1. A very sweet-natured 15-yr-old blond basketball player who came in with a sore throat, swollen anterior cervical lymphadenopathy, fatigue, and an erythematous maculopapular rash: positive for mono! Sadly, there is no medication for this viral infection, and she will have to refrain from contact sports for 6 to 8 weeks to decrease the risk of her spleen rupturing.
2. A woman who slipped on ice and hurt her R middle finger: her distal interphalangeal joint (the joint closest to the fingernail), will not flex at all. She has a flexor tendon injury & needs to see a hand surgeon for tendon repair before the damage becomes permanent. This is also known as a "jersey finger" because the injury is commonly seen in football, when players grab the jersey of an opponent who wrenches away from them, causing hyperextension of the fingers.
3. A family of 4 children who literally have dirt in their ears: their mother wanted to make sure they didn't have ear infections. My nurse tells me the family is very impoverished, and they live up in the mountains with no running water or electricity.
4. An elderly lady who fell on an outstretched hand and broke her triquetrum (one of the tiny bones of the wrist): she somehow ended up with an enormously heavy short arm cast and came in to complain that her arm was hurting more since the cast was applied. I removed her cast and replaced it with a dainty, more lady-like wrist splint to keep her wrist immobilized for another couple of weeks.
5. Strangers who ask for candy: And by candy, I mean anything in the DEA Schedule II Controlled Substances group, which consists mainly of narcotic pain medications. I am alarmed by the sheer volume of patients requesting opiates and consuming them nonchalantly like candy.
Acutely fractured ribs: definitely painful enough to need opiates like vicodin or percocet
Fractured ribs 7 weeks ago: should have healed by now
Depression: emotional pain does not resolve with opiates
I'm allergic to advil, tylenol, aleve, gabapentin, toradol and tramadol: spoken like a true narcotic seeker
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