The focus of this web site is medicine. In this blog, you’ll read about patient stories. The situations have been changed to be HIPAA compliant. Factual statements may or may not be true. I may change ages, gender or presenting complaints about patients. I may even entirely make up complete patient encounters from my fertile imagination. Trust me, if you think I’m writing about you, I’m not. There are billions of people in this world and readers send me stories about patients all the time. It isn’t you.
You’ll also read a lot about health care policy. I may throw in posts about life lessons, computers, and will even throw in family stories once in a while. If you’re looking for articles about politics, sports, or celebrities, you’re in the wrong place – unless the topics have some relationship to medicine.
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There was a lull in the patients at 2:15 AM. Conversation turned from splinting and IV drips to baby names and childrearing as two of our nurses are currently pregnant. The aroma of freshly-brewed coffee filled the air. Then the next patient registered. A girl in her early 20s. She sheepishly came up to the registration window and said “there’s something crawling inside of me.” Yes, we thought it, too. “OK, ma’am. When was your last menstrual period?” “I think it may have been a month ago … or maybe two months.” “Did you check to make sure you’re not pregnant?” “Yes, a home pregnancy test was negative about three weeks ago.” “How long has this been going on for?” “About 3 weeks.” Yes, we thought it, too. “If this has been going on for three weeks, why did you wait until 2AM today to decide to come to the emergency department?” “Well … it was worse.” “At 2:00 AM tonight?” “Yeah. Usually it feels like a chipmunk running around inside there. It will scamper around a little bit, then it will stop. Then it will scamper around a little bit more, then stop. I was trying to get my mom to feel it tonight and it wasn’t moving, but then it felt like it had hiccups or something. I couldn’t sleep.” One of the pregnant nurses and I gave each other quizzical looks out of the corners of our eyes. Then the secretary came in and handed us the results for the normal urinalysis and the negative pregnancy test. The pregnant nurse and I gave each other another quizzical look out of the corners of our eyes. “No other problems? No diarrhea? No discharge? No pain?” “No. Nothing. Just something moving. I really need to know what it is.” The patient was rather thin. Her exam was normal. Since she was so thin, it was easy to feel that there were no masses in her stomach. Nothing. “Wait! There. Do you feel it? Feel it hiccuping right there?” She grabbed my hand and held it firmly to the middle of her stomach. “You mean that regular pulsing down deep?” “Yeah! THAT! What is it?!?” “Tell me something, can you feel the same pulsing in your neck?” At that point, the pregnant nurse standing behind me blurted out “Thank GOD! I thought I was crazy! Every time my baby moves, I feel a pulsing in my neck, too. I had no idea what it was and was too embarrassed to ask. So what is it?” “She’s not pregnant, remember?” Then both of them in unison ask “So what’s causing the pulsing?” “Her pulse maybe? Here, check your wrist and see if the pulsing is going at the same rate as the movement in your stomach.” It was. “The biggest blood vessel in your body runs right down the middle where you are feeling the movement. You’re supposed to be able to feel pulsations there.” We all got a good chuckle. After the patient went home, we all sat around the nursing station telling baby stories. While she was talking, one of the nurses started rhythmically contracting her stomach … about 60 times per minute. Everyone else joined in unison shortly thereafter. The pregnant nurse turned red. “Hey, it’s my first baby. Cut me some slack.” Everyone just kept talking and rhythmically contracting. “I’m wrapping up his poopy diapers and mailing them to all of you.” “As long as you don’t bring him in for hiccups, I’ll be fine,” I said. “You’re going to be the first one for a poop bomb, WhiteCoat.” ...Read More »