Cyndi Lauper came to see me 3 times this week. Okay, not the real Cyndi Lauper, but a patient who bears an eerie resemblance to the 1980s "Girls Just Wanna Have Fun" chanteuse. She was the most unreliable historian ever.
Visit 1: After complaining about a 3-week history of diarrhea with fecal incontinence, then getting lightheaded and requiring infusion of IV fluids, she mentioned on her way out the door that she has been taking miralax (a moderately strong laxative) every day. An abdominal x-ray confirmed that her colon is holding a very large amount of stool [yes, faux Cyndi Lauper, you are full of crap]
Visit 2: The next day, she returned to the clinic insisting that she needed antibiotics for strep throat. Really, Cyndi Lauper? Her rapid strep test was negative, she had no tonsillar swelling or exudates, she was afebrile and well over the typical age range of 3 to 14 yrs for strep throat. I usually order a rapid strep test only for patients with a modified Centor score of 2-3, but people in this town seem to think that all pharyngitis is strep, and they fear strep throat like it's the Bubonic plague.
Visit 3: The patient popped up on my schedule, proclaiming, "I broke my ankle!" She had been rushing to get to the bathroom when she tripped on a throw rug, "and now my ankle is really floppy". As I tried to examine her for ligament and tendon stability, she kept making her ankle flop like a fish that was caught on a hook and struggling to get free. Finally, I gave up and ordered an ankle x-ray which was, of course, completely normal. At least she didn't start crooning "True Colors" or "Time After Time", for which I am extremely grateful.
1 comment:
Tonasket, don't mess with Dr. Chan! She has spent half of her career on a quality improvement brigade to employ the Centor criteria!
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