Med Glossary - Part 4
This is fun! How about,
"I haven't had a bowel movement in two weeks."
Honestly, we get people who come in saying that. What they really mean is:
1) I haven't had a fulfilling bowel movement in two weeks, and I really haven't been regular ever since Bush stole the election.
(My advice: just relax and think of Hillary. Works for me!)
2) I've had some little turds, but I still feel bloated. My stomach doesn't normally look like this. (Picture 250# person lifting their pannus)
3) I've given myself a dozen enemas and I'm still so uncomfortable. Do y'all give enemas here?
4) Dang, this vicodin really binds a fella up, don't it?
5) There is a parasite in my intestinal tract that is consuming all of my nutrients, and as he grows, my stomach swells more and more. I got it from eating goat cheese in Lithuania. I've been to sixteen different parasitologists at the Mayo Clinic, and they all tell me my condition is incurable. I have a PhD in epidemiology, and I'm now in law school. I'm sick of getting the runaround from everyone; I want you to get to the bottom of this problem tonight. Do you have a parasitologist on call?
6) Can I get a work note?
"I haven't had a bowel movement in two weeks."
Honestly, we get people who come in saying that. What they really mean is:
1) I haven't had a fulfilling bowel movement in two weeks, and I really haven't been regular ever since Bush stole the election.
(My advice: just relax and think of Hillary. Works for me!)
2) I've had some little turds, but I still feel bloated. My stomach doesn't normally look like this. (Picture 250# person lifting their pannus)
3) I've given myself a dozen enemas and I'm still so uncomfortable. Do y'all give enemas here?
4) Dang, this vicodin really binds a fella up, don't it?
5) There is a parasite in my intestinal tract that is consuming all of my nutrients, and as he grows, my stomach swells more and more. I got it from eating goat cheese in Lithuania. I've been to sixteen different parasitologists at the Mayo Clinic, and they all tell me my condition is incurable. I have a PhD in epidemiology, and I'm now in law school. I'm sick of getting the runaround from everyone; I want you to get to the bottom of this problem tonight. Do you have a parasitologist on call?
6) Can I get a work note?
posted by scalpel at 12:05 AM
10 Comments:
Good series. :) Things must get just a bit exciting around there when you get complaint #4 from section 2.
Or they're what nurses call "bowel obsessed", which means those types of people who analyze the size/shape/consistency of their poop on a constant basis, and by golly if they don't have what they consider a "proper" BM every single day of their life they want to know WHY.
Also, there's the fact that some older people simply can't REMEMBER the last time they pooped due to dementia or failing memory. I had one elderly lady tell me she "hadn't pooped in two weeks" and so I told the assisted-living center staff that I would call the doc---and they laughed and told me that the woman had pooped so vigorously the day before that they'd had to clean the poop explosions off the walls.
(This post touched a nerve because, as a nurse, I feel like I've been slogging through poop for umpteen years, heh!)
#5 is the worst type of patient (and client, in our situation), isn't he/she?
My favorite patient is the one in kidney failure who's got severe motility issues. Maybe they're on peritoneal dialysis, and all the water's being sucked out of their colon by the dextrose solution. Maybe they've got PKD and their kidneys take up so much space they can't move their bowels worth a crap (ha!). Maybe they're on a lot of oxy on top of it. Either way, it's been a week since they last strained productively into the porcelain. Imaging comes back with a glowing intestinal snake - they're full from the bottom up, literally. Because, of course, not emptying at one end in no way stopped their filling at the other. You give more PEG than you thought humanly possible to ingest and have the distinct honor of explaining to both the nurse and your patient that yes, there will be an enema every half hour on the half hour until the system is clear.
It makes me think of the scene in "Brazil" involving the exploding plumber.
Re: Parasites
I used to take x-rays and one time something showed up on an IVP study. The radiology resident made me repeat the films. "Do it again with him prone." I knew it wasn't an artifact and I had a suspicion as to what it really was. The staff took one look and said "here's something you don't see often". Diagnosis: a calcified tapeworm.
That poor worm didn't even want to live in this guy.
Love the Med-Glossary series - great stuff!
Ahaha. I love this series.
had a little old lady tell me last month, re her husband who was ill and intubated, that "his balls haven't moved in two days". took me a bit off guard till i figured it out.
How about "he's lethargic". works equally well for peds, adults and nursing home patients with preexisting "O" signs.
Awesome.
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