Monday, November 13, 2017

THC

I've been hearing more and more lately about THC.

A friend of mine is on chronic pain meds and has started taking a mix of THC and cannabis to relieve pain, and has found it significantly cuts back on his narcotic use.  And the formulation with minimal THC doesn't really even get you high at all.

In a time when opioid abuse is at epidemic levels and death from overdose is out of control, I don't understand why we can't explore THC/cannabis as a serious treatment for chronic pain.  Yet right now, insurance won't pay for medical marijuana and they won't even pay for visits to doctors who are prescribing it.

Although this is talking from the perspective of being in a place where recreational use is not legal.  Maybe in states where recreational use is legal, it's more acceptable to use this as a treatment?

Thursday, November 2, 2017

Creepy Halloween Guy

So the other night, I was trick or treating with my kids and a friend of my daughter.  When we got to one of the houses, which was lavishly decorated for the holiday, a man opened the door holding his phone.

"Before I give you candy," the man said to the kids, "can I take your picture?"

So he took a photo of my kids while I waited on the curb, feeling extremely uncomfortable about the whole thing.  Then they took candy from him and left.

Later, the mom of my daughter's friend whispered to me that man always takes photos of the trick or treaters, and she finds it really creepy, but never says anything.  My husband said he wanted to tell the guy not to do it, but it all happened so fast and the kids were already running ahead to the next house.

I still don't know what to make of the whole thing.  Doesn't the guy realize how creepy it is that he's taking photos of random kids?  But then again, they're all wearing masks or costumes... it's not like they were in bathing suits.  But somehow it just seems like someone should tell him to STOP. 

I'm glad I don't live in that guy's neighborhood.

Friday, October 27, 2017

George HW Bush

I have to say, I'm irritated by the accusations coming out against George H. W. Bush that he groped women while posing for photos.

It's great that women are more comfortable going public with their sexual assault allegations against rich and powerful men.  That's a major step for women. 

It's different with Bush though. 

First of all, he's 93 years old.  He suffers from vascular Parkinson's and is on medications for that.  The chances that he doesn't suffer from at least some degree of dementia are slim.  He's probably sexually disinhibited.  I see patients like that all the time, and yes, they do sexually inappropriate things sometimes. Lucky for them though, it doesn't land them in the newspaper to be humiliated in front of the whole country.

I really don't think Bush would make a David Cop-a-feel joke if he were all there.  The proof is that even with all these women coming forward about the photo op harassment, nobody has made any accusations about non-demented Bush from years ago.  Now would be a perfect time to do it, but nobody has.  Which makes me think this is new behavior from his dementia.

Is it right that Bush grabbed those women?  No.  Do they have a right to come forward?  Yes, absolutely.  Is it Bush's fault this happened? I don't think so.  Is it somebody's fault?  Yes. Somebody around him who was aware of this behavior should have warned the women or not put him in a situation where this was likely to happen.  I mean, at least if the women were warned, they could be prepared and know it's not meant in a predatory way. 

I guess my point is I feel there's something wrong with tarnishing Bush's reputation because of things he does while demented. Hate him for Desert Storm, don't hate him for this. The finger-pointing should at least be directed at the right people.

Monday, October 23, 2017

Medical slang

From a discharge summary: "Patient went to the ER with sinusitis, and was treated and street'd."

Aside from the fact that I've never used or heard anyone actually use the term "treated and street'd" in real life... honestly, is that really the language you want in a medical document

Not that this is the equivalent, but I was reading a story about a doctor who had entered “TTFO" (this apparently means "told to f*ck off") on a patient’s chart. When he was asked about it later, the practitioner said that the initials stood for “to take fluids orally."

Tuesday, October 17, 2017

Proposal

Me: "Do you have any other questions for me?"

Patient: "Yes. Will you marry me?"

Me: [laughs]

Patient: "I'm sorry.  I put you in an awkward position.  You don't want to marry me, but you don't want to upset me by saying no."

Me: "I'm already married."

It would have been a lot more flattering if the patient weren't ninety years old.  And mostly blind. 

Still, it's nice to know I have options!





Tuesday, October 10, 2017

Food boredom

I am officially bored of everything I cook.

Worse, my family is bored of it.  I've started bringing home food for my daughter from the hospital cafeteria because she was so bored of everything I made for her.  You know things are bad when the hospital cafeteria is a treat.

Any easy meal ideas?  I have about 20 minutes to make dinner before I turn into a pumpkin.  (Seriously though, I don't cook anything that takes much longer than 20 minutes.)

Monday, October 2, 2017

Antibiotic overuse

I went to med school in a place where Lyme disease was endemic.  So when I was on my Medicine rotation and one of my co-students complained about feeling tired and achy for a few days, our attending immediately said to him, "Get tested for Lyme disease."

The student was reluctant.  He didn't have a rash.  Our student health plan was crappy with a huge deductible, so he would have had to pay for the test out of pocket.  Also, I pointed out (from a personal Lyme scare) that he could get a false negative this early on.

"Well, if you don't want to get the test," the attending said, "I'll write you a prescription for doxycycline and you can just treat it."

And then we saw another attending, who totally agreed with this.

Even years later, I still find this offensive.  The course of treatment for Lyme is 10-21 days of antibiotics.  Would you really give someone up to THREE WEEKS of antibiotics because they were tired and achy a few days?  I took doxycycline and it made me throw up... not something I'd personally be excited to take for weeks for no reason.  And... hello, antibiotic resistance?

I'd like to believe that the attendings were just overtreating because it was a colleague and not something they recommend to all their patients.

Friday, September 22, 2017

Goodbye, Cyndi Lauper

When I first started practicing, any time a patient would have brain surgery, the surgeon would inevitably shave half their head to do the surgery.

I found this practice ridiculous.  The patient would come out of the surgery looking like Cyndi Lauper at her worst.  I have never witnessed anyone who looked good with half their head shaved. (Including Cyndi.)  I always felt like it then fell to us to deal with the remaining hair.

More recently, the trend has changed.  Instead of shaving the whole head, the surgeon will just shave a teeny area at the incision site.  So instead of rocking Cyndi Lauper, the patient looks pretty normal post-surgery.

From a perspective of compassion for people's vanity, I think this is awesome.  I love it.  It's bad enough you have to have brain surgery without losing all your hair and changing your entire appearance.  So I'm glad about this change.

But from the perspective of the doc who has to monitor these incisions, it's so.  Annoying.  Half the time, I have to do a search for several minutes to find the damn incision.  If it started looking worse, it would be really hard to tell.  And digging staples out that are caked in both dried blood and hair is not a fun task.  Shouldn't we put patient safety above hair?

I'm really torn on it, honestly.

Thursday, September 14, 2017

What day is it?

Me: "What is today's date?"

Patient: "Well, it's the day after yesterday!"

I'm going to have to remember that one for when I'm old and confused.

Thursday, September 7, 2017

The Pediatrician's Dilemma

A friend of mine who is a pediatrician told me the following story.

He has a patient who is a little girl with some chronic medical issues.  The girl's mother had some legitimate issues with the nursing care that the girl was receiving while hospitalized as an inpatient.  Although this was not the pediatrician's fault, the mother apparently laid into him, screaming at him publicly for a good five minutes.

Of course, the girl is still hospitalized and he's the pediatrician on the inpatient service right now.  So now he has this awkward situation with the patient's mom.  He said that if this girl had been one of his clinic patients and he'd been treated that way, he would have requested she find a new doctor.  But since the girl is hospitalized and probably will be for another week or so, he's stuck.

"I just have to suck it up," he told me.

That's a rough situation though.  Even though the mom screamed at him, she didn't fire him so he's still allowed to see her daughter.  Is there really no alternative to treating a person whose family was verbally abusive to you?