Proud members of the Vast Right Wing Conspiracy. We strongly believe in personal freedom, responsibility, and gun rights. We also believe in the 90/10 theory. That means that 10% of the people have 90% of the talent. Unfortunately, we are not in the 10% category. However, the rest of us are still better than 90% of the politicians.

Tuesday, August 27, 2013

Found in the H&Ps

Really busy at work this week.  Nonetheless, it's still fun to have the interns around.  There is always something interesting with them. Of course, our clientele is frequently classic (I definitely do not mean classy!) as well.

These were culled on the weekend;

patient states she thinks her "bladder has come out" after a coughing spell.

Admits to drinking liquor regularly in the past, but states that for the last past month he “ain’t  been drinking nothing but a pint of wine a day”.

Pt reports he does not know how many times he was shot.  He states he was just walking around outside and fell to the ground after being shot.  He denies being involved in an altercation and states he was just minding his business.

weakness related to the exercise of rest, dysphagia but he admitted having the hoarseness of the voice.

Patient denies any IV drug use.  He denies any recent surgeries.  Patients only recent trauma he states was about 3 weeks ago when he ran from a cop and lost his shoes causing bad cuts to the bottom of both his feet.

Reports he has stopped drinking but was drinking a 30pack within 2 hours. (I guess stopping for two hours counts)

presents with rectal foreign body x 2. He states he placed these into his rectum 2 days ago and has not been successful at retrieving them. He has done this in the past and cannot state what possesses him to do so.  The objects are a baby bottle and several marbles.  An attempt was made to remove the objects at the bedside, without success.  The bottle is the most distal of the objects and is turned sideways and is projecting up into his pelvis.  Enemas, digital probing, and plastic forceps were unsuccessful in dislodging the bottle.  We will take him to the OR for rigid proctoscopy to attempt to remove it.  If that is unsuccessful, laparotomy will be needed.

Op Note Findings:  Baby bottle and 23 marbles removed from the rectum

History and Physical  [Date 00:10], Visit:, Incomplete, Entered, Signed in Full, General

Chief Complaint:

i am not eating enough and loss of appetite.  (but this needs to be attended to at midnight on Saturday in the ED)

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