (heh, gies) speaka their language. I apologize in advance my friend. 1 Quote Link to comment Share on other sites More sharing options...
ANESMCR Posted June 27, 2021 Share Posted June 27, 2021 12 minutes ago, thinkertdm said: I feel that way in primary care as well- they block up the schedule, the waiting area and my patience. They look at me like I’m speaking Latin when I discuss fodmaps or generally tell them to stop eating crap. I figure you guys in gi (heh, gies) speaka their language. I apologize in advance my friend. To be completely honest with you, I am relieved when I see a referral from a PA PCP. That way I usually know the correct standard w/u has been done accurately. If it’s a particular MD, or usually any ARNP (especially exclusively run NP practice) on any given day I see FOBT on asx 85 year olds, U/S abd for unexplained weight loss, gas X for abd ascites, CT A/P w/o cont for fatty liver/elevated LFTs (every time). List goes on. 2 1 Quote Link to comment Share on other sites More sharing options...
newton9686 Posted June 29, 2021 Share Posted June 29, 2021 "My chiropractor recommended you order."..... "No i don't have any medical history.".... "I only drink socially"..... "I have never used cocaine, but my boyfriend does, I think I got it from having sex with him.... "They usually have to give me two rounds of antibiotics for my "sinus infection" before it gets better".. "I get bronchitis every year and need a zpac to get better"... "A fever for me is 97 because i normally run 95" 1 Quote Link to comment Share on other sites More sharing options...
Reality Check 2 Posted June 29, 2021 Share Posted June 29, 2021 The cocaine in the urine drug screen was the product of oral sex and swallowed…. Yep, that is what she said straight faced….. 1 Quote Link to comment Share on other sites More sharing options...
Administrator rev ronin Posted June 30, 2021 Administrator Share Posted June 30, 2021 20 hours ago, Reality Check 2 said: The cocaine in the urine drug screen was the product of oral sex and swallowed…. Does she realize that the colloquial name for fellatio does not, in fact, correspond in meaning to the colloquial name for cocaine? 3 1 Quote Link to comment Share on other sites More sharing options...
Komorebi Posted June 30, 2021 Share Posted June 30, 2021 I'm in psych. My big "hmmm" moment is when the patient says "I'm just switching providers and need to continue my routine medications, Adderall and Xanax." 2 Quote Link to comment Share on other sites More sharing options...
Incognito Posted July 5, 2021 Share Posted July 5, 2021 Boyfriend brings his girlfriend's underwear in and wants the smegma tested to see if there is sperm in it from another man. This was his medical emergency as he presented to the EM department. I told him we can send it to the lab but the test is very expensive...over $1000 and must be paid ahead of time in cash. He left AMA. Quote Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted July 5, 2021 Moderator Share Posted July 5, 2021 On 6/29/2021 at 7:56 PM, Komorebi said: I'm in psych. My big "hmmm" moment is when the patient says "I'm just switching providers and need to continue my routine medications, Adderall and Xanax." "oh, ok. at what dose?" "um, the highest dose" Quote Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted July 5, 2021 Moderator Share Posted July 5, 2021 16 minutes ago, Incognito said: Boyfriend brings his girlfriend's underwear in and wants the smegma tested to see if there is sperm in it from another man. This was his medical emergency as he presented to the EM department. I told him we can send it to the lab but the test is very expensive...over $1000 and must be paid ahead of time in cash. He left AMA. I love it. people think the ER is a crime lab or something. "test this pizza/drink/waffle/strand of my hair for poison!" No Quote Link to comment Share on other sites More sharing options...
camoman1234 Posted July 5, 2021 Share Posted July 5, 2021 On 6/25/2021 at 10:21 AM, Reality Check 2 said: Dr Oz said - anything, anything at all and my head hurts I want a whole body MRI because I had a headache once (can't make this up) I am very sensitive to all medications and you are giving me too much thyroid (TSH 4) This has bothered me for a long time but I haven't said anything - TEN notes in the chart from 4 specialists finding nothing My hydrocodone is for my back - my knee is what hurts now Why would you say I am anxious? - bouncing knee, fidgeting, fifth visit for vague sx and constant worry I don't want to take an anxiety medicine everyday - those are dangerous. Just something when I need it - like Xanax.... And the full moon was last night and the spaceship just landed out back with all my morning patients in it Godspeed everyone "I am very sensitive to all medications and you are giving me too much thyroid (TSH 4)." This right here is the reason I am so busy in my practice. Providers do NOT listen to their patients. This is your typical cookbook medicine. If your TSH is 4 you are "normal", give me a break...I can tell you that I personally have several things medically wrong with me that Western medicine could never touch for 3 years. After I went to the right person that actually listened and did not blow me off (like the above quote) I started getting better. Normal values are very broad and the range of normal comes from a average (of a 18-70 year old range) plus these value are only normal for the people that get lab work in a primary care setting. Most these people are on average sick so that deviation is skewed for a large amount of people (like myself). I respectfully take this sentence as very frustrating and ignorant. We as primary care providers should be doing a better job than at listening and not assuming patients don't know how THEY feel and that each individual person does know their body NOT the PCP. Quote Link to comment Share on other sites More sharing options...
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