Thursday, August 30, 2012

I'm So Dizzy, My Head is Spinning

A 63 year old man walked in with dizziness.  Dizziness is always so vague; it is a gateway symptom to something else that's going on usually.  In this guy's case, there was also a bunch of other stuff, including leg swelling for months, and oh, yeah, this numbness in my face.  He hemmed and hawed and thought out loud about each and every question which just makes triage so much more difficult.

Dizzy Guy was accompanied by a female friend; close friend from the looks of it and the way she tried to answer every question.  Or contradict every response he made.  Or point out another symptom.  Or correct a time frame.  Or rat out yet another symptom.  Or embellish and speculate on every triage question.

Me:  Are you diabetic?

Dizzy Guy: Well, I haven't seen my doctor in about a year, so I could be...

Dizzy Girlfriend: He has to be...

Me: To be clear, you have never been diagnosed with diabetes or pre-diabetes and are taking no medication?

Dizzy Guy: Um, no, but sometimes my blood pressure is up.  I have some back pain, and I.....

Dizzy Girlfriend: He has been under a lot of stress at work; I want you to write that down.

Dizzy Guy: I'm FINE.  I'm NOT having a heart attack.

Dizzy Girlfriend: I want them to know everything and you don't tell them everything....

Dizzy Guy: I have been having some leg swelling, but I think I've been walking around a lot..

Dizzy Girlfriend: I think he's been trying to cover up the fact that he's been short of breath when he walks

Dizzy Guy: Not really, it was hot yesterday and I was...

Dizzy Girlfriend: Yes, I really think he was!  And he didn't eat as much as he usually does, and...

Me: Time out!  Let me just talk to Dizzy Guy for a minute, mmmmkay?

Dizzy Girlfriend: OK, I'll shut up.  Did he tell you about these little dots on his legs?  And why does it look like they are 2 different colors...

Me: Why don't you have a seat over there for a minute?

Dizzy Guy: She will drive you nuts.

Dizzy Girlfriend: I'm just looking out for you

This exchange was rapid-fire, neither one could focus.  And they kept interrupting each other AND me.  I became frustrated being unable to get a word in edgewise so I kinda lost it.

Me: OK, nobody talk but me, then I want the Reader's Digest abridged version unless I ask.  Got it?

Things deteriorated when the doc told them Dizzy Guy might be having a TIA.

Dizzy Girlfriend: (yelling into the phone) He could be having a TSA!  He has to go for a CAT scan!
Dizzy Guy: Is she driving you crazy yet?

Me: (banging head against desk) TIA!  TIA!  TIA!  TSA is at the airport!
Partner in crime: Well, at least they won't need the complimentary strip search.

I pulled a 7th grade Vocabulary Workshop word out of my a** and pronounced them garrulous.

As he was wheeled away, the paramedics offered him a blanket.

Dizzy Guy: Well, I don't know, I could.  I really don't need it, but I suppose I could take one and....
Me: Just take it!  It's a blanket, not an investment decision!

They were nice people, but exhausting.