Sunday, September 6, 2009

surprises, not the good kind.

Yipes. I think God may be trying to teach me a lesson when I get into my "you're not actually sick" mode- see my disaster a couple of months ago, when my prescription refill turned out to be a heart attack. I get it the worst when I work yellow zone- you would think people with STDs and flu like symptoms wouldn't wait for 8 hours to be seen in the ER, but you would be wrong. They wait, but are super pissed off at everyone by the time they get back there. I respond by being incredibly annoyed, since when I see gunshot wounds and heart attacks every other day of the week, your 10/10 finger pain and tonsilitis are not as urgent in my mind. That doesn't stop those patients, of course, from being on the call light every ten minutes and making me want to run in and slap them senseless.
I had one of these, or so I thought, the other night. The patient spoke little to no English- he had a family member in there translating for him who was incredibly demanding. His cheif complaint was fever- when they took it in triage, it was 97.9. She started telling me all of this totally off the wall stuff- there must have been some kind of language barrier- He has "fever from the inside". He drinks 5-6 gallons of water a day, and he says it all tastes like salt. He got an over the counter Penicillin shot(?) because some healer told him he had an infection? What the hell? I told them I would wait for the Nurse Practitioner to come in, and the family member got pissed off because a Doctor wasn't going to see him. Five minutes later, he hits the call light to let us know he's feeling bad. Uh, yeah. I start a line at this point just so they feel like I'm doing something. The NP sees them, and they finally calm down for a while.
Right as I'm telling people how they're driving me insane, the lab calls to ask about the patient's history. None, why? They're getting "weird" results. So far the blood sugar is reading 1,000. And then it hits me- drinking tons of water? Nausea? Ugh. New onset Diabetes. I look at his urine results- high ketones. Great. Now I have a DKA patient. I do a recollect on the blood just to make sure and call my charge to get this dude the hell out of yellow zone. After the transfer, the lab calls me back- the final blood sugar reading was 1208. The guy ended up going to ICU. Turns out, I can't always tell who's "not sick".

1 comment:

  1. 9 out of 10 times you can tell. There's always one that fools ya though.