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“It’s because you are fat”
“That will be $5900”.
I need to start carrying around a bingo board with tape over each spot, in case I have to go to the hospital. Then I can have squares on all the stupid shit one checks before waiting in line for hours, spending hundreds, and missing a workday.
“You’d be prettier if you smiled more”.
Just manifest a positive aura
Well there’s your problem right there.
Idk, but “u’re” gave me a minor aneurysm
Sure, we can all see the x-ray, but when was your last period?
“We’re just gonna do a pregnancy test to rule that out”
Is this the inside of a llama’s stomach? Perhaps one wearing a hat?
Spouse was at a dentist visit and her blood pressure was so high they threatened to call an ambulance. Has been that high off and on for weeks.
Take her to the doctor, doc knows she’s had a full hysterectomy, knows she doesn’t exaggerate, knows she refuses to take anything medincinal unless forced. This lady raw dogs migraines to avoid Ibuprofen.
First words out if doc’s mouth, “BP that high isn’t unheard of in women having their periods. Are you sure it’s not your time of the month?” Followed by, “well I’m sure you’re just nervous around doctors, it will go down when you get home.”
We need to start beating them
High blood pressure alone is not an emergency. Definitely something to be concerned about preventing/treating in the long term, but no blood pressure number alone warrants an ambulance without also having symptoms of something like a heart attack or stroke that indicates organ damage.
That said, that kind of blasé approach to markedly elevated blood pressure with no real plan to reassess or find a root cause is still unacceptable, especially lazily blaming it on menstruation like is so common. So not trying to undermine your experience, I just had to chime in bc the “hypertensive crisis” thing is a pet peeve of mine.
but no blood pressure number alone warrants an ambulance without also having symptoms of something like a heart attack or stroke that indicates organ damage.
Idk, I’d say a blood pressure of 300/200 or 50/20 would warrant an ER ambulance trip, even without symptoms
50/20 is just about my normal resting.
I guess we could argue at what point it is no longer physically possible to be asymptomatic with an extremely high blood pressure, but to date there is no evidence to support the treatment of the blood pressure number alone in the acute setting.
Low blood pressure is a separate issue, but also only really treated if causing issues for a patient; however similarly, one questions the plausibility that a patient could be properly perfusing their organs and therefore have no other signs/symptoms of organ damage with a mean arterial pressure of ~30 mm Hg.
I was hospitalised before by ambulance purely for a hypertensive crisis and heart palpitations, no other concerning symptoms. Magnesium infusion sorted it out, felt so much better after that.
It came out of nowhere, couldn’t sleep due to heart palpitations so I checked BP and it was wildly high along with pulse. Root cause was essentially C677T homozygous SNP, taking methylated folate and b12, and trimethylglycine helps a lot and prevents further episodes
Yeah, heart palpitations would be a great example of a symptom associated with markedly elevated bp that indicates you should be treated emergency. I’m glad you got effective treatment.
Yeah this very much depends on the actual specific number. I work inpatient so I don’t blink at 155 systolic because we’re gonna take it again in 12h and honestly these days the hospitalist says current evidence supports not even treating emergently until 170. The ED actually keeps insisting that 180 isn’t their problem for patients they want admitted to psych. A small dentists office might not be up to date on current best practice for treating hypertension.
When I interviewed for a CSU they were even like “how would you approach an intake where your new pt has a BP of 180?” and I, coming from the university hospital where I had residents subject to my whims I struggled to come up with an answer that wasn’t “page the oncall I guess?” But I did manage “…tell them to take some deep breaths and take it again…?” which was apparently the right answer???
150s to me is a GP/PCP’s problem 3 months from now and ultimately they’ll probably just tell the person to start with eating less salt. It also sounds like it was asymptomatic and there’s also the possibility that the doctor just figured she wouldn’t take anything anyway based on this person’s description.
No seriously, there is no number that you need to treat emergently without accompanying signs of end-organ damage. The AHA recommends considering “permissive hypertension” even for SBPs over 180. So you could be 220/180 and if no other symptoms or signs of organ damage, you should get treated the same as someone who is 145/95, and even then that’s only if the hypertension is chronic. The only difference is it will probably take a lot more meds to chronically control someone whose bp is that extreme.
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Yeah >180 is definitely serious, I may have overstated myself there trying to make my point. If you read that high, it’s recommended to contact your doctor asap, but not to seek emergency treatment unless you’re having symptoms.
Current (but limited) evidence actually suggests some harm caused by unnecessarily treating asymptomatic markedly elevated blood pressure, and low risk of acute (hours to days) adverse events caused directly by the hypertension.
I’m a PharmD who works in the ED at a large teaching hospital. I have this conversation often.
Recommendations from the AHA directly to patients/lay persons
A great “Things We Do For No Reason” article about the topic. (There’s even one article in this paper that specifically talks about patients with systolic >220, only 0.2% of which had a negative vascular outcome at 7 days without inpatient treatment.) I highly recommend this paper. The folks at SHM/JHM do great work with this series.
Every lady’s experience in a red state. Seriously, I’m not making a joke, being a “conservative” as defined in the US political system NEEDS to be categorized as a mental disorder that precludes people from being doctors at the least.
There are so many misogynists in the center (we don’t have a real left) that the orange idiot beat two women.
This definitely isn’t just a female thing. We were all exchanging doctor stories the other night and everyone had ones like this. Weirdly they were all in the past few years and that being gaslit or dismissed by a doctor just feels normal now.
Doctors are useless assholes nowadays, more interested in yapping about themselves than anything remotely useful.
I’d rather have a drunk North Korean veterinarian who lost his license and doesn’t understand a word of English address my issues than any of the psychotic freaks Canada is cranking out lately.
It’s still hard for to believe I was denied renewal of a medication I was already on for years for serious mental health problems, because “maybe you just need to get out more,” or “might be on your period.” By multiple Canadian GPs.
It took two years of waiting for a female psychiatrist to find someone who was like “Oh yeah, you’ve got severe depression, ADHD, AND psychosis from untreated severe depression, let’s get you on meds ASAP.”
Sounds like that’s all in your head. Did you see that on the internet?
(My imitation of a doctor. Pretty good huh?)
😬
Multiple compound and comminuted fractures in carpometacarpal particularly on the right as well as compound and comminuted fractures on the left distal radial and ulnar bones.
Amputating 100%, but where will depend on the possible presence of any severe lacerations, contusions, and third or fourth degree burns.
It’s not lupus
doc says they can’t lend a hand
This is textbook hysteria. This woman needs a lobotomy, stat, before the damage spreads to her vagina. Without that, she’s only got her mouth.
Our latest research has shown that anal sex is a very humane way to give a woman’s life meaning after losing her vaginato hysteria.
First step: pregnancy test
They’ll be asking her unconscious body 15 times if she’s pregnant, and her lifeless corpse at least 4 times.
Im not a doctor but I think she might be on her period. meow meow meow meow meow meow meow meow meow meow meow meow meow meow meow meow meow meow meow meow meow meow meow meow meow meow meow meow meow meow meow meow meow meow meow meow meow meow meow meow meow meow meow meow meow meow
Ooh, are we playing Cat Or Doctor? The party game from Hello From the Magic Tavern? I’m going to guess… cat.
I am cat doctor.
