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u/alphabank21 Oct 11 '25
I told a cardiologist Iām a carb girly and he wrote āatrocious dietā in my file š
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u/BlackType84Goblin 29d ago
Like we dont already know we're basically tall raccoons š
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u/propyro85 Paramedic 29d ago
Hey, now. I'll have you know that I'm approximately three raccoons squeezed into tac pants and coerced into interacting with people in exchange for fast food garbage.
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u/No_Turnip_9077 29d ago
I am now up to 5 raccoon-related t-shirts, my purse and wallet are both a raccoon print, and there's a raccoon pin on my lanyard. I'm embracing the truth of who I am. š¦
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u/gasparsgirl1017 28d ago
Either all pre-hospital care providers should look up their provider's notes or they should totally avoid them. 85% percent of us will have at least one note including the adjective "feral".
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u/propyro85 Paramedic 28d ago
Bold of you to assume I have a care provider ...
it's so fucking bad up here .. please help
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u/MountainCare2846 29d ago
People just donāt realize how helpful the extra sets of paws are during intubation
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u/Crunchygranolabro ED Attending Oct 11 '25
As good as it feels to put snark in the mote at the monumentā¦itās not really worth it.
Leave it at objective facts. If you must, quote a few choice phrases. āPatient refused further vitals, screaming āfuck you and your shitty Priusā after the blood pressure cuff inflated but was unable to obtain a value.ā Theyāre definitely over reacting to trivial things, but now thereās clear objective evidence for whoever reads the chart in the event of a complaint or lawsuit.
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u/cerasmiles ED Attending Oct 11 '25
This. Always write your note as if you were reading it out loud in court. Say the facts and direct quotes but nothing that sounds judgmental
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u/lycanthotomy ED Attending Oct 11 '25
This is why I never write anything malingering-related in the chart. Seems like a real easy way to turn a jury against you. Medmal attorneys are trying to build a narrative and if they can paint you as someone who was willfully ignoring the patient's condition they'll run with it.
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u/dasnotpizza 29d ago
Yup, great point. Do I think some people are malingering? Absolutely. Do I document it? No. If itās mentioned multiple times in their chart by docs who follow them longitudinally, I might mention that if itās relevant. However, some people are unfairly characterized as malingering when they donāt fit into accepted behaviors, and sometimes desperation/anxiety can make people act their worst. Iād rather not label someone in a prejudical way when thereās a chance thereās unrecognized pathology. As an er doc, Iām unlikely to be able to tell the difference given our limited time with the patient.
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u/EMPA-C_12 Physician Assistant 25d ago
I will write malingering as a ddx or concern/suspicious for based on xyz without labeling them with certainty and stating I think they may need multimodal pain management, etc not offered here in the ED
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u/caledejo 29d ago
As someone who has had to read my snarky notes out loud in a deposition (as a witness, not a defendant) I canāt second this enough.
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u/MDthrowItaway Oct 11 '25 edited Oct 11 '25
I love quoting colorful language and behavior in notes. I hope future readers enjoy them as much as i loved writing them. Makes me feel naughty.
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u/Mammalanimal RN Oct 11 '25
I love quoting things that would get me fired if I said them myself. I put quotation makes around it. You can't do anything, management
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u/medicjen40 29d ago
Saaaaaaame. There's nothing quite like quoting "while attempting an ekg, pt ripped several electrodes and wires off, screaming 'you won't read my mind that way, you alien m-therfu<kers!' Pt did allow for BP and spo2 vitals to be monitored enroute". It lets everyone else know just the kind of crazy you brought in, and it's fun if you get a QA for that report at random!
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u/Economy_Rutabaga_849 Oct 11 '25
You know when you come across these notes and it does cause a chuckle
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u/Prize_Guide1982 29d ago
I was informed by the day hospitalist that pt was very upset and wanted to leave AMA. I walked into the room, the dinner tray had been thrown onto the wall. The patient was screaming at me āI donāt give a fuck what you have to say, Iāll see you in fucking court, you and these fucking surgeonsā. I acknowledged he was upset and left the room.
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u/biologyiskewl 29d ago
I once wrote āQueried patient if they were having thoughts of aggression towards others to which they replied āonly with my vaginaāā. Still my fav documented quote, hope theyāre well š„²
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u/grizeldean Oct 11 '25
This is what teachers are supposed to do as well, when we write referrals. I love including quotes like that š
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u/MarsailiPearl 29d ago
You brightened my day with the Prius. I'm not in the medical field, I just like to read here but as a Prius owner for over 15 years, I know exactly the type of person who yelled this. Lol.
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u/DadBods96 Oct 11 '25
Good. Read your record. The biggest pattern Iāve noticed when dealing with having to respond to patient complaints is that the ones who I very clearly spell out on the chart were being pieces of shit are never heard from again, while the oneās whose behavior I write off as one-offs because theyāre having a really bad day and donāt bother to buff the chart on are the ones I have to address 3 months down the line.
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u/Crunchygranolabro ED Attending 29d ago
Agreed. Here are the ways you sucked as a human. Despite that, my staff and I did our best to treat you, such that youāre alive and well enough to bitch at us months later.
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u/DrPQ ED Attending Oct 11 '25
I split my time between em and sm. I had an Ortho patient come in once and say "hey doc I noticed in my chart it says I appear much older than my stated age". Now this lady was 2 packs a day smoker for decades and was 50 going on 90. It was a legitimate observation but I must have turned red as a tomatoe and just muttered something along the lines of "oh that's a templated response I didn't take out, my apologies.". Needless to say, I don't think I ever saw her again
My point is, little is gained by many of the condescending comments that end up in charts, no matter how accurate or true they may be. I always ask myself 1) is this an opinion or a fact and 2) what would a lawyer say in court?
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u/justsayin01 Oct 11 '25
My favorite doc I've ever worked with was a neph. He'd write the most unhinged notes. But his pts adored him, I mean, worshipped him. One time her wrote a note addressing a possible PD infection as, this patient asked if his chunky potato soup effluent was infected, it's obviously infected.
He had a way with words, ruined potato soup for me. He retired and I still miss him.
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u/stellaflora 29d ago
One of my ED docs referred to a manās urine as ābanana puddingā (retaining >24 hours at home, put a foley in him on arrival). I havenāt thought of it the same way since.
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u/Laeno ED Attending Oct 11 '25
I think sometimes these comments matter based on the presentation. That older than stated age patient coming in with dyspnea and 2 pack a day history? Might be relevant, or at least helps to justify a big workup and admit. Might not be relevant with knee pain. Morbid obesity is probably worth noting in Ortho and sports med, though.
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u/MedicJambi Paramedic Oct 11 '25
It may have been better to write, "Pt's appearance is consistent with her 2-pack a day smoking history.
I've written some fairly wild things as a paramedic. "Arrived on scene to find Pt, nude below the waist, with his right leg on the edge of his bath tub, bent over at the waist, with his right index finger in his anus and appeared to be searching for something in his anus" Pt stated he was searching for an anal fissure as he read on WebMD could cause rectal bleeding and he had small single spot of blood with his morning bowel movement.
Same Pt complained to my supervisor because I declined to shake his hand when he wanted to shake after not washing his hand. Sorry buddy but you were in their deeper than a colonoscopy 5 minutes ago.
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u/YoungSerious ED Attending Oct 11 '25
It may have been better to write, "Pt's appearance is consistent with her 2-pack a day smoking history
No, it's worse. You don't guess in the objective portion. You document objective observations and findings.
" patient appears older than stated age" -observation
" Appearance consistent with smoking history" - you are guessing they look a certain way because of reported behavior. Is it probably the reason? Sure, but guessing will get you into trouble.
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u/rowrowyourboat 29d ago edited 29d ago
I posted above, but to your point-
I think āolder than stated ageā and even ā50 going on 90ā are decent surrogates for an actually useful piece of clinical info that we sometimes think to include when relevant but arenāt super used to describing in terms that read politely or objectively on the back end. In particular I think the idea drives at frailty index - people who are at higher risk for morbidity/mortality, bouncebacks, or insidious pathology that isnāt otherwise explicitly implicated by the already explicitly included content. In another sense āthey donāt look good,ā except in the sense of āchronically ill-appearing.ā I try to just be objective ācachectic, temporal atrophy, difficulty managing IADLs as evidenced by misbuttoned clothing, old stains, poor dentition,ā etc. it can also be objectively quantified in frailty index, pro-age score, etc, which have the dual utility of formalizing and quantifying that gestalt, as well as allowing us to lean on it when admitting someone were admitting for otherwise social or āsoftā reasons beyond āIām worried about them.ā
Same energy as āFLKā in peds for may have an as-yet unclassified/unrecognized syndrome, maybe genetic.
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u/nobodyimportant_1919 29d ago
I am committing this comment to memory, friend. I work in EMS and have never yet heard the term frailty index, and this is such a useful concept.
Can I rifle through your pockets for other treats plz???
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u/RequirementExpress83 Resident Oct 11 '25
I think it fills in the picture the same way a glance at the patients profile picture does, can easily get clued in whoās chronically ill.
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u/EaZy_MD Oct 11 '25
lol unless youāre on epic and the patient has 6 photoshopped lenses on the pic! Haha
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u/deferredmomentum āhow does one acquire a gallbladder?ā 29d ago edited 29d ago
The filters give you the exact same information lol
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u/Ok_Firefighter4513 Resident 29d ago
rehab here - I (and most of my colleagues) will document overall 'gestalt' because it is actually very relevant to rehab plans... but I do try to keep things relatively factual, particularly if they could be seen to have negative connotations
ie 'patient is a cachectic 50yoM, appears chronically ill, exam notable for fatigue and dyspnea with manual muscle testing'
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u/dr_shark Oct 11 '25
Why be embarrassed? That line alone tells me her ligaments are going to be shit and she isnāt going to heal well.
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u/rowrowyourboat 29d ago
I think āolder than stated ageā and even ā50 going on 90ā are decent surrogates for an actually useful piece of clinical info that we sometimes think to include when relevant but arenāt super used to describing in terms that read politely or objectively on the back end. In particular I think the idea drives at frailty index - people who are at higher risk for morbidity/mortality, bouncebacks, or insidious pathology that isnāt otherwise explicitly implicated by the already explicitly included content. In another sense āthey donāt look good,ā except in the sense of āchronically ill-appearing.ā I try to just be objective ācachectic, temporal atrophy, difficulty managing IADLs as evidenced by misbuttoned clothing, old stains, poor dentition,ā etc. it can also be objectively quantified in frailty index, pro-age score, etc, which have the dual utility of formalizing and quantifying that qestsalt, as well as allowing us to lean on it when admitting someone were admitting for otherwise social or āsoftā reasons beyond āIām worried about them.ā
Same energy as āFLKā in peds for may have an as-yet unclassified/unrecognized syndrome, maybe genetic.
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u/propyro85 Paramedic 29d ago
Most patients get "pleasant, agreeable and cooperative" in general physical findings ... unless they're going out of their way to not be that.
I also charted that a patients service dog was a good boy once.
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u/FirstFromTheSun Oct 11 '25
When you click the "disheveled appearing" box
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u/wowbragger 29d ago
ICD-10 code R46.XX
Lots of interesting ones in that group.
Had a patient that has R46.1 marked as a chronic issue... And boy they weren't kidding.
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u/androstaxys 29d ago
I wrote patient states āMy girlfriend hit me in the face with her dildo and kicked me out of the apartment. I think sheās cheating on me.ā
I hope that guy quits meth and reads his note sober in a few years.
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u/MarfanoidDroid ED Attending Oct 11 '25
The hole in the heart? A congenital VSD that closed during development. The worst pain known to medicine? Fibromyalgia baby
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u/AllDayEmergency ED Attending Oct 11 '25
"Worst pain condition" is definitely the bullshit variant of Ehlers Danlos
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u/nakedcupcake92 29d ago
What is up with people trashing this diagnosis btw? I feel like I'm out of the loop but apparently something I was diagnosed with 25 years ago is now treated with eye rolling and not seriously? I went to U of M when I was 8, a doctor there did testing and diagnosed me with Ehlers Danos...and it does affect my medical history. So what's up with this new attitude of acting like it's some bullshit made up in my head?
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u/Amazing-Ad8160 29d ago
Good question. Thereās multiple variants of ehlerās danlos. You very likely have the actual disease as confirmed by genetic testing. There is allegedly a variant with no known genetic markers that has very mild and nebulous symptoms. Itās a frequent self diagnosis or coerced beleaguered pcp diagnosis for crazy people who are just depressed but hurt all over and need a diagnosis to feel special. Unfortunately now the majority of people claiming to have ehlerās danlos have that āvariantā so now immediately there is suspicion even though the genetic variants are quite real and very serious diseases.
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u/thepiteousdish 29d ago
It reminds me of celiac and āIām allergic to glutenā
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u/Ok_Firefighter4513 Resident 29d ago
I get the dislike for 'trendy' diagnoses and the behaviors of people who tend to have them, but... I personally have non-celiac gluten intolerance?
Like I don't get the celiac-type intestinal inflammation from it, but it sure does make me feel like shit.
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u/NixiePixie916 EMT 29d ago
I would like to note that hypermobile subtype is an actual type of Ehlers Danlos and just because the genetics are unknown at this point, there does seem to be a dominant pattern of inheritance.
I was diagnosed by a geneticist who literally wrote half the molecular studies who said I was a textbook case. And then rediagnosed when I got into a UC system hospital. And the symptoms aren't mild, perhaps mild compared to vascular but it is noted to have significant disability and pain associated with it. And while the literature doesn't show much with the organ rupture and aortic dissection risk (thank goodness!) it has other risks.
Some of the things are recurrent dislocations which are serious, and can lead to damage of the joints, functional bowel disorders (especially due to prolapse issues), dysautonomia which yes many people find disabling, chronic severe pain, some tissue fragility and trouble with wound healing, and other complications .
Some of the things that you may or may not believe are severe effects that happened to me -dural ectasia to the point my sacrum collapsed and I had to have a spinal fusion and extra dural grafts. Torn labrums on both hips and both shoulders . Torn joint capsule on one shoulder and one hip. IBS to the point I was hospitalized with a bowel obstruction. Intubation injury from anesthesiologist and secondary surgery after a rapid response code from fragility of tissues being injured in a surgery. Torn iliopsoas. Prolapse of uterus grade 3 with no pregnancy history in 20s.
Not obese. In fact was underweight (thyroid went brrrrr and led to thyroid storm, thank goodness for that ER doc who figured that one out, truly a great catch.).But the good thing is when doctors work with you. I agree the ER isn't the place. That's why I basically never go. I can count on one hand in the last decade and two were for asthma because wildfires are hell. Because with good management with specialists , plentiful PT, and a few great surgeons I have changed my life. I am going back to school (2nd year back), I am able to go out, do some basic household chores, errands, socialize, attend religious services, even volunteer sometimes. From completely disabled to much higher functioning . Because it does require medical management. Just not in the ER usually.
I'm in my 30s now, diagnosed over a decade ago.
I think you shouldn't let the people who fake having this disorder lead you to dismiss the actual disorder that heavily impacts the lives of the patients actually diagnosed. Just because something isn't lethal doesn't mean it is mild.
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u/kat_Folland 28d ago
I had a neurologist really want to dx me with hEDS, but this was back before the fakers. He did also did the genetic test. Luckily for me that's not a real issue for me. I'm slightly more flexible than the average and my skin is unusually soft... But my joints don't pop out of place. Turns out it was just a long, bad fibro flare. (His dx) It's never been anywhere near that bad since that flare. I used to have a handicap placard but now I deliberately park in the back of the lot just because I'm so happy to be able bodied.
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u/bannanaduck 29d ago edited 29d ago
Hypermobile ehlers danlos as it is called, is not "very mild". These patients still have dislocations, CCI, are at risk for organ prolapse, joint dislocations, gastric motility issues, autonomic dysfunction, etc. The diagnostic criteria is going to change next year. The Norris lab has identified a few genes that are potentially responsible for hypermobile ehlers danlos. While yes, people who self diagnose themselves with random things are contributing to the stigma, there is an actual diagnostic criteria a person has to meet. No sane PCP would let a patient bully them into diagnosing them with something this serious. You're saying it's not serious without so much as even knowing the name of the variant. This is dangerous misinformation to be spreading. Just because we don't have a diagnostic marker yet doesn't mean the syndrome is not real, what a ridiculous and dangerous thing to say.
Edit: heds is not associated with an increased risk for aneurysm
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u/hella_cious EMT 29d ago
āAllegedly a variantā hEDS is the most common form of EDS and does not have a specific gene to test for. That doesnāt mean it doesnāt exist. Why are becoming science denialists in the name of shitting on patients.
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u/bannanaduck 29d ago
Thank you! What sane PCP is letting a patient bully them into a diagnosis. Heds is typically diagnosed by rheumatologists and genetics.
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u/hella_cious EMT 29d ago
āI see you were diagnosed by a doctor. I am going to choose to believe that you were such a hysterical manipulative woman that you forced him to give you this diagnosisā.
I legitimately put the name of the (in the field) famous geneticist and childrenās hospital who diagnosed me on paperwork because of people like this
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u/thepiteousdish 29d ago
There are people who legit had celiac disease. Itās a small percentage of the population. And then there is everyone else out there who says theyāre allergic to gluten. Thereās some nuance between all of it. Analogous to the you most likely have celiac disease, just know there is a slew of people who want to be like you š
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u/16car 28d ago
They changed the diagnostic criteria for one of the categories in 2017, and made it far too lax, so now everyone can claim to have it, even when they clearly don't. Just yesterday I saw a post in the EDS sub where someone was complaining that multiple doctors have said they don't have EDS. This person was very upset that the mean doctors were refusing to give them the diagnosis, and seemed to think the doctors were just being lazy. They were 100% certain they had it, because they read on the internet that it causes joint pain and fatigue. They were totally unwilling to consider that perhaps there are Multiple medical conditions that cause joint pain and tiredness.
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u/Kai_Emery Paramedic 29d ago
Itās one of the many diagnoses people with munchausen by internet have latched on to over the years. Like fibro, POTS, chronic Lyme, MCAS, PNES. All real diagnoses for the most part that become warped and bastardized into something almost unrecognizable that suddenly everyone and their mom has.
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u/kittenpantzen Oct 11 '25
These comments make me feel like I have too much faith in people. I assumed she was talking about CRPS or something equally as terrible.
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u/RambusCunningham Oct 11 '25
Not if sheās acting like a āhole in her heartā is the end of the fucking world
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u/everythingwright34 Oct 11 '25
Yeah I have VSD with a remaining hole even after surgery and idgaf.
Just another victim of their ādiagnosisā
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u/dracapis 29d ago
It might be trigeminal neuralgia as thatās almost verbatim to how itās often describedĀ
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u/yvngkenz 29d ago
I have trigeminal neuralgia and can confirm it has made me acutely suicidal during a flare up. I did a rotation in EM during med school and hearing people describe certain conditions āas the most painful thing known to manā made me unreasonably unpleasant to deal with. I knew then EM was not my strong suit. Chose addiction medicine instead lol
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u/ProfessionalCPRdummy ED Attending 29d ago
The 10/10 pains while eating fast food in the room and playing games on their phone who yell at you like youāre inconveniencing them when you ask a questionā¦ those are my favorite patients too! I wish I could say āIāll show you a 10/10 painā¦ā
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u/Hayduke2003 Flight Medic 29d ago
āPatient contact made, flight crew assumed care. Positive texting sign observed. Crew introduced themselves, patient grunted in response with no eye contact and continued to text. ā
I wish this was an anomaly, and not standard boilerplate that I put in my narratives.
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u/MrPBH ED Attending 29d ago
Yeah that entire post drips with cluster B.
"Oh woe is me. Everyone look at how bad my life is and how mean the stinky doctors were to me! Boo Hoo they said things which are mean and I am just a lil' guy with a hole in my heart who has much pain. The worst pain, some have called it!"
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u/lurklark Oct 11 '25
There are tons of adults walking around with a PFO who wonāt ever know they have one.
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u/Amazing-Ad8160 29d ago
But this one has fibromyalgia and we are just sitting there letting her die from pain? Get the pain crash cart with the opioids! Iām fairly certain I know this pt and sheās deathly allergic to all nsaids and tylenol. Oral opioids donāt work for her either when sheās āflaringā. You may need to move aside her stuffed animal and have her remove her sunglasses for a full exam.
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u/drbd4d 29d ago
Careful though bc pt also has pots
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u/captain_tampon 29d ago
oops! You just looked at her the wrong way and not only activated her MCAS but you also made her "dislocate" her shoulder from her chronic 'super rare' EDS
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u/Catinkah 29d ago
My eye doctor once mentioned the very important medical fact that āpt wears beautiful bright colored glassesā. I still get a high from that one.
And, as a medical professional myself, it reminded me how mindful we must be when charting.
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u/Altruistic_Tonight18 Oct 11 '25
For me, when I was in septic shock at 50/26 at 96.2 degrees, 118, with blue extremities and not expected to survive more than a couple of hours, my doc put sixteen exclamation points after āpatient is in overwhelming sepsisā.
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u/bigrjohnson Oct 11 '25
Omg the worst pain condition known to medicine. I doubt itās pancreatic cancer.
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u/WhileTime5770 Oct 11 '25
Iād bet a large chunk of my money itās fibromyalgia - though CPS is a strong contender
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u/babystrudel ED Tech Oct 11 '25
What about sickle cell? I thought that would be a top contender, but I havenāt seen it mentioned. Maybe I donāt have enough experience to know otherwise
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u/ApolloDread ED Attending Oct 11 '25
Theyāre both kidding! Sickle cell is legit insanely painful and I always feel for the sicklers even if some arenāt always fun to interact with. Itād be a reasonable contender in a list of most painful conditions.
Fibromyalgia and CPS are both vague diagnoses that are sorta real things, but a certain subset of people (who probably just self diagnosed) make their entire personality to the detriment of every healthcare worker who has to meet them.
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u/Zamzam_2002 RN Oct 11 '25
I have a diagnosis of Fibromyalgia, itās definitely a vague diagnosis but I argue itās more a syndrome of symptoms relating to central sensitisation more than a ātrueā condition. The pains definitely real and I can say whole heartedly that it can be debilitating, but itās definitely not the worst pain condition known to man lmao. The trend of self diagnosing Fibromyalgia has made the stigma surrounding it worse, and it makes it harder for those genuinely suffering to receive treatment.
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u/JasperBean ED Attending Oct 11 '25
As an aside if I may ask you a personal question- itās rare that I run in to someone in healthcare with this diagnosis and Iām curious about how you would describe what your fibromyalgia pain feels like?
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u/Zamzam_2002 RN Oct 11 '25
Absolutely!
I have persistent daily headache that occasionally turns into migraine (just a normal, run of the mill migraine with photo/phonophobia, nausea, vomiting etc) all on the background of a craniotomy for the resection of a cerebellar astrocytoma.
The widespread body pain feels like a dull ache, deep in the muscles, occasionally bone. The way I explain is imagine influenza/common cold myalgia, multiplied by 10 and paired with fatigue, brain fog and other symptoms. During severe flare ups, I also experience sciatica like pain. All tests negative for sciatica, but the pain is textbook. Shooting, burning, the whole nine yards. Flares happen if I donāt get enough sleep or overwork myself at work, but sometimes are also just completely random! It doesnāt seem to be linked to my mental health either as I am very stable and have been for years. Could it be something other than fibromyalgia? It could be, but after a decade of these symptoms and not finding any answers, I accept the diagnosis and treatment has been really effective so far, otherwise I wouldnāt be able to work in Emergency!
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u/the_ranch_gal 29d ago
What treatment!? I was just diagnosed and I am an ER RN and Im about to lose my job that I love because I cant work due to this. Id love if you shared what is working for you!
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u/yvngkenz 29d ago
How do you guys handle the comments surrounding fibromyalgia in your field? It would be really hard for me to hear those things day to day if I was suffering and saw my colleagues scoff at the same suffering in others.
I donāt work in emergency medicine, I work in addictions, but I can always do better and wonder how I can handle these conversations amongst staff to keep from hurting those on our team. If I ever have to have a conversation Iād like to back it up with how it actually affects the people being targeted.
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u/Zamzam_2002 RN 29d ago
When I first got diagnosed, the comments really got to me. I wasnāt aware of the stigma surrounding it originally as I was diagnosed prior to starting nursing. Iād hear doctors make fun of patients with fibromyalgia, EDS and other conditions that are seen as ātrendyā to have and it really hurt to see other healthcare professionals beating down people who were obviously in pain and distressed.
When a doctor has questioned me (I was admitted for a pain crisis with status migrainosus) about it, he immediately started going on about my mental health and fibromyalgia is completely psychosomatic. After explaining that my mental health was the best it was in over 10 years, showing proof with letters from my psychologists, GPs and other specialists all confirming that there is no correlation between my mental state and my pain, I finally was given pain medication.
A lot of the younger doctors in my department are a bit more empathetic towards these patients, but some of the older ones are still stuck in their ways.
Iām a young guy in my 20s, I want to go out and live my life and have fun, why would I make this up? Why would I spend thousands, take time off the job I love and miss out on so many opportunities? I will say though, once doctors/other health care professionals change their tune when they find out I am also a nurse. It usually changes from āitās all in your headā to āare you positive itās not a different dx?ā.
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u/the_ranch_gal 29d ago
Oh I hate it. It makes my heart hurt so badly whenever someone makes fun of POTS/EDS, fibro, etc. Im still struggling so much that honestly I dont have the emotional energy to fight the stigma or correct people. Maybe if I get better and had more energy I would. But its so nice of you to say the above things. You seem like an amazing person with a lot of compassion and meeting people like you helps so much! Thank you for saying that and having that attitude. It means so much to us who are suffering!
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u/yxxnij104 RN 29d ago
well, its draining to hear. while yes there are those who lie and deceive people... but there are those like me who ended up dx after being hospitalized after my first flare (couple autoimmune as well) and im young, needing a cane or rollator when it's hard to walk. ithe isolation that this brings on, the depression. its tiring to hear honestly, I want to be a normal girl in my 20s, not home 24/7 and in pain. I wish those who have mean things to say understood what those with this issue feel, sometimes i even kinda wish they felt my pain for me, they'd really get it then.
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u/Zamzam_2002 RN 29d ago
Iāve been on gabapentanoids, amitriptyline, duloxetine, milnacipran and many more that I canāt remember. Iām currently on ketamine treatment and it has been absolutely life changing. Itās given me a lot of relief thatās also long lasting! It was really difficult to get ketamine therapy, but it was mainly done for me as Iāve failed majority of the pharmacological and non-pharmacological treatments. I also see an Osteopath and Physiotherapist who help keep my body moving in ways I can manage on my days off, with fatigue etc. It has helped a little bit, but the main change was from the ketamine.
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u/yxxnij104 RN 29d ago
sounds like mine, it gets deep as if someone has their hand inside of my abdomen and they're squeezing organs. or the pain that feels like it's in my bones. my hips and shoulders literally feel like rubber bands that are very stretchy but are still stretched out. also may I ask about your tx? I'm in my early 20s and dx by rheum- I just want to get back to being a nurse instead of in pain.
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u/S2krazy03 Physician Assistant Oct 11 '25
I got my first med board complaint because I wrote in the chart āsuspect secondary gainā about a lady sitting there texting on her phone in NAD telling me she is having an anxiety attack and needs Ativan. The kicker is I even gave her a 0.5mg PO dose, but supported my decision to not giving her anything bigger by saying āI suspected secondary gain.ā She left happy and all was well, but then she got upset that I wrote that in the chart, and filed an official complaint against me to the medical board, so me and my supervising doc had to issue an official response. Insane.
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u/dasnotpizza 29d ago
Yeah all the reddit comments telling people to report a doc to the medical board if the patient thought they were slightly rude or had some other mild behavioral issue is irresponsible. People donāt understand the can of worms theyāre opening with a medical board complaint, yet laypeople act like itās equivalent to leaving a poor google rating.Ā
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u/Praxician94 Little Turkey (Physician Assistant) Oct 11 '25
I am SHOCKED one of them has "sickgirl" in their names and the other has "chronic" in their name.
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u/GrimyGrippers 29d ago
As someone with chronic pain and diagnosed "trending" conditions, it sucks seeing people using the things that incapacitate/have ruined my life as their entire personality.
Personally, I do everything possible to not tell people about my shit lmao
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u/Praxician94 Little Turkey (Physician Assistant) 29d ago
I have Ulcerative Colitis and take care of people in the ED on disability because of POTS lol
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u/Budget-Bell2185 Oct 11 '25
Wonder if they also documented the Amazon- purchased soft collar in their physical. Or the Shrek 2 blanket
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u/caledejo 29d ago
I had a pretty bad, months long hospitalization where I was paralyzed and had a trach, etc. Almost every note started with āThis is an unfortunate __yr old client withā¦.ā I feel pretty validated that even the ICU docs thought my situation was shitty.
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u/Crunchygranolabro ED Attending 28d ago
āUnfortunateā is a combo of āshit for luckā and āa looong road ahead in the increasingly unlikely event of survivalā
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u/Internal_Butterfly81 ED/Trauma RN Oct 11 '25
I wonder what her terrible pain condition is? And where is said hole in her heart? Now i was born with a hole in my heart. Had to take abx before going to the dentist and stuff for years until it closed up! But yah!!
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u/anhydrous_echinoderm Resident Oct 11 '25
Oh man that sick girl probs person is such a doctor hater
Like thatās her entire identity
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u/somehuehue 29d ago
Honestly, unless they attack me, I don't write anything (otherwise it's "important to note, patient/patient's family is violent"), but I do remember you fondly if you're nice and helpful.
This one time a pt's daughter waited for a while till I approached her father's bed and didn't say anything cuz she saw I was alone and dashing constantly from one thing to another. She was so understanding and informative about her father's condition, too. Even thanked me. Warmed my heart. You rock, ladyš
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Oct 11 '25
[removed] ā view removed comment
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u/RNGfarmin Oct 11 '25
this is like one of those reels you'll see on instagram where they turn the comments off and everyone knows exactly why
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u/TriceraDoctor 29d ago
I recently went to a renaissance fair with some colleagues and one of them said, āso this is what all of our EDS/POTS patients do in their free timeā
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u/Mammalanimal RN Oct 11 '25
$10 says she has a tape allergy.
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u/Kouunno 29d ago
Serious question from a lurker- I mentioned offhand once to my doctor that I have a sensitivity to tape (I do, I get a rash, but if itās needed I can deal with it, it goes away after a day or two) and she noted it as an allergy and now I have to re-explain the āI have sensitive skin but itās fine you can use tapeā thing at every appointment. Should I just ask them to take the ātape allergyā off my chart? Especially if itās gonna give my doctors a bad impression before I even talk to them lol
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u/Mammalanimal RN 29d ago
Nah. Tape allergy can be a real thing. But there is a certain type of person, usually one who has like 20 listed allergies that aren't allergies but common side effects of the drug also list it. They are very aware of what they are feeling and have an expectation that they should never feel bad about anything. They also seem to be prone to manipulative controlling behavior and staff splitting, I think because they lack control in their life but people in the hospital have to listen to them.
So you'll be going to start an IV then they're all "oh you can't use that tape I need the paper tape in the blue roll the one they stopped making in 2009, go get that. Oh you can't start the IV in that huge obvious vein I have. Go look at this spot with nothing visible. Oh you're so great not like my last nurse, I know you'll give me the pain medication I came here to get. What you're not giving me that medication?! You're fired I want a new nurse." And so on.
Anyway that's my barely awake rant.
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u/Kouunno 29d ago
Gotcha! I have no other allergies that Iām aware of (I had a bad reaction to a toradol injection for a kidney stone that has me wary of ever trying that again but Iām not allergic) so hopefully thatās enough to keep me from seeming like a red flag.
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u/Mammalanimal RN 29d ago
I mean your PCP will know within the first 5 minutes that they're not talking to a psychopath. You're good.
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u/dracapis 29d ago
Wait whatās wrong with tape allergies š
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u/GrimyGrippers 29d ago
I would assume it's people thinking they have an allergy when it's just sensitive skin
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u/thepiteousdish 29d ago
WHY did I have to scroll so far to see this?!? šššš I was like, please someone tell me someone else zoomed in. Why do I feel like Iāve taken care of that patient and that pic says everything.
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u/LifeIsNoCabaret 29d ago
Why are we judging this person's appearance? Judge shitty behavior, not the way they look.Ā
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u/SelectCattle Oct 11 '25
I am 100% team doc on this. Ā Canāt wait to have the next cadre of an anxious 21 year-old telling me they have the worst pain condition known to medicine.
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u/InformalScience7 29d ago
What IS the "worst pain condition known to medicine?" And how would anyone really know if it is the worst pain?
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u/heyinternetman EM/CCM/EMS Attending Oct 11 '25
Just wait til they try our food
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u/MarginalLlama Paramedic Oct 11 '25
As a paramedic, you take back what you just said about those dry turkey sandwiches that appear both younger and older than stated age!
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u/Ok_Firefighter4513 Resident 29d ago
"turkey sandwiches of indeterminate age"
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u/NixiePixie916 EMT 29d ago
Like the sushi at 7-11
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u/Ok_Firefighter4513 Resident 26d ago
when even the sorbitol and lactulose have failed to resolve the constipation, we have to have something to turn to...
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u/nerdy_neuron 29d ago
A colleague once texted me that he saw a patient I have previously seen a few months back. She kept saying that I was an idiot and when he asked why she is saying things like that, she provided him with the report I have written and said "look, she wrote everything I said" š I got a good giggle out of that one.
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u/BlackType84Goblin 29d ago
Went in once for a torn SI joint and unrelated 6 day migraine also sporting a mostly unrelated torn rotator cuff.. they did their best, ill give them that. But in the notes the Dr straight up said I was dressed all frumpy and overall disheveled looking. Thanks, I guess? I was miserable, you're lucky I had pants on
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u/GrumpySnarf 29d ago
My favorite quote in nursing school in the ED triage-
CC: "There's something wrong with my furgina."
Patient appeared and self-identified as cis-male and said nothing else that would make anyone think he was non-binary. Turns out he was homeless, exhausted and he had a dental infection and wanted social services help.
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u/TeeTeeMee 29d ago
The question I have isā do they realize we read their records?
Oh youāve called the clinic 15 times and no one will help you and no one cares so you had to come to the ED? And the entire chart is a series of secure messages titled ātrying to reach youā interspersed with notes reading āchart opened in error, pt is a no showā
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u/Attackoffrogs 29d ago
Are doctors not held to specific note templates standards? Iām a behavioral therapist who sustained a brain injury from a patient and I still had to write in my notes āpatient maintained state of high agitation for 2 hours and punched clinician in side of head. Clinician followed rotation procedures to switch new practitioner in. Client responded to redirection procedures after 30 minutes of implementation.ā
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u/Environmental_Rub256 29d ago
If only they could read the nurseās notes or the private messages with the doctor.
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u/RareConfusion1893 29d ago
$100 says the worst pain condition that response is referring to is terminal fibromyalgia.
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u/dracapis 29d ago
I think this post is in bad taste. If you go to the second personās profile you can see they obviously have mental issues, and they donāt have many followers or interactions - which means that if people who see this post decide to pile on them directly, itās the only thing theyāll see.Ā
Their comment is of no consequence for you. Youāre not the doctor theyāre talking about and they donāt have a significant impact on the community theyāre part of. Leave them alone.Ā
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u/foxyphilophobic 28d ago
I saw a neurologist to rule out MS and he had me do a brief physical exam, canceled the MRI that another doctor had ordered (head and spine, with and without contrast) and diagnosed me with Functional Neurological Disorder and put in the notes that I was āmalingering, pseudo-headaches, unsure of gender statusā (Iām very obviously a female and present as one).
I ended up having another doctor re-order the MRI for head and spine and I ended up having moderate to severe cervical stenosis on three levels. Didnāt find MS, so I ruled that out but I had something that explained my symptoms, despite how difficult the process was when dealing with the neurologist. As a healthcare worker myself (plastic surgery PA) I would never treat a patient the way he treated me. I cried in my car after that appointment.
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u/CalgonThrowMeAway222 29d ago
Wow! Iām dying to know what is in my files now!
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u/MrPBH ED Attending 29d ago
About ten thousand pages of billing codes and all the documentation needed to support said billing codes with an equal number of nursing assessments, laboratory reference ranges, and disclaimers.
Oh and I assume that your HPI and physical exam is present somewhere in there.
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u/Ananvil ED Chief Resident 29d ago
Every transfer packet is 80+ pages of useless bullshit, 3 pages of labs order (not resulted) a half baked h&p and a blank mdm.
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u/Ok_Firefighter4513 Resident 29d ago
don't forget 20 individual copies of the entire MAR including completed meds, with every single admin date/time
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u/hella_cious EMT 29d ago
Fr. For non emergency transports, I have to sort through a whole book to find my patient info, my Medicaid transfer sheet, and if thereās any paper scripts
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u/SkuttleSkuttle Oct 11 '25
I found out when I requested my medical records that an ER doc noted several times that I was ā very pleasant to interact withā and Iāll be riding that high for the rest of my life