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Archive for the ‘Cardiovascular’ Category

65 year old female, hx: Fibromyalgia, depression, headaches and IBS phones:

Caller: My vein is sticking out!!!!

Me: What? Where?

Caller: You know (me: no I don’t, but anyway) right here on my arm? Do I need to go to Emergency???

Me: Where on your arm?

Caller: Right at my elbow on the inside.

Me: That’s called your antecubital fossa.  That vein is supposed to stick out.  In fact, sometimes  when we need to use it for drawing blood or start an IV if desperate –  we actually put warmth on it to make it stick out.

Caller: But – I’ve never seen that happen before…!!!!!!!!

Me: It’s normal.   Don’t go to Emergency, whatever you do.  They won’t appreciate it.

Caller: But……..

Me: Believe me.

*sigh*

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Caller has crushing chest pain, going down arm and into jaw:

CALLER: what should I do?

ME: Call 911

CALLER: oh, I don’t want to do that!

ME: Then have someone DRIVE you to ED …although 911 would be the wisest and safest choice.

CALLER: I think I’ll walk over to the Doc-in-a-box nearby……”

(yup, I am totally convinced they will be REAL  happy to see him there….)

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Phonecall from healthy woman age 44, no health issues:

CALLER: My chest hurts when pressing on it. What is wrong? Could it be something in my surface veins blocking up?

ME: Let me ask you a few questions – and by the way – I don’t diagnose, I am not a MD.   Do you have pain as in pressure or a tight feeling in your chest, crushing squeezing, going into your back or jaw, either shoulder or arm??

CALLER: NO

ME: Any shortness of breath?

CALLER: NO

ME: Pain with breathing? or Swelling and warmth in a calf?

CALLER: NO

ME: How bad is the pain?

CALLER: 3/10.  When I press on my chest I feel pain. When I don’t – there’s no pain.

ME: I know – you already told me. Any other symptoms?

CALLER: NO.  Do you think it’s my blood vessels in my chest that is blocking – one just under the skin?

ME: Any redness, swelling, anything at all?

CALLER: NO.

ME: Uh, no……

CALLER: What do you think it is????????

ME: I am not an MD, but I would say – quit pressing on your chest……………….

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Elderly lady with Chest pain radiating to jaw, SOB, dizzy with nausea, on the phone –  with daughter listening in on another line, just told to call 911 (never mind there is an automated disclaimer for those with chest pain to hang up and call 911 when the phone first connects) but tells me she is opting to drive to ER despite recommendation because, hey – it’s a free world and it’s cheaper – and besides, daughter probably has O2 and all the resuscitation equipment in her car that she bought real cheap from Amazon that she can use whilst also driving her mother in:

Daughter pipes in: “I have one question first – long-ish pause for effect – mom has a dry mouth. Do you think that this has something to do with what’s going on?”

Me: “ummm……thunk-thunk-thunk***……. I think that her dry mouth is the least of your problems at the moment……..”

***Me banging my head on the desk

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