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   Begem0t

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: 13.06.2013
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, 06 2009 . 04:50 +
... , , … . … Attending , . … . , . , , .
 
. 74 , - , , , , a , . ? ! rotation. , , 8 , a ! , , “” . chart. ! 4 !!! ! , .… : “That’s why we need students! Hey! You! What’s your name? Why are you just standing here doing nothing when you have to be learning? Go ahead my friend, check the chart and report, you have about 5 minutes, till the nurses finish their stuff, I think that is more than enough time.” 
 
… … , , , . , , , , . , ? , 8 . “Hey you!! Have you finished? Then go help the patient to the exam room do history and physical and then report what you found”…. 20 … ! -… . 
 
-So? What did you find?
-Well, , , .
-Well, first things first, let’s be professional and speak the language that everyone around us understand. Ok? You do speak English, right? Now report what you found.
-74 y/o white female with PMH of borderline hypertension, pseudo seizures, stated diabetes with 5 stated hypoglycemic episodes, stated CHF and multiple stated strokes with stated left sided hemiparesis. Presents to clinic for a follow up complaining of periumbilical abdominal pain for 5 days, non radiating, no nausea vomiting, no diarrhea or constipation, no blood. Also lumbar area pain radiating to then neck. Both complaints: Pain is 10 out of 10 and sharp not relieved by anything and everything makes it worse. Surgical hx: TAH BSO, appendectomy, lapcholy, left hip replacement. ROS: everything is painful from head to toes. On physical everything is normal but subjective complaints on every test. Ambulates with a walker but had no difficulty getting on the examining table and off it. There is only appendectomy scar noted.
-What is your plan?
-Psychiatric evaluation consultation, I mean refer her to Psychiatric clinic.
-Ok, let me be the judge of that. Why is her PMH all stated?
-There is no evidence for any conditions that she listed.
-Probably because you did not go through the whole chart.
-Yeah, right, and lumbar pain radiating to the neck also makes sense…
-Excuse me?
-Ah.. nothing.
-Gimme your notes and go through the chart again I’ll go see the patient.
 
: “Adduction of the left thumb increases pain in the neck” ??? , Hoover test is positive, . , . , … … 6 , physical eam . 
… 
, 40 , 40 !!!! Ψ!!! 30 ! : what’s wrong with my mother doctor?. . , , ! , , ….! …
 
-Hi doc, again. 
-Yeah?
-Well I just wanted to find out what is wrong with my mother cause you know I did not understand. I’m very concerned cause we lost our father like year and a half ago … and she’s been getting worse….
-Well, to tell you the truth .. I’m not sure I know myself, this is a very complicated case and I need to speak to my attending….
-Wait!!!! Doc !!!! You want to tell me that it’s that serious??? She is dying???
-No! (, ) You know what! Your mother is “lying like a rug”. She does not have anything, nothing is wrong with her and if she wants I can give her clearance to fly in a space rocket to the moon, she is that healthy. She is healthier than I am!
-What? 
-She probably just wants company!!! You! And made up the whole thing so you would not leave her and be with her and care for her or something of that nature! 
-WHAT?
-I’m sorry, are you developmentally challenged? I just explained to you that nothing is wrong with her! She is using you!!!
-But I left my girlfriend and quit my job, moved back to New York …WHAT ARE YOU SAYING?
-I am saying that probably you should not have done all that!
 
! - . , , . , “” . , , ! , , , ,
 
- ? 
- ! . , ?
- ,  
-, - ? ?
- , ! 
-Listen, one more word out of you and you will get an extra call next week!
- ! ?
-He is enabling her for this behavior! If he will stop she would get better!
- ! 
- That’s it! I’m not gonna listen to some shithead ..
CODE BLUE MAIN LOBBY, CODE BLUE MAIN LOBBY, CODE BLUE MAIN LOBBY
- …
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. … “” , arrhythmias. ( , ), left ventricle was affected left main… angiogram 35-40% stent . On chart review: MI with subsequent V.Fib…medications … … , . 
 

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, 26 2011 . 03:23 +
, . , . , , 
 
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"" 34 , , , . - “emergency room”, , . , 34 , , , , . , , , , , . , , , , . , ( ), , , “emergency room” , .
 
, , . , : . , , . . , , . , - , , , . 
 
. , , . , . , , , . . , , , , , , , , . 
 
, , . , , "". , , , .

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, 22 2012 . 05:28 +
. , , . . , , , , , - , , , , . ? " " , , , , , . ? , , : " ! ! ?" , , , . ! , , , , . , , , , - , , . 
 
, , , . , . . : , . , "" . , , "" . , . 
 
. , , . , - amoxicillin, - 3rd generation cephalosporin. . :
 
- , ?
- ?
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-? ?
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- , .
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- ! !
- RADT.
- ?
- rapid antigen detection test
- RST! , ! 5 ?
- 5 ?
- ! 5 ! ?
- 5 10 ? ?
- .
- ?
- , .
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- !
- . .
- ?
- , , strep throat, , .
- ! ! , . 
 
, , , , , . , , , . , . , , . , , , . , , , , , . . 

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(0)

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, 15 2013 . 04:38 +
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(8)

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, 14 2014 . 03:40 +
, . , , . , - . , , , . , , , . . . - , , , - wo-face . , , . , , , - . , , . , , , , - Bell's palsy ( ) . , 40 , . , , . , , , . 
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