The magical mystery land of community health

I don't make this stuff up!…but I do change identifying information.

Another Edition of the Totally Inappropriate Comment February 18, 2010

Filed under: Uncategorized — lesbonurse @ 3:35 am

Here’s another installment of the Totally Inappropriate Comment (TIC).

30-something year old patient with heart failure, renal failure and HgbA1c > 15, with point-of-care blood glucose of 439 (fasting): “Yes, I’ve been taking my insulin.  Yes, every day.”  Actual comment: “Have you been missing some doses?  Because you’re on a LOT of insulin, and it usually works better than this.” TIC: “You’re gonna die.  Soon.  Like, really soon.”

Patient requesting a pregnancy test: “Well, I finished my pills and I didn’t get my period, so I didn’t start the next pack.”  Have you been having unprotected sex in the 3 weeks since you stopped your pills?  Patient: “Well, yeah.”  Actual comment: “Had you missed any pills in the pack last month?”  TIC: “Well, if you weren’t pregnant before, you are now!”

Me, to ex-alcoholic patient who had been complaining of severe hip pain (and had been brushed off as drug-seeking over the past month): “So…the xray of your spine shows 2 compression fractures, and the xray of your hip shows something that we call ‘collapse of the femoral head.’  That’s a big deal.  That’s why you can’t really bear weight on your hip.”  Patient: “Does this mean I can get something stronger than naproxen for my pain?”  Me: “Yes.  I’ll give you something stronger for your pain today.  And we’re sending you to see Orthopedics asap.”  TIC: “Boy, were we wrong!  You’re not faking it at all!  I can’t believe you’ve been walking around on that non-existent hip joint! I’m sorry.”  *Lest you think I am a jerk, I did actually apologize for our clinic not catching the severity of the hip problem sooner, even though it wasn’t me that brushed the patient off.