Chimney Time

Good morning. I hope you all enjoyed the quotes from yesterday, with all the crazies coming in recently it was rather difficult to pick which ones to feature. That said, I’ll try to keep up the Quote Boat tradition, at least until July. Speaking of, as of July 1st, I’ll be returning to residency, so the vibe of the blog might change a little. Although I’m planning to still see disability patients for a little extra cheddar, I’ll begin introducing a lot more OB/GYN related stories and insights – so stick around, a little change will do you good.

Yesterday was a rather frustrating day. Being a taxonomist at heart, I always try and break down the claimants into groups and subgroups of conditions – for what reason, I don’t know, I think it just satisfies a small part of me that’s a little OCD. Anyway, there were a good number of “self inflictors” yesterday; people who decide to hurt their bodies, be that by drug use, overeating or whatever, and then when their body fails on them, attempt to receive Disability to help continue their habit. The second patient of the day was one such claimant.
She was a tall, thin, leathery lady who walked into the office, midriff showing and carrying a Coach purse. She sat in the waiting room while I reviewed her chart, and I noticed that while she was waiting, she took a couple of calls on her iPhone. Not your usual claimant, at least by economic terms, but whatever. Anyway, I called her back, and she handed me a list of what was wrong with her. Lovely. For your viewing pleasure, here is the list.
1.) Chronic obstructive pulmonary disease
2.) COPD
3.) Angina
4.) Chest pain
5.) Emphysema
6.) Chronic back pain
7.) Pain in back

Pretty impressive, right? I mean, it’s not like there are repeated conditions on that list or anything…Anyway, after talking for a little bit, it turns out that she only has chest pain (otherwise known as angina) if she starts coughing too much, and if she keeps coughing, she’ll eventually develop pain in her back from bending over. Makes sense…but here’s the kicker. She was diagnosed 10 years prior with COPD, and told at that time if she wanted to live to see her 60th birthday, she needed to quit smoking her pack of cigarettes a day. I asked her if she still smoked and she responded yes, “Two packs a day.” Ok, so not only did she not quit smoking, she decided to smoke more! I asked her, “Why did you decide to smoke more if your lungs were so bad then?” She responded, “Oh, I figured that doctor didn’t know what he was talking about, but I guess he did.” Yep, he did. We moved on to the physical exam, and her lungs were atrocious, it’s amazing any air was moving through those brochi at all. When I asked her to “take a deep breath,” she immediately burst into a coughing fit, and proceeded to cough up a huge amount of junk. I handed her a Kleenex, she spit it out and showed the resultant lung butter to me, of course, saying “this is what causes me to hurt so bad.” I mumbled something, and tried to purge that image from my mind. For some reason, phlegm really bothers me…I can deal with other excretions, no problem. But lung junk, no thank you. She left the office, and I guess as a treat, left the Kleenex for me to clean up. Thank you very much.

I know I harp on smoking a lot on this blog, I know, but it see people in here every day that can’t breathe because they’ve been puffing on cigarettes all their lives. I could go into the same diatribe about over eating, drug use or tanning – the moral of the story is the same. Your bad habits can really hurt your body. Most of us, however, know that what we’re doing is not good – it might feel good at the time, but we know in the long run it’ll catch up with us. Live and let live, right? This lady stands out in my mind, however, because she not only kept smoking, but increased her pack per day intake. Well, I guess tobacco executive’s kids have to go to college, too, and if she does get disability, it’s not like she’ll be around much longer to receive her checks.

And now for the disability quote of the day:

Man: “It’s like there’s a party in my head, and everyone’s invited – Mike Tyson, Russell Simmons, Andre 3000 – but they sent me out to buy beer.”

Claimants written response to the question, “Why did you stop working?”
“I flashed too many people and got fired.”

Until tomorrow,
-DD