February 2012
77 posts
6 tags
TSK: The Power of Negative Thinking
Cranquis: Well that strip of painful redness and blisters on your chest and back is shingles, ma'am.
60-something female patient: IT IS? HALLELUJAH!
Cranquis: Uh, ok -- I have to know, what did you ~think~ it was, that you feel shingles is a better option?
Patient: I thought it was breast cancer!
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Transcriptionist FAIL 8: I guess the infection is...
What I said: “Assessment: Symptoms consistent with a viral infection.”
What the transcription says: “Assessment: Symptoms consistent with a rival infection.”
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Facebook Page Weekly-Theme Winner: "Shadowing your...
withwhatwehave submitted:
Hey Dr. Cranquis,
I’m a pre-med student really interested in pediatric medicine, especially pediatric gastroenterology. I know I won’t need to choose a specialty until after medical school, but I’ve grown up with Crohn’s Disease so am fairly certain peds gastro is the path I want to pursue. I’ve been accepted as a summer intern in a...
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A little shingles humor
madladyrandom submitted:
Today I was pondering the wide variety of unpleasant sensations I’m experiencing in my right arm due to shingles. Not too surprising, since the reactivated varicella-zoster virus is actually messing around in my neurons. Then it struck me—having shingles really gets on my nerves! Ha!
For some reason, thinking up a terrible medical pun reminded me of...
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“Can you please tell all your fellow students something for me? Tell them to look...”
– My grandmother.
Sounds like common sense, but a lot of people fail on this. Your patients can’t follow your advice if they never heard it to begin with.
(via wayfaringmd)
Related to this, a neat trick I learned somewhere: if your patient is hard of hearing, but doesn’t have hearing aids...
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TSK: Dead eyes with a blank stare, and me with my...
Cranquis: So the nurse said you are feeling really angry at your parents?
30-something female Army veteran with multiple psych issues: YES THEY MAKE ME SO MAD THAT MY HEAD WANTS TO IMPLODE. I COULD SHOOT MY DAD IN THE BRAINPAN AND I WOULDN'T EVEN CARE.
Cranquis: Do you have any firearms available to you?
Patient: NO BUT I'M ARMY TRAINED, I COULD KILL MY MOM WITH A PENCIL THROUGH THE EYE SOCKET. I'M A DANGEROUS BITCH.
Cranquis: I think maybe you need to return to the psych hospital that you were in a couple weeks ago, don't you?
Patient: OH YEAH, I NEED A VACATION FROM THIS CRAP. PLEASE CALL THE COPS TO COME GET ME.
Cranquis: I'm on it!
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blargh
The Horrible: Worst. Shift. Ever. (Number of patients, critical nature of multiple situations, still seeing patients 2 hours after the front desk closed, mountain of charts to dictate). More details later.
The Tolerable: The Girl Scout cookies I ordered from the secretary a month ago just arrived. YUM, LEMONADES(tm)…!
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18 Patient Identifiers HIPAA Defines as Off Limits... →
ermedicine:
dorasnursing:
The Nerdy Nurse blogging about HIPAA.
Things to avoid if you blog about medicine.
Can I Blog About My Patients?
“You can absolutely blog about specific patient encounters, but you have a duty to be respectful of the patients privacy. They allowed you to participate in their care and they deserve the utmost respect from that. However, if telling a story can...
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“Could we speed this up? I have a soda in the car and it’s getting warm!”
– 5-year-old boy, impatient because I was taking “too long” to talk with his mom about his cough.
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You win some, you hate some.
Today was a day for unusual events of varying enjoyability.
First, Mrs. Cranquis and I celebrated Valentine’s Day (a few days late — long story) by going on a date… to a video and game arcade. We haven’t played skeeball, Dance Dance Revolution, and random “shoot the bad guys” games in years. It was ridiculously fun.
Then, I spent 45 minutes on the...
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TSK: Passive-Aggressiveness can go both ways
Dear Mr. Obviously Annoyed Guy,
I am sorry you had to wait an hour to see me today in Urgent Care. I’m sure your symptoms of “cough, sinus headache, and sore throat” contributed to your irritated attitude — although, since you had an appointment to see your primary physician yesterday, and you “no-showed” it, I don’t know if you really have a...
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Fast Lane Reply: "Non-Compliant Grandpa with COPD"
First, I would like to give you a little background:
My grandfather was diagnosed with Chronic Obstructive Pulmonary Disease about 5 years ago. He is a very bad patient. His doctor told him that he can never recover from the disease. (My grandfather also suffers from selective hearing and thus did not hear the part about slowing the progress by taking medications.) He refuses to take...
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TSK: Tasting the Technicolor Rainbow
Cranquis: Well, since you've been vomiting all food and liquids since this morning, Ralph, I'm going to have my nurse give you some Zofran and then we'll have you try some liquids in a little while.
Ralph (30-something male patient): Oh, I have Zofran at home.
Cranquis: Oh! So you're still vomiting, even after taking Zofran?
Ralph: No, I didn't take any Zofran yet.
Cranquis: Um... why not?
Ralph: I thought it might interfere with something.
Cranquis: Oh yes, it ~would~ have interfered -- with your ~VOMITING!~
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Cranquistador Hive Mind: Help a med-student...
malgosh submitted:
Opinion needed! As a physician, your patient suspects that their immune system may be suppressed; what laboratory/serological testing would you order? Aside from CBC, sed rate, electrophoresis, flow cytometry, measuring levels of Ig in serum. Let’s get creative :) Something quick, easy, and wouldn’t cost an arm and a leg.
So malgosh and I were chatting...
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Medically-Correct Nursery Rhymes: Ring Around the...
“Ring around the Rosie,
Pockets full of Posies,
Ashes, Ashes, we all fall down!”
WELL…
(Could refer to Black Death,
Prob’ly not about that,
I says, I says, let’s all calm down!)
SO INSTEAD…
“Ringworm on your toesies,
Pimples on your nosesies,
Rashes, Rashes, they’re all around!”
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Anatomy Quiz: Is it a real eponym, or not? →
I scored 23 out of 30. How did YOU do?
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“In the sick room, ten cents’ worth of human understanding equals ten dollars’...”
– Martn H. Fischer, physician and author (via klbyrd)
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TIME article: "Googling symptoms helps patients... →
But to debate whether patients should or should not Google their symptoms (which a surprising number of doctors seem to enjoy engaging in) is an absurd exercise. Patients already are doing it, it is now a fact of normal patient behavior, and it will only increase as Internet technology becomes ever more ubiquitous. The average Joe has more health information at his fingertips — both credible and...
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TSK: "Sugar and Spice, and also some Ramen...
Cranquis: Ok, mom, any questions about little Carmen's strep throat?
Mom: No, doctor.
5-year-old Carmen *raising hand politely*: Yes, I have a question. Can I have ramen noodles when I get home? Because my mommy says that they're nice and soft and it won't hurt so much.
Cranquis: Absolutely, Carmen! Ramen noodles are great when you have a sore throat. In fact, I think they're great ~any~ time!
Carmen: Me too. *pause, as if thinking, and then* You're nice, doctor.
Cranquis *caught off guard in a pleasant way*: Oh, uh, so are you, Carmen! Enjoy your noodles!
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TIME article: "When the Patient is a Googler" →
There’s so much information (as well as misinformation) in medicine — and, yes, a lot of it can be Googled — that one major responsibility of an expert is to know what to ignore.
Great article about an orthopedist’s over-informed patient, and the way that doctors have to adjust their communication styles for “Googlers”.
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Med School Interview Tips -- FROM THE DAWN OF...
So, I was cleaning out some old emails from one of my old email accounts (oh, Hotmail, remember when you were so cool?), and I came across a list of med school interview tips which I wrote over 10 years ago, for a buddy who was in charge of my alma mater’s Pre Med Club. Thought you guys might like to see what kind of advice Dr. Cranquis was giving to pre med students, back before he was...
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: A Little Piece of Happiness: Therapy Dogs →
chroniccurve:
Puppy Appreciation Post: There are few things that calm me or make me feel better when my pain exceeds the point of toleration. My dog sensing my pain and distracting me is one of them.
Meet Baylee. We rescued her when I was 13 and fell in love with those sad brown eyes. Right now, she…
ChronicCurve explains just how much a pet dog has helped her to survive through...
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TSK: Paparazzi Patient
Well, THIS was a new experience for me.
So, there’s this Mom that brings her toddler son to the Urgent Care pretty often. The poor boy probably has asthma (too young to diagnose, but always wheezing, + strong family history of asthma and allergies) and is always in my UC for “coughing and wheezing”. What makes things complicated is that the Mom and Dad are divorced, and even...
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Weekly "Guess the Theme" contest at the Official... →
Don’t forget, the first person to correctly guess the Theme of the Week gets a Fast Lane Cranquis Mail: submit a question even though the Inbox is closed, and it gets jumped to the start of the queue for reply!
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Medically-Correct Nursery Rhymes: Little Jack...
Little Jack Horner sat in a corner,
purposefully isolating himself due to a complex set of mental conditions including childhood schizophrenia and an autism spectrum disorder,
and eating a Christmas pie.
He stuck in his thumb and pulled out a plum,
thus contaminating said pie with a gastrointestinal virus which ruined Christmas for the rest of the family later,
and said, “What a good...
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New Diet Plan
wayfaringmd:
Patient: Ooh, have I lost any weight since last time? I’m on a new diet!
Me: Really, what have you been eating?
Patient: Bacon.
Me: *holding in laugh* Well, let me check your weight…. No ma’am, actually, you’ve gained 3 pounds.
At that point I just wanted to say,
*guffaw!*
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Behind the Medic: Sometimes even I groan at my own...
Cranquis' PA: Hey did you see the typo on the chief complaint for the patient that just signed in?
Cranquis: No.
PA *reading from computer screen*: Right-side abdominal pain pain.
Cranquis: Wow! He must be doubled over.
PA: *punches self in face to escape the pain of that terrible joke*
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TSK: Recipe for "Doctor a la Cranquis, in a White...
Ingredients:
1 20-something female with mildest case of acne ever
1 extremely-busy shift with wait-times averaging 45 minutes
Directions:
Wake up with a single spot of acne on your face
Realize that you ran out of your acne medications a year ago
Call your dermatologist’s office, and find out that they won’t refill your meds anymore without a visit because you haven’t...
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Medically-Correct Nursery Rhymes: Jack Be Nimble
Jack be nimble,
Jack be quick,
Jack jump over the candlestick.
Jack have impulse-control disorder with pyromanic features,
Jack hyperactive and not consider consequences,
Jack get a combination of 2nd and 3rd degree burns when his baggy knickerbockers burst into flames, and spend 6 weeks in tertiary-level burn ward.
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Medically-Correct Nursery Rhymes: Hey Diddle...
“Hey diddle diddle, the cat and the fiddle,
The cow jumped over the moon!
The little dog laughed to see such a sport,
And the dish ran away with the spoon!”
Nurse, we’re going to need more haloperidol over here, STAT.
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TSK: That's gonna suck.
Cranquis *looking in 5-year-old girl's ear*: Uh-oh, looks like Lacy has an ear infection, mom.
Mom: Oh no! She's never had one before!
Cranquis: Well, these things happen. But she'll be ok.
Mom: But I don't understand, I even breast-fed her until she was 2. Isn't that supposed to help prevent ear infections?
Cranquis: Yes, while the child is still breast-feeding...
Mom: So maybe I should start breast-feeding her again?
Cranquis: Uh... that's up to you, I guess? And her? And your hormones? But let's talk about antibiotics now.
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Sci fi medicine?
menacinghowl submitted:
Have you heard or read about Dr David Loftus’ NASA biocapsule? Search it up. That thing is insane.
WOW. So cool! At first I thought it was just a glorified “implanted medical-data recording chip” — but it dispenses medications as needed. And is cheap to produce. And could be used for many MANY different medical conditions. Heck yeah SCIENCE.
...
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TSK: Feel my pain... FEEL IT!!
Cranquis' P.A.: Can you describe the pain in your leg, sir?
30-something muscle-bound facial-tattooed leather-pants-wearing male patient: YEAH IT'S LIKE, IF YOU TAKE YOUR KNUCKLES AND JUST START DRAGGING THEM UP AND DOWN YOUR THIGH, OVER AND OVER, YOU KNOW?
PA: Ok, so the muscles feel tight or cramped?
Patient *starts grinding knuckles into his own legs*: NO IT'S LIKE THIS! IT FEELS LIKE THAT! YOU DO IT, YOU'LL SEE WHAT I MEAN!
PA: Ok, I think I understand.
Patient *still grinding*: NO, DO IT TO YOURSELF SO YOU CAN FEEL WHAT I'M FEELING!
PA: I'm not going to do that, sir.
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(Living with a Family Member with) Cancer
zoradomain submitted (2 months ago! Oops, sorry for the late reply!):
So, i’ve had a rought time trying to submit to your ask box. This is something I have wanted to know about for a while, however, now i realize it as not much of a question as it once was.
I guess I’ll kind of introduce myself, Im julie and I’m only eighteen but my mom was diagnosed with breast cancer this...
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TSK: You might be a JERKY FATHER if...
If you bring in your needle-phobic 16-year-old son to the Urgent Care for “stomach aches for 4 months”, and then proceed to say the following phrases:
“I don’t care if you think it’s heartburn, doctor, I demand that you do blood tests on him today.”
“Son, all I know is that getting blood drawn hurts like a bitch.”
“Hey nurse, are you a...
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“Ok, I need to have some stickers now.”
– A 7-year-old female patient, after patiently enduring a series of swab tests (throat swab for strep, nasopharyngeal swab x 2 for influenza and pertussis). She got a handful of stickers.
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Yay, I Won the Theme Contest!
30somethingcrisis submitted:
I missed the open Cranquis-Mail inbox the last go-around, so I’m glad I won!
I have a question regarding being a living kidney donor. Someone I know is currently on dialysis awaiting a kidney transplant. I do not know thatI am compatible, and before I would even broach the subject with them, I would want to know if it would even be medically advisable for me...
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Medically-Correct Nursery Rhymes: Little Miss...
Little Miss Muffet sat on a tuffet,
Eating high-fat-content dairy products.
Along came a spider and sat down beside her,
And frightened Miss Muffet away.
However, her poor dietary choices had made her large and cumbersome,
So she was too slow to escape getting bit upon one meaty thigh by the spider,
Which turned out, unfortunately, to be a Brown Recluse.
This resulted in a rapidly-enlarging...
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Gamer Dies Playing League Of Legends In Gaming... →
videogamenostalgia:
A 23 year old Taiwanese gamer, Chen Rong-yu, died while playing an extended run in the game League of Legends at a local Taiwanese gaming center in New Taipei. Thirty gamers surrounding him did not notice he was dead until 9 hours later. His body was positioned upright with his hands motionless on his keyboard.
This is a starking reminder than staying still for any...
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TSK: Where in the room is Sally Sandiego?
Cranquis *entering exam room*: Hello, is this Sally's room?
Mom: Yes, this is Sally.
Nervous 3-year-old Sally: No, it's not! *whispers loudly to her mom* Tell him I'm not Sally!
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Dr. Trix in "All I Kneed is You"
Dr. Trix: So what brings you in today?
Kid: I have a new bump on my knee and knee pain.
Dr. Trix: Have you had any injuries to your knee?
Kid and Mom: No.
Dr. Trix: So what was going on the first time you started having knee pain?
Kid: I fell on my knee in football practice.
Dr. Trix: Hey, do you hear that?
Kid: What?
Dr. Trix: The sound of crickets chirping...