I know it's been awhile. First, let me freak out for a second. Match day is less than a year away. Holy shit....how am I nearing the end of my 3rd year?
Alright some updates: the patient who was hallucinating, the next day when I went to see him, he was lining up all the cords on his body and said "Now if I can just get these lined up, I'll get the clock to work." A couple days later, I saw him again and he told me that he was building a modular home in the room but he and Obama had gotten into a fight the night before about the house. Obama was taking the house away but making him pay $700,000; he was kind though and was letting him do a payment plan. Wow. So the diagnosis: pancreatic cancer. Bummer.....one of the worst cancers out there. I imagine he won't be with us too much longer.
A 30 something female works out extensively on weekends. She did so a week ago. Monday, she woke up sore. Tuesday, she was feeling pretty weak. Wednesday, she couldn't move the lower half of her body. So she came to the ER. Her potassium was 1.6. That is the lowest value I've ever seen. It's supposed to be between 3.5-5. The next day that I saw her her K+ had increased to 2.2. I said something about it out loud in the dictation room and one of the other doctors was like "2.2 is not high." I was like "Well it was 1.6 yesterday so I'm pretty happy with the 2.2. By the second day, she was able to walk again. It was one of the coolest cases ever. Not the normal heart attack, congestive heart failure, pneumonia, UTI patient. We had to consult heme/onc, rheumatology, and nephrology. She was gone today when I got there, so I was slightly disappointed but her K+ was up into the 3s.
Last week, I had a new admit from the ER. He was an older gentleman who had a stroke. I had done his complete history and physical. He was sweet as pie. The next day I went to round on him, and he chewed me a new asshole. He was starving and was NPO because he was having a stress test. I walked in the room and quickly knew something was wrong since he started yelling the second I came in. I asked if he had his stress test yet and he yells back "You're giving me a stress test right now!" Okkkkkkkk. He kept saying he was going to refuse the tests and wither away and die. Drama queen much? And this man was not lacking for some body weight. He probably could have gone a lot longer and not withered away. Anyways, his daughter works at the hospital and she came and found me today to apologize for his behavior. Apparently the nurses called her after he yelled at me. LOL.