Tuesday, April 28, 2009
A reminder of my drive to becoming a doctor
During the recent papal visit to Cameroon earlier this year, he made a speech at a Rehabilitation Center in the Capital city of Cameroon, Yaounde. Here is an extract from his speech which sent chills down my spine and reminded me of why I wake up every day wanting so bad to be a doctor and set on the trail of helping my fellow people around the world. Pope Benedict said, Doctors “are called, in the first place, to protect human life” because they “are the defenders of life from conception to natural death.” May God “graciously grant the prayers of all who turn to him. He answers our call and our prayer, as and when he wishes, for our good and not according to our desires,”
Thursday, April 16, 2009
Basic health care is not common. Is it really basic?
Greetings to everyone visiting this block. I must welcome the newest follower, Linda, to the blog! Feel free to add to the discussion and air your experiences and visions.
So I'm a day shy of being 2 wks into my Internal Medicine rotation and I'm at the Veterans Administration well known for its acronym "VA". My classmate was taking care of this patient, an AA in his 50's, who has chronic lung disease, diabetes and schizophrenia. As part of assessing the patient's oxygen saturation, we usually check patient's oxygen saturation using a machine called a pulse oximeter "pulse ox" before, during and after walking the patient. So my classmate approached the aforementioned gentleman and explained that in order to give him appropriate treatment he'll have to walk so that we can get a good sense of his oxygen saturation level. He blatantly refused to walk saying at first that he was tired then later that he didn't feel like walking and "no one is gonna make me do what I don't feel like doing." So at this juncture, the chief resident got involved and explained to him that he will let him go it he didn't want to cooperate with his care. He was so ready to sign the damn - Leaving Against Medical Advice form, what is generally referred to as "AMA". While in the midst of all these, we (the medical students) had to leave for a noon conference, which we have every day. The guy was out by the time we returned to the Unit about an a hour later.
This serves like a very good base, I think, of what I'm going to talk about next. My parents are from a small village in South West province of Cameroon called Lewoh. In Lewoh, there is a health care center which is not currently staffed by a doctor. There is a nurse and and some nurse assistants and that's about it! So you have all these villagers who flock in every day with various types of complaints and illnesses. Some may need something as simple as an anti-pyretic to antibiotics or as complicated as needing surgery. As you can imagine a health care center without a doctor, all these poor villagers just have to do with what is available to them... and guess what? At the end of the day, the are very grateful that someone is even at the health care center to consult, talk and prescribe them some medicine. The credentials are really not the first thing that comes to mind.
The VA patient who didn't even want to walk so that we could better assess him and take care of him has all the doctors and specialists at his disposal. Yet, he's not compliant and won't make good use of his available resources. Only if some of these patients knew how well they got it going. Ask one of the Lewoh villagers who's sick and can't even get out of bed to walk and if he/she knows that it will contribute in some manner to the improvement of his/her health, I bet you, he/she will somehow by some means walk! Access to health care is a word we use quite often these days. Quality health care is another word. When I think of the Lewoh villagers, I think of these two words. Yes, there is a problem of access to health care in the US but it's a whole different entity when you think of poor access to health care in Lewoh; Quality of care is just far and deep in the trenches. We're just thinking access and praying that Quality will sometime come in the future. I guess Lewoh is in a developing country but then humans are humans and they all hurt the same. Appendicitis or malaria in any part of the world is the same thing but some have access to medical personnel and facilities to help take care of these same problems while others don't. God, bless your people. This's really not a problem in Cameroon but many developing countries.
I really don't want to make this block political but I can't refrain from saying that the big names in Cameroon government just keep getting richer and richer while their people's suffering increase exponentially day after day. People think that Cameroon is peaceful just because there
isn't war. But if we look at peace as the absence of justice then there ain't no peace in Cameroon, which is how I see it.
In order to promote better health care in the Lewoh village, it's Cultural Organization known as Lewoh Cultural and Development Organization (LECUDEM) is launching a fund raiser so as to renovate the lewoh healthcare center. These villagers need a chance to receive health care, I mean basic health care. Nothing but Basic. These villagers need basic things as:
-Pregnant women go through their entire pregnancies without ever getting an Ultrasound. Imagine how un comforting that can be. Their lives and that of their fetus are at the mercy of good luck.
-Children have to be sent to hospitals that are thousand of miles away b/c they are too sick to be taken care of at the health center with nothing besides BP cuffs, thermometer and a stethoscope. At times, they end up dieing b/c parents can't afford to take them any where else.
-Patients routinely come to the hospital just because they are given only medications that are available even when it's not the best/right agent for their illness. As a result, they have to stay away from their farm which is basically the only means of living for most families.
- There aren't even enough beds and those that are available have nothing but a few inches of mattress that your back hurts like crazy when you lie on it. How uncomfortable can you get at a hospital??
- Imagine having palpitations and feeling like your heart is about to jump off your chest just to go to the hospital and there's no mere EKG to check your heart? This's what has become common to these people.
So attached is more information about the fund raiser and if, please, anyone is willing to help the people of Lewoh village, don't hesitate to contact me. Your help will prevent a tragedy in a family, prevent a child from staying away from school b/c of illness or just bring smile to a woman's face because they can be sure of a healthy baby at delivery. see more about the fund raiser at the following website: LECUDEM.ORG
_________________________________________________________________________________
LECUDEM-USA ANNOUNCES A SUMMER FUNDRAISER FOR ATLANTA, GA.
The Lewoh Cultural and Development Meeting in the United States (LECUDEM-USA) has announced a June 2009 meeting in Atlanta, Georgia to help raise funds for the up-grading of the Lewoh Health Center at Anya. The fundraiser is aimed at raising some $50,000 for the project. The not-for-profit organization has already raised $10,000 here in the U.S. and the Cameroon government, in its 2009/2010 budget, has earmarked ($50,000) as an initial amount for the up-grading efforts. The government allocation is already at divisional level in Menji awaiting the award of a contract for work to begin.
In a conference call last Sunday night with some of his executive members and a development think tank the President of LECUDEM-USA, Mr. Michael Fondungallah, who has just returned from Cameroon, reported that on-going efforts to partner with the Cameroon government to up-grade the Lewoh Health Center are well underway. He noted that during his trip to Cameroon he visited Anya (Lewoh), Yaounde, and Limbe where he held working sessions with staff of the health center, and home-based members and executives of the mother branch of LECUDEM. The up-grading will raise the health center to a divisional hospital with the following features: a neonatal ward, an obstetric and gynecological ward, an emergency and trauma unit, and an infectious disease unit.
The Minnesota-based Attorney said that up-grading the health center remains LECUDEM-USA’s priority project for the 2009/2010 development year. Mr. Fondungallah said that he also met with staff of the health center and noted the absence of a resident medical officer at the facility. He discussed the needs of the health center with staff and LECUDEM members in Limbe and Yaounde and the Lewoh traditional Council before meeting with His Majesty Fotabong Lekelefac I, the Atemangwat of Lewoh. He also met with the organization’s international relations officer HRH Fuafe’eh (Prof. Leke Tambo).
LECUDEM-U.S.A is a non-profit organization certified by the IRS service code 501 (c) 3 to procure tax-deductible donations. The mother organization, LECUDEM, brings together both the home-based and Lewoh sons and daughters in the Diaspora with the purpose of harnessing their energies toward coordinated, meaningful, and planned development initiatives that uplift the human person by improving on the quality of life of the people of Lewoh. The organization has built a portable water project in the Fondom, a trans-Lewoh road that needs funding to surface and build bridges and culverts, and supported educational projects. Story by Asonglefac Nkemleke, PRO.
{ a picture of Lewoh health care center was here - unable to download for some reason]
LECUDEM-USA PRESIDENT, MICHAEL FONDUNGALLAH Esq. with staff of the Lewoh Health Center (April 2009)
So I'm a day shy of being 2 wks into my Internal Medicine rotation and I'm at the Veterans Administration well known for its acronym "VA". My classmate was taking care of this patient, an AA in his 50's, who has chronic lung disease, diabetes and schizophrenia. As part of assessing the patient's oxygen saturation, we usually check patient's oxygen saturation using a machine called a pulse oximeter "pulse ox" before, during and after walking the patient. So my classmate approached the aforementioned gentleman and explained that in order to give him appropriate treatment he'll have to walk so that we can get a good sense of his oxygen saturation level. He blatantly refused to walk saying at first that he was tired then later that he didn't feel like walking and "no one is gonna make me do what I don't feel like doing." So at this juncture, the chief resident got involved and explained to him that he will let him go it he didn't want to cooperate with his care. He was so ready to sign the damn - Leaving Against Medical Advice form, what is generally referred to as "AMA". While in the midst of all these, we (the medical students) had to leave for a noon conference, which we have every day. The guy was out by the time we returned to the Unit about an a hour later.
This serves like a very good base, I think, of what I'm going to talk about next. My parents are from a small village in South West province of Cameroon called Lewoh. In Lewoh, there is a health care center which is not currently staffed by a doctor. There is a nurse and and some nurse assistants and that's about it! So you have all these villagers who flock in every day with various types of complaints and illnesses. Some may need something as simple as an anti-pyretic to antibiotics or as complicated as needing surgery. As you can imagine a health care center without a doctor, all these poor villagers just have to do with what is available to them... and guess what? At the end of the day, the are very grateful that someone is even at the health care center to consult, talk and prescribe them some medicine. The credentials are really not the first thing that comes to mind.
The VA patient who didn't even want to walk so that we could better assess him and take care of him has all the doctors and specialists at his disposal. Yet, he's not compliant and won't make good use of his available resources. Only if some of these patients knew how well they got it going. Ask one of the Lewoh villagers who's sick and can't even get out of bed to walk and if he/she knows that it will contribute in some manner to the improvement of his/her health, I bet you, he/she will somehow by some means walk! Access to health care is a word we use quite often these days. Quality health care is another word. When I think of the Lewoh villagers, I think of these two words. Yes, there is a problem of access to health care in the US but it's a whole different entity when you think of poor access to health care in Lewoh; Quality of care is just far and deep in the trenches. We're just thinking access and praying that Quality will sometime come in the future. I guess Lewoh is in a developing country but then humans are humans and they all hurt the same. Appendicitis or malaria in any part of the world is the same thing but some have access to medical personnel and facilities to help take care of these same problems while others don't. God, bless your people. This's really not a problem in Cameroon but many developing countries.
I really don't want to make this block political but I can't refrain from saying that the big names in Cameroon government just keep getting richer and richer while their people's suffering increase exponentially day after day. People think that Cameroon is peaceful just because there
isn't war. But if we look at peace as the absence of justice then there ain't no peace in Cameroon, which is how I see it.
In order to promote better health care in the Lewoh village, it's Cultural Organization known as Lewoh Cultural and Development Organization (LECUDEM) is launching a fund raiser so as to renovate the lewoh healthcare center. These villagers need a chance to receive health care, I mean basic health care. Nothing but Basic. These villagers need basic things as:
-Pregnant women go through their entire pregnancies without ever getting an Ultrasound. Imagine how un comforting that can be. Their lives and that of their fetus are at the mercy of good luck.
-Children have to be sent to hospitals that are thousand of miles away b/c they are too sick to be taken care of at the health center with nothing besides BP cuffs, thermometer and a stethoscope. At times, they end up dieing b/c parents can't afford to take them any where else.
-Patients routinely come to the hospital just because they are given only medications that are available even when it's not the best/right agent for their illness. As a result, they have to stay away from their farm which is basically the only means of living for most families.
- There aren't even enough beds and those that are available have nothing but a few inches of mattress that your back hurts like crazy when you lie on it. How uncomfortable can you get at a hospital??
- Imagine having palpitations and feeling like your heart is about to jump off your chest just to go to the hospital and there's no mere EKG to check your heart? This's what has become common to these people.
So attached is more information about the fund raiser and if, please, anyone is willing to help the people of Lewoh village, don't hesitate to contact me. Your help will prevent a tragedy in a family, prevent a child from staying away from school b/c of illness or just bring smile to a woman's face because they can be sure of a healthy baby at delivery. see more about the fund raiser at the following website: LECUDEM.ORG
_________________________________________________________________________________
LECUDEM-USA ANNOUNCES A SUMMER FUNDRAISER FOR ATLANTA, GA.
The Lewoh Cultural and Development Meeting in the United States (LECUDEM-USA) has announced a June 2009 meeting in Atlanta, Georgia to help raise funds for the up-grading of the Lewoh Health Center at Anya. The fundraiser is aimed at raising some $50,000 for the project. The not-for-profit organization has already raised $10,000 here in the U.S. and the Cameroon government, in its 2009/2010 budget, has earmarked ($50,000) as an initial amount for the up-grading efforts. The government allocation is already at divisional level in Menji awaiting the award of a contract for work to begin.
In a conference call last Sunday night with some of his executive members and a development think tank the President of LECUDEM-USA, Mr. Michael Fondungallah, who has just returned from Cameroon, reported that on-going efforts to partner with the Cameroon government to up-grade the Lewoh Health Center are well underway. He noted that during his trip to Cameroon he visited Anya (Lewoh), Yaounde, and Limbe where he held working sessions with staff of the health center, and home-based members and executives of the mother branch of LECUDEM. The up-grading will raise the health center to a divisional hospital with the following features: a neonatal ward, an obstetric and gynecological ward, an emergency and trauma unit, and an infectious disease unit.
The Minnesota-based Attorney said that up-grading the health center remains LECUDEM-USA’s priority project for the 2009/2010 development year. Mr. Fondungallah said that he also met with staff of the health center and noted the absence of a resident medical officer at the facility. He discussed the needs of the health center with staff and LECUDEM members in Limbe and Yaounde and the Lewoh traditional Council before meeting with His Majesty Fotabong Lekelefac I, the Atemangwat of Lewoh. He also met with the organization’s international relations officer HRH Fuafe’eh (Prof. Leke Tambo).
LECUDEM-U.S.A is a non-profit organization certified by the IRS service code 501 (c) 3 to procure tax-deductible donations. The mother organization, LECUDEM, brings together both the home-based and Lewoh sons and daughters in the Diaspora with the purpose of harnessing their energies toward coordinated, meaningful, and planned development initiatives that uplift the human person by improving on the quality of life of the people of Lewoh. The organization has built a portable water project in the Fondom, a trans-Lewoh road that needs funding to surface and build bridges and culverts, and supported educational projects. Story by Asonglefac Nkemleke, PRO.
{ a picture of Lewoh health care center was here - unable to download for some reason]
LECUDEM-USA PRESIDENT, MICHAEL FONDUNGALLAH Esq. with staff of the Lewoh Health Center (April 2009)
Friday, April 3, 2009
Omega-3 is beneficial to the Heart
Just adding a link to a paper which I co-authored entitled:
"Fish oil, but not flaxseed oil, decreases inflammation and prevents pressure overload-induced cardiac dysfunction". It's a cardiovascular research. We found the benefits of omega-3 polyunsaturated fatty acids are cardio-protective and decrease incidence of Left Ventricular Hypertrophy and subsequent heart failure. Here's a link to the abstract and entire paper. My mentor in this research project, Dr. William Stanley is excellent and has been very supportive. He's just plain awesome and down to earth as it gets. Enjoy browsing through or reading! :-)
"Fish oil, but not flaxseed oil, decreases inflammation and prevents pressure overload-induced cardiac dysfunction". It's a cardiovascular research. We found the benefits of omega-3 polyunsaturated fatty acids are cardio-protective and decrease incidence of Left Ventricular Hypertrophy and subsequent heart failure. Here's a link to the abstract and entire paper. My mentor in this research project, Dr. William Stanley is excellent and has been very supportive. He's just plain awesome and down to earth as it gets. Enjoy browsing through or reading! :-)
The picture on top left is of myself in the Lab. Taken during the research. I'm measuring and analyzing BP measurements on rats using a computer software. Dr. Brian, one of the great post docs, was so kind to get the pic for me.
The pic bottom left: presenting the preliminary results of the research at the Annual Medical Student Research Forum at my school (University of Maryland School of Medicine). Much thanks to Dr. Stanley's Lab - Cardiovascular Research.
http://cardiovascres.oxfordjournals.org/cgi/content/short/81/2/319
http://cardiovascres.oxfordjournals.org/cgi/content/short/81/2/319
Friday, March 13, 2009
Sleeveless T-shirt in 35*F
So yesterday, Thursday 3/12 was a nice day. It started off with a standardized patient encounter at 9:30a. Even though it was scheduled to start at 9:15a, no big deal.
What's standardized patient (SP) encounter?- some of you migt wonder
It is when someone is acting as a patient. That is they present with a complain and have a script which they follow. This is used as a teaching tool so that medical students can act as doctors and attend to the SP's complaints, do physical exam then come up with an assessment and plan on how to treat the patient (SP). My first SP presented with a neurological complain and the second one presented with some generalized complain (realize that I'm trying not to be specific here b/c we're not allow to talk about specifics of the encounter) so I apologize if I'm not being clear enough or at all. Then I returned home which is about 10 minutes walk from the hospital. Ate some lunch then drove to the Family Medicince clinic.
I saw this 39y/o African American (AA) . Upon entering the exam room, I saw a gentleman, unkempt wearing a sleeveless t-shirt, sitting down while shaking both legs which were crossed at the ankle. During part of our conversation, he told me that he had a chronic flank pain (pain around the R mid back region) due to kidney stones and was on Percocet (a narcotic). He wanted a refill of his narcotic. I wanted to assess how well the Narcotic is working and how to adjust (if necessary). He proceeded to tel me that he used to take Oxycontin (a Narcotic) and was changed a couple of months ago to Percocet. "Dem Percs sure work like magic doc. They must hae some enzyme or something. Ever since I been taking dem, my stones are coming out in tiny pieces and not as big as they used to be when I was on Oxy's).
It's also amazing how many people will come to the doctor with diagnosis already and just wanting to get some Antibiotics for their self made diagnosis. I'm all about empowering the patient but I think the patient should have an open mind and let the doctor explain his thought process ... at least a doctor has spent a lot of years in school learning about all these things.
Later.
What's standardized patient (SP) encounter?- some of you migt wonder
It is when someone is acting as a patient. That is they present with a complain and have a script which they follow. This is used as a teaching tool so that medical students can act as doctors and attend to the SP's complaints, do physical exam then come up with an assessment and plan on how to treat the patient (SP). My first SP presented with a neurological complain and the second one presented with some generalized complain (realize that I'm trying not to be specific here b/c we're not allow to talk about specifics of the encounter) so I apologize if I'm not being clear enough or at all. Then I returned home which is about 10 minutes walk from the hospital. Ate some lunch then drove to the Family Medicince clinic.
I saw this 39y/o African American (AA) . Upon entering the exam room, I saw a gentleman, unkempt wearing a sleeveless t-shirt, sitting down while shaking both legs which were crossed at the ankle. During part of our conversation, he told me that he had a chronic flank pain (pain around the R mid back region) due to kidney stones and was on Percocet (a narcotic). He wanted a refill of his narcotic. I wanted to assess how well the Narcotic is working and how to adjust (if necessary). He proceeded to tel me that he used to take Oxycontin (a Narcotic) and was changed a couple of months ago to Percocet. "Dem Percs sure work like magic doc. They must hae some enzyme or something. Ever since I been taking dem, my stones are coming out in tiny pieces and not as big as they used to be when I was on Oxy's).
It's also amazing how many people will come to the doctor with diagnosis already and just wanting to get some Antibiotics for their self made diagnosis. I'm all about empowering the patient but I think the patient should have an open mind and let the doctor explain his thought process ... at least a doctor has spent a lot of years in school learning about all these things.
Later.
Wednesday, March 11, 2009
doctoring
Another interesting day at the Family Medicine clinic. In all honesty, I'm having more fun that I thought I will. Learning fast and my preceptor, Dr. Evans is GREAT!!! I did a presentation on Hyperparathyroidism today and I think I did fine.
So I was seeing this mid age AA female who came in with periorbital edema and erythema. She asked if she could get a tetanus vaccine, she has had the last short over 10yrs ago. Sure you can. Why are you asking for a tetanus shot? I asked. "It's because of my allergies. I need it for my allergies".
I'll be having a standardized patient tomorrow and I'm about ready for that. Will see how it goes!
Will keep you posted!
So I was seeing this mid age AA female who came in with periorbital edema and erythema. She asked if she could get a tetanus vaccine, she has had the last short over 10yrs ago. Sure you can. Why are you asking for a tetanus shot? I asked. "It's because of my allergies. I need it for my allergies".
I'll be having a standardized patient tomorrow and I'm about ready for that. Will see how it goes!
Will keep you posted!
Tuesday, March 10, 2009
A boy or a girl? that's the question.
So today was another fast pace day at the Family Medicine clinic in Baltimore, at Edmodson where I'm currently doing my rotations. Here are a couple of things that are worth remembering from my day.
Went into the room to see a 1y/o male who was accompanied by his mom. He had his hair plaited in corn rows. My first statement after I introduced myself was ... I'm going to talk to you and examine her then ... before I could finish, I was interrupted by mom who said "you mean see him?" I'm so very sorry, I mean him; I replied. That kid totally looked like a girl compounded with the fact that he had corn rows.
So I was seeing a 62y/o female with history of COPD who was discharged 4ds ago from the hospital following a 10day hospitalization secondary to pneumonia. On reviewing her social history: Do you smoke or have you ever smoked? "I quit already" she said. OK, congratulations that good! When was the last time you smoked a cigarette? "3days ago. But I quit because I was told at the hospital that if I smoke again I will die. So I didn't smoke while at the hospital but I had to smoke when I got home on the first day because I just couldn't quit like that"
Was seeing an 80y/o female with history of HTN. On reviewing his diet: Do you watch your salt or sodium intake? "Yes, I usually have to boil my hotdog twice in 2 different water in order to get rid of the salt in it"
Went into the room to see a 1y/o male who was accompanied by his mom. He had his hair plaited in corn rows. My first statement after I introduced myself was ... I'm going to talk to you and examine her then ... before I could finish, I was interrupted by mom who said "you mean see him?" I'm so very sorry, I mean him; I replied. That kid totally looked like a girl compounded with the fact that he had corn rows.
So I was seeing a 62y/o female with history of COPD who was discharged 4ds ago from the hospital following a 10day hospitalization secondary to pneumonia. On reviewing her social history: Do you smoke or have you ever smoked? "I quit already" she said. OK, congratulations that good! When was the last time you smoked a cigarette? "3days ago. But I quit because I was told at the hospital that if I smoke again I will die. So I didn't smoke while at the hospital but I had to smoke when I got home on the first day because I just couldn't quit like that"
Was seeing an 80y/o female with history of HTN. On reviewing his diet: Do you watch your salt or sodium intake? "Yes, I usually have to boil my hotdog twice in 2 different water in order to get rid of the salt in it"
Friday, March 6, 2009
"Peotry of life"
The director of Family medicine clerkship at my school, Dr. Colgan, is a great clinician. In my opinion, one of the finest teachers of medicine. He teaches with passion, you can feel it sitting across the room from him. During today's lectures, he encouraged us to collect interesting quotes from our patients as something to look back on some years from now. I thought it was a great idea but decided to take it a step further: I'll be collecting quotes from both patients, colleagues and doctors.
The first one happens to come from a doctor. "You're still people but you're dangerousely close to becoming doctors" Dr Ferentz on supplements and vitamins and how doctors should advise their patients on not taking them because they're worthless.
"Sir, you must be very smart" a caretaker accompanying a mentally challenged pt mumbled to me. Why do you say that, I asked. "Because many young foreigners come to this country [US] and don't really do anything with their lifes, like my mom's husband" replied the caretaker. Little did she know that I was in her exact same position about 8yrs ago.
"What's your name again?" a pt asked. "Anselm" was my reply. "Ohh Handsome! I bet you must be getting in a lot of trouble with that name don't you?" pt replied. This same patient tells the doctor "only the 'dine works for my blood pressure. I done try all the other stuff ... the HCZ or whatever and dem, I done try them. I'm telling you ...." Pt w/ h/o drug abuse wants only Clonidine ('dine) for control of his HTN.
"... and there's a hole in the back of my throat. Do you think them cold drops could have caused that?" the patient asked. Wait huh?, I thought to myself. How many cough drops do you take? "I've taken as much as 380 in a day. You know I don't suck on them, I just crunch them with my teeth. They go just like that. I'm addicted to them ... do y'all have some cough drops around here?" I'm sorry, we don't.
After an otoscopic exam a pt, who came in w/ cold symptoms, asks me "do you see that I'm dehydrated?"
While taking a sexual history a 21y/o female pt says; "you be sitting there and hearing all these things but acting all professional, even though you young ..."
Mr. L, your BP still looks high today. Talking to a pt who does NOT want to be started on anti-hypertensives "...well it's probably 'cause I had some canned soup for lunch and used nasonex this morning ..."
To be continued...
The first one happens to come from a doctor. "You're still people but you're dangerousely close to becoming doctors" Dr Ferentz on supplements and vitamins and how doctors should advise their patients on not taking them because they're worthless.
"Sir, you must be very smart" a caretaker accompanying a mentally challenged pt mumbled to me. Why do you say that, I asked. "Because many young foreigners come to this country [US] and don't really do anything with their lifes, like my mom's husband" replied the caretaker. Little did she know that I was in her exact same position about 8yrs ago.
"What's your name again?" a pt asked. "Anselm" was my reply. "Ohh Handsome! I bet you must be getting in a lot of trouble with that name don't you?" pt replied. This same patient tells the doctor "only the 'dine works for my blood pressure. I done try all the other stuff ... the HCZ or whatever and dem, I done try them. I'm telling you ...." Pt w/ h/o drug abuse wants only Clonidine ('dine) for control of his HTN.
"... and there's a hole in the back of my throat. Do you think them cold drops could have caused that?" the patient asked. Wait huh?, I thought to myself. How many cough drops do you take? "I've taken as much as 380 in a day. You know I don't suck on them, I just crunch them with my teeth. They go just like that. I'm addicted to them ... do y'all have some cough drops around here?" I'm sorry, we don't.
After an otoscopic exam a pt, who came in w/ cold symptoms, asks me "do you see that I'm dehydrated?"
While taking a sexual history a 21y/o female pt says; "you be sitting there and hearing all these things but acting all professional, even though you young ..."
Mr. L, your BP still looks high today. Talking to a pt who does NOT want to be started on anti-hypertensives "...well it's probably 'cause I had some canned soup for lunch and used nasonex this morning ..."
To be continued...
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