Sunday, September 20, 2009

Shoulder Pain


Shoulder pain is a very common chief complaint in the emergency department. It's also a pretty easy work up and disposition. This case was no different, but the story behind it was classic....

So the patient was a 30 something year old male. He complained of bilateral shoulder pain. Further history revealed that it had been worsening for 2 years. When I asked him if he had any clue what could be causing the pain....he had a pretty good reason:

"Well doc, ya see it's like this. I like to go down on my girl friend. I spend a lot of time down there. I mean like 4 to 5 hours at a time. When I'm down there, I have my hands stretched above my head to play with her nipples. I think all that time with my arms up messes up my shoulders. I don't think all the meth helps either."

It was one of the only times in my short career my jaw dropped during an interview. Totally caught me off guard. I discharged him with a prescription for some NSAIDs and advised he takes breaks while he's "down there."

After his classic quote, I noticed he had really bad teeth. I wonder if it was from the meth or from.....

-ER Doc
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10 comments:

  1. nai naiSeptember 20, 2009 at 11:04 PM

    oh boy... we're learning therapeutic communication in my nursing courses, and i've obviously haven't been paying attention because i wouldn't know what to say in that situation.

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  2. DreamingTreeSeptember 21, 2009 at 4:52 AM

    nai nai -- silence is often therapeutic. ;-)

    My favorite part: "I don't think all the meth helps either." Ya think it's a problem? What a mess.

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  3. The Lonely MidwifeSeptember 21, 2009 at 5:14 AM

    And I can only imagine what SHE will be showing up complaining of---

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  4. Doctor DSeptember 21, 2009 at 5:35 AM

    "4 to 5 hours at a time"

    Impressive, and a little disturbing.

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  5. AnonymousSeptember 21, 2009 at 8:15 AM

    wow.....I'd settle for four to five MINUTES (but I'll take a pass on the meth, I think)

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  6. AtYourCervixSeptember 21, 2009 at 11:24 AM

    ewwwwww ick ick ick

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  7. BangBangMedicSeptember 21, 2009 at 3:12 PM

    I don't even want to think about the personal hygene issues involving a couple of meth-heads....

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  8. LizSeptember 21, 2009 at 6:49 PM

    "4 to 5 hours"? Seriously? That's unimaginable.....if it takes that long, he's either very bad at it or very good....eeewwwwww.

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  9. Milk Chocolate MidwifeSeptember 22, 2009 at 9:19 AM

    Hahahahahahahaaa!!!!! Too funny! I wouldn't have known what to say either. 4 to 5 hrs? I think the meth is screwing with his sense of time.

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  10. Dr. RuthSeptember 23, 2009 at 7:56 AM

    You know how men exaggerate numbers "honey believe me it's six inches", yeah right. So 4-5 hour, I will take that with a large grain of salt, so to speak. Ewwwwwww

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