Paging Doctor Obvious

I know that your residents have told you in great detail that you must be careful around the nurses. They must be led to the right decisions and when you are not available, be given adequate, concise and precise instructions for the successful administration of medications and interventions to heal you patient. But really? Did you really need to write this order?

Hold lorazepam for respiratory depression or oversedation.

It’s not like we’re going to say, "Hmmm…Mrs. Smith is only breathing 11 times a minute and won’t stay awake for more than a brief moment, but she seems anxious. Maybe I she just needs a little more lorazepam…" Maybe some might though. But the vast majority of us do have the common sense not to do something as boneheaded as that, we don’t need it spelled out for us.

And also, taking 4 hours to write admit orders is just not kosher. Learn to speed it up a bit buddy.

Change is good. Kind of.

So what’s the answer?
Why I ask is that I’ve been looking through themes, and well, I’m a little tired of what I have.  I’m thinking about spicing it up, re-arranging the furniture and stuff.  But I want to know if it worth the time and effort.  The only time I end up on someone’s actual site is to leave a comment (and there are those I avoid at all costs – Happy, I’m looking at you – it was like a hyperactive chihuahua designed yours, but that’s something entirely different) or like Nurse K, who won’t seem to syndicate her entire feed (that would be so much nicer/easier…).

Just fill out the poll.

Thanks!

Chart Bloopers

It’s fun when doctors commit a gaffe in writing, but really, they’re only humans with a vast array of knowledge and learning at their disposal, and somehow cogent thoughts that the rest of us can understand don’t always come out. What’s more fun is when a non-medical medical person, in this case a case worker, does much of the same thing. Actual quote:

During this admission the patient was started on Plavix for treament of depression

I guess allowing greater blood flow to the head could make one less depressed…

It’s Hot

Hot with a capital "F". It was in the high 80’s on my way to work last evening, edging it’s way to 90. Sure I spent my time in the desert, so I’m not unfamiliar with heat. But this was killing me. Guess I’m not as used to it as I once was.

But there is something about the heat here in Oregon. First, it seems hotter than it really is. We’ve got nothing on humidity compared to such places as the Deep South, but it still gets humid. Second, everyone seems to get stupider. I know that it is shock from having to ditch our North Face parkas and stumble out into the bright sunlight, but c’mon. I encountered so many idiots on the roads, head in the clouds, not paying attention, that I lost count. Even the docs are in on it as well. Had one document that the patient had "insulin controlled hypertension." Third, it just isn’t us. I moved here and love it here because we stay away from the extremes. We are the definition of mild, and I like it that way. When the temps climb into the 90’s it just makes me (and everyone else around here) cranky.

I know though I’ll be missing this when I’m riding to work in the dark, in pouring rain, with a nasty crosswind in the middle of December. But hey, I’ve got to bitch about something. Right?

Dr. Wes: Prasugrel and Dronedarone: Rough Roads to Approval

Dr. Wes: Prasugrel and Dronedarone: Rough Roads to Approval.

Precisely when these drugs will be available to the general market is uncertain, but I suspect you’ll know when meals start showing up in cath labs and offices again.

Now that’s just plain funny right there!

These sound promising but with new drugs comes new costs and you know these ain’t going to be cheap.  Plavix already strains the budget of many cardiac patients as Sanofi Aventis/BMS managed to evade it going generic for some time now, so I can’t begin to imagine how a newer version is going to make things any easier on those folks.  One can hope that docs will weigh these issues when deciding which drug to put folks on, rather than going with the newest, most shiny toys on the market.

Funny Allergy

Found in a patient chart.

Allergy: Atropine sulfate
Reaction: Increased heart rate

Really? Isn’t that what it is supposed to do?

Talent and Dedication

Is what it takes to be massively non-compliant and end up in the ED with a blood glucose of 1038. And even better? Not even a hint of DKA. Yep, VBG looked beautiful, electrolytes were a little off, even the Beta-Hydroxybutyrate wasn’t even off. And had she taken any diabetic meds in the last 5 months? Not a single one.

See what I mean? Talent and dedication.

Still Alive and Kicking

Kind of.
 
Laptop is still dead.  Haven’t had the time to pull the old desktop out from storage in the dungeon, errr, basement.  But I have one for y’all to think over:
 

Why would you let an erection last for 6 days?

 
I mean really, don’t the Viagra commercials say that if it lasts for more than 4 hours you should seek medical attention?  So 6 days?  Wouldn’t it be dead by then?  Or at least so painful that just moving would be so excruciating that it was almost not worth it to continue?  Is pride really that big of a thing when your manhood is about to fall off?
 
So what would keep you out of the ED for 6 days while sporting said erection?
 
Posting will be sporadic still as the wife and I are going on vacation.  A true blue, not visiting family (although we might drop in on those where we’re going to say "Hi"), but having a good time, by ourselves vacation.  It’s something we haven’t done since our honeymoon nearly 7 years ago.  All the other vacations have been to visit family, scope out a place to move, or other obligations, not a kick back, drink umbrella drinks by the poolside, sleep until noon, no commitments type of vacation.  You could say I’m looking forward to it!

What’s Eating Our Kids? Fears About ‘Bad’ Foods – NYTimes.com

What’s Eating Our Kids? Fears About ‘Bad’ Foods – NYTimes.com

I’m all for trying to eat healthy.  Low fat, low sodium, easy on the processed food and trying to keep white sugar to a minimum.  I’m not exactly successful some days.  Others, not so bad.  It’s sad though when kids  get so fixated as displayed in the article.  On the flip side, my wife once took care of a child who would only eat chicken tenders and ramen, the complete opposite of healthy.

I think this quote sums up the article best though:

“It’s a tragedy that we’ve developed this moralistic, restrictive and unhappy relationship” with eating, she said. “I think it is making kids nutty, it’s sucking the life out of our relationship with food.”

Bon appetit!

Difficult Answers

Braden over at 20 out of 10 had a great meme, Answers to Life’s Difficult Questions, and being a sucker for a meme I had to partake. So here goes.

First the rules:

1. Put your media player on Shuff​le.
2. For each quest​ion,​ press​ the next butto​n to get your answe​r.
3. You must write​ down the name of the song no matte​r how silly​ it sound​s.
4. Put any comme​nts in brack​ets after​ the song name.
5. Tag at least​ 10 frien​ds.
6. Anyon​e tagge​d has to do the same,​ becau​se fun point​lessn​ess sprea​ds like a virus​.
7. Ignore rules 5 and 6.  They are dumb. (okay, I added that one)
8. Rule number 3 kinda sucks, too.  Instead, keep going until you find the first song title that makes an interesting answer (even if it isn’t accurate).
9. If you obey rule 8 then you don’t really need rule 4.  It is more fun if people can figure it out for themselves.
10. No random and pointless meme shall have less than 10 rules.

If someo​ne says,​ “Is this okay?​”​ You say?
Take a Joke America (Carlos Mencia)

How would​ you descr​ibe yours​elf?
I’m So Lonesome I Could Cry (Hank Williams, interpreted by Me First and the Gimme Gimmes)

What do you like in a ​girl?
I’m In Love With a German Film Star (Passions)

How do you feel today​?
Fuck the Kids (NOFX)

What is your life’​s purpose?
I Wanna Be Sedated (The Ramones)

What is your motto​?
No End In Sight (Mudhoney)

What do your frien​ds think​ of you?
Franco Un-American (NOFX)

What do you think​ of your paren​ts?
Comfortably Numb (Pink Floyd)

What do you think​ about​ very often​?
Pudding Time (Primus)

What is 2 + 2?
Woke Up This Morning (Nickelback)

What do you think​ of your best frien​d?
Patience (Guns N’ Roses)

What do you think​ of the perso​n you like?
Life is Sweet (Chemical Brothers)

What is your life story​?
You Don’t Know How It Feels (Tom Petty)

What do you want to be when you grow up?
Wandering Star (Portishead)

What do you think​ of when you see the perso​n you like?
I Can’t Help Myself (4 Tops)

What will you dance​ to at your weddi​ng?
Pale Green Stars (Everclear)

What will they play at your funer​al?
Gone Away (The Offspring)

What is your hobby​/​inter​est?
Sound is Vibration (Atmosphere)

What is your bigge​st fear?
Something’s Got to Give (The Beastie Boys

What is your bigge​st secre​t?
Bitch Please (Eminem)

What do you think​ of your frien​ds?
Wicked Sensitive Crew (Dropkick Murphys)

It’s funny, I almost hewed to the rule exclusively.  Maybe my taste in music does define me.  So now I know I supposed to tag people to participate, but I’m more of a free-will kind of person.  And since I appropriated this as well, consider yourself tagged.