chest pain, arm tingling, dyspnea ,,, oh my

02/09/2009 at 6:35 AM Leave a comment

Had a patient call me friday at  five minutes of five. apparently the prior saturday he developed sudden intense chest pressure, arm numbnes/tingling, shortness of breath, fatigue and a vague feeling of unease. He is calling me 6 days AFTER the event. 

He continued with his dinner plans and in 2 hours the episode passed. For the past week he has felt weak, his legs dont have the normal strength and he gets occasional bouts of mild chest pressure.

Of course by the time he calls he is feeling pretty normal. If I send him to  the ER they are going to send him back to me to get him worked up. I called him in some Nitroglycerin to have on hand in case he gets another episode and see him Saturday morning ( fortunately I was in the office that day). He actually showed up, his EKG is normal  but that does not rule out the posibility of heart disease. Oh did I mention that his grandfather died of a heart attack at a very young age. At an age younger than the patient is now?

Did I mention that he did not pick up the nitroglycerin last night? Despite his failings he is a wonderful guy. I have known him for many years, I know his sister (who can be just as stubborn). Yet what chance do I have at getting this guy checked out promptly?

Enter his wife, Hipaa be dammed, getting her involved will assure his compliance.

I feel sure that at least she will call if he develops any problems prior to his stress test. 

Of course he isnt the only man with denial problems.

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Entry filed under: Doctor Musings, humor. Tags: , .

EMR Hell EMR- saves money? No really why do it.

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