Hospital Rounds:
88 year old man with seizures from a collection of blood in his head after he fell. Also has prostate cancer.
84 year old man with advanced Alzheimer's dementia (used to be a hell of a guy) in the hospital with a bleeding ulcer after his wife gave him an Advil for his sore knees.
An exercise treadmill (Stress Test) on a 44 year old woman with chest pain.
Office:
New diagnosis of prostate cancer in 56 year old man
New diagnosis of prostate cancer in a 57 year old man with an artificial valve (his mother was a Christian Scientist and didn't treat his strep throat as a kid so he melted his aortic valve with rheumatic fever)
Removal of a basal cell cancer from the neck of a 62 year old woman
Discuss the pros and cons of Lipitor with a lovely gentleman who just retired here. Doc back home just started him on the med.
Inject a frozen shoulder on a 79 year old woman who had a stroke last year and now has to lean on her walker.
Removal of a gnarly lesion off the scalp of a 52 year old male. Looks suspicious for squamous cell cancer.
Three month check up of a 63 year old male, 290 pounds, with borderline adult diabetes, and 12 months out from 3 vessel bypass surgery. He also has emphysema. He lost 10 pounds since last visit.....
Examined a 92 year old woman's knee. She is unable to stand on it, 3 years after a total knee replacement. Came on suddenly.
Family conference with a woman and her 2 daughters about the husband/father who has dementia. Getting impossible to care for him at home. Questions about nursing homes, end of life care, and the ethics of discontinuing his medical care.
Interviewed by a couple whose current doctor only allows them 15 minutes and "1 problem" per visit. Wanted to know if I could "put up with them".
73 year old male, basically healthy with treated high blood pressure with sudden onset pain above and around his left eye. No blurred vision. Negative fundoscopic exam. The question: MRI or not?
62 year old male with Gaucher's disease who presents with numbness and pain in his right shoulder. MRI shows severe spinal stenosis.
21 year old woman with 15 body piercings and 3 tatoos and bipolar disorder who stopped her medication because she thinks she's pregnant....
250 pound 44 year old male with bilateral conjunctivitis. He thinks he gets it from "sweating too much" while doing yard work.
Brown Tail Moth rash on 2 patients (rained here for 10 of the last 11 days so when the sun popped out briefly on Sunday everyone rushed out to do yard work and got hammered by the moths).
59 year old house painter, 30 pounds overweight, just read somewhere about "insulin resistance" and came in for a "diabetes" test. Did not want to talk about diets ("I have no time, you know" he said)
Removal of 45 stitches from the jaw of a man who drove his 18 wheeler into the back of a logging truck 2 weeks ago. Has a metal plate in his jaw. Has a slowly healing tracheostomy site in his neck and stomach (G) tube since he cannot swallow right now. Unclear to me how he is alive... All he wants is some ice cream
Showed a woman how to self inject insulin, how to take blood sugar readings. Had diet controlled diabetes for years that got rapidly worse in the past 3 months. Not overwieght, eats a healthy diet. (does many of the alterations at LL Beans if you are ever in town...)
That's most of them... in between patients answered questions from nursing home nurses about patient's problems. Covered a few OEX puts and argued with CC.
No real point here... just a day in the life...
