So, it's 2am. The "bat phone" rings and my coworker picks it up. The ambulance operator on the other end says we've got a 45 yr old male with stable vital signs coming in with.............testicles that have been swollen for a month... Okay, look. Sure, it's not normal when your testicles are swelling. That's a given. But how in the hell do you just up and decide at 2 in the morning that you've just had enough. Not only have you had enough of the swelling, but you're so fed up that you don't even want to drive yourself (or let someone else drive you) to the ER. You just HAVE to call for an ambulance.
There was no pain, no sudden intensifying of the symptoms, no nothing. He just up and decided that he wanted to go waste our damn time. All we did was end up referring him to a urologist, which he could have done himself. Doesn't matter anyway. He won't go to the urologist cuz that would involve having to PAY for the care given. Why do that when he can get a full work-up and exam for free if he comes to the ER? And while he's at it, why not get the actual ride to the ER taken care of as well? Let's call an ambulance and waste their time, too! Yay!
Monday, November 29, 2010
Wednesday, November 24, 2010
A New Definition of Sex
Oh buddy. Sometimes I just can't believe it when it happens. And sometimes I just laugh until I can believe that it happened. Guy brings his girlfriend to us and says that she has been really pale for the last day or so and "isn't really feeling herself." After a history and physical have been obtained, I ask about her allergies, the meds she's on at home, recent surgeries, anyone else close to her who has been ill lately, etc.
Looking at the girl, yeah, she had that "look" that tells you they're really really sick. Not just the usual crap that clogs the ER like the sniffles and hangnails. Then I ask her when the last time she's had a BM was...she says that she is constantly pooping b/c she has a colostomy that it is coming out of, which had been put in after some major issues with her large intestine that led to much of it being removed.
"Aha!" is what I'm thinking. Now I'm getting somewhere (apparently she didn't consider this a "surgery" b/c it wasn't mentioned when I asked her about recent surgeries.). So, if this was a recent procedure then I'm probably on to a post-surgical complication. But alas, she had had the colostomy in place for a year and a half, so much of my guesswork was shot down. So, I asked to look at it. When I did, I knew that it was the source of the problem. It was as if the stoma had been pushed inside of itself, and it was inflammed with a bit of pus-like drainage around the rim.
When I query her about the condition that her colostomy is in, she says, "Oh, it always looks that way for a while after we have sex." I ask for clarification... "Well, it always ends up pushed in like that and is sometimes very raw after he is finished." OMG! Apparently, she has been letting her boyfriend have sex with the stoma/hole of her colostomy!!! The pus-like drainage I saw...well, let's just say it actually wasn't pus, it was some donated material from him. Ick! Why do people do this shit?!
It turned out to be a very good thing that she had come in b/c she had a massive infection along with a pretty good sized bleed from his, um, appendage poking around in there. Sheesh.
Looking at the girl, yeah, she had that "look" that tells you they're really really sick. Not just the usual crap that clogs the ER like the sniffles and hangnails. Then I ask her when the last time she's had a BM was...she says that she is constantly pooping b/c she has a colostomy that it is coming out of, which had been put in after some major issues with her large intestine that led to much of it being removed.
"Aha!" is what I'm thinking. Now I'm getting somewhere (apparently she didn't consider this a "surgery" b/c it wasn't mentioned when I asked her about recent surgeries.). So, if this was a recent procedure then I'm probably on to a post-surgical complication. But alas, she had had the colostomy in place for a year and a half, so much of my guesswork was shot down. So, I asked to look at it. When I did, I knew that it was the source of the problem. It was as if the stoma had been pushed inside of itself, and it was inflammed with a bit of pus-like drainage around the rim.
When I query her about the condition that her colostomy is in, she says, "Oh, it always looks that way for a while after we have sex." I ask for clarification... "Well, it always ends up pushed in like that and is sometimes very raw after he is finished." OMG! Apparently, she has been letting her boyfriend have sex with the stoma/hole of her colostomy!!! The pus-like drainage I saw...well, let's just say it actually wasn't pus, it was some donated material from him. Ick! Why do people do this shit?!
It turned out to be a very good thing that she had come in b/c she had a massive infection along with a pretty good sized bleed from his, um, appendage poking around in there. Sheesh.
I Missed Out
I was thinking the other day that I really missed out on some totally free healthcare when I was a bit younger and poorer. There's a problem with healthcare in general, and it needs a major overhaul I agree, but I just don't have the time or energy anymore to try to fix everything that's screwed up in this world. When I had just gotten married, we were fairly poor as most younger married folks tend to start out. We had no insurance like most of the population, too. However, I can remember going to the ER only once in those 5 years without insurance. I apparently had a kidney stone, and it was pretty bad. I got the bill a month later...$1300 for fluids, pain meds, and preventative antibiotics. *Sigh* I was crushed. Not only were we already poor, but now we owed $1300. But, we paid it off over the course of one year. Little did I know that I could have just refused to pay it and got off scot free. It's frickin ridiculous the stupid crap people come crawling into the ER with. And they have no insurance and no intention of ever paying one cent for the care they receive. Now, I understand that there really are cases of folks who downright really can't pay. But you can't tell me that the lady who brings her toddler to the ER for a runny nose is utilizing our services properly. Especially since she's visited us 35 times this year for similar complaints (mild headache, stuffy nose, zit on chin, etc.) It's stupid. They know what they're doing. They don't give a shit, though. They just keep coming back and wasting time and resources, which then drives the price of healthcare up even further.
Why does an aspirin given to you in the hospital cost $35? Because of the dirt-lickin' idiot down the hall who came in for "toe pain." A full workup later, and there's nothing wrong, but they want their pain medicine, and they want it quickly. They don't care if someone else just got brought in by ambulance who can't breathe or who's heart has stopped beating. They want their candy and they want it now (and for free.) And then there's the stupid moronic people who call an ambulance to pick them up for a minor cough b/c they know that if they come in by ambulance, that they will get to go straight back and not wait in line. They really need to change the law that says we can't turn anyone away. We should be able to screen folks and say, "Sorry, but you're just an idiot with a hangnail trying to get some free medical care that you could do for yourself at home. Goodbye."
One man actually went on and on telling me about how he keeps coming back every week b/c of his particular ailment, and then he had the nerve to say, "And all y'all do is give me a shot of pain medicine and send me home." Uh, duh. We're here for emergencies, not primary care. We stabilize you, not fix you. Our job is to stabilize you to a point to where you can either last through the illness or make it to your primary care doctor. From there, your dr should be able to devise a course of treatment for your problem and follow your progress. But like I said, I missed out on loads of free health care. I can't count the times when I stayed home for a day due to sickness and just slept and took Nyquil when I could've just gone to the ER and gotten some free drugs and wasted time. Oh, what times I could have had...
Why does an aspirin given to you in the hospital cost $35? Because of the dirt-lickin' idiot down the hall who came in for "toe pain." A full workup later, and there's nothing wrong, but they want their pain medicine, and they want it quickly. They don't care if someone else just got brought in by ambulance who can't breathe or who's heart has stopped beating. They want their candy and they want it now (and for free.) And then there's the stupid moronic people who call an ambulance to pick them up for a minor cough b/c they know that if they come in by ambulance, that they will get to go straight back and not wait in line. They really need to change the law that says we can't turn anyone away. We should be able to screen folks and say, "Sorry, but you're just an idiot with a hangnail trying to get some free medical care that you could do for yourself at home. Goodbye."
One man actually went on and on telling me about how he keeps coming back every week b/c of his particular ailment, and then he had the nerve to say, "And all y'all do is give me a shot of pain medicine and send me home." Uh, duh. We're here for emergencies, not primary care. We stabilize you, not fix you. Our job is to stabilize you to a point to where you can either last through the illness or make it to your primary care doctor. From there, your dr should be able to devise a course of treatment for your problem and follow your progress. But like I said, I missed out on loads of free health care. I can't count the times when I stayed home for a day due to sickness and just slept and took Nyquil when I could've just gone to the ER and gotten some free drugs and wasted time. Oh, what times I could have had...
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