They're starting them out awfully young, these days

"She has been seen by the year-old gynecologist."




(Dictated: "...by the urogynecologist")

Oh, that's what he meant by 'burning sensation'

"No chest pain or recent congestive heart fire."

Seems a little harsh; I'd prefer a daily prescription, wouldn't you?

"...other societies, including European public health agencies, recommend continued relaxation every 5 years."




 (dictated: "...continued re-vaccination")

That symptom sounds mighty atypical, sir

"Mr. Patient has been having worsening congestive heart hair loss."

Err...may I direct you to the Peds floor?

"I was asked to see this 56-year-old female child."

Department of Redundancy Department

"The head is cephalic." 

T is for Turtle!

"He had repeated movements like that tortoise... " 




("...throughout his...) 

Life: It's just breathe, breathe, breathe, all the time.

"He has a history of recent hospitalization . .  with pulmonary continuation."




(Something we all should strive for. Oh, and it was actually "contusion").

Speech WRx: The Quiz!

What? You say it's no fair giving a quiz on a Monday? Meh. Nobody said life was fair. 


Here's a whacked-out med list. Can you guess all the Speech WRx?



1.  "An umbrella."
2.  "Total collapse."
3. "A cycle of beer." (Speech Wreck has a thing for beer, as we've seen).
4.  "Cole is seen." 
5.  "Old train him."  

6.  EXTRA CREDIT--Two WRx in one: "Pretty impulsive drugs."

Answers:

1. Enbrel
2. Dulcolax
3. acyclovir
4. colchicine
5. Ultram
6. "Pyridium, sulfa drugs"'

Don't you just hate it when this happens, II

"She woke up feeling dead."

I guess this means his heart sank

"He also underwent cardiac catheterization; he had diffuse disease in the knees."

Well, 10 shouldn't have percussed it

"The abdomen is distended, 10 panic to percussion." 


Serves them right.




(... dictated was "tympanitic" to percussion)

If there was soup down there, this patient needs more than a bronch

"There was an area of abnormal mucosa . . . along the airway leading to the right lower lobe, just distal to the soup."
   


(dictated was, "... distal to the superior segment...")

Life: It's just like a football game!

"Prior to this progressive weakness, he had been losing on the ground fairly well."


(One hopes this doesn't mean the patient will soon become airborne).




 (Dictated was, "... he had been living on his own...")

As if it wasn't already bad enough...

"She will be initiated on BiPAP suppository."

Hmmm . . . I wonder if anything has grown out yet

"She does have a 7-year-old culture pending."

(dictated was "urine culture." Go figure).

Alternative to common sense?

Not a blooper, just a mini-rant. Sorry.


I understand that there's a role for alternative/complementary/non-Western medicine, and that it genuinely helps a lot of people, and that there's much about how the body works that science has yet to figure out. I get all that, I really do. 


But, see... if you have an enlarging and painful boil-like thing in a delicate location of your nether regions (i.e., a Bartholin cyst/abcess), why--oh, why--would you think, "Oh, dear, I seem to have something problematic on my hoo-ha, I'd better go to the....[wait for it]






.... acupuncturist?" 


Why? 


(And yeah, it did occur to me that maybe she was being practical because acupuncturists have lots of big needles lying around. I already thought of that). 


P.S. The story has a happy ending, as it was actually the acupuncturist who sent her to the ER for I&D and a Word catheter...

What a difference a pronoun makes

"...he was scheduled for cardiac catheterization, which had to be postponed because his wife broke his ankle."

Umm . . . could you be any less specific?

"The patient states difficulty with an ache in the past few days."

What's THAT doing there, Part Deux

"The placenta was then easily explanted from the pocket."  


. . . the problem is, it's a pacemaker placement, and the patient is elderly and rather, well, male.  


(dictated was "pulse generator")

Good-- he's able to do a face-palm!

"No knuckle rigidity is noted."

 (dictated: nuchal rigidity)

OMG . . . That, like, totally makes the pain worth it

"The risks and benefits [of C-section] were reviewed...In short, the benefits to vaginal delivery are: Less maternal morbidity, immortality, avoidance of further major surgery. . ."

Fun with names, April edition

Speech Wreck has a special affinity for mangling the names of providers in interesting ways. The latest crop: 


Dr. Does have been ordered


Dr. The knees and grooming to empty


Dr. Out of the way man


Return to work bowel, FNP 

(Yeah, it would be even funnier if I could tell you the real names, but dang it, I can't).

Do we call a surgeon, a neurologist, or a building contractor?

"SKIN: Pink, warm, and dry colossus head."

That's an inflammatory process, all right

"She . . . was found to have abnormal signal at the T12 and S1 disks, indicating an inflammatory/infectious process or menopause." 

Unfortunately the doc was smoking Wreck

"Once he has stopped smoking weekend play in his revision surgery."

Dictated: "Once he has stopped smoking we can plan on his revision surgery."




(Speech Wreck from a reader, Donna. Thanks!) 

Better make it caffeine-free, then

"Will schedule a soda p.r.n. as he is fairly anxious here in the hospital."

Call a CIA consult stat!

"She was brought to the emergency room, where she was noted to be an extremist."




(Dictated was "... noted to be in extremis," which is serious business and not, of course, a laughing matter).

They may be intact, but they're probably not very happy

Dictated:  "Neurologic: Cranial nerves II through XII grossly intact."


Draft:  "Neurologic scrub nurse 2 through 12 grossly intact."

Weak, or just lame?

Dictated: "EXTREMITIES: She had weakness. . ."


Draft: "EXTREMITIES: She did not have a handyman."

Good thing they're not positive. Or is it?

"His CPK has come down to 1000 now with negative condoms."

A little Why

For some reason this PA decides he needs to spell "oxycodone." I mean, after all, hardly anyone has heard of that. So off he goes:  "O-Y-C-O... that is, O-X-Y-CODONE . . ."

And speech wreck gives him:  


"A little Y but hold X."

Which just about serves him right, I suppose. 

"Hey, Joe, check out this MRI, it looks like a frowny-face."

Dictated:  "... involutional changes of aging."


Draft:  "... emotional changes of aging."

I'm from there, so this makes perfect sense to me

"She is from Florida. No other complaints."

Did you bill her insurance for that?

Dictated in a complicated gyn history with HPV, etc.: "She has had sex only with men."


Draft:  "She has had sex only with me. "

Rx: Trouble

Today's theme is Strange Prescriptions. See if you can guess what they're supposed to be. Some are obvious; some, not so much.


1.  "Start traveling” 


2.  "Or a headache 25 mg daily" 


3.  "Cat away"


4.  (From same report--seems to be a cat obsession here) 
"There are cats 100 mg p.o. t.i.d." 


5. "Limits dull 100 mg t.i.d."






1. Sertraline

2. Oretic

3. Caduet
4. Lyrica

5. Lamictal

Humor, NOS

Not a blooper or a speech wreck, but it needs to be posted up anyway. 


This was dictated by an orthopod who has never manifested any sign of a sense of humor before, so I'm just kind of wondering...was he making a subtle little joke, or was he being serious? You be the judge. 


He's doing an H&P on an 87-year-old patient with the usual constellation of medical issues, and the last item in her list of diagnoses is: 


"Advanced age, NOS." 

Readers write!

...Pretty busy today, and I'm grumpy because it's in the 80s here today and I'm so not ready for summer yet, so I'll let others do my work for me. Here we go: 

It's now against the rules to have a heart attack:

"...56 year old male with myocardial infraction..."

(Dictated: myocardial infarction) 

"....history of migraines several times a moth."

(Dictated: several times a month)

"The patient was given bilateral lemonade."

(Dictated: bilateral hearing aids)

"... order glucose tolerance test due to symptoms of constant surf . . ."

(Dictated: constant thirst )

Thanks to the ever-diligent Anonymous!

In honor of the day: A transcription prank. By a doctor, no less.

Anyone have any April Fool's pranks to share? I've been guilty of a few in my time, but have only been on the other end of one since being in the MT line of work. 


This was about a decade ago... I was working away as usual, no thought of what day it was... The next report started, it was one of the ER docs; he quickly gave the patient name as usual.  Then it took my brain a couple of seconds to catch up with my ears before I realized he was dictating in Spanish. I just sat there, sort of stunned (my high school/college Spanish was, sadly, far too long ago to be of much help to me). He had got through most of the HPI before the staffers who were, obviously, gathered 'round the mike behind him, could no longer restrain themselves and all started cracking up. He stopped and calmly said, "Oh. I seem to be dictating in Spanish. Oops. Better go get your dictionary." And then he started to laugh, and the staff around him guffawed, and so did I. 


(He later re-dictated the report sensibly, of course. Which is kind of too bad, because it would have been interesting to run the dictation through Google Translate). Sort of like speech wreck, but even sillier.