Curbside Consult Thread

[The_Douger]

I significantly doubt it. I've trained plenty of PAs, NPs, Med Students, and Residents to know that you had absolutely no idea how to calculate a PPV and NPV.

You took the bait. It was fun to watch. Keep pissing on that little fire hydrant of yours.

[doctorcoug]

You took the bait.

That is a good excuse. You have the unfortunate problem of being a midlevel, which means your medical knowledge level is about 3 standard deviations below the mean of physicians. The onus is on you to show that you have a higher level of medical knowledge, which has yet to be displayed from your posts.

[San Juan Sun]

I'll admit it, I don't know the first thing about strep tests/swabs. And frankly, I find it boring. This little argument is amusing though.

[doctorcoug]

I'll admit it, I don't know the first thing about strep tests/swabs. And frankly, I find it boring. This little argument is amusing though.

I'll gladly do mental masturbation about stats over open lap due to peritonitis or diverticulitis. There are some smells that no earthly being should have to endure.

[San Juan Sun]

I'll gladly do mental masturbation about stats over open lap due to peritonitis or diverticulitis. There are some smells that no earthly being should have to endure.

Every OR has wintergreen oil that you can out in your mask. I never really have to worry about a smelly laparotomy.

Today I did:
Lap incisional hernia repair with mesh (transverse colon and omentum incarcerated - fun case

Lap cholecystectomy with cholangiogram

Mediport placement

Incision and drainage of a diabetic leg abscess

excision or forearm mass


- Done with everything at 2:30 pm and off to baseball practice.

Oh yeah, I also sent a kid to rehab that should be dead. He was thrown 150 feet out of a rolling car. He came in a and had fixed, dilated pupils in neurogenic shock. Neurosurgery did an emergency craniectomy for a huge subdural, while I operated concurrently and did a splenectomy and femoral artery repair. He was in such shock that he essentially would not make clot for 24 hours. I closed his abdomen 2 days later. Over the last 6 weeks we've done two thoracotomies (one wedge resection, one decortication), a trach, a PEG, a t-spine ORIF, and a removal of an infected bone flap on Christmas night. He is a paraplegic now, but he's alive, and talking, and has a productive life ahead of him after rehab. I'm amazed and delighted at where he's at now.

[doctorcoug]

Every OR has wintergreen oil that you can out in your mask. I never really have to worry about a smelly laparotomy.

Today I did:
Lap incisional hernia repair with mesh (transverse colon and omentum incarcerated - fun case

Lap cholecystectomy with cholangiogram

Mediport placement

Incision and drainage of a diabetic leg abscess

excision or forearm mass


- Done with everything at 2:30 pm and off to baseball practice.

Oh yeah, I also sent a kid to rehab that should be dead. He was thrown 150 feet out of a rolling car. He came in a and had fixed, dilated pupils in neurogenic shock. Neurosurgery did an emergency craniectomy for a huge subdural, while I operated concurrently and did a splenectomy and femoral artery repair. He was in such shock that he essentially would not make clot for 24 hours. I closed his abdomen 2 days later. Over the last 6 weeks we've done two thoracotomies (one wedge resection, one decortication), a trach, a PEG, a t-spine ORIF, and a removal of an infected bone flap on Christmas night. He is a paraplegic now, but he's alive, and talking, and has a productive life ahead of him after rehab. I'm amazed and delighted at where he's at now.

Sounds like you are living the dream.

Back in residency my attending was the medical director of a long-term neuro rehab facility. I saw my fair share of TBI and got plenty of experience managing AEDs. We had one guy that couldn't hear, so we had to write on a whiteboard all the admit questions. Problem is his reading sucked, too, which meant that admit took three hours.

Glad you are having fun. It sounds like you are seeing a wide variety of pathology, though I suspect down the road you will be happy to get rid of the trauma, unless you get paid by rvu instead of collection.

via a galaxy s3 far far away

[dabrockster]

First, thanks waup, I took some liquid antacids for instant relief and am also taking zantac (Generic) to resolve this for the long-term effect. I have had acid reflux in the past and it never felt like this before so I didn't think it was that. So your input was helpful.

As for what I have caused via my initial question.. Sorry guys..


I did want to give you more info. I had no signs of flu prior nor after Saturday (Fever, aches, pain etc). Just the sore throat. Prior to going to the ER, my throat had tons of white spots/mucus on it and when the ER looked at it he mentioned all the white puss/mucus excreting out of certain pockets etc. It was only waking up in the middle of the night with a severe case of aches, fever (Temp 102) that I thought I might have the flu..

If it was the flu, I am just grateful it only lasted one night.. It was a nasty fever with aches and chills..

[doctorcoug]

First, thanks waup, I took some liquid antacids for instant relief and am also taking zantac (Generic) to resolve this for the long-term effect. I have had acid reflux in the past and it never felt like this before so I didn't think it was that. So your input was helpful.

As for what I have caused via my initial question.. Sorry guys..


I did want to give you more info. I had no signs of flu prior nor after Saturday (Fever, aches, pain etc). Just the sore throat. Prior to going to the ER, my throat had tons of white spots/mucus on it and when the ER looked at it he mentioned all the white puss/mucus excreting out of certain pockets etc. It was only waking up in the middle of the night with a severe case of aches, fever (Temp 102) that I thought I might have the flu..

If it was the flu, I am just grateful it only lasted one night.. It was a nasty fever with aches and chills..

Not the flu.

via a galaxy s3 far far away

[falafel]

This thread has been enormously entertaining.

[ERCougar]

I really try to empathize with patients, try to understand them, figure out where they're coming from, etc.--even the dirtbags. But sometimes--often--I just fail.
My patient just joked that Monday is N***** Day and that he'll have to remember his white pointed hat.

WTF? What do you say to that? On what planet is that appropriate or funny?

[doctorcoug]

"Monday is N***** Day and that I'll have to remember my white pointed hat, and when is my morphine coming? "

" Sorry, it is on back order, but I need to do a rectal exam."

"no lube? "

" backorder, too"

FIFY


via a galaxy s3 far far away

[Joe Public]

I really try to empathize with patients, try to understand them, figure out where they're coming from, etc.--even the dirtbags. But sometimes--often--I just fail.
My patient just joked that Monday is N***** Day and that he'll have to remember his white pointed hat.

WTF? What do you say to that? On what planet is that appropriate or funny?

Wow.

[FN Phat]

I really try to empathize with patients, try to understand them, figure out where they're coming from, etc.--even the dirtbags. But sometimes--often--I just fail.
My patient just joked that Monday is N***** Day and that he'll have to remember his white pointed hat.

WTF? What do you say to that? On what planet is that appropriate or funny?

I bet he has an assault rifle!

[ERCougar]

I bet he has an assault rifle!

I don't think you want me asking him that. Just sayin--not going to help your cause.

[Pheidippides]

I really try to empathize with patients, try to understand them, figure out where they're coming from, etc.--even the dirtbags. But sometimes--often--I just fail.
My patient just joked that Monday is N***** Day and that he'll have to remember his white pointed hat.

WTF? What do you say to that? On what planet is that appropriate or funny?

What did you say to that? I presume it's a breach of medical ethics to punch him in the gonads?