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Archive for the ‘Neurology’ Category

Caller is wondering about her symptoms, phoned in with head stuffiness and vertigo:

ME: Are you having any other neurological symptoms other than dizziness…such as numbness, weakness – especially one side of the body, trouble seeing in one or both eyes, trouble speaking, confusion – trouble understanding simple statements, problems with balance or coordination or seizures?

Caller: Well, I am yawning.

ME: That’s not on the list….. (to myself) but I’ll put you down for “trouble understanding simple statements…….”

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Headache

CALLER  *just* got back from MD, had taken child for c/o  headache:

CALLER: my 8 year-old daughter has a headache – it’s really bad.

ME: Worse than when she saw the MD?

CALLER: no….

ME: have you given her anything for it?

CALLER: No. 

ME: Did the doctor tell you that you could give something for the headache?

CALLER: Yes – he said to give advil.

ME:  But you haven’t given it because…….???

CALLER: …Because it’s a bad headache….

ME: But that is why the doc said to give the advil….then if it doesn’t work –  call back…..

(common sense goes a long way)

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Trying to figure out how bad the headache is, I ask a simple question that requires only ONE number:

ME: How bad is your headache, on a scale of ZERO to TEN, Ten being the worst pain you can imagine.

CALLER: I have a high threshold for pain…..

ME: It’s a scale that is subjective – it’s how YOU perceive pain…so – what number do you give it?

CALLER: Well, it’s not THAT bad…..

ME: can you give it a number?

CALLER:It’s only on the one side….

ME: But HOW bad is it?

CALLER: I have had it since this am

ME: I want to know HOW BAD IT IS…can you tell me? Just give me a number…

CALLER: Well, I wouldn’t take anything for it….

ME: So it’s a MILD HEADACHE then you would say…?

CALLER: It’s bad enough……

ME: (in my head) FML

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Caller phones, trying to clarify Rx instructions:

CALLER (clearly upset and frustrated): Hi, I saw my MD today and he told me I have vertigo.

ME: ok….and?

CALLER: He gave me a printout of instructions….

ME: uh huh……

CALLER: ….and he gave me an Rx for it and he didn’t tell how to take it. (angry)

ME: what does the bottle say?

CALLER: “take 3 times a day”

ME: so ….  you take it three times a day.

CALLER: but WHEN??

ME: …three times a day – just space them so when you take them it’s approximately the same distance apart.

CALLER: ….but WHEN??

ME: what do you mean when?

CALLER: IT DOESN’T TELL ME WHEN TO START THEM.

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Young caller with a slight 1/10 headache phoning about his concern:

CALLER: I just got out of the hot-tub and my VEINS ARE STICKING OUT!!!

ME: And….?

CALLER: sticking waaaaaaaaaaaaay out!!!!

ME: Any other symptoms?

CALLER: I am trying to tell you – my veins are sticking out!~!!!!

ME: You just got out of the hot tub! They SHOULD be sticking out.

CALLER: But I have never seen them do that before!!!!!

ME: Believe me, they probably HAVE done that before – you just didn’t NOTICE.  How do you think we get good veins on people we try to start IV’s on??

CALLER: You put them in a hot tub??????

ME: NO – we use MOIST HEAT.    Have you tried Tylenol or ibuprofen for your headache?

CALLER: No – I wanted to see if there was a problem with my veins first, I didn’t want to hide any symptoms that might be IMPORTANT…..

ME: I see…………………………………..

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40 year old male who is dizzy and weak after passing out:

CALLER: I still feel very dizzy and I can’t stand up….

ME (after in-depth questioning) Perhaps you should call 911

CALLER: Nah….I think I will just go back to bed

ME: I thought you were calling for advice?

CALLER: I did. I just wanted to see what you thought.  Now I know…..I’ll just sleep it off……

*click*  (he hung up on me)

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