The Prescription Drug Problem

I have thought a lot about the prescription narcotic problem. I have experienced it every day I have worked in the er, and I have seen friends and family members consumed by it. I have hated it. every day I see the crimes and blights on society produced by it, my car was even stolen from my driveway. I am ashamed that educated "professionals" contribute to the drug problem. However, recently, I have been thinking a little different lately. There has always been a drug problem, throughout history, and will always be. The only thing that changes is the drug abused most commonly. Right now, in my region, and in most of America, the drug of choice is prescription opiates. Is this the worst drug that we could have as our drug of choice for users? Maybe not. Unlike cocaine, heroin, or the like, these drugs are not furnished by large cartels in other countries. Organized crime has less opportunity to become involved. The manufacturers of these drugs are legitamate companies that provide jobs for legitamate american workers, unlike the slaves in the fields of south america. Even the people who make money from dealing these drugs are middle and upper class Americans who likely pump this money back into the US economy. Maybe this system is not the worst possible way our drug abusers could get their drugs. At least this way provides more income to our country and even to some innocent people (such as those drug factory workers). This is probably the wrong way to think, and I am going to continue to fight against this thing every day in the ED, but at least it is a small way to look on the bright side of the problem. On a related note, do you know that the street price for oxycontin is a dollar a milligram? So the average monthly prescription of say, 90 pills, 80 milligram oxys, the street value is 7200 dollars! Wow! Think of the people who just drive around all day, obtaining prescriptions for these things! More on this next time.

The wild wild south?

The town is in an uproar and the hospital has been on lockdown two nights this week. Killings and reprimands have shaken the city. It started with a guy who was stabbed, but survived, then somebody stabbed the first stabber and he came in as a full trauma code, with thoracotamy. the families spilled into the waiting room and fights broke out there and in the parking lot. this went on for an hour before we were able to get the police to even respond to our calls. The guy who was accused of killing this guy then had his house burned down the next day, then, three days later another man was shot in the stomach and killed in his yard. Online community message boards are filled with posts, supposedly from atlanta and houston gang members who threaten coming to town and carrying out revenge killings.

Pessary

A pessary is a small device worn, often by elderly women who have had multiple children, to hold bladder or uterus in place. It is a small plastic disc placed in the vagina. As you can imagine these things can get very nasty. All it takes is a demented nursing home pt. to forget that she has one of these for a couple months and.....zang! But nothing could prepare you for a chief complaint of "leaves from virginia". A friend of mine saw a lady, brought in by her daughter, with just this complaint. When he looked it was true. She had a vine, with leaves, protruding from her "Virginia". Turns out, the demented lady had secretly , for years, used slices of potatoes as pessaries! When she forgot that she had it in, the warm, moist environment was perfect for sprouting spuds!

New Format

Hi. Been a long time, I know. Anyway, the new format I was talking about is going to be too close this blog to public reading. I suspect people from my hospital spy on the blog, and I don't feel that I can write about what I want. So, for you people who are already followers, if you want to post or send me in some way your email address so I can add you after I go private, I would like that. If you don't follow already, sorry. I can't accept new email addresses now, because I won't be sure who it is. In short, I am going to turn this into a private space for me to write what I want, with no desire to publish publicly, but those of you few who have been loyal readers are welcome to come along. Let me know.

34 year old grandma

sewed up the arm of a 33 year old grandma tonight! How old was her grandchild? Well she has 6, but the oldest is 7!! How? That means she was a grandma at 26! if she was 13 when she had a child, who then had a child at 13, that is the only way this is possible (roughly).

New Post

It has been a while since I have made a new post, but working a lot in the ICU again. Also, I am thinking of going to a new concept on the blog in general. I will fill you many loyal readers in on this in the future. The world awaits with baited breath. As part of this new concept, I would ask all the people who casually follow the blog (if there are any) to add themselves to my official reader list, or whatever it is called. Being a follower will facilitate moving to the new style of blogging. You will understand when I unveil the new plan. Thanks for staying posted!

White Wedding

At a nearby doctor's office, where an internal med friend of mine was doing his "rural med" rotation, a wedding occured recently. The receptionist was married on her lunch break, with the doctors and office staff presiding. A minister showed up and everything. The cake was a dairy queen ice cream cake. Two Avatar action figures were placed on top, with their faces lit up. It was beautiful! After lunch, the groom went home, and the bride returned to work! They have no plans for a honeymoon. It is the third marriage for her, not sure about him.

The Hiney Shot at Walmart

Went to walmart this morning and noticed a large sign out front. "Free H1N1 shots....Lawn and Garden! I had to chuckle.

First Case Post By Red

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!