Saturday, January 30, 2010


Too old to do what? That is the question....

I see A LOT of very elderly patients. Most come from nursing homes, which is always challenging. I see many elderly patients who are very active. They are probably the most fun patients. They have a great outlook on life and are usually very humorous.

Fist patient to tell you about was a 71 year old female who came in for arm pain. She had an obvious forearm deformity. The X Rays were already taken before I saw her. She had a broken arm. "Ma'am, how did you injure your arm," I said. With a very straight face looking me straight in the eyes she replied, "I punched my granddaughter in the head." I immediately thought oh shit! I pictured having to call CPS and Adult Protective Services, getting this lady a geriatric eval for dementia, and all kinds of painful stuff. But then I asked her how old the girl was....thank god she was 18. And apparently, she deserved to be hit. I put her in a splint, and she said she was done boxing.

Second patient was a 71 year old male veteran. He came in for chest pain, and only because his PCP made him come in. He was convinced he was "healthy as a horse" and didn't need to be there. Chest pain questions are pretty routine. We always ask about alcohol, smoking, and drugs. Sometimes I feel bad asking seniors about I am disrespecting them. For this gentleman: Smoking...NO. Alcohol...NO. Drugs...Not cocaine anymore, but marijuana...Yes. Ecstasy....Yes! I was obviously taken back. He said, "I probably got a bad blunt that made my chest hurt. I was around in the 60s and 70s, and it was second nature to use back then. Never felt the need to stop. Is that a problem, Doc?" He was admitted for his heart attack.

-ER Doc


Anonymous said...

Ha, they should tell these stories to medical students when they learn to interview patients! As an intern (my first month!), I once admitted a 81 year old man for renal failure and heart to everything except his DAILY crack cocaine use. Keep in mind, Caucasian upper middle class midwestern medium-sized town. His suppliers were his grandkids. We actually UTox'ed him because my attending didn't believe me.

I now ask EVERYONE about their drug use.

StorytellERdoc said...

LOL...funny post. Keeps us on our toes, this crazy job of ours. Well done.

Mary Jane said...

Are we just seeing the tip of the iceberg here, so to speak?

The baby boomers are retiring and with the higher rate of drug use than the preceeding generations I predict we're going to be seeing more of these cases.
Working age probably tempered their use of recreational drugs because of employer testing, but now that they are retired, who or waht's going to stop them?

RehabNurse said...

Yes, Doc, I work for Uncle Sam and we hear this stuff all the time.

The sweet lil' old characters are usually the pot smokers, especially if they did time in 'Nam.

It helps their spasms/nausea/fill in blank.

I learned to not be surprised right away.

Generic Wiseass said...

Tell him to start smoking joints, those tobacco blunt wrappers are bad for you.:D