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Wednesday, November 1, 2017

Medical Stories

Medical Stories

There are lots of different people in the world.  Some are educated, some less so.  Some are medically educated, some have watched a few episodes of ER and some are totally clueless.  To follow are random stories, some true, some not.  All names are fictitious to ensure anonymity (and comply with HIPPA rules), of course, except for the names that made headlines!!

Sleeping Bag
I spoke to a patient who was going to have eye surgery.  I went through my pre-op questionnaire and as a middle age guy he was healthy and met all the criteria to have surgery in a non-hospital setting.  I asked him if he had a responsible driver to take him home.  Uh...no.  He was going to have surgery in the morning, hang around our office all day and sleep in his car in a sleeping bag overnight. (the seat folded down, so he would be comfortable, he assured me).  He would be able to go to his post-op visit with the doctor the next morning without traveling home 150 miles.

I asked him if his surgeon's office was aware he planned to spend the night in his car - in our parking lot the night after surgery.  Yes, he said, they told him it was OK.  I advised him that we could not allow him to sleep in our parking lot due to the liability, he could get a local hotel and have medical transport bring him there after surgery but he could not stay in the parking lot.

   ****our surgery patients can ONLY be discharged to a responsible person, not a cab, not a bus, they can't walk home and they can't drive themselves home.  They are considered DUI until the next day.  The liability of releasing a patient any other way would be catastrophic. 

I called the surgeon's office and spoke to the named assistant who told him it was ok.  I told her it was NOT ok for him to sleep in our parking lot.  She said she didn't know he was going to sleep in our parking lot.  I asked her where she thought he was going to park his car as he could not drive away.  I advised her that he could park his car in HER parking lot, walk down the street for surgery then get medical transport to take him back to HER parking lot and spend the night in his car in a sleeping bag.  She gasped at the thought of this.  

Now she was beginning to see my side of the story.

I could see the headlines in the paper "Patient Dies after Surgery in Parking Lot"  OMG!!! 

I got a call later from the surgeon's office to let me know the patient had a hotel room and a confirmed ride with medical transport back to his hotel after surgery.  I'm not sure who is picking up that tab, but I am happy that the patient will be able to get the surgery he needs, and be safe!!

9mm safety
I had a 17 year old patient for hand surgery a few years ago.  He had massive hand trauma and it is usually my thing to ask a patient how they got hurt.  Curiosity I guess, as well as being a nurse. 

In this case there was a note in the chart to NOT ask the patient how they got hurt as he was so embarrassed by the question. 

The chart stated he had heard that the Glock 17, 9mm had a safety feature which prevented the gun from going off if it had direct contact with a person's skin.  His friends bet him that is didn't, so he put the gun against his palm and pulled the trigger. 

I can't even imagine how much alcohol had to be involved for such poor judgement.  Good thing he didn't put it against his head.

Wildlife Fun
I had a patient a few years ago who had broken her elbow in a fall.  As usual I asked her what happened.  Curiosity?  Yes.  Also it was a way to find out if the patient was being assaulted. 

The patient stated that every night around dusk, she would bring a tray of food out to the back of her property and feed the wild animals.  She would bring leftovers, fruit, vegetables and other things she thought they might like.  She said she was getting quite a following and sometimes there were animals waiting for her.

On the night she was injured, she was bringing out her tray of food as usual.  She said it made her happy to see the animals waiting for her.  There were deer, raccoon, skunks and possums.  When she came around the corner, the animals saw her and made a run towards her.  She said she turned around, threw up the tray and ran for her life!!  Halfway back to the house she tripped and broke her elbow!  Good thing there weren't any bears waiting for her!!

Another Broken Elbow
I had an elderly lady with a broken elbow.  I asked her how it happened.  She said she was going to go on a cruise and was packing her bags to go.  She was meeting her group at the airport the next day.  She stepped up on a small stool to retrieve a bag from her closet located on the high shelf.  She lost her balance and fell off the stool, landing on her elbow and breaking it.  Sadly, she said she did not have vacation insurance and lost $30, 000 dollars with the cruise, hotels and air fair.


Eye Surgery

I have been having some eye problems - lots of foggy floaters.  My eye doctor said that I had cataracts and subsequently did cataract surgery.  Big surprise to me - my vision got worse.  Oddly, the staff and the doctor was not surprised my vision got worse.  Well of course it did - after cataract surgery you can see your floaters more clearly.  I told them that the floaters was why I went to the clinic in the first place. 

Follow up #1 - My doctor said they could do some laser surgery and get rid of the floaters.  I made an appointment and had to wait three months to see the doctor because they had to have an appointment long enough to have the laser done.

Follow up #2 - I work about 5 minutes away on the same road.  I was pretty busy at work so I called ahead to make sure I wouldn't have to sit in the waiting room when I could still be taking care of patients myself.  The staff said all was great and to come on down.  I waited for 45 minutes after my appointment time, was dilated and seen by the doctor.  So when do we go back and do the laser? 

The doctor said that although he had never had complications after doing laser surgery, he was leaving the country that weekend and would not be available for me if there was a problem.  I would have to reschedule until a time when he had long enough to do laser and for him to be in town for follow up.

Follow up #3 -  When I made the appointment for my (THIRD) follow up.  I waited two months.  I was finally getting my laser surgery.   I could start to get my clear vision back.  Maybe I would be able to clearly read my computer.  Being able to read street signs while I rode my motorcycle would be so awesome.  My appointment was at 2:00 pm.  I was so excited.  I worked extra hard all week to make sure I was caught up enough to get off a couple hours early and not affect patient flow. 

About 40 minutes prior to my appointment, I called the office to ask if he was running on time.  I could keep working if they said no.  They said I had missed my appointment.

I told them - NO!  My appointment wasn't for another 40 minutes!  The lady said no, they had rescheduled my appointment for 12:00 and I did not show up.  I told her I was not notified of a schedule change.  I work on the phone all day - I did not get a call.  I checked my phone.  There was a message that said I had missed my appointment.

I told her I was just 5 minutes down the street and could come right away.  Oh, sorry, the doctor has left the country.  I waited 6 months and now he is out of the country again. 

I fired him as my doctor and got another one.  I got a super fast appointment and got referred to a retinal specialist.  I got an appointment with them within a couple days.  I get to see them tomorrow.

Mental note:  don't get a jet setting doctor who prefers to take care of people in other countries over people who live in the same town.

Update - 11-22-2017
One of the nice ladies I work with told me that Dr. Paden at Paden Eye Care was a straight shooter, would totally be honest with me and she said he was an excellent doctor.  I got an appointment within a week.  After a thorough exam he told me that I wasn't even a candidate for the laser surgery that the last guy kept dangling in front of me.  I needed a retinal specialist.  He referred me to Dr. Gonzales in Ashland, Oregon.  I got an appointment with her in a week. 

The appointment with Dr. Gonzales was about 3 hours long.  There is an awesome team that performs the dilation and eye check, then retinal photography followed by a visit with the doctor who goes over all the tests.  She said the best thing for my situation was a vitrectomy (to remove the vitreous jelly from my eye that was filled with the nasty floaters), a membrane peel (to remove the part of the membrane that had ruptured around my retina) and gently open my ocular opening to allow for better eyesight. 

I knew exactly what she was going to do as I had been an operating nurse circulator in an eye room doing these procedures.  I was so excited that there was a plan for getting my clear vision back.  She said she could do it in less than two weeks!

So here I am now.  One week after surgery.  The surgery was cake.  I could see the instruments inside my eye during the procedure but couldn't see out because of the corneal shield they use.  The post op pain has never needed more than ibuprofen and Tylenol.  Lots of eye drops.  I wear an eye shield at night to protect it.  It itches but I can't touch it!

Some of the drops in the first week keep it dilated but that should be over soon.  I can already see better.  Even dilated, my vision is 20-20 in that eye, but the dilated vs. non-dilated is causing me to squint a lot when I'm tired.  I can read street signs again but all the lights at night have big stars around them. 

I hope I will be able to see well enough after it heals to carry on with my life but I would not hesitate to get the other eye done, especially now that I know what to expect. 

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