Wednesday, August 4, 2010

Summer Stuff

It has been a hot month. Even here in the arctic tundra it has been over 100 degrees some days. It is so hot the face of the Old Man of the Mountain would have slid off by now, if it had not already done so.

I hate the heat, there is nothing about it I like unless I am floating in water with a frosty drink in my hand. Can't eat, can't sleep, have no energy to do anything. Plus I stick to my leather sofa.

Mary, my kayaking buddy won't even go paddling if the temperature is any higher than about 93 since she doesn't do well in the heat either. Now she is being treated for Lyme disease since she discovered that pesky bulls-eye rash after a couple of days of fever.

If you have pets, and they tend to be outdoors a lot, ticks are a part of life. If I have fallen behind with the tick treatment for Tina, I can pick 7 or 8 of them off at a sitting. Tina loves it when I check her for ticks...she gets the most marvelous massages.

So I really don't get why people come to the ER to get a tick removed...and we get a lot of them, sometimes 3 or 4 per night. And these are ticks that I could basically pull out on my own in triage...but I won't, now, will I? Everyone pretty much gets treated for Lyme anyway, just to make the visit worthwhile.

One young man was brought in by an aunt; I suspect he had some sort of developmental delay. He was spending the summer working in the area.

Auntie had just returned with her nephew from her PCP; he had diagnosed his rash as heat rash. While not a classic bulls eye rash, the aunt was unsatisfied, and insisted we test him for Lyme.

Sure, no problem; and based on some of his other symptoms, Lyme was not completely out in left field. We treated him for Lyme anyway, something the PCP had not done. Several days later, the test came back positive. The kid was already being treated and everyone was happy.

We also get a lot of 'spider bites', 'allergic reaction to bee stings', and bug bites in general.

One mother brought in a 2 year old with "hives"; turns out there were about 30 mosquito bites, the poor kid looked miserable. Discharge instructions included "keep child away from mosquitoes". Ri-i-i-ght.

A 17 year old was brought by EMS with allergic reaction to a hornet sting; hives, swelling, itchy mouth, and epinephrine administered prior to her arrival. THIS, people, is the kind of thing that you SHOULD call 911 for. We watched her for a couple of hours while we waited for a parent to arrive. Nice kid, beautiful girl. A pleasure to care for.

Once the hornet sting was squared away, we get a very "interesting" 18 year old girl who "passed out" (at least twice) while lying down in the car on the way back from the beach. Huh huh. Her boyfriend came racing into the ambulance bay door; I was on the phone with Kerry at the time who had forgotten to tell me something when she left. I hung up on her and never did get back to her. Anyway, boyfriend looked to be about 35; scruffy; tattooed, body pierced and about the same age as her father, who was equally scruffy in appearance.

The young lady walked into the ER, albeit leaning heavily on the boyfriend. She lay down on the stretcher and immediately closed her eyes and pretended to be unconscious; I really hate that. Please don't waste my time and make me dig my knuckle into your sternum. We kicked out the rest of the young lady's fan club, started an IV and drew the appropriate labs (as well as a pregnancy test), all of which were entirely normal, of course. She complained and moaned about the IV so much I pulled it out and handed her a glass of water and told her to drink; I had long since lost interest in this "interesting" patient.

It must have been the heat that caused the co-worker of an 18 year old to pick him up and hurl him into a wall; a metal edged dry-wall wall. He had a 4 inch gash on his scalp which was easily fixed with about 11 staples. Gil of course asked him if he wanted the police notified. He did not, in part because it was a misunderstanding. Also, he had gotten up after being tossed around like a bean bag and clocked his assailant, splitting his lip. Gil jinxed us by joking that we would probably get the split lip as a patient, which we did. He didn't offer much information about the incident.

Hot weather brings out the nut bags; 95 degree heat is sure to inspire individuals to go to the ER with maladies they have suffered from for, oh, say 2 years. Like swelling in the head that was diagnosed as an infected hair follicle. The long list of psychiatric meds should have been a tip-off.

Cathy was taking care of a patient with chest pain, left over from day shift. We were waiting for an in patient bed assignment; yeah, that's not such a quick process. The day shift reported that the lady was on 2 1/2 pages of meds (never a good sign), had fibromyalgia (yawn) and a "mystery illness" that nobody could figure out (read: crayzee woman with vague nonsensical symptoms). This was confirmed when Cathy took her temperature, and it was a shade under 98.6. "That is usually a sign that something is seriously wrong!", the woman exclaimed. Clearly, with a laundry list of medical issues and drugs, and the dreaded mystery illness, it should have come as no surprise that she would obsess over a non-issue such as that.

Cathy had some insight. "You know, I read an article that it is no longer politically correct to call anyone a hypochondriac; they are individuals with 'heightened symptom awareness'. I blame the Internet".

" I think that it is a lot of non-medical people thinking up stupid names for garden-variety crayzee", I observed.

Yeah, it's gonna be hot again tomorrow.