No Left Turn

Since things are pretty busy right now, and yesterday's blog was rather heavy, I thought that tonight I'd just share an encounter from disability this AM. Social Security allots 30 minutes for the History and Physical, but as long as the patient doesn't talk too much, I can usually get everything done, including the paperwork, in around 20. Of the seven people scheduled this morning, three showed up. As you might imagine, this was rather frustrating since I get paid by the patient, not by the time I spend in the office. Sometimes, however, these massive gaps in the schedule can be nice, as they allow me catch up on my reading, chat on the phone or deal with really crazy patients who don't know how to stop talking, and proceed to tell me everything that has ever gone wrong with them and how that affects (or doesn't) their ability to work. My first patient this morning was one such yapper, and while I've seen some talkers this year, no one so far could hold a candle to this lady's ability to just talk and talk, often without any sense behind the words she was saying.

She walked into the exam room wearing a dark blue sweat suit, her nails painted bright yellow, and the bottom of her sweatpants tucked into what I assume were Ugg boots, although it's was difficult to tell since the boots were covered in Christmas garland. "Merry Christmas, doctor!" was the first thing out of her mouth (which contained two teeth, by the way). I responded in a similar fashion, and asked her to have a seat in the chair next to my desk. She walked across the room and sat on the exam table. Sigh. Then it began.
"So, what keeps you from working?" I asked.
"Well," she responded, "it's my back...pain, yep, pain in the back of my back, but that was probably caused from the seizures, which came from getting my head slammed in a door."
"...So your back pain keeps you from working, is that correct?" I asked, my mind reeling from what she had just said.
"Well yeah, but the seizures are pretty bad too. You know, I have seizures that cause me to shake! Have you ever heard of that? It's crazy...although I don't remember the seizures, I just assume I have them, since I black out, and when I wake up, I've peed on myself."
"...How often do you have these seizures?"
"Well anytime I'm in an ambulance, I can get them, especially if my blood sugar gets below 40. I was told I was a type II diabetic, and that means I have too much sugar, so I have to watch how much candy I eat, but that's ok, I'd rather not have a seizure."
"...About your back pain, you said that was caused by a seizure?"
"That's what did it, that and falling down during my job at Long John Silver’s. I loved that job, but they wouldn't let work after I almost fell into the fryer - boy, would that have sucked. Imagine that," she started waving her arms around. "Ah, the fries are burning me, death by fries - that could've made the news!"
As you might imagine, it was very hard not to just burst out laughing. I bit my tongue, however, and pressed onwards.
"Ok, so back to your back..."
"Let me ask you something," she interrupted. "Are you a medical doctor?"
"Yes I am," I replied (I get asked this question a lot more than you would think).
"Ok, because I've been wondering why I can't turn to the left after I have sex."
"You can't turn to the left after you have sex?" I was honestly perplexed.
"No, I'm like, 'boom, that's a wall' after I hit the wall, since I can only turn to the right."
"Well," I replied, "I have no idea. There's no physiologic reason why you shouldn't be able to turn left after sex, but let's get back to your back pain."
"Oh, ok." She hopped off the exam table. "I should also tell you that my back pain could be caused by my foot." She began to take the garland off the right boot. "You see, I was in the hospital for like...three months because I had an infection in my foot. I thought that someone had stabbed me in the foot, probably with a paring knife, by the looks of it, while I was sleeping. As it turns out, it was a spider bite!"

So far I had been able to write down almost everything she said. After that last comment, though, I just sat my pen down and let her talk. I believe that all in all, she talked for about 15 minutes straight - pretty impressive for a lady with two teeth. With the exception of a large scar on her foot, her physical exam was negative, and the exam concluded around 40 minutes after it started. Luckily, the patient scheduled to follow her no-showed, and I was able to finish everything and stay on schedule.  Sometimes having that extra time is nice, especially if you can laugh about what happened.

After that, do we really need a disability quote for the day?

Until next time,

-DD