z pak

Celej včerejší den jsem poslouchala životní příběhy jiných.
Mrtvý člen rodiny.
Chlapi, co ji bijí.
Opuštěné, bipolární dítě.
Bohatá, namyšlená drbna.
Manželé, co si jsou cizí.
Inteligentní syn, co si vyhulil mozek z hlavy.
Babička, co upravuje pravdu podle potřeby.

Prosím, ať už to skončí.

No pity.

Patient: Doc, I think I need an antibiotic. I’m dyin here. 

Wayfaring: Mmmkay…how long have you been sick with this cold?

Patient: Oh it started 2 days ago. But I think it’s moving into my chest. Probably need a Z-pak or somethin. Hey you sound kinda sick too, doc!

Wayfaring: Yeah, I’ve got the same virus you do.

Patient: Well what are you taking for it?

Wayfaring: I’m constantly sipping ginger tea with honey and lemon. And Nyquil at night. 

Patient: Oh you musta just got it. It hasn’t gotten bad yet. You just wait till you’re where I am. How long you been sick?

Wayfaring: Let’s see…. today makes 3 weeks. 


submitted by Nicholas Chopp

External image

Everything to the left of the Nexus 6P is in the bag, everything else is my person. Not pictured: 1. Springfield XD(M) 3.8 9mm with 19rd magazine, Aliengear 2.0 Tuck, 2x 13rd magazines (when going somewhere other than on-post) 2. Diapers, Wipes, and extra changes of clothes for kids (when I’m not flying solo) 3. Lenovo Y500 Core i7 laptop (rarely)

Cat dan Sapu.
  • <p> <b><p></b> <b>Aku:</b> Buk, masa ya Buk, Pak Z yang ngecat rumah kita tu ngelewatin satu spot. Jadi dirumah Jogja tu ada yang masih belum ke cat temboknya. Kotak gitu karena ada kardus yang ditaro disitu. Padahal ya Buk, kardusnya tu bisa digeser Buk.<p/><b>Ibuk:</b> Sama kayak orang nyaponi (nyapu). Kadang ada yang gak kesapu. Ibuk aja kadang gitu, ngira pojok sana udah kesapu, ternyata belum. Mungkin rasa-rasa Pak Z tu kardusnya udah dipindah.<p/><b></b> Jadi, tersirat dari respon Ibuk, manusia itu tempatnya khilaf. Jangan fokus ke kesalahan orang lain yang sebenarnya kita juga pernah melakukan kesalahan serupa.<p/></p><p/></p>
Today’s adventures in Hellacious scheduling
  • found out my NP was out today when I arrived this morning. I never get advance notice
  • had a full schedule before the day started plus a double-book. 
  • this is bad. walk-ins happen. 
  • Walk-ins happened.
  • Nine of them.
  • Nurse tells me to breathe.
  • 6 month check up became surprise physical
  • sewed a face
  • faces take forever to get numb
  • middle aged white men are the biggest wimps. 
  • middle aged white men are the clumsiest patients. 
  • Not all itchy vaginas have yeast in them!
  • No ma’am, you don’t need a z-pak. 
  • Yes ma’am, the blooming pecan trees and 3 inch-deep pollen outside might have something to do with your sneezing and watery eyes.
  • I saw 22 patients before lunch. 
  • Yesterday I saw 20 all day. 
  • Gobbled lunch down in 20 minutes and then found that I was no longer double booked. I was triple booked. 
  • sure I can do a worker’s comp and a hospital follow up and a 6 month check up all at the same time. no problem.
  • Nurse tells me to breathe again.
  • Oh hello, panic attack. Heart rate of 130? Oh yeah I’m fine. 
  • three hospital follow ups
  • no sir today’s appointment is to get your stitches out, not to do a complete workup on the condition that 5 different doctors have seen you for and have all come to the same diagnosis on.
  • no you can not have Klonopin.
  • Nurse asks if I’m ok. 
  • NO. *enters next room*
  • 7 back pains. S E V E N. 
  • shots for everyone. seriously.  Toradol? Decadron? Kenalog? Rocephin? B12? Did them all. Multiple times.
  • yes sir I understand you have arthritis and everything hurts but you CAME HERE FOR CHEST PAIN pleeeease let’s focus on that.
  • worker’s comp patient should have been sent to ER. They were sent to me. 
  • I can’t find the CT scan glasses that everyone seems to think I have. 
  • If someone else tells me to take a deep breath I’m punching them in the throat and telling them to take a deep breath. 
  • oh you want Diabetic shoes? But you’re not diabetic. Hmmm…
  • 6 more walk-ins turned away during the course of the day.
  • oh you had a wreck 4 days ago and declined evaluation by EMS but now you want to be seen? Too bad. We full.
  • Finished the day with 32 patients and 7 minutes before 5:00 to spare. 
  • Called mentor. Complained. She offered to beat everyone up. I declined. 
  • Pardon me while I go sleep 18 hours so I can be ready for the *joy* that is the nursing home tomorrow.
The disaster that was today
  •  ER doc tells me “for future reference” to let the EMTs call them after evaluating a potential stroke patient rather than me calling them with a code stroke. Never mind that I’ve already examined the patient, know them well, and am watching them have a stroke in my office. Just to clarify, you trust the EMT who hasn’t seen the patient over me? And you don’t want a little heads up on a patient who is a poor historian? So noted. 
  • EMT #1 completely ignores my presence in the room. She assumes I am ancillary staff. She ignores my report about the patient. She gives me an eye roll when the patient walks to the stretcher. Because apparently people who are having strokes universally cannot use their legs. EXCEPT WHEN THEY CAN WHICH IS ALL THE TIME. 

  • EMT #2 is only concerned about the patient’s completely normal blood pressure. Because apparently people with normal blood pressure don’t have strokes. EXCEPT WHEN THEY DO WHICH IS ALL THE TIME LIKE RIGHT NOW.
  • Shock of all shocks, my patient was admitted with–you guessed it–a stroke! Wayfaring-1, Common Courtesy and Common Sense-0.

  • Breast cancer everywhere. Three abnormal exams today. Three. All with different presentations. 1 strong family history with bloody nipple discharge, 1 horribly abnormal mammogram, 1 survivor with new dimpling and skin thickening. WHAT EVEN IS THIS DAY?
  • And oh sure, let’s add on a surgical clearance for that elderly patient who is here for a physical. Sure. All they really need is a signature. I mean the surgery is already scheduled for next week. Don’t worry if they might die on the table from one of their many comorbidities. No need to be thorough in your evaluation. They just need a signature. No EKG, no chest X ray, no labs required. Put me to sleep, doc, I’ll be fine.
  • And don’t you think I need a Z-pak?
Demi Lovato — Rushed to ER

Demi Lovato was hospitalized Tuesday for a nasty lung infection … TMZ has learned.

We’re told a friend took Demi to the ER at Providence Tarzana Medical Center because she was having significant trouble breathing.

Doctors did a bunch of tests and decided her problem was flu-related. They gave her medication, including a Z-Pak.

As of late Tuesday afternoon, we’re told she was still at the hospital.

The timing sucked, because Demi is recording an album and she had studio time Tuesday with a big producer and she had to cancel.

Get well soon, Demi!

anonymous asked:

The US allows direct patient advertising which seems totally strange to me. Does it ever cause you problems as a prescriber? Do patients ever come in demanding a specific brand of drug...or for some self diagnosed problems?

yaaasssss it’s so annoying. 

Patients come in requesting drugs all the time, but not necessarily always the ones that are advertised (screw you, Z-pak!). Occasionally it’s appropriate. Usually it’s not. Patients get their hopes up about a new drug they saw on tv but they don’t realize that that drug will cost them $350 a month or that it won’t work for their condition or it interacts with their other drugs.

Then you get the patients who pick up on one symptom–usually the most vague one–listed in the “ask your doctor about drug A if you have X, Y, or Z” and come in convinced that they need that drug. For example, I’ve seen a lot of men lately who have come in complaining of fatigue and who demand to have their testosterone checked. “It must be low T!” Well the phrase “low T” comes straight off the commercials. Never mind that these men are often out of shape or get crappy sleep or have 5 chronic conditions that can all cause fatigue. The tv says it’s low T. It must be low T. Also: these same patients don’t typically care to hear about the side effects and interactions of the drug they think will cure all their ailments. 

The only drug commercials that I’ve seen consistently good outcomes from are vaccine commercials. It’s fairly common for me to have a patient walk in and say, “do I need that new pneumonia shot?” or “what do you think about Gardasil?” Good conversations usually come from those questions. 


Sice trošku drsnější, ale občas mám dilemat, zdali mi chybí opravdová čistá láska nebo pouze sex. Tyto pomyslné váhy se čas od času převáží, občas víc k jedné straně. Svádím tím pádem boj, do kterého jsou zapojené nikoliv dvě, ale rovnou tři stránky.

ROMANTIK ve mě říká, že láska.
NADRŽENEC křičí, že sprostý nestydatý dirty sex.
A pak z povzdálí v naprostém klidu sedí CYNIK, který se váhy snaží vyvažovat průpovídkami o zklamáních či radostech (které se stejně nakonec proměnily ve zklamání) a jako alfu omegu řešení doporučuje panáka do ruky.

V konečném důsledku se nedokážu domluvit sám se sebou. Na lásku mám nejspíš smůlu, čistý sprostý náhodný sex je mi cizí, tudíž z toho všeho vyplývá, že jsem psychicky (roz/nar/vz)rušený a že jediný hlas který ve mě zní nejjasněji mě táhne k alkoholismu.

Well done, zase jednou šach mat.