Monday, August 20, 2012

Basic Problem Solving Skills

Sometimes I feel like they're doing this to me on purpose now to listen to my rants and tirades, but anyway, charge brings a lady with cc: rectal pain to my room.  Of course. How long? Over a year.  Of course.
I'm sure I've mentioned it before, but I rarely ask why anymore.  I certainly never attempt to explore any situations like this myself, but I walked the young lady through what she could expect as far as the rectal exam and then threw the deuces up.  I had a couple of other patients with a more acute complaints.
I'm going about my business when sassy lady ER doc grabs me to chaperone the rectal exam.  Fun times.  Yup, little lady, there sure are some fissures there, she tells her.  Okay, so I'll go head and prescribe you some cream and  OH ALSO YOU SHOULD PROBABLY STOP HAVING TEH BUTTSECKS  FOR A WHILE NOW K?

Yup.  I don't know what the first thought that crossed YOUR mind was, but I was immediately shocked that after a year or more of relentless butthole pain that this chick was never like "hm, maybe a should lay off the anal intercourse for a little while." You'd think before coming to the ER and waiting to be seen for 8 hours you might try this, but yeeaah.  Her reaction to these discharge instructions was one of complete shock, like she had never made the connection before.  I tried to tell her about sitz baths, but I don't know if it really helped. .

9 comments:

  1. I once had a PACU (but wide awake- whole thing done under local, shouldn't have come to PACU- so goofiness was not an excuse)patient tell me it hurt 20/10 when she tapped her postop-tendon-release finger on something. "Well, stop doing that.". (Cue laughter from all staff and conscious patients.). I didn't mean to mock her, but really??

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  2. She probably just thought you were being an asshole.

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  3. This reminds me of nursing school when I had a couple in for prenatal care. (She was 19 and 8 months pregnant and he was 45, they lived in a motel, 23 years ago this was something of note.) The woman told me they were having trouble with their sex life because it was "hard to breathe." I felt kind of strange discussing positions other than missionary, but they were grateful as they didn't know you could do it any other way.

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  4. The meme makes this post complete! I needed that laugh after last night's hellish shift!

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  5. Reminds me of my patients who complain of dizziness when they twirl around. Stop twirling around. You're not a ballerina.

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  6. I'm a physical therapist and find myself having to give advice over the phone to family/friends. My favorite was "my knee hurts when I sit cross legged for a while" and with my expert critical thinking skills I reply, well stop. Imagine that, it worked!

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  7. This is a third hand story but I found it amusing. A guy came into the ER with the tube from a ball point pen stuck in his urethra. It required emergency surgery to remove the thing. Turns out he couldn't get an erection (this was decades before Viagra) and so he stuck the thing up there and was going at it like gangbusters when it was pushed back into his urethra and ruptured it. His girlfriend was lucky he didn't hurt HER.

    Anyway, the doctor who removed the pen tube had a wicked sense of humor, and he kept the tube, taped it to a piece of paper, and put it on the bulletin board in the doctor's lounge. His caption? "If you can't come, write."

    :)

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  8. The word butthole is so hilarious. Gah I'm so immature. How am I a nurse?!

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  9. Had a mom once who came in for a lump in her daughter's "vagina". Turns out it was actually her clitoris. I told mom that and she had no idea what that was- and she had 2 kids.

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