Benign

2013 in review

Posted on January 21, 2014. Filed under: Benign |

So in a quiet year, when I’ve hardly blogged at all, I’ve still had visitors from 110 countries. Well that’s great and I like to say thanks to my top referererererers. That’s http://www.jacksonvilleu.com/, http://www.rncentral.com/ and more than any other my blog mum – who sadly has hung up her blogging keyboard and gone into a full retirement, the wonderous and fabulous Kim at http://www.emergiblog.com/ and my blog sister Gina at http://www.codeblog.com/

The WordPress.com stats helper monkeys prepared a 2013 annual report for this blog.

Here’s an excerpt:

A New York City subway train holds 1,200 people. This blog was viewed about 5,200 times in 2013. If it were a NYC subway train, it would take about 4 trips to carry that many people.

Click here to see the complete report.

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Alternative Medical Dictionary

Posted on September 9, 2011. Filed under: Benign |

Definitions of words and origins of sayings have always fascinated me. So I think it’s time we compiled a ever growing medical dictionary.

Today a post, but I’ll make it a page and keep adding to it if I get some help from you…yes you. Please add a comment and include your own definitions. Go on you might just enjoy it!!! (Why do I bother? I can see that lack of enthusiasm glazing over your face. Go on just think of one!!! They’ve got to be better than some of the corny ones below!!)

Amenorrhoea :
1: [Amen-hurray-arr] Meaning: So be it, thank goodness, a celebration of no longer having periods, followed by the realisation that you are about to have a hot flush.
2: [Ay-men-aroun
'-'ere]. A condition of absent period that can be induced by pregnancy, derived from the old Anglo-Saxon expression used by fathers who discover that there daughters are pregnant. “Aye? You’ve ‘ad a man around ‘ere!”

Cerebro-vascular Accident [CVA]: The Stroke Association states a CVA “happens when the blood supply to part of the brain is cut off and brain cells are damaged or die”. I’d like to clarify when they say “cut off”, they mean blocked and not amputated. Having the blood supply to your brain amputated is likely to cause one hell of a headache, really you’d need the police, a lawyer and not to mention one rather good neurosurgeon! The use of the word Accident also needs clarification, you can’t have a “Cerebro-vascular did it on purpose”.

Chlamydia: [clam-mid-ye-ha] Sexual infection that won’t spread if you clammed up you mid area.

Diarrhoea: [dire-rear] Something bad is happening to your rear.

Gonorrhoea: [goner-here] A sexual infection suggesting that someone that came has now gone and left something with you.

Macroscopic: [Macro-skop-ik] See “microscopic” but bigger.

Mastitis: [Mass- tit-tes] An infection of the breasts that makes you have a mass of the titties.

A red tit, not to be confused with the blue tit found on a hypothermic patient.

Microscopic: [My-crow-skop-ik]:

Sphygmomanometer. [S-fig-mo-nom-o-metre]: Truly a brilliant word, firstly if you ignore the false vowel (“y”- (y not?)). It has a full 6 letters before it reaches a proper vowel! Definition: Well the “meter” bit means obviously that it measures something. So it obviously measures “sphygmomano’s”, which are the amount of male mummies in a Sphinx. Doh!

Stroke: [st-r-oke!] Something you can do to a cat even if only one half of you body works. See also Cerebro-vascular Accident.

Syphilis: [sieve-a-list] A sexual infection in which the sexual health clinic will have to sieve through a list of all you sexual conquests and ring them up to let them know what you’ve shared with them.

Tinnitis: [Tin-ear-tis and not Tit-te-ness as my elderly relative used to call it] A noise in the ear that can be tinny.

Vaginosis: [Vag-he-noses] A vaginal infection that smells to the extent your boyfriend might notice.

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COC, LARC’s and UPSI daisy.

Posted on June 10, 2011. Filed under: Benign, Journal from behind the desk... |

Part of my daily battle is explaining contraceptive methods to a patient who comes in and simple says “I want to go on the pill!”

“OK dear, here we are!”…. Oh if only it was that simple. 

First you have to tip toe through the mine fields of contra-indications for the various contraceptive groups: This included the medical twist on the “not tonight dear I have a headache” which is… “You have migraines…No COC for you!” If you unfamiliar with the abbreviations, all will become apparent further down!

Even if you’ve established that they may be an uncomplicated patient that can use any type of contraceptive, you then have to give the patient choices, and these have to be informed.  I find I have so much information to give out and so little time in which to do it!

Ok so you’ve 10 minutes to establish any medical reasons they shouldn’t have any particular method of contraception, discuss safe sex, be satisfied they are not already pregnant having had UPSI!  (I’ll give you that one now… as it is probably my favourite medical abbreviation: UPSI stands for Un-protected Sexual Intercourse. Obviously I like it because it sounds like the sort of thing a perfect gentleman would say when they realises his mistress is not “on the pill”.  Oooops Daisy.  I was horrified to find my daughter talking about UPSI, when she’s not even 2 yet). 

The Night Garden?…Upsy Daisy? The Ninky Nonk?  Sounds a bit perverse to me!

If the patient has had UPSI, then you can give them a MAP!!!  (that’s the Morning after pill, and not directions on where to buy cots, and absolutely nothing to do with helping men finding the “G” spot).

…and then still in 10 minutes you have to go over the following options.

COC: That’s the Combined Oral Contraceptive. Whoever decided to think that title up should be shot. What’s wrong with calling it a CCT (Combined contraceptive tablet)?  It would save patients seeing it written down and saying…”If it wasn’t for COCK I wouldn’t need a contraceptive!”  This “funny” gag gets reused later in this post too!

With COC’s you have to advise the patient that it can cause:

 – headaches…(more “Not tonight love, I’ve a headache” gags!);

- weight gain (but not as much as an 8lb baby);

- and increased risks of thrombosis and cervical cancer, but not much.

POP: Progesterone Only Contraceptive (and not the sound of a condom allegedly breaking).  Easy peasy, less risk of complication, although if you miss one by mistake there is an increased risk of getting a parasitical infection with life altering effect. The parasite slowly increases in size, cause body swelling, nausea and after about 9 months burst out of your vagina and starts screaming at you, you then need to look after it for about 18 years, before it moves away, but still rings you asking for money and bringing it’s dirty washing to your house.  Surely that would scare you enough to remember to take the pill at the same time every day!  With the modern POP’s you can even be relatively late taking it and be fine.

Next we have the LARC’s: These are the Long Acting Reversible Contraceptives. They are progesterone based and can cause some people to bleed, although normally this resolves and they can stop periods for the full duration of use (and a bit afterwards).  The LARC’s include:

Implant: A simple procedure where a small implant is popped into the patients arm and gives contraceptive cover for 3 years.

Injections: A twelve weekly injection that keeps your patient from getting pregnant,

Both these involve needles and so give the patient an opportunity to giggle, when the clinician says “Just a small prick” and the patient retorts: “If it wasn’t for a small pricks I wouldn’t need contraceptives”. Oh hilarious …again!

Then there is the IUD – Intra- Uterine Device! An IUD is a small, T-shaped contraceptive device made from plastic and copper that fits inside the womb (uterus). The clinician inserts it via the vagina…(If it wasn’t for things going in my vagina I wouldn’t need contraceptive…oh give it a rest now, would you?)…and basically it acts as spermicidal barbed wire with a hint of chemical warfare.

Other LARC’s include actually having children, for the next 18yrs you and your partner will be too knackered for sex and on the odd occasion you can muster the energy and enthusiasm, one of you children will cry, vomit or do something else that ruins the mood.

Permanent Contraception: These include “the snip”, getting the man in the relationship so drunk and on so many promises he agrees to have a vasectomy.  This contraceptive only works if the female is only having sex with the man who has had the vasectomy!!! Female sterilisation is another option, or becoming a nun, a lesbian, or just abstaining from sex, or better still a lesbian nun that’s abstaining from sex, (although I suppose there’s always the immaculate conception risk!  An angel came from heaven…discusting high velocity splatter!)

Nun1.jpg

…and there you have it, the most cram packed 10 minute consultation….Come on! Decide would you?!?  Sadly that 10 minutes I spend talking to woman about sex, is probably longer than they’ve ever talked about sex with their partners, or even worse, longer than the act itself actually takes…surely not!

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Post Natal Drip.

Posted on January 6, 2011. Filed under: Benign |

I have a theory… partly based on professional experience and partly based on personal experience.  It’s well excepted that in pregnancy the brain goes “squishy” and a hormonal induced reduction in mental capacity occurs.  My theory is that these raised horror-moan  hormone levels initiate the growth of a new gland: Let’s call it the “Mummery Gland”.

During pregnancy the Mummery Gland gets to work at suppressing normal intelligence, but it is after labour that the gland really kicks in.

The Mummery gland releases GSH into the blood stream. (That’s Guilt Stimulating Hormone and NOT Good Sense of Humour!). 

The effects of GSH are that the previous rationale woman goes nuts, a progressive post natal dripping of guilt builds into a life long problem.

Lets take a case of Mrs A. You know the kind: The childless professional, who from 20 metres can criticise and find fault in the way all her family and friends bring up the children, with classic common sense and states things like…

“Fancy putting them in front of the TV with a bowl of chocolate 30 minutes before dinner!”

…or…

“Well no wonder the baby won’t sleep in its cot by itself at night, if she spends the first 3 hours of the night cuddling it and singing to it…really!!”

Mrs A then gets herself “in the family way” or as we used to say in the posh town I grew up in “up the duff”.

The Mummery Gland develops in pregnancy and eradicates all this previous “logic” about child care. During labour GSH is produced and from that day until the day Mrs A. final finds herself terminally ill with scabies in an old folks home, she suffers from severe, irreversible symptoms as shown below:

Overwhelming feeling that if she plays with her children she is failing as a domestic goddess and an overwhelming feeling that if she does house work she is a failure as a mother.

She strongly believes if she shout at her children she is too strict and that if  she doesn’t she is too soft.

She also feel that if she cuddles her screaming child at night it’s because she is a bad mother and  just doing it to stop the noise, but if she doesn’t cuddle that screaming child at night she is traumatising them and causing separation anxiety that will lead to life long psychological problems.

Mrs A thinks that helping her children get ready for school suppresses their independence but if she doesn’t help them she is making them feel that she doesn’t care, especially as it takes 4 times longer and she end up shouting at them.

In later years Mrs A will feel that  holding her teenagers hair so they don’t vomit in it after their first encounter with alcohol excess, is giving non verbal signal that it is accepted to binge drink but if she doesn’t hold their hair, they will choking on their own vomit and it’ll all be her fault as a bad mother.

These are simply key examples – there are many others!

Childless women should be warned of this wide-spread occurence of Post natal drippiness and the dangers of the Mummery glands with the life long devastational effects of Guilt Stimulating Hormones.

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Welcome back…

Posted on November 3, 2010. Filed under: Benign |

It’s unlikely you’ll get excited by the thought of me posting regularly again…so don’t, I still can’t afford the time.  This post is entitled “welcome back” simply because I had a weeks holiday and had the ultimate monday morning on my return so I felt the need to off load…

There are better ways to off load…but not many…

So I get to work, and rather than a friendly…”Welcome back, did you have a nice week off”  I get “Don’t turn your computer on, we’re havin’ trouble!”

So 1 weeks worth of emails, scanned post, blood results etc. I can’t check.

Oh well I crack on with the “actual” post rather than virtual post!  A letter from the prescribing authority stating I have prescribed two control drugs that I shouldn’t be prescribing. I know I haven’t but I am going have to look at why they think I have and they can’t give me the patient details, but just the month it was prescribed. Another unnecessary time consuming exercise, but I can’t sort it yet because…. the computers are down.

Then the patients start coming, an influx of complicated patients whose note I can’t access…sweet joy! Once again I find myself wishing for a UTI (not personally of course!) But no, I get patients that have been discharged from hospital awaiting heart surgery, patients wanting to know the results of investigations I have never heard of, patients who want some more of the tablet they had this time last year but have no idea what it was.

Eventually the computers come back on-line, by which time I am running more than ever-so slightly late!

There’s a knock at my door mid consultation and I find two school children dressed as doctors… a weeny bit late for trick or treat… Oh hang on! One has a stethescope around his cute little neck… Medical students!  I would have known they were coming, if  I’d read my emails…which I couldn’t as the computers were down when I got in!

“Oh do come in!!”

So now I have to try and catch up, look competent and entertain the children students.  I get to the end of the morning clinic feeling completely ragged. 

Do I need another holiday? Hell no! I’d have to come back again!

Still, I have kind of caught up with myself today, so much so that I could have a quick blog.

I feel better already.

Highlight from the week so far:  I called on one of the GP’s for a second opinion of a prostate.  He stood there, finger firmly up the patients arse and said quite proudly with confidence and in a reassuring tone:  

“Oh yes! That feels wonderful!”

I’m sure the patient was reassured, but I doubt he thought the experience “felt wonderful!!

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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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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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In the ideal world…

Posted on November 23, 2009. Filed under: Benign, Journal from behind the desk... |

A patient came in today complaining of having a sore throat, runny nose and feeling awful… 

Aaarg- tichoooooooooo!

I assessed him and advised him that he appeared to have a virus…not an uncommon occurence, but the fact he told me he was feeling awful sort of amused me, then started my brain ticking…(oh no!!)

Why do viruses have to make us feel awful?  I appreciate this microscopic life forms need to reproduce and spread from person to person to keep their existence, and as annoying as this is, it is basically the same as any other life form on the planet, so good luck to it. If the survival of their species is the only reason colds and other viruses exist, would it make evolutionary sense to encourage the host (AKA us!) to stop trying to get rid of them?

Surely if viruses evolved to make us (the host) feel good it would become a happy symbiotic relationship, a bit like the bird that eats the annoying bugs off the hippos back, leaving the hippo less irritated and the bird fed (only the poor bug loses out!)

3 birds on his back…Sounds like being married with two daughters to me!

Why can’t we have airborne viruses that make us feel energised and full of the joys of spring with a euphoric bounce in our step?  If this was the case then people would want viruses, we would feel great when we had them and the virus would be encouraged to thrive.  Sure you’d have some virus abusers, trying to get a viral fix all the time, but perhaps it’d cut down on drug abuse.  See now I’ve ruined this idea with a vision of slutty dressed girls going up to greasy old men in clubs, and slyly whispering in their ear…”Eh mate, fancy a virus?  20 quid???”

There is a down side to every nice thought…what’s that expression…Every silver lining has a cloud?

My original nice thought was this…

Pt: “Good morning Max!  I’ve had a virus and I think it’s gone to my chest”

Max: “So what symptoms did you have and when did they start?”

Pt: “Well before the weekend I started with a tickle in my throat, really made me giggle and feel happy, then I think I had a raised temperature because I felt like someone was giving me a nice warm hug all day, but over the last few days my chest has been tickly as well.  I’m sure it’s just a virus, but would you mind listening to my lungs and check?”

Max after throughly examining the patient: “Your chest is as clear as a bell, it must just be an Upper resp-giggle-tory infection. The bad news is it’ll be cleared up in a few days”.

Ahhhh….how nice….

Max!! Max!!! STOP dreaming….my nose is streaming!

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Blog fog and 9 legged spider???

Posted on October 2, 2009. Filed under: Benign, Elsewhere in the blogisphere |

Arrg…it’s happened again. So busy the week has disappeared and my blog has remained unposted…. Kim can relate…in fact read her post

One thing did get my attention this week….Yes I was fasinated by a story about combatting erectile dysfunction. Apparently the venom from a poisonous spider can help as a remedy for erectile dysfunction.  Seems quite obvious really, any insect bite can cause redness, heat and swelling….well what more do you need to combat ED (That’s Erectile Dysfunction not Emergency department…..nobody knows the cure for the latter!)

Quite how the researchers came up with the hypothesis -Toxic Spider bite cures ED,  I don’t know, and if I did have ED I’m not sure how keen I’d be to try this approach…. “Well hello, nice legs, fancy going down for a bite???” (Sorry I’m feeling smutty this week!)

Hmmm, I think I’ll have to stop there, sorry it is short and random, this week, next week promises to be worse…but I’ll try my best…

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