“Doc, he’s been having some problems at home with his wife for the past few months. Took up drinking and now he’s been tipping the bottle on a daily basis.”
Wasn’t exactly what we wanted to hear for a patient having chest pain.
The patient’s story was concerning for heart disease and he had several cardiac risk factors, so after his initial labs came back normal (and after we excluded pancreatitis), he got admitted to telemetry for further evaluation.
But it wasn’t quite that simple. When the floor nurses heard that he was a daily drinker for the past few months, they refused to accept the patient. Didn’t want him going into DTs on the floor, ya know. So he got put onto the DT pathway and sent to the stepdown unit. His initial CIWA score was elevated, so he got his first dose of Ativan in the emergency department.
“What’s that for?” he asked.
The nurse explained “It’s a pill that keeps your body from having alcohol withdrawal symptoms. It has effects on the brain similar to alcohol, but allows us to slowly lower the dose to keep you from having shakes or even seizures.”
“Ah. I get it. A six pack in a pill, huh? I may need to get me some more of these.”
“I’m sure you will, sir. I’m sure you will.”