Tuesday, December 2, 2008

Teachable Moment

While working another princess shift last night (the calm before the storm of final exams), EMS delivered a middle-aged male complaining of shortness of breath.  History of CHF and hypertension, with a room air sat of 92% and a systolic in the 190s.  

Legs were incredibly swollen from fluid retention, and combined with his obesity and shortness of breath, he was finding it difficult to take even a few steps.  Perhaps unsurprisingly, the patient did not have a regular doctor, missed his clinic appointments, and was non-compliant with his medications, which he hadn't taken in a week.  As I got him on the monitor, ran an EKG, and tried to find a vein, he lamented that "they" wouldn't give him "the weight loss surgery."

Later he promised that if he "lived through the night," he'd start to take better care of himself.  Hopefully a visit to the ER will scare him into taking better care of himself, but I'm not holding my breath.  All the weight loss surgery in the world won't make a difference if he keeps eating salty food and doesn't take his meds.  It makes me wonder, though, if patients like these aren't getting enough education about their serious health problems, or if they truly just don't get it and think that by ignoring their chronic conditions they'll simply go away.  

1 comment:

Anonymous said...

It scares them long enough that they change for about a day or two, and then they sliiiiide right back into the old ways.