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Thursday, February 21, 2008

Clinic Note


PATIENT NAME: Bertha Magilicutti (name has been changed to protect the afflicted).

CHIEF COMPLAINT: See history of present illness below as there is not just one complaint.

HISTORY OF PRESENT ILLNESS: This is a 21-year-old female who presents today with a myriad of complaints. She states that since starting her job she has noticed increased itching all over. It really depends on the day but mostly when she is transcribing dermatology reports. She also describes low back pain and knee and ankle pain mostly when she is transcribing bone, spine and joint clinic notes. She states that she is worried that her kidneys are not working properly especially since she "transcribed a report of a patient who had acute chronic renal failure." When questioned further about this fear of her own kidneys failing, she stated that yes, her own kidneys do seem to bother her at times. Ms. Magilicutti asked questions regarding cholecystitis as she feels that she may have cholelithiasis. The patient coughed several times throughout the examination and stated that she is sure she is coming down with bronchopneumonia.

PAST MEDICAL HISTORY: Surprisingly unremarkable.

SOCIAL HISTORY: Patient is married and has five children. She does not smoke and denies recreational drug use. She does not drink but wonders if this might be helpful for her at times.

PHYSICAL EXAMINATION: This is a 21-year-old female in no acute distress. She appears older than stated age but otherwise looks normal. Neck is full in range of motion although examination was limited by the patient's lack of cooperation. She admits that she is afraid it might damage her spinal cord as she "thinks she has read about this happening." Speech output is within normal limits. She kept saying things like "arss" and "beaver dam". Neurologically, Ms. Magilicutti was alert and oriented to person, place and time. Lungs: Clear to auscultation bilaterally. Abdomen: Soft, nontender, nondistended, obese. Skin: Normal appearing. Extremities: Within normal limits.

MEDICATIONS: Prayeren t.i.d. and then on a p.r.n. basis, Scrpiturelyn 1-2 times daily and then on a p.r.n. basis, hugitol twice from each family member and then on a p.r.n. basis, Blogilyn read 20 posts each day and write one twice a week, Commenton 100 each day (note: any less and she believes she will not make it).

ALLERGIES: Dirty dishes, dirty laundry, dirty kids, dirty dogs.

IMPRESSION: New onset hypochondriac.

PLAN: Continue to take current medications as this will definitely ease her symptoms. I will also refer her to the loony bin. If she has any other questions she may feel free to contact my office.

139 comments:

JerBear & Co. said...

Well I think the doctor said it clearly, Birtha(Bertha) needs to go on vacation to Texas so she can take her medications there.

Anonymous said...

I too agree with the Dr. Bertha needs to go to Texas to visit her favorite brother. Even though I am your favorite sister;-)

Anonymous said...

Perfectly hilarious - made my day - visit us in Alaska - we have the perfect remedy. Love WoW

Pineapple Princess said...

I thought I gave you the perfect rememdy yesterday. Is the ice cream not working?

Can I tell you some of my symptoms? You're hired.

Pineapple Princess said...

Just giving you another dose of Vitamin Comment.

Also, I am clicking the little box so I can see the comments from the rest of the hypocondriacs.

Also, wondering if you would like to be my assistant at the Brotox Party I am having. Check out my post today.

Pineapple Princess said...

And some more Vitamin Comment.

That's all. For now.

sharebear said...

I will see you in the loony house.

sharebear said...

The commenton doesn't seem to be working. i guess you'll have some cathing up to do when you're felling better.

Tamster said...

Drugs!!! Hehehhee!!! Drugs!!! And more drugs!!! Hehehehehe!!!

Tamster said...

Must

Tamster said...

have

Tamster said...

daily

Tamster said...

prescribed

Tamster said...

dose

Tamster said...

of

Tamster said...

drugs

Tamster said...

(clear

Tamster said...

throat)

Tamster said...

uhhh...

Tamster said...

I

Tamster said...

mean

Tamster said...

medication!

Tamster said...

Drugs!!!

Tamster said...

:-)

Tamster said...

Sorry, but I don't think I can quite make it up to 100 on my own!

Tamster said...

I believe the drs. prescription actually meant for the patient to give 100 daily, not receive them.

Tamster said...

It is in giving and serving others that we find joy.

Tamster said...

So we'll all be expecting a large does of commenton from Bertha each day!

Tamster said...

And...

Tamster said...

she's more than welcome to take her meds. in Texas as suggested!

Tamster said...

:-)

Tamster said...

Love you, Bertha!

Tamster said...

By the way, if you should happen to talk to that OTHER Gooch who doesn't seem to want to REALLY join us all in Blogland... I just had a grand idea of what she could name her next kid, if she were to have another one ever. I just saw a comment on a friend of mine's post from a couple, and the girl's name was Cedar! I thought that would work in the mix! :-) Pass it on to her! :-)

BonBon said...

You guys think I am just kidding don't you. Why just today my heart started racing for no reason. I was just sitting here working and no kidding it just started racing. You guys will feel sorry one day for laughing at poor Bertha. When she drops dead for no apparent reason. I will have to visit you from the dead and say "told ya so!"

Anonymous said...

Birtha, Birtha, Birtha.

Poor girl, r u sure it wasnt racing from lack of commentos.

heres some more for ya.

Anonymous said...

My bonnie lies over the ocean,

Anonymous said...

My Bonnie lies over the sea

Anonymous said...

bring back,

Anonymous said...

bring back

Mike and or Cindy said...

Bring back my Bonnie to me.

tis what we'll all be singin if you r pushin up the daisies.

Tamster said...

Okay, here goes. This is a multiple winner opportunity. 10 points for each name of members of my (Tami's) family--that can be parents, siblings, nieces and nephews, siblings' spouses, even grandparents, aunts, uncles, or cousins, if you know them. You have to actually know them, not just guess random names and hope you hit something right. Good luck. There are ways... :-)

Mike and or Cindy said...

Heres some fun ones for u to decode.

Mike and or Cindy said...

10 POINTS PER WORD DECODED CORRECTLY. U GOT 5 DAYS.

CTD, GLM, GPO, TEETH, UBI, FLK, GROLIES, LOBNH, CNS-QNS, PUMPKIN POSITIVE, DBI, PFO, PGT, DIGGING FOR WORMS, DEPARTURE LOUNGE, HANDBAG POSITIVE, FREUD SQUAD, GASSERS, SLASHERS, COFFIN DODGER,

Anonymous said...

I think that the reason your heart is racing is because of side affects from getting to many comments so quickly.

Anonymous said...

Well I think that Bertha's heart is racing because of comment overdose.

Anonymous said...

Just because the last two people think that Bertha is getting to many comments, I think her heart is going fast is because of the excitement from seeing all the comments that she has received.

Mike and or Cindy said...

And some more,

stream team, rule of 5, rear admiral, raisin farm, pafo, o-sign,
inbreds, hearts and farts, gomer, donorcycle, disco biscuits, code yellow, code brown, captain cangaroo, bury the hatchet, bounceback, leeches, blamestorming,
banana, c&t ward.

That oughta keep ya busy, and boy lots of points at stake here, every man(and woman) for himself. Anyone can guess. One with the most points wins.

Anonymous said...

coffin dodge is escaping death.

Jerbear

Anonymous said...

bury the hatchet is put the past behind you

Jerbear

Mike and or Cindy said...

OH AND MY FAVORITE,

TUBE, WHAT IS IT?

NO WRONG ON BURY THE HATCHET.

Tamster said...

Tube is TV. :-)

Anonymous said...

Bury the hatchet= to make peace.

Jerbear

Mike and or Cindy said...

NO THESE ARE MEDICAL TERMS TO DECODE. I'LL GIVE YOU A HINT, TUBE...MEANS TOTALLY UNNESSESARY BREAT EXAMINATION.

Mike and or Cindy said...

Anyone who is 21 with 5 children would have AT LEAST these symptoms.

Mike and or Cindy said...

maybe fibing about one's age is a symptom too?

Mike and or Cindy said...

or is it fibbing??

Mike and or Cindy said...

10 POINTS TO JERBEAR ON COFFIN DODGE

MIKE

BonBon said...

I think Bertha is scared to state her real age for fear it will take her closer to death.

BonBon said...

Here goes...
Give me a minute...
Give me your resource...

Mike and or Cindy said...

NOPE I WONT GIVE AWAY MY SOURCES YOU HAVE TO GUESS... SOME OF THEM ARE EASY

CODE YELLOW....COME ON THATS EASY.

MIKE

BonBon said...

Bury the Hatchet=accidentally leaving a surgical instrument inside a patient

BonBon said...

C&T Ward - Coma ward - "cabbages and turnips

BonBon said...

Code Brown - a fecal incontinence emergency

Mike and or Cindy said...

YUP VEGGIES

BIRTHA PULLS AHEAD WITH 20 POINTS

BonBon said...

Code Yellow - a patient who has lost control of his or her bladder

Mike and or Cindy said...

BIRTHA = 30 POINTS

BonBon said...

Stream team - the urology service collectively

BonBon said...

Disco biscuits - Referring to the nightclub drug ecstasy

BonBon said...

Hearts and Farts - unit specialising in geriatrics and cardiology

BonBon said...

Am I good or what???!?!?!

Mike and or Cindy said...

BIRTHA = 30
JERBEAR = 10
MIKE = 10 FOR GIVING AWAY ...TUBE.

BonBon said...

GOMER - "get out of my emergency room"

Mike and or Cindy said...

CORRECTION
BIRTHA 60 JERBEAR 10 MIKE 10

BonBon said...

I've got them all. Do you want me to keep going? I had to learn all these because they use them all the time in charts.

BonBon said...

Inbreds - doctors whose parents are also doctors

BonBon said...

Rule of Five - means that if more than five of the patient's orifices are obscured by tubing, he has no chance of survival.

BonBon said...

Digging for Worms - varicose vein surgery

Mike and or Cindy said...

IF YOU DONT SOMEONE ELSE WILL GET THEM AND WEEEN LIKE ESQUILITO AND IGNACIO IN NACHO LIBRE.

BonBon said...

ok, I'll keep going. The rest of you can just give up now.

Mike and or Cindy said...

BIRTHA =100
JERBEAR=10
MIKE =10

BonBon said...

Raisin Farm - old person's home, geriatric ward etc

BonBon said...

Rear Admiral - a proctologist

BonBon said...

PAFO - "Pissed And Fell Over"

I see this one a lot...

BonBon said...

O-sign - A patient is "giving the O-sign" who is is very sick, lying with his mouth open. This is followed by the Q-sign - when the tongue hangs out of the mouth - when the patient becomes terminal

BonBon said...

Captain Kangaroo - head of a paediatrics department

Mike and or Cindy said...

I BETTER CATCH UP NOW

CTD= CIRCLING THE DRAIN=
ABOUT TO PASS ON

Mike and or Cindy said...

DEPARTURE LOUNGE= OLD FOLKS HOME

BonBon said...

Bounceback - a patient who returns to the emergency department with the same complaints shortly after being released

come on Jerbear, giving up so easily?

Mike and or Cindy said...

TEETH =

TIED EVERYTHING ELSE TRY HOMEOPATHY

BonBon said...

Blamestorming - Apportioning of blame after the wrong leg or kidney is removed or some other particularly egregious foul-up happens.

BonBon said...

Banana - a person with jaundice (yellowing of the skin and eyes)

Mike and or Cindy said...

DONORCYCLE= SOMEONE ON A MOTORCYCLE REFERS TO HIGH RATE OF ACCIDENTS ON MOTORCYCLE WITH NO HELMETS ON

Mike and or Cindy said...

LEECHES= LAB TECH WHO TAKES BLOOD

Paul said...

If you were my patient, there would be a PIA fee tacked on to your visit...

BonBon said...

Handbag positive - confused patient (usually elderly lady) lying on hospital bed clutching handbag

BonBon said...

Freud Squad - the psychiatry department

BonBon said...

Gas Passer - an anesthesiologist (also Gasser, Gas Man or Gaswallah)

Mike and or Cindy said...

PIA =PAID IN ADVANCE

BonBon said...

Slasher - surgeon

BonBon said...

Wow! That was a blast!

Mike and or Cindy said...

DBI= DIRT BAG INDEX=

Dirt Bag Index, and multiplies the number of tattoos with the number of missing teeth to give an estimate of the number of days since the patient last bathed.

Mike and or Cindy said...

BIRTHA = 230
JERBEAR=10
MIKE= 80
PAUL=10

BonBon said...

GPO - "Good for Parts Only

Mike and or Cindy said...

GPO= GOOD FOR PARTS ONLY

BonBon said...

Donorcycle - nursing slang for a motorcycle, so named due to the amount of head trauma associated with motorcycle accident, but less so with the body, making the perfect candidate for organ donation

Mike and or Cindy said...

JINX

BonBon said...

I beat you on that one!

BonBon said...

Baby Catcher - an obstetrician

BonBon said...

404 moment - The point in a doctor's ward round when medical records cannot be located. Comes from internet error message, "404 - document not found. Bertha must have messed up again."

Mike and or Cindy said...

CNS-QNS=
CENTRAL NERVOUS SYSTEM QUANTITY NOT SUFICIENT

Mike and or Cindy said...

PUMPKIN POSITIVE=
refers to the idea that a person's brain is so tiny that a penlight shone into their mouth will make their empty head gleam like a Halloween pumpkin

BonBon said...

I already got that one. Minus 10 for you...

BonBon said...

I think we made everyone else's day tomorrow. There inboxes will be full!

Mike and or Cindy said...

BIRTHA = 240
MIKE =110
JERBEAR=10
PAUL=10

Mike and or Cindy said...

VERY FUN!!
I THINK I ALMOST CAUGHT YA BUT I COULDNT TYPE FAST ENOUGH

BonBon said...

It's called copy and paste. Oh did I say that?

BonBon said...

I think we scared Jerbear away. Are still there?

Mike and or Cindy said...

THATS CHEATING
AS THE HIJACKER OF THIS BLOG I DECLARE MYSELF WINNER BECAUSE YOU CHEATED!

BonBon said...

I just think that is way cool that we found the same page out of billions of them! It was so fun to read! I will have to bookmark it!

You win. I think I am feeling a little lightheaded. I took more commenton today than I was supposed to.

Mike and or Cindy said...

OVERDOSE!!! CALL A DOCTOR QUICK I THINK SHES ABOUT TO GO CODE YELLOW FROM LAUGHTER!

BonBon said...

I'm looking a little banana...

Mike and or Cindy said...

OH AND TAMI = -10 POINTS FOR WRONG ANSWER ON..... TUBE.

Anonymous said...

IF THERES A DOCTOR IN THE HOUSE MAYBE HE CAN PRESCRIBE ONE FOR YOU TO BE ADMINISTERED BY DR. JERBEAR

BonBon said...

Thank you all for all your medication today! It was a blast and brought more humor into my day/night. I will promise not to complain anymore!

BonBon said...

Code Yellow!

Mike and or Cindy said...

ROFLMA!!!!!!!!

sharebear said...

I think I need some of this commenton, I'm starting to feel a little green.

Mike and or Cindy said...

JUST GOT OFF THE PHONE WITH BIRTHA AND HAD TO WALK AWAY FROM MY DESK CAUSE ALL MY COOWORKERS WERE STARTING TO WONDER WHY I COULDN'T STOP GIGGLING! THEN MADE TRIP TO BATHROOM TO CLEAN CODE YELLOW.
SORRY SHAREBEAR YOU'LL GET YOUR TURN TO IM SURE. JUST START A NACHO LIBRE THREAD OR SOMETHING LIKE THAT. MAYBE THE DOC CAN PRESCRIBE A TUBE FOR YOU TOO. THAT WILL HELP U NOT FEEL SO LEFT OUT.

Huck Finn & Co. said...

Looks like I really missed out last night! I am very worried about Bertha Magilicutti's extreme overdose of Commentum and hope one extra dose from me does not put her in the C&T ward...

Pineapple Princess said...

I guess political correctness hasn't hit the medical world yet. The secret is out now. Wow. Hope I have never been tubed.

Tamster said...

There are a few problems I've noted. First of all, there should be automatic disqualification because Mike went out of turn. If he wants to ask a question, he has to answer and win the previous question. He skipped right over it and decided to ask one himself, when he had not earned that privilege by answering one. Second, he cannot win his own question; if we did count his question (which I have just established should not have been counted in the first place) I would have to say Bonnie definitely got more points than Mike (nobody said you couldn't cut and paste), and Mike shouldn't even be able to get any points because he asked the question and should therefore know the answer. And thirdly, that question seemed a bit one sided toward Bertha, who obviously has had more experience in this area.
Of course, Mike and Bonnie had a lot of fun together last night, and that's really what this is all about.
An extra 10 points to anyone who can actually find my question amongst the overdose of commenton! :-)

BonBon said...

Chris, Britt, Ben, Abigail, Becca, Raymond, Kalani, Susie, Natalie, Lydia, Michelle Kelly, Dave Kelly,Amanda, Melody & Steven Kelly, Ryan, Kevin, Cindy,Grandma Kelly, Grandpa Kelly...

That's all I got for now. Add up the points!

BonBon said...

And I found your comment between two of mikes. It was on Feb 22 at 8:03 pm. 10 more points!

Tamster said...

Wow, Bon! That's 190 points for you so far; sorry, but I'm not going to count Grandma and Grandpa Kelly--too vague, but nice try. You are a good researcher and have paid attention; I can tell! :-) You got my hint.
It would appear that no one but you is playing this game. How can we get others involved? Mike and Sharon have played some, but not with my question. Mike said he'll be gone a few days, so maybe we'll get a response from Sharebear. Other than that, we need to get others to participate. Not that I don't want you to enjoy your numerous comments increasing, but maybe we need to give someone else a turn at lots of comments. Who shall we share the commenton with? :-)

Wendy in Alaska said...

HOLY CR*P! What the heck?

I missed out! Man!

When I saw the number of comments, I thought I was going to see a bunch of this

Wendy in Alaska said...

from

Wendy in Alaska said...

everybody

Wendy in Alaska said...

again...I guess not....thanks for the fun

mamabearharder said...

Holy moly!! I missed out for sure! I only had a few minutes to catch up and I couldn't even read them all. Too funny though! Birtha really knows her stuff huh?!?! Kudos to you sis :)