by Your ER Doc on January 29, 2009
Q:What is the difference between a mild heart attack and a major heart attack? Isn’t a heart attack a heart attack?
Q:
I heard the term
MI used on another blog. What is that and how do you treat it?
A:
Good questions, let’s knock out both at once. Actually you can have tiny heart attacks,
huge heart attacks and everything in between. A heart attack is when blood flow through the coronary arteries slows or stops resulting in damage to the heart muscle downstream. This is also known as “myocardial infarction” aka MI. Symptoms and the end result vary widely depending on the location of the obstruction in the coronary arteries. Some patients can have a heart attack with minimal pain, and never come in. We diagnose these after the fact. There is even a particular kind of blockage in the coronary arteries that is called the “widow-maker’s” heart attack. That’s because if a patient has this kind of blockage, it will cause a severe block in blood flow to a large part of the heart, often resulting in death.
by Your ER Doc on January 28, 2009
I’m starting to think narcissistic disorder is a relatively common affliction among the powerful. See my recent post on Rod Blagojevich. Perhaps there is a functional business or political advantage gained by this particular personality disorder.
CEO of Merrill Lynch John Thain recently had to resign after it was discovered he had spent 1.2 million dollars redecorating his office. Doing that in the best of times seems insane to me, especially since the toilet alone cost $35,000. But to spend so frivolously when Merrill Lynch was completely imploding, and needing to be bought out by Bank of America is pathologic. Normal people would not ask the federal government for billions of dollars while their company was completely falling apart, and then spend that much on decorating. Oh, and he also bonused out several billion dollars to Merrill Lynch executives prior to their take over by B of A.
Wow.
As a doctor, I am pathologically motivated to explain this insane behavior by making a diagnosis, so we’ll go with narcissistic personality disorder. But why are these narcissistic people (Thain, Blagojevich, Bernie Madoff, etc) so successful? I mean they’re running companies, getting elected governor, and people are handing over their life savings to them. What gives?
Well, this can’t be coincidence. I put forth that their success is in fact due to their narcissism. Situations that would make the normal person nervous, and cautious, have no effect on these individuals. They simply charge forward to face whatever challenges life throws at them, and in so doing, appear heroic. At least initially. Then at some point, their heroism is recognized for what it really is–Hubris, foolishness, and narcissistic personality disorder.
by Your ER Doc on January 27, 2009
Welcome to another installment of the Top 10 Ways to Avoid the ER
Number 4 – Drugs
Drugs like
methamphetamines, heroine, and
cocaine are the scourge of every emergency department I have worked in. Meth is the biggest problem now. If these drugs did not exist, I have no doubt that health care costs would be much lower, people would be much happier, and my job would be way easier.
Here are the problems you can anticipate if you are using these drugs:
Strokes
Heart attacks
Infections in the skin, heart and blood
Psychotic behavior (sometimes shrieking profanities at your ER doctor)
Rotting teeth
Heart failure
Liver damage
Kidney disease
Brain damage
It’s always amazing when I see patients who have been using meth for days, and they come into the ER complaining of “Not feeling good.” Shocker! I usually ask why they expect to feel good after using these destructive chemicals for days on end. Then I explain that we are going to get to know each other very well, because they are going to come back repeatedly into the ER until their body is a complete toxic waste dump–unless of course, they quit. Sometimes this works.
by Your ER Doc on January 26, 2009
One unfortunate occupational hazard of being an ER doctor is learning way more than you want to about the sexual practices
of your fellow citizens. This may give us a skewed perspective on what most people enjoy doing in their spare time, but it also keeps the job fascinating. A young man presented to the ER one day with lower abdominal pain and cloudy urine. Urine testing confirmed an infection in the bladder, but he was quite uncomfortable, so an Xray was done as well. This showed very strange, wispy coils of material in the location of the bladder that baffled the radiologist. “Clinical correlation is needed.” said the radiologist, which is what they say when they have no idea what they are looking at, so you better go talk to the patient again.
The ER doctor went right back to the patient and asked him why he might have strange material floating around in his bladder.
“Well, I suppose it could be the snakes I’ve been putting in my penis.” said the patient.
Apparently, there are tiny baby snakes that fit right inside the urethra, and can make it all the way into the bladder. It’s hard to imagine this being a pleasurable sensation, but evidently this patient thought so.
by Your ER Doc on January 24, 2009
Welcome to another installment of the Top 10 Ways to Avoid the ER.
Number 5 – Drive slow
Whenever I go to the airport to fly somewhere, my wife worries about me. She is terrified about plane crashes. When I point out to her that I am far more likely to die on the way to the airport in my car, this makes her feel no better. But it’s true. I think we need to really think about what is most likely to kill us. And motor vehicle crashes are a significant cause of death for otherwise healthy people. You have a risk of death from car crash of slightly more than 1 in a thousand, per year! If you are a male, you are more likely to die than females. And if you are between 16 and 24 years old, you are in the highest risk group of all. Why? Because young people drive too fast!
We all need to drive slower and decrease the risk of getting killed or injured out there. We would not tolerate any safety measures being skipped as we get on board a jetliner, just to save a few minutes, and it should be the same on our roads.
