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

10 comments:

nai nai said...

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.

DreamingTree said...

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.

The Lonely Midwife said...

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

Doctor D said...

"4 to 5 hours at a time"

Impressive, and a little disturbing.

Anonymous said...

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

AtYourCervix said...

ewwwwww ick ick ick

BangBangMedic said...

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

Liz said...

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

Milk Chocolate Midwife said...

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.

Dr. Ruth said...

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