Archive for December, 2009

Welcome to 2010…

Posted on December 31, 2009. Filed under: Benign |

Thank god for that, pass the axe… Christmas is over and I’m gonna hack down that needle shedding pine and get my carpet back!

Ahhh, bliss it’s time to get back to normal and stop all this messing around. One minute it’s crazy busy, then we are all sitting around doing nothing because the patients can’t be bothered to drag their over fed corpses to the surgery.

So another decade is decayed and the Noughties are over. (What are we calling this decade…”the ackward teens” or “the Ten-tickles?”)

Now I’m not one for picking over the bones of the previous year, although I do a little and end up realising that a fairly straight forward year still contains a few shocks, surprises and giggles.   I like to look forward and make predictions and then look back on them and realise what a prat I’ve been….

So here are my 2010 predictions:

I’m going to have a new hybrid flying car and learn to speak Jupitian. (OK a little over the top perhaps…I can’t even speak French very well!)

I will say something hugely inappropriate to a patient. (Highly realistic and happens most weeks).

I will get agitated by several patients. (Unlikely! I love my darling patients).

I will continue to love my job.

I will contemplate whether to carry on blogging at least once a month, and then when I miss a post I will panic and type one, however it’s plausible I will get a new job and with that the future of this blog is uncertain….

… (Feeling sorry for himself and fishing for compliments….) …it’s not like anyone would miss me!

Watch this space….

Have a fab New Year! Be happy and healthy and I shall report back soon (when you’ve all begged me to stay, and not before!!!)

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’tis the season to be a wally…

Posted on December 17, 2009. Filed under: Benign |

HO! HO! OH NO!?!?!

Yes time hath flown and Christmas season is upon us again.

It’s that joyous time of the year when patients try to fatten the staff up, in hope that we’ll be nice to them next year. (As if we can remember who did and didn’t buy us what!) Still all chocolates welcome and I shall work as part of a team to ensure their rapid demise!

Now I am not going to go on about the patients rushing to surgery saying ….”but I need to be better for christmas”…. or ….”I wouldn’t have normally come, but it’s Christmas next week”…. because without even looking I’m fairly sure that I moaned about that for the last 2 years!  Although I vaguely remember writing something about Cliff Richards last year!!!  (Just put the link in and realised it was ’07…my how time flies when your blogging!)

SO what am I going to tell you about….ahhhh, how about I tell you my top 10 things I  learnt from the works Christmas night out….Here goes….

1: Once you’ve half a brazilian wax, you have to keep on top of it, or else it itches. Incidentally older blonde women don’t have pubes worth waxing.  (Both these points I learnt from conversation, and they are not eye witness acccounts, it was a good night out but not that crazy!)

2: Most of the men I work with don’t like the idea of coming out with a bunch of drunk women….I’ve been doing it since I was 16, so am well trained and used to it.  (I’m sure I did something else as well when I was at college and Uni’, something involving books and classrooms, it’s just a vague blurry memory)

3: One of the Practice Nurses likes to grab my arse every year.

4: Those young girls in reception looked shocked by the oldies misbehaving at the start of the night, and realise that they didn’t invent getting drunk, and actually experience pays off, it’s alright though I’m sure her mum will wash her dress for her!

5: Just because you have a Doctorate doesn’t mean you have any sense when it comes to drinking alcohol. (I mean really, red and white wine together and slurping straight from the bottle!)

6: When the waitresses are your patients, you don’t have to remember what you ordered for dinner, I just hope they knew it was mine as they like me and not put it aside and spat in it!

7: When your patients are also having a night out at the same venue, you can get feedback on whether the patients like you or not….”Hic, you’re that Purse Nactitioner, I fink you’re lovely”…sweet, the effects of alcohol on people.

8: That cute girl in reception that you flirt with is going to drag you onto the dance floor, thankfully rescuing me from the drunk patients.

9: Just because you used to be able to twist down so low your bum was on the floor, doesn’t mean you still can!

10: When the taxi driver is your patient you can expect to hold a consultation for the duration of your trip home, even if you are a little inebriated.

Incidentally we have a sexual harrassment problem in the surgery…there is just not enough of it, so I’ve bought some mistletoe in,  bet I get caught by the old hag with bad breath!

We’ll I doubt I’ll have time to post next week, so in the event I don’t, I wish you  a good un, enjoy drink responsibly (i.e. don’t spill red wine and white carpet), and may the children get all they want and those of you on duty enjoy yourselves, remember if it wasn’t for you some other poor bugger would be doing it!

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Redefining “Urgent”

Posted on December 10, 2009. Filed under: Journal from behind the desk... |

Sometimes there is a real “urg” in Urgent…

Imagine the scene…It’s the end of a long and tedious day, you’ve been working a full week and scarcely seen daylight as it has now reached that time of the year when you get to work in the dark and you leave in the dark. You only get to see your garden at the weekends…(like some weird divorce settlement).  You think you’ve seen your last patient for the week and an appointment slot suddenly appears, with a patient’s details in it and a red line meaning it’s an urgent appointment.

OK, so I don’t want to spend ages doing a full cardiac assessment then waiting for the ambulance and be really late home, but fair enough if it is urgent….

I call the patient, no chest pain, no breathing difficulty, but she does have a headache…could it be a subarachnoid haemorrhage (for those who don’t know a subarachnoid haemorrage isn’t a bleed in an underground spider) or perhaps Meningitis? So I take a history from this rather well looking lady.

She’s had the headache for about 5 years….

Suddenly I think perhaps my adrenaline surge was wasted somewhat.

Why is it urgent? Because the patient has the afternoon off work and she doesn’t know when she’ll next be able to get an appointment….URG!!!

The same thing has happened to me a lot recently. One of the others was also a headache, for several years, that the hospital consultant felt was caused due to cervical spondylosis, but what could be causing the headache…. urm… cervical spondylosis perhaps!

Right that’s it. I want to make a poster for the waiting room defining Urgent….

If you require an URGENT appointment please ensure the following…

 

You meet one of the following criteria: 

*You are experiencing chest pains

*You are having difficulty with your breathing that can’t be resolved with a few slow deep breaths into a paper bag.

*You have had your symptoms for a few hours only.

*You really do think you are about to die.

 

 

You do NOT meet any of the following criteria:

*You need to be seen today as it is not convenient to be seen when the next routine appointment is.

*You’ve Googled the symptoms you’ve had over the last few months/years and now convinced yourself your demise is imminent.

*Your boss said you need a sick note before tomorrow

*You have several days of pain, and want a prescription, but haven’t taken anything from the pharmacist to help.

*You’re a bit bored and happen to be walking by the surgery when you saw the lights were still on.

*It’s raining outside.

*You only have one week left on your prescription.

Do I think it will help???  NO!

Anyway with Christmas fast approaching I will invariably be inundated with urgent cases that “wouldn’t have normally come” but… “don’t want to be ill for Christmas!”  ‘Tis the season to be a wally….Tra la-la la-la, la la la aarrrrg!

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Britain uncut…NP cures life long problem!

Posted on December 4, 2009. Filed under: Benign, Journal from behind the desk... |

This week I feel good.

Mr Brown is awaiting his hip replacement

Most of the time I see my patients, I feel I do my job well, and sort out whatever it is they have dragged their sorry arses in to the surgery to see me about. Sometimes they have to come back and try something else which will work, or I’ll need to refer them on to someone with specialist knowledge (or just someone brighter than me!)

Last week I exceeded my usual ability to resolve short-term problems…Here’s what happened. A 78 yr old with phimosis (that’s foreskin tightening to those who don’t have the misfortune to already know!) presented as the end of his foreskin was itchy and red. I asked him about how long it had been a problem and he said the rash was only there for a few days.

When I asked about the phimosis, he looked surprised and said he’d been like that all his life, or at least as long as he could remember. He thought it was normal for his foreskin not to retract…”surely that was only for circumcised men”… 

Sorry America…this is Britain Uncut!

So I gave him a prescription for some clotrimazole cream, and said he need to return in a week so I could see if anything much had changed, I wasn’t hopeful with such a basic treatment, but I needed to start somewhere.

One week later he comes back impressed as anything, as he can now fully retract his foreskin. Not often can you resolve a life long problem with a £1.84 product!

I wonder what he found under there!

And then of course there are all those people who come in limping and coughing and leave without a cough or a limp…. the laying on of my hands must be miraculous!

Anyway enough bragging!

For every one miraculous occurance, their are aproximately 3 who leave muttering: “What a waste of time, he didn’t even give me any antibiotics”.  But lets not go there!

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