Sunday, September 11, 2011

Surgery cant cure phantom symptoms

Every now and then there is a patient that makes you just sit back and know that it is going to be a hard case. Not because it is technically difficult, but that the patient will be difficult. What I mean is, there are some who make up symptoms to be put into the hospital for the attention that it gets them. This is far more than the fibro patients. These patient complain of everything, but on careful questioning their symptoms wander all over and they cant quantify or localize any specific complaints. Unfortunately, sooner or later, someone will do a diagnostic study for one of the most rare conditions that exist. In the study, something incidental will show up. The patient then focuses on that and we are off to the races. Well, we had a patient like this show up in the ER. They were admitted and started their whole history. When the resident called me, the first thing I said was call every medical center in a four hour radius and get all her records and charts. Sure enough, the patient had been in every one and had every test known to medicine. At each hospital was a psyche consult that showed the patient was not right. This patient had years ago complained of vague abdominal pain. Unfortunately, someone went and did a laporoscopy. So every time she comes into the hospital, someone else decided that since nothing is showing up she needs another laporoscopy or open exploration to look for adhesions. As a result, we are off to the races. It is going to be a long call week.

3 comments:

SeaSpray said...
This comment has been removed by the author.
SeaSpray said...
This comment has been removed by the author.
SeaSpray said...

Glad to see you back Throckmorton! :)

I think I wrote this in here once, but I knew a woman in her mid to late 30s that always seemed to have a lot of different surgeries. She was thin and seemingly in good shape, but always out for something. She glowed when she spoke about her surgeries. It was weird... and sad. Single ..I think surgeries were her joy in life. definitely odd.

Re: Laparoscopy, I guess unfortunately the things that are meant to help a patient can cause more harm as with the scarring and then it's an unending circle of treatment.

Because my catastrophic deductibles were met this year, and is a good time to do tests/procedures I have been putting off ...I recently *joked* with my new PCP that I wanted to be tested for everything because everything 100% covered now. I HOPE he knew I was joking. Can you imagine testing a patient for *EVERYTHING* ..every diagnostic test known to man? ;)

I hope your call week goes better than you are anticipating. :)