Friday, April 07, 2006

I had this pain....

When newFNP has a pain that self-resolves, she is thankful and happily moves on with her life. That is not the case, however, for many of newFNP's patients. I cannot begin to tell you the frequency with which I hear of bygone aches and pains, now entirely resolved.

So you say that your back hurt 3 months ago? Interesting.

What's that? You had a headache last year, just once and then it went away? Well, aren't you a medical miracle.

Pardon me? What caused that pain you experienced last July? NewFNP must confess, she'd be hard pressed to say.

Lest anyone think that newFNP is an asshole, she does in fact inquire as to whether there are any other health concerns that might have brought the patient to the clinic. Most frequently, the answer is no. Sometimes, however, there is another chief complaint.

One such example is my mid-30's male patient who segued from resolved pain to constipation. Ah, poop. Now there is something you can really assess and sink your teeth into during the history-taking!

For instance, when was your last BM? Today.

I see. And how often do you have a BM? Every day. Twice a day.

This is the point during which newFNP questions her Spanish skills. Twice a day? Constipation? Something is not adding up!

OK, well, twice a day falls well into the range of normal...

At this point, newFNP's patient won the Brown Star Award when he disclosed his normal bowel pattern of three movements per day. Maybe the day after Thanksgiving, but every single day?!?

As newFNP sees it, Mr. Poopie has just saved himself an estimated roll or two of TP per month, not to mention an estimated 30-45 minutes per week away from the throne.

Perhaps he could devote that saved time into an extra workout!

1 comment:

Anonymous said...

i work in a fqch too and i'd imagine my patient population is similar to yours. i get a single complaint of fever a lot. no other aches, pains, symptoms and the fever is usually tactile, not measured. when i measure it the temp is usually hovering around 98.

it's amazing to me that some folks will come in for what seem like little issues but the kid with the bad asthma exacerbation who i sent home only because his sats were up and he ws loaded with steroids and his mother PROMISED to bring him in the next day for a recheck won't come in despite my calling to check in. where did he end up? in patient.... ugh.