Dr. Cranquis' Mumbled Gripes
(Disclaimer: Questions related to medical topics will be answered to the best of Dr. Cranquis' (and Google's) knowledge, but the internet-delivered wisdom on this blog CAN NOT AND SHOULD NOT SUBSTITUTE for your Real-Life Doctor's personal attention + examination, and your own common sense too! If you think you're having a medical emergency, hang up and go email 911. The author of this blog takes no responsibility for any medical, relationship, scholastic, financial, or other decisions you may make based on information found in this blog.)
It is a true test of the doctor’s Keep A Straight Face ability to discuss constipation, vaginal itching, and terms like “urethra” and “groin” with a parent in front of two giggling pre-teen girls.
- Cranquis: So when did your stomach start hurting, Jerry?
- 13-year-old Jerry *in a faked spooky voice*: Last night, while I was watching Alien! OoOOoooh!
- Cranquis *double-take*: Uh, what?
- Jerry and Father (and eventually Cranquis): laughing
Teenaged girl, in reply to my question “Have you had any vomiting recently?”
Her mother and I couldn’t stop giggling after she said this.
- Cranquis *entering room, vaguely recognizing teenaged female patient*: Hi, I'm Dr. Cranquis, I've seen you before haven't I?
- 16-year-old Jenny: Yes, I think so.
- Jenny's mom: Oh yes you definitely have, you treated her about 3 years ago, I remember you very well.
- Cranquis: Wow, after 3 years? Well, I hope that's because I gave you good service.
- Mom: No, I just remember your beautiful eyes.
- Jenny *mortified*: MOM!!!
- Cranquis: Soooo, Jenny, how can I help you today?
- Greatest ER Nurse in the Universe *watching teenaged boy walk calmly into the triage area*: So why did you come in to the ER today?
- Boy: I hurt my foot playing with my dog.
- Mother *hovering over him*: HE CAN'T EVEN WALK ON IT!
- GNU: So it is painful?
- Boy: Nah, it's all numb and stuff.
- Mother: NOW BE HONEST TONY, JUST BECAUSE IT'S NUMB DOESN'T MEAN IT DOESN'T HURT!
- GNU: I can tell we're all gonna have fun tonight.
- Cranquis: Well mom, based on the symptoms and physical exam, it appears very unlikely that Tonya has strep throat. So I wouldn't recommend doing a strep throat swab.
- 12-year-old Tonya: YES! YOU ARE THE BEST DOCTOR EVER!
- Mom: Now, Tonya, you know that if he thought you might have strep, he ~would~ have done the strep swab on you.
- Tonya: Oh yeah, I know, but that's what makes him a good doctor, cuz he doesn't make me do the test if it's not going to change anything about my treatment.
- Cranquis: I am quite stunned by your grasp of evidence-based medicine, Tonya. Wow!
…The amount of caffeine [the girl] drank in the two Monster energy drinks is about the same as that found in 14 cans of Coca Cola — and is almost five times the recommended caffeine limit from the American Academy of Pediatrics.
Apparently, if you happen to have Mitral Valve Prolapse (a usually-harmless condition, found in approximately 10% of the population), as this unlucky teenager did, it may only take 2 cans of Monster (consumed within 24 hour period) to kill you — as opposed to the “normal” prediction of 55+ cans, according to the Death by Caffeine calculator.
There is nothing healthy about energy drinks. Please people, just don’t drink ‘em.
- Cranquis: So Veronica, I understand you're having painful cramps with your periods?
- 14-year-old Veronica *staring fixedly at her phone*: uh... yeah.
- Mom: Oh good grief, let me tell the story, she's too embarrassed.
- Cranquis: No problem.
- Mom: Ok, so everytime she gets her monthlies, she gets bad cramps. At first, we thought it was just because she was so gassy --
- Veronica *embarrassed*: Mom!
- Mom: -- but even when she'd let out a big fart --
- Veronica *face bright red*: MOM!
- Mom: -- she'd still have the pains. So I told her to try pooping more often --
- Veronica *mortified*: Oh god mom just stop!
- Mom: Honey, the doctor needs to know these things.
- Cranquis: Yeah, I wish I didn't, but it's true.
So, Tiffany. You’re 16, female, and come to my Urgent Care for “burning when you pee” — but your urine test is completely clean.
Hmm. And I notice that you made your mom stay in the waiting-room, instead of coming in to the exam room with you.
Spider-sense TINGLING. So, let me ask you this: Are you sexually active? Wait. What do you mean, “Maybe”??
Allow me to clarify, Tiffany. Have you had sex? ”Yes.” Ok. (No, I’m not shocked by these teenaged “confessions”… not anymore).
So let’s try the next question on for size. Do you think you might have a sexually-transmitted infection?
“Yes, but I don’t know how I could’ve gotten an STD, because I’ve only had sex with one guy, my boyfriend of 2 months.” Ok, that’s nice and all, but has your boyfriend ever slept with anyone else before you? ”Well, just one girl a few weeks ago, but just one time, and he promised not to do it again.”
Oh dear. Listen, one more question, Tiffany, and I really REALLY hope your answer is Yes: Can I have your permission to discuss this with your mom? ”Yes”.
Whew. Sweet, let’s get mom in here and have a bit of a talk.
***Time passes; Tiffany and I have a discussion while Mom just sits there blank-faced; a pregnancy test is negative; and now it’s time for Ye Olde First Pelvic Exam***
First of all, Tiffany, I’m going to use a light to look at the skin outside of your vagina, checking for any rashes and…
Oh. Um, nurse, we’re going to need a viral PCR swab. Tiffany, how long have you had these clear tender fluid-filled blisters all around your pubic hair and vagina? ”2 weeks.” I see. We’re gonna be doing some testing for genital herpes. “WHAT? I thought those were just razor burns!”
Now THIS portion of the test uses a lighted speculum to look for discharge inside the vagina. And if my instincts are correct… yeah, we’ve got more than a little bit of discharge here.
You can get dressed now, Tiffany. When I come back, we’ll talk about the various medications that you need to start taking to treat the herpes and the pelvic infection. Oh, what’s that, Mom? You have a question? ”Well, I’m not comfortable with putting harmful medications into her body. Don’t you think she could just treat the rash with some fungal cream, and maybe eat some yogurt for the discharge, or something?”
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 newbie at drawing blood? Cuz my son’s freaking out.”
- “Wow, son, it’s a good thing you have your eyes closed, because she is taking a LOT of blood out of your arm.”
…then you are a JERK of a dad, and do not deserve any presents for Father’s Day. >:E
- Mother of 13-year-old female patient with stomach pain: Well, doc, was the pregnancy test positive?
- Cranquis: No, it wasn't.
- Mom: Well, THAT'S a surprise, the way she sleeps around with everyone in her school.
- Patient: *sits calmly, smiling*
- Cranquis: *picks up jaw from floor*
- Cranquis: Ok, let me try asking the same question in a different way -- Is there any part of your body that DOESN'T hurt today?
- 17-year-old female patient: NO EVERYTHING HURTS AND I'M JUST TIRED AND I FEEL LIKE S--- AND THIS SUCKS.
- Cranquis: Okey dokey. (Does physical exam, determines a sinus infection and bronchitis). I'll be putting you on some antibiotics and cough medicine, and I think you should stay home from school today and tomorrow.
- Patient: I WANT TO BE OFF ON THURSDAY TOO, SINCE IT'S JUST A HALF-DAY BEFORE CHRISTMAS BREAK AND I'M JUST TOO TIRED TO GET OUT OF BED.
- Cranquis: But of course. (A bit of paperwork and prescriptions, and the patient is discharged). Ok, I hope you get well soon, bye-bye.
- Patient: YEAH YEAH. (Patient goes into waiting area, starts yelling at her mom without realizing that I can totally still hear her) COME ON MOM, LET'S GO GET SOME TACO BELL!
- Cranquis: Ah, the satisfaction of curing the ill.
Fantastic! :)
SUICIDE
Hi there Dr. Cranquis c:
I’ve been meaning to send this for a long time, but well, yeah. Anyway.
Basically I’ve been feeling depressed for a good two years now and it really isn’t fun, I’ve attempted suicide, I’ve hurt myself, I’ve deliberately destroyed relationships with people in an attempt to ‘make their lives better’. I’ve been to a school therapist and my GP, however, it seems to have done nothing at all. I’ve had very few answers and more questions than when I started. I’ve attempted to explain that none of the therapy has worked to parents and doctors etc. however I seem to get the ‘you’re a hypochondriac’ look. I used to think it was tied to hormones/PMS however, it just seems to be a constant state of ‘I hate myself’. Sorry for wittering on so much, I was just wondering if you could make sense of any of this?
Thanks
Hi there. Well your symptoms do certainly sound like clinical depression — and if you’re to the point of actually attempting suicide and destroying personal relationships, I think you’d benefit from the help of an actual psychiatrist. School therapists can be useful, but are often under-trained to deal with these situations besides “referring to a doctor” or “advising to get help.” And if your GP isn’t willing to take you seriously, THEN YOU KICK THAT FELLOW TO THE CURB AND GET SOMEONE WHO WILL TAKE YOU SERIOUSLY.
Now, some of the symptoms/behaviors you describe could also fit with a Borderline Personality disorder — which just re-emphasizes your need for professional help from someone(s) trained in working with depressed, suicidal teenagers. (I assume you’re a teen, from your icon picture.) Borderline-personality people with depression are extremely tough to get into a proper treatment regimen, so you’d need an experienced therapist and psychiatrist managing your care.
Your emotional states might be worsened/enhanced by the hormonal changes of a menstrual cycle, but women with PMS don’t try to commit suicide. (They may, however, dabble in homicide, if they don’t get their chocolate bonbons on time… HEY-O! Sorry, couldn’t resist). :)
So please, ask your GP for a referral to a child/youth psychiatrist. You need more help than just a “reassuring” pat on the head. Good luck!
***Pending Cranquis-Mails: 4; InBox: Closed***
SELF HARM
What would you say, as a Christian man, as well as a doctor, to teenage girl who’s struggling with self harm? I keep relapsing. Worse and worse. I do have help, but i don’t know how to stop, and i’m drifting away from God. I’m so terribly confused. It’s like i don’t even realize what i’ve done until i’ve done it.
Dear Struggling Sea Horse —
As a doctor, here’s what I’d say to you:
- Define this “help” that you claim to have. If you’re just referring to a really-concerned friend, pastor/priest, parent, or teacher, that’s probably NOT going to be enough help for you. You need professional help: a counselor, therapist, psychiatrist, or other professional who has experience in dealing with people who self-harm and all the underlying psycho/emotional trauma that this behavior often signifies. You need to be working with someone who is aware that self-harm does not (necessarily) equal suicidality, but who will take it just as seriously. Depending on your “co-morbidities” (physical, emotional, and psychological issues which go hand-in-hand with this behavior), you may even need to be on medication (temporarily or longer?) to help stabilize your mind while you strive to return towards a non-cutting/self-harming lifestyle.
And as a Christian, here’s what I’d say to you:
- Everyone, Christian or otherwise, struggles with sin/temptation/bad habits/”things we do even though we know better”. This is just status quo, life-as-usual for us broken residents of this broken planet. What sets a Christian apart from a non-Christian is not projecting an external image of human perfection, but an internal awareness of imperfection and a desire to pursue after God’s perfection.
- You can’t drift far enough away from God that He will give up on you and stop pursuing you. It takes a tremendous amount of persistent, dedicated effort on the part of a human being in order push God out of your life. The very fact that you continue to struggle and feel torn about your situation means that you still feel God calling you. He will always call after you.
- What does being a “Christian” or a “friend of God” really mean to you? Have you truly developed a Best-Friends-Forever relationship with God — or is your Christianity just a ritual of church attendance, prayer time, having a monogrammed Bible, and trying not to let people hear you swear? All the ritual in the world won’t help you a bit when you find yourself struggling with temptation. You need to forge an alliance with God in order to achieve real change. Personal exploration of the Bible, reading books that help to outline the foundation of Christian living and belief, spending time around other people who have a real relationship with God — these are VERY IMPORTANT in your situation (or for ANYONE who is trying to make a change in his/her life).
- My father, a therapist, uses this example a lot when discussing the importance of involving God/spirituality in the process of making real change about any unwanted situation in your life: Imagine that you wanted to make a blended smoothie. You have a recipe book, you have all the ingredients, you have measuring cups and drinking glasses and straws, and you even shelled out for an awesome blender with tons of fancy attachments. Now you follow all the directions, fill the blender with the yummy stuff, and push the Frappe button —and nothing happens. Why not? Blender is unplugged. It’s not plugged into a power source. You have no influx of external energy to actuate the process that will turn your logical intentions into delicious outcomes. The blender can sit there, full of fruits, creams, ice etc. all day long, but no matter how much you mash the button, that smoothie will not materialize until you plug in the blender. I think the metaphor explains itself.
I’ve written a few posts before about Self Harm and about Spirituality. I strongly encourage you to get professional help in both the psychological and the spiritual fields as you deal with this. Good luck and God bless you, friend.
***Pending Cranquis-Mails: 2; InBox: Closed***
