Sunday, January 24, 2010
Friday, January 22, 2010
Hi everybody! My name is really Arthur, but some people call me "Red". Hope you like the case format. These cases are not complete and are not intended to really teach, but are just for fun.....A three month old girl presents with profound muscle weakness, and "Floppyness". On exam, hepatomegaly is noted. The chest X-ray is shown. Note Cardiomegaly. There has been no exposure to honey or home canned goods. .....The child has Pompe disease......An autosomal recessively inherited lysosomal storage disease. The deficient enzyme is alpha glucosidase, which is needed for glycogen breakdown.......The disease was first characterized by Johann Pompe in 1932. Pompe was danish, and was executed in 1945 by Nazi Germany for espionage.....The disease is also featured prominantly in the upcoming film Extraordinary Measures, which I believe is a statement against big pharama, and Bristol Myers Squib in particular. ......Besides Botulism (alluded to in the pertinent negatives of the case), a differential would include Werdig Hoffman disease. ...Stay tuned for more cases in the future. I hope to do atleast one every couple of weeks. Thanks!
Tuesday, January 19, 2010
A nurse in the ED recently saw her grandfather pass away. He was old and chronically ill, and he was admitted through our ED and died several days later on the floor. I told the nurse I was sorry. She said thanks, but the worst part was that she had to pay the money to have the old man's dog euthanized. That Bitch!
Sunday, January 17, 2010
The people who have worked around an emergency department for years have seen all sorts of rectal foreign bodies. everything from gerbels (often in weather men or local news anchors if you believe the urban legends) to coke bottle to vibrators, shampoo bottles, fruits and vegetables, and whatever else you can think of. I have only seen a vibrator, a condom half full of crack (crack in the crack), and most impressive, one of these long oil funnels that is big on one end and tappered on the other. The bad thing is, this guy (who was just changing the oil in his car naked and slipped and fell on top of this thing on accident), had it in his rectum big end first! HOW!? Good thing is, it was easy to remove. pass a foley through the hole, blow up the balloon and pull it out. Crazy guy!.......in other news, arthur "Red" Heirin is working on his first case presentation for the blog, and it should be up soon. Stay tuned.
Wednesday, January 13, 2010
I am a dog person. I have grown up with dogs, all my life, and I have dogs now. Today, and not for the first time, (probably the third or fourth time) I had a person cry about a dog to me. A patient I mean. "I just want to get home to my puppy" The 87 year old man said. It almost brought me to tears as well. Should have, if I would have let it. I should have let it. I think I will take a rawhide or something to him to give to his dog when he does go home. If they let him go back to living alone.
Sunday, January 10, 2010
With a patch of bad weather coming through the area lately, the ER has been busy. Car accidents, of course, and slips and falls with broken hips, and broken everything else, and hypothermic bums, and hypothermic little old ladies. And of course fires, which are the worst, and even people getting killed trying to make fire, like the two different guys we have seen killed cutting firewood this winter. I am certainly not a global warming naysayer, but this is the coldest winter since at least 1977 in many parts of the world. It is the coldest it has been in Key West for 131 years! I like the cold sometimes, but this is causing a lot of anguish, and is having all kinds of unseen effects like driving up fuel prices, and may even contribute to another flu (swine or otherwise) outbreak by keeping everyone jammed together in doors. ... (By the way, sorry to use all these dots and wierd punctuations, but it seems you can't start a new paragraph and indent on here.)..... Anyway, I have been using some of my extra time inside to reflect on the razorbacks. I am happy with the bowl we got, and I think we beat a tough team, from a tougher than most think conference. I am not Happy with Mallett, though. He looks like Gumby trying to play football, and he thinks he could have even thought about going pro? I doubt it. But the thing I hate the most is here he is, after his "sophomore" year, wanting to go. We know he doesn't care about the team. We can see where his selfish thoughts lie, and we have to spend the whole next season knowing he is leaving us early, and wishing he could have done it sooner. Oh well, I do think we will have an awesome season next year, maybe we actually will be a contender in the west?
Tuesday, January 5, 2010
Ok, the bus driver, who may be my only reader except maybe a family member or friend or two would love to hear more views, so we are going to try to get my dissident friend Cade set up on here, and also my other friend who will provide the occasional medical factoid or case study or some such interesting thing. Will probably be a bit before they get set up and rolling, but that is coming.
Monday, January 4, 2010
New Year, same shit. Haven't had a day off since last year! I was thinking last night, well actually I woke up in a cold sweat last night, thinking about the guy that died, and was asystolic for about ten minutes, and we hade spoken to the family, and went back to work, when he suddenly sat straight up in bed, let out a blood curtling scream, and fell back, dead as ever! That shit will fuck with your head! ............Thinking about adding an author or two to the blog, like maybe my friend cade....I don't know/ Not that anybody actually reads this anyway, but if anybody does, what do you think about me adding an author, maybe two? It might create more posts, and add a different voice and viewpoint. Cade, I don't know what he would blog about....nonsense probably, but I am thinking about adding an author who is actually interested in medicine as well, who can provide some case scenarios and pictures and (cool?) stuff like that. I mean, I do put some cases on here, but just when it is gruesome or gory or sad or something, maybe he could come on and just do some medical teaching