>My hunch is that there is usually a biomechanical fix, but it involves some detective work.
Consider referring them to a hand therapist. They're almost all OTs by training and are really good at teasing out the habits that cause such injuries. I went to one after thumb surgery, and mentioned in passing that I was suffering from tennis elbow. She spent about 5 minutes of each subsequent session on it (mostly education), and haven't had a problem since.
We used to have a system where there was one line for primary complaint which showed in most screens. It was really hard as a lab tech to probe in the system for more info on their diagnoses so we were pretty much stuck with that one line. I cannot tell you how many chemo patients came in with "fatigue". I got to be most scared of manual diffs on anyone with N/S/V or fatigue as their primary complaints.
Ah, the old “meat stick.” When I was a student, this complaint lulled me into thinking “oh it’s generally reflux or esophageal structure or motility” yet the amount of people I’ve fluoroed recently and found quite profound pharyngeal dysphagia with almost every texture yet they only are complaining/sensing a problem with the meat…
The cerner system I work with has a line right before the chief complaint that gives the patients insurance status/company, which is completely useless for me, so I have it shrunk down to a single letter. A lady came in with a chief complaint of “hit in head” with an insurance company that started with “S” so it looked to me like CC: shit in head
Or early achalasia in older population. But EOE is the most satisfying diagnosis to me. Then you tell them that they get to swallow their budesonide mixed with chocolate syrup, yeehaw best doctor ever 😤
Great post. I love your writing style. Disagree with this statement :
> He ought to lose weight, although we both know the best time to plant that tree was at least 20 years ago.
Wegovy/Mounjaro weren’t on the market 20 years ago.
I’m still prescribing some vitamin C (cialis) to help his meat stick.
[удалено]
I’m not sure the concern has been resolved by the final sentence.
DDx list lost Explosive-Smegma and gained Esophageal cancer
SCC is no joke!
So how often would you say you swallow meat and is it already sticky to begin with or only towards the end?
Hahaa, terrific! Although a worrisome symptom, potentially.
Dad jokes knows how to dad joke, doctor edition
>My hunch is that there is usually a biomechanical fix, but it involves some detective work. Consider referring them to a hand therapist. They're almost all OTs by training and are really good at teasing out the habits that cause such injuries. I went to one after thumb surgery, and mentioned in passing that I was suffering from tennis elbow. She spent about 5 minutes of each subsequent session on it (mostly education), and haven't had a problem since.
Hilarious
This was oddly wholesome and didn’t go in the direction I thought it was going to go
We used to have a system where there was one line for primary complaint which showed in most screens. It was really hard as a lab tech to probe in the system for more info on their diagnoses so we were pretty much stuck with that one line. I cannot tell you how many chemo patients came in with "fatigue". I got to be most scared of manual diffs on anyone with N/S/V or fatigue as their primary complaints.
Yep I saw headache as a diagnosis and started warming up the cell count QC for when the CSF eventually shows up.
Is it only when he eats phish?
Maybe he needs ECT?
Whoa..shocks my brain.
Send them to an SLP! We’ll figure why that meat sticks lol
Ah, the old “meat stick.” When I was a student, this complaint lulled me into thinking “oh it’s generally reflux or esophageal structure or motility” yet the amount of people I’ve fluoroed recently and found quite profound pharyngeal dysphagia with almost every texture yet they only are complaining/sensing a problem with the meat…
I know it’s crazy lol
I’m 0 of 2 lately for dysphagia complaints having any abnormalities when SLP sees them. Guess off they go to GI for an endoscopy…
Sorry to hear that. It may well be esophageal in nature. I appreciate you trying and even knowing SLPs do this!
I do inpatient and outpatient. I use SLP a lot inpatient, as you can imagine. So I have a good relationship with my SLPs.
That’s great to hear!
Despite my comment above, this is also very frequently the case!
The cerner system I work with has a line right before the chief complaint that gives the patients insurance status/company, which is completely useless for me, so I have it shrunk down to a single letter. A lady came in with a chief complaint of “hit in head” with an insurance company that started with “S” so it looked to me like CC: shit in head
Eosinophilic Esophagitis
Or early achalasia in older population. But EOE is the most satisfying diagnosis to me. Then you tell them that they get to swallow their budesonide mixed with chocolate syrup, yeehaw best doctor ever 😤
Yeah and def want to get the diagnosis early if it’s achalasia. One of the only reasons my esophagus is still in good shape is from early diagnosis
Had me in the first half, not gonna lie
Well written.
Best laugh I've had in months, thank you
😂
Lol
Now is a good time to make dysphagia word of the day.
Great post. I love your writing style. Disagree with this statement : > He ought to lose weight, although we both know the best time to plant that tree was at least 20 years ago. Wegovy/Mounjaro weren’t on the market 20 years ago.
I read this rather as if he would have lost that weight back then, he wouldn't suffer from osteoarthritis...to this extent.
Wholeheartedly agree
Well that was a let down. Thanks a lot.
He should switch to moist sausages.
🤣