Sometimes I am at a loss for words after hearing certain things come out of patient's mouths. I wonder where they get these ideas and why they think it makes sense. No matter if it is here, or in the US, the things I have heard people say are sometimes mind blowing!
I have had patients tell me that they developed an inguinal hernia because their wife has Diabetes and perhaps her high blood sugars caused her to have an infection that spread to the man. To treat it, he has tried topical anti fungal cream and antibiotics. He was shocked that the pain was not going away after so many different medications.
Patients believe that they only need to take their blood pressure pills when they feel a "pressure headache" (aka a headache so bad their vision becomes blurry and they feel dizzy). One of the blood pressure readings for a patient who was experiencing these symptoms was 210/130.... I was amazed he was still standing.
A woman came in today needing a refill for Metformin and Glipizide to control her diabetes. We refill the medications, do a physician exam, and only when she is about to walk out the door does she say "Doc, I feel bad. I feel bad all the time and I think I am pregnant." You would think the patient would disclose her concerns about pregnancy BEFORE we refill medications that could potentially be harmful to the developing baby, but it seemed like a last minute decision to say something. We send her for a urine pregnancy test in the clinic and tell her to come back so we can discuss the result. The patient left and never returned. Thankfully she wasn't pregnant.
My favorite patient is the one that has a weeping vascular ulcer on the side of their leg, uncontrolled blood pressure, and a fasting blood glucose of 302, yet they have "no medical conditions." At the moment they feel great so therefore they are healthy.
Patients sometimes think that the coldness, tingling, and numbness in their toes and legs is from the chill in the air, not their chronic uncontrolled diabetes.
I have had a few patients with a single swollen lymph node, and no other symptoms, come in demanding a full cancer workup be ordered because the internet told them they have cancer that will kill them in the next 48 hours. One man was so convinced he placed a large Amazon order of expensive things he had always wanted to buy.
One patient had a very obvious yeast infection, but she did not know that was the problem. As a result, she tried treating it herself by using rubbing alcohol and Vick's rub on the area. She continued using these two items for weeks and suffered through severe pain with each treatment. Finally she decided to come in to the clinic when she could barely walk because of the pain.
For some patients I blame the internet. If you google any of your symptoms on WebMD at least one of the possibilities is cancer. If I had no medical knowledge or understanding of medicine, I too would be very scared to think that my cold could potentially be a sign of something that could kill me. However, I am sometimes shocked to think that the patient still believes the worst. Everyone has had a cold in their life and knows someone else who has had a cold. You would think they remember these symptoms or talk to someone who had a similar problem and realize they would be okay after some rest and perhaps some antibiotics, yet they still come running in thinking the worst.
In Belize City, fewer people have access to the internet to look up their symptoms so ideas come from friends and family members. For example, a patient's cousin may have regained control of his blood pressure so the doctor took him off his medications. As a result, the uncontrolled hypertensive patient decided that he too should stop his medications because his family member is now better. I have also found that many moms put rubbing alcohol on their children when they have fevers because their mothers before them did the same (I realized this is done because when rubbing alcohol dries it feels cool on the body so mothers believe the alcohol cools down the feverish child). Word of mouth from friends, and strong family traditions, are hard to break and make it very difficult to explain why certain practices may not be safe for the patient.
We were told so many times by different professors that the best thing someone can do for their patient is provide a little patient education. After 5 rotations, I have come to appreciate the importance of this statement. Patients need to be told exactly what to do. To them medicine is a foreign language, something completely out of their control and in the hands of their doctor. They have a lot of questions that they may be afraid to ask, but you should not let them feel intimidated. I have learned to encourage patients to ask any question they have, even if they think the answer is obvious.
I have observed and learned to take a few minutes to explain how many times a day patients should be taking their medications, even though it is printed on the medication bottle, and why they need those pills. It is important to encourage patients to eat healthy, exercise, rest their body when they are ill, and drink lots of water everyday. There are always a few patients that need a little extra time and reassurance that they are not going to die, but the satisfaction you feel when the patient walks out of the room and no longer feels worried for their life is incredibly rewarding; you helped make a patient feel better in ways medication never could.
I love the stories and ideas that patients bring with them to their appointment. It adds a little laughter to sometimes long, boring days. No matter where I am, Staten Island, Brooklyn, Belize, or beyond, I will never forget the importance of talking face to face with a patient. Not only does it create stronger patient-practitioner relationships, it also educates the patient so to be in control of their own health rather than having their health placed in the hands of their doctor.
Beautiful!
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